I'm a federal bureaucrat--and unapologetic about it. The medical professions need to be policed. I'm a floating investigator, myself--a shaman inspector. It's part accounting--I go in and check the books of doctors of all kinds, to make sure they're not raising the cost of insurance. But it's part medical ethicist and cross-cultural expert, too.

There's a traditional African recipe, for example, that requires a kitten thrown alive into a boiling pot. Should I disallow that on grounds of cruelty? That particular shaman argues "Western medicine kills millions of animals slowly in drug testing. And then there's your slaughterhouses! You eat meat, don't you!" Well, no, I don't, and I don't casually sanction lab-animal deaths, either.

The REAL questions are, is the illness your recipe cures FATAL? And is the cure PROVEN to be effective? Does NOTHING else work? And is the kitten absolutely ESSENTIAL? If any of these are false, why even consider it? Only if all four are true, do the shaman's cultural arguments become worth even weighing. I might be swayed, if it's clearly a trade of an animal life for a human life--but somehow, when looked at closely, nearly every case fails one or more of my four preliminary filters.

A real death now, for some uncertain future gain, just won't pass my test. My job is to weigh real losses and gains--not of money, that's a cultural artifact, a fantasy--but of life and death. That's always been a shaman's job. It's just that... standards have risen. We have to look beyond tradition.

NOTES ON WAKING UP

• Source of the dream: I just read a sour book by Robert Hughes, Culture of Complaint. Says he's for multiculturalism, but mocks the assumption non-Euro cultures can do no wrong. He catalogs slavery around the world, especially in Africa and Mideast. "If anyone should pay reparations, how about the oil-rich Muslim countries who kept enslaving people well into the 20th century?" My dream agrees there are practical criteria; not everything's culturally relative!
• Sacrifice a kitten: read a few cat stories from an Andre Norton collection. Cats on the brain! O well, why not? Plenty of people out there have human rights on the brain.

1. Are you saving LIVES? And if it's NOT life or death, by what right do you drag death in?
2. Is your cure PROVEN? How can we be sure your sacrifices won't be for nothing?
3. Does NOTHING else work? Show us why your solution is the ONLY one.
4. Is this sacrifice ABSOLUTELY essential for your method? No work-arounds at all? Why not?

And how often can they all be met?

Not very. Not bloody very.

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