Confessions

Reading Anne Applebaum’s Gulag: A History, I was struck by her formulation of a question that I had wondered about myself, and never seen explicitly stated:

Why the Soviet secret police were so obsessed with confession remains a matter for debate…

What is the motivation to force a prisoner to “confess”? Even if the interrogator believes the charge to be true, why is it important for the prisoner to say it? Surely a confession under duress is not going to convince anyone else. Of course, you may want to use a confession extracted under torture to deceive someone else into thinking this was a confession freely offered, but it is hard to see how that can be relevant to system where torture is standard.

Furthermore, in the pre-video era, it’s hard to see why anyone would go to the trouble of manufacturing a deception by torturing the prisoner to put his own signature on the confession, rather than simply forging the signature. And yet it was important enough for interrogators to spend months attempting to extract the “genuine” confession, and for prisoners to submit themselves to agonies to resist.

The officer investigating Vladimir Tchernavin, a scientist accused of “wrecking” and sabotage, threatened him with death if he refused to confess. At another point, he told him he would get a more “lenient” camp sentence if he confessed. Eventually, he actually begged Tchernavin to give a false confession. “We, the examining officers, are also often forced to lie, we also say things which cannot be entered into the record, and to which we would never sign our names,” his interrogator told him, pleadingly.

In the context of the Inquisition, at least, it is possible to believe in a certain sort of twisted altruism: Being convinced of the truth of the accusation, the inquisitor believes the unrepentant sinner’s soul to be forfeit to Hell. His life is of no account, but the soul can be rescued, if only said sinner can be moved to whole-hearted penitence. In this context, the confession has its own value, and it is clear why it must come from the heretic’s own lips.

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Blaming the victim: Antibiotic edition

Having failed to hold back the tides, King Camerute is now taking on the worthy task of stemming the flood of antibiotic resistant microbes, according to a report on the front page of today’s Times. On the inside pages we have an opinion piece by one Theodore Dalrymple, under the title

Patients, not GPs, are to blame for the antibiotics crisis

Since GPs are responsible for prescribing most of the antibiotics in this country, I was curious how they were not to blame. I assumed the story would take one of two tacks (or both):

  1. Patients are obtaining prescriptions under false pretences, perhaps by exaggerating or misrepresenting their symptoms.
  2. Patients are somehow acquiring antibiotics without prescriptions.

Neither of these is mentioned. In fact, despite the headline — which Dr Dalrymple is presumably not responsible for — the article states clearly “The real problem we face is the over-prescription of antibiotics in ordinary medical practice.” Patients are never mentioned in the article until the last paragraph, which states, in full

And, hard though it ma be for some to accept, it would help if patients took their GPs’ advice rather than demanding the drugs they want. Doctor really does know best.

Well, that’s it then. The responsibility does not lie with the GP who actively wrote a prescription. It lies with the stupid but strangely powerful patient who “demanded” it. And it gets worse. We live, it seems, in a “litigious age and doctors are afraid”.

There is, after all, more rejoicing by malpractice lawyers over one missed diagnosis than over 99 people treated unnecessarily with antibiotics.

Presumably the author thinks they should rejoice more over all the people treated unnecessarily with antibiotics? I’m confused. In any case, they’re bad people, so anything that makes them happy is bad for the rest of us.

I’m no expert in British law, but why would a treatment with unnecessary antibiotics prevent a lawsuit? How many doctors have actually been sued, under circumstances where a random antibiotic prescription might have forestalled the lawsuit? Dr Dalrymple doesn’t even have a silly anecdote to offer.

Or could it be that overworked GPs find prescribing antibiotics to be a convenient substitute for actually talking to the patients? Dr Dalrymple, we learn at the bottom, is a “retired prison doctor” which, I think, helps to explain where he acquired his exquisite contempt for patients.