Kirt C. Butler, associate professor of finance

Research by Kirt C. Butler, associate professor of finance at
Michigan State University, and Domingo Castelo Joaquin, associate
professor of finance at the College of Business at Illinois State
University, shows that correlations pick up in big sell-offs.
“The fundamental rationale for international portfolio diversification
is that it expands the opportunities for gains from portfolio
diversification beyond those that are available through domestic securities,”
the two wrote in their paper on this issue. “However, if
international stock market correlations are higher than normal in
bear markets, then international portfolio diversification will fail to
yield the promised gains just when they are needed most.”3

Health policy and health care

Despite its obvious appealandgrowingcurrency in discussions of health
policy and health care, the notion of quality of life raises a difficult conceptual
issue for health professionals and policy makers: what outcomes
(or types of outcomes) are connected closely enough with health to be
taken account of in assessing the impact of health interventions on quality
of life? Health care cannot be concerned with all aspects of life or
well-being without giving it an impossibly broad mandate. That is just
what theWorld Health Organization (WHO) appeared to have done in
1947, adopting a definition of “health” that made it virtually coextensive
with quality of life: health was “not merely the absence of disease,
but a state of complete physical, mental, and social well-being.”2 That
definition, which set no limits on the scope of health policy or health
care, was widely criticized and, though it remains a piece of interagency
political rhetoric, plays no scientific role today even at the WHO.

An emerging consensus

Concerns about quality of life first surfaced in the public debate as a
basis for limiting medical interventions. As physicians became capable
of indefinitely sustaining the mere biological functioning of individuals
who had lost (or appeared to have lost) all capacity for consciousness, a
sharp controversy emerged in the 1970s over whether continued health
intervention was an appropriate use of health care resources, especially
when it went against the previously expressed wishes of the patient or
the current wishes of the family. An emerging consensusAn emerging consensus that the patient
herself should make that decision whenever possible was reflected in
the development of standardized living wills, medical powers of attorney,
and do-not-resuscitate orders. This consensus has not reached two
controversial areas: physician assistance in bringing about death sought
by competent individuals hoping to avoid a continued existence with
chronic impairment or pain, and the withdrawal of life support sought
“on behalf” of cognitively incapacitated patients who have left no written
instructions (for a summary of, and comprehensive references on,
these debates, sce Battin, 2003).

Materia Medica Pura

So confident was Hahnemann that he was listening to the pure language
of nature, he chose the title Materia Medica Pura for the volumes in which
he recorded his own provings. There, and in similar works produced by
converts who oversaw additional provings, were listed all the effects found to
occur in healthy volunteers when they took one or another drug. For each
remedy, symptoms were organized with regard to body area affected, progressing
from the head down to the feet.

true Materia Medica

With all those precautions in place, Hahnemann was certain that his
experimental results were accurate indications of the effects produced by each
tested drug and of the symptoms they would cure. Orthodox physicians
thought otherwise. Indeed, the provings were one of the chief elements of
homeopathy they had in mind when they sneered at the system as a “monument
of human folly.” To regular doctors, the provings appeared to be unscientific
and naive, because, as we would say today, they included no control
subjects. The reactions of provers testing a drug were not compared to the
sensations experienced by a similar group of people not taking the drug; the
several provers of each drug, furthermore, did not all experience the same
symptoms themselves. How could Hahnemann be sure that the symptoms
reported to him had been produced by the drug rather than being some of
the random occurrences of day-to-day living? Many of the reactions he ascribed
to drug action, after all, were things that everyone experienced on a
regular basis, whether taking any “drug” or not: pimples, hiccups, sneezing,
and snoring, for example, were repeatedly credited to drug action. (A much
later commentary, a cartoon from the 1990s, shows Snow White making the
acquaintance of the dwarves. “Sneezy, Dopey, Sleepy, Grumpy?” she says. “I
take it no one here’s ever heard of homeopathy?”) Hahnemann brushed aside
such objections with the assurance that “the drug being taken in pretty large
quantity, no disturbance can take place in the organism which is not the effect
of the drug.” To him, provings were the only way to “a true Materia Medica,”
one that “should exclude every supposition, every mere assertion and fiction;
its entire contents should be the pure language of nature, uttered in response
to careful and faithful inquiry.”