Don't boycott Google because it's evil. Boycott it because it's terrible

Google's dodging taxes. But its worst crime is messing around with search results.

Google's Eric Schmidt went all out yesterday, saying he was "very proud" of his company's tax "structure", and that "it’s called capitalism."

Inevitably, this had led to calls for a boycott of Google until it starts to pay its fair share of corporation tax.

Of course, these calls have also marked out part of the folly of such boycotts. It's easy to boycott Starbucks: within 30 seconds walk of most UK branches you'll find more coffee. We are basically a nation of people selling coffee to each other with a bit of banking on the side.

Google is… harder. If you use any of its web services, you are likely to feel locked in (everyone knows your gmail address! Think how much work it would be to change your address books!); if you have an Android phone, you are probably contracted in without even a choice to leave; and if you use their web search, you'll probably have finished the search and clicked on a link before you even remember that you were supposed to be boycotting in the first place.

On top of that, of course, a boycott doesn't look like it would be as effective for Google as it was for Starbucks. Within days of the first allegations about the coffee company coming out, it had posted an open letter on its website; and then even before the big UK Uncut protests, it had already agreed to radically restructure the way it declares its taxes. Comparing that to Schmidt's bombastic comments, we can infer that Google might put up a bit more of a fight.

The thing is, people ought to be boycotting Google, especially their main cash cow, web search. Not because of tax avoidance, but because it makes a terrible product used only through exactly the same inertia which will kill any political action.

Once upon a time, Google search was the unambiguous best. Its page-rank system, which replaced manually editing search results with an ingenious methodology which used links to a site as guarantors of that site's quality, meant that it gave more accurate results than many of its now-defunct (or nearly so) competitors like Alta Vista or Yahoo! Search; its simple UI made it easier to use, as did its massive step up in speed, a fact reflected in its show-off display of how many hundredths of a second the search took.

Most importantly, Google refused to offer paid placement, a relatively common practice at the time which mixed advertising with editorial content: companies would literally pay to appear in the search results for a given keyword.

Those principles lasted a long time; even when Google started "personalising" searches, it was still aimed at reducing bad results. Someone who always clicks on cars after searching for "golf" probably wants different results than someone who clicks on sports sites.

Then came Google+. Terrified by Facebook, the company launched a rival social network, and in an attempt to catch up, decided to leverage its existing businesses. Personalised searches are no longer based just on what you have previously searched for. They're also based on your Google+ contacts, and what they've posted about and discussed. A piece written by someone "big on Google+" – a dubious accolade – can get boosted up the results based just on that; and strangers' faces have started popping up in results, like this:

It's not just the failed attempt at cross-promotion which has damaged Google; it's also been hit by the falling value of web advertising as surely as every other web business. It's responded by increasing the amount of page space devoted to selling things – and correspondingly decreasing the space devoted to it's actual product.

Compare, for example, this from 2005 with this from June this year. Although it's looking at Google US, don't doubt that it's coming your way as well.

There are alternatives. I like DuckDuckGo, which consciously strives to replicate the experience of Google circa 2005 (albeit with a number of powerful below-the-hood improvements). I'm not the only one; the site has shot from an average of 80,000 searches a day in December 2010 to around 1.7m a day this month. But really, it doesn't matter where you go – even if it's to Bing – so long as Google gets the message.

Photograph: Getty Images

Alex Hern is a technology reporter for the Guardian. He was formerly staff writer at the New Statesman. You should follow Alex on Twitter.

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Why does the medical establishment fail to take women in pain seriously?

Women with mesh implants have been suffering for years. And it's not the only time they have been ignored. 

Claire Cooper’s voice wavered as she told the BBC interviewer that she had thought of suicide, after her mesh implant left her in life-long debilitating pain. “I lost my womb for no reason”, she said, describing the hysterectomy to which she resorted in a desperate attempt to end her pain. She is not alone, but for years she was denied the knowledge that she was just one in a large group of patients whose mesh implants had terribly malfunctioned.

Trans-vaginal mesh is a kind of permanent “tape” inserted into the body to treat stress urinary incontinence and to prevent pelvic organ prolapse, both of which can occur following childbirth. But for some patients, this is a solution in name only. For years now, these patients – predominantly women – have been experiencing intense pain due to the implant shifting, and scraping their insides. But they struggled to be taken seriously.

The mesh implants has become this month's surgical scandal, after affected women decided to sue. But it should really have been the focus of so much attention three years ago, when former Scottish Health Secretary Alex Neil called for a suspension of mesh procedures by NHS Scotland and an inquiry into their risks and benefits. Or six years ago, in 2011, when the US Food and Drug Administration revealed that the mesh was unsafe. Or at any point when it became public knowledge that people were becoming disabled and dying as a result of their surgery.

When Cooper complained about the pain, a GP told her she was imagining it. Likewise, the interim report requested by the Scottish government found the medical establishment had not believed some of the recipients who experienced adverse effects. 

This is not a rare phenomenon when it comes to women's health. Their health problems are repeatedly deprioritised, until they are labelled “hysterical” for calling for them to be addressed. As Joe Fassler documented for The Atlantic, when his wife's medical problem was undiagnosed for hours, he began to detect a certain sexism in the way she was treated:

“Why”, I kept asking myself, when reading his piece, “are they assuming that she doesn’t know how much pain she’s feeling? Why is the expectation that she’s frenzied for no real reason? Does this happen to a lot of women?”

This is not just a journalist's account. The legal study The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain found that women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. 

An extreme example is “Yentl Syndrome”. This is the fact that half of US women are likely to experience cardiovascular disease and exhibit different symptoms to men, because male symptoms are taught as ungendered, many women die following misdiagnosis. More often than should be acceptable, female pain is treated as irrelevant or counterfeit.

In another significant case, when the news broke that the most common hormonal birth control pill is heavily linked to a lower quality of life, many uterus-owning users were unsurprised. After all, they had been observing these symptoms for years. Social media movements, such as #MyPillStory, had long been born of the frustration that medical experts weren’t doing enough to examine or counter the negative side effects. Even after randomised trials were conducted and statements were released, nothing was officially changed.

Men could of course shoulder the burden of birth control pills - there has been research over the years into one. But too many men are unwilling to swallow the side effects. A Cosmopolitan survey found that 63 per cent of men would not consider using a form of birth control that could result in acne or weight gain. That’s 2 per cent more than the number who said that they would reject the option of having an annual testicular injection. So if we’re taking men who are afraid of much lesser symptoms than those experienced by women seriously, why is it that women are continually overlooked by health professionals? 

These double standards mean that while men are treated with kid gloves, women’s reactions to drugs are used to alter recommended dosages post-hoc. Medical trials are intended to unearth any potential issues prior to prescription, before the dangers arise. But the disproportionate lack of focus on women’s health issues has historically extended to medical testing.

In the US, from 1977 to 1993, there was a ban on “premenopausal female[s] capable of becoming pregnant” participating in medical trials. This was only overturned when Congress passed the National Institutes of Health (NIH) Revitalisation Act, which required all government funded gender-neutral clinical trials to feature female test subjects. However, it was not until 2014 that the National Institutes of Health decreed that both male and female animals must be used in preclinical studies.

Women’s exclusion from clinical studies has traditionally occurred for a number of reasons. A major problem has been the wrongful assumption that biologically women aren’t all that different from men, except for menstruation. Yet this does not take into account different hormone cycles, and recent studies have revealed that this is demonstrably untrue. In reality, sex is a factor in one’s biological response to both illness and treatment, but this is not as dependent on the menstrual cycle as previously imagined.

Even with evidence of their suffering, women are often ignored. The UK Medicines and Healthcare Regulatory Agency (MHRA) released data for 2012-2017 that shows that 1,049 incidents had occurred as a result of mesh surgery, but said that this did not necessarily provide evidence that any device should be discontinued.

Yes, this may be true. Utilitarian thinking dictates that we look at the overall picture to decide whether the implants do more harm than good. However, when so many people are negatively impacted by the mesh, it prompts the question: Why are alternatives not being looked into more urgently?

The inquiry into the mesh scandal is two years past its deadline, and its chairperson recently stepped down. If this isn’t evidence that the massive medical negligence case is being neglected then what is?

Once again, the biggest maker of the problematic implants is Johnson&Johnson, who have previously been in trouble for their faulty artificial hips and – along with the NHS – are currently being sued by over 800 mesh implant recipients. A leaked email from the company suggested that the company was already aware of the damage that the implants were causing (Johnson&Johnson said the email was taken out of context).

In the case of the mesh implants slicing through vaginas “like a cheese-wire”, whether or not the manufacturers were aware of the dangers posed by their product seems almost irrelevant. Individual doctors have been dealing with complaints of chronic or debilitating pain following mesh insertions for some time. Many of them just have not reported the issues that they have seen to the MHRA’s Yellow Card scheme for identifying flawed medical devices.

Shona Robison, the Scottish Cabinet Secretary for Health and Sport, asked why the mesh recipients had been forced to campaign for their distress to be acknowledged and investigated. I would like to second her question. The mesh problem seems to be symptomatic of a larger issue in medical care – the assumption that women should be able to handle unnecessary amounts of pain without kicking up a fuss. It's time that the medical establishment started listening instead. 

 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman

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