NAÏVE DUALISM AS A FORM OF MADNESS IN HEALTH POLICY AND SERVICES

It is not enough to have a good mind; the main thing is to use it well.

Rene Descartes, Le Discours de la Methode, 1637

Those readers with even a bare smattering of Western philosophy will know of the dominant theory in the philosophy of mind from the mid-17^th to at least the mid-19^th century – interactional, or Cartesian, dualism.

‘Cartesian’ because, famously, the idea was brought to its intellectual apogee and propagated by the French rationalist philosopher and mathematician, Rene Descartes, whose main works, Meditations on First Philosophy and Discourse on the Method, first appeared in the short period between 1637 and 1644.

Dualism in the philosophy of mind is the hypothesis that mental phenomena are, in some or all respects, non-physical, or that the mind and body are not identical. The idea is that the body works like a machine; that is, it has only material or physical properties. The mind, on the other hand, is nonmaterial and is not subject to the laws of nature.

The key idea in interactional dualism is that, the above notwithstanding, mental states such as beliefs and desires causally interact with physical states; a view that appeals to our common sense or folk-psychological view of ourselves and our conscious experiences.

Descartes, in a speculative leap that today looks foolhardy at best, argued that the mind interacts with the body at the pineal gland; which, many readers will know, actually produces the serotonin derivative melatonin, a hormone that affects the modulation of sleep patterns and seasonal functioning.

Astute and interested readers, even if untrained in analytic philosophy, will I trust also have detected a wider and more fundamental problem with the interactional hypothesis. Indeed it is so well known and commonly taught to first year philosophy students that it has a name – the Link Problem in interactional dualism.

The Link Problem emerges directly from the Cartesian view of the body and the mind – the former is physical, extended, divisible and unconscious; the latter is spiritual, unextended, indivisible and conscious. The problem is this: how could two such fundamentally different sorts of things – one subject to physical laws, the other not – causally act on each other?

Moreover, for Descartes, while minds have no general physical properties, they are located in space and time. But how does this spooky non-physical entity, the mind, get tugged around by and causally interact with the rest of us, the body, to which it is notionally linked?

In the mid-20^th century the Oxford philosopher, Gilbert Ryle, dubbed Cartesian dualism the dogma of the ghost in the machine, wherein ‘the body and the mind are ordinarily harnessed together, but after the death of the body the mind may continue to exist and function’. Ryle’s purpose was to highlight the absurdity of dualist systems like Descartes', in which the means of interaction are without explanation.

As Ryle argued, it is a doctrine false not in detail but in principle. Mind and body are not separate things to be linked. To believe them to be so is not just a factual error; it entails what philosophers call a category mistake. Mental activity is not linkable with physical states – it is (something like) a function of (some) physical states; thus, if there is no physical stuff (eg a brain), then there is no mental activity.

In this light, to maintain a commitment to interactional dualism would be like asserting that cars can be linked to motoring. It may be cute as a metaphor, but as a scientific grounding for the study of transport, it manages to be both pointless and misleading.

Whatever one’s religious or metaphysical views might otherwise be, naïve dualism is not a candidate for the deeper understanding of our mental and physical states. And so, a fortiori, it should not feature in the grounding of health services for Homo sapiens in the 21^st century, any more than do voodoo or occult medical practices languishing from a pre-scientific culture. But alas it does.

*          *          *

Mental Disorders and Physical Health: Linking body and mind

TheMHS Summer Forum, UTS Sydney, 21-22 February 2013

While it is not likely, as far as I know, that the imminent fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), will list as evidence of a disorder the belief in interactional dualism, reliance upon it in dividing the mental health world from the physical health world is in my view a form of social or institutional madness. Why so?

It is instructive to consider a scenario put to the above forum by a psychiatrist with an interest in physical health, Dr Jackie Curtis: we can call the scenario, the emergency response to the torso and the head. Imagine two teams of emergency clinicians on the pavement outside your local ED, one team dealing with the torso of a patient, the other a few metres away, examining the head.

It’s a silly scenario, of course – and it’s meant to be. It’s meant to throw into relief the folly of dealing with mental health problems in isolation from physical health problems. And as far as it goes it highlights the point fairly effectively. The problem is, it doesn’t go nearly far enough. The division of mental health from physical health is starkly more absurd than that.

How come? Well, for two reasons: the detached head is still the locus of ophthalmology, ENT, head and neck, maxillofacial and neurological surgery, et alia. And mental health, if it is to be represented as separate even from neurology, needs to have a third team in the scenario; one attending, if Cartesian dualism were right, an entirely mysterious entity ‘hovering’ who knows where.

Ryle’s attack was against not just philosophers – he targeted the views then prevalent among a wide range of theorists, including psychologists and religious teachers. And, as whacky as some even relatively recent (ie 20^th century) psychiatric theories have been, naïve dualism still conveniently dwells in customary thinking not only in mental health but also in the wider health field.

For reasons that Dr Curtis and fellow speakers in the Summer Forum on Mental Disorders and Physical Health otherwise amply demonstrated, this matters for consumers of health services. If we are to treat people as whole individuals, whose mental and physical life is one, we need to integrate health services. But resistance to this change remains ingrained on all sides of the various clinical fences, and the naïve belief in dualism helps entrench it.

Part of the reason for this is of course the prominent role that religious institutions had and to an extent still have in the provision of health services. And many practitioners in health care, their scientific education notwithstanding, retain a degree of personal if not professional religious affiliation. Some, I dare say, privately even believe in such things as the immortality of the soul.

Mostly in their working lives they keep these quaint ideas in check; separate from their roles and opinions as health professionals. But occasionally these notions leak out.

These philosophical poltergeists are especially prone to emerge from their closets in debates about the roles and relationships of various parts of those complex social entities we call health services; and can do so even inadvertently, as would appear in the title of the forum, Linking body and mind.

Why do I say these views are mad, rather than just wrong? Because, as I trust DSM-5 would have it, the beliefs are not in accord with reality and have a propensity to cause harm to self or others. But what’s the harm? It is the deleterious impact on the structure, relationships and effectiveness of health services, and therefore on the optimisation of health outcomes for whole human beings.

Within the Australian health system, there are some notable and forward-thinking exceptions, such as the Brain and Mind Research Institute at the University of Sydney. But even its thinking is a fair way, I suggest, from seeping through the core of health services policy and practice. Despite 20 years or more of mainstreaming in mental health, almost all health services, and a great deal of health policy, still turn on dualist notions of the incommensurability of mental and physical health.

I implied in the title of this piece that only naïve dualism is a form of madness. But there I was being excessively generous. Without glossing over the last 60 years of the philosophy of mind too lightly, it can be rightly said that the only competing views with any prospect of success have been some take or other on physico-functionalist accounts.

And the advances in the neurosciences generally over the same period have simply served to strengthen the case for non-dualist accounts of the mind*. Thus, any form of dualism that permeates health policy and practice in the 21^st century is in reality mad.

We’ve largely moved on from the beliefs about medical and health sciences of the 17^th, or even the 18^th or 19^th, century. We need to do the same with the philosophical views of human nature that underpin health and medical policy and practice. So let’s get motoring.

Dr Enrico Brik

March 2013

* The only notable remnant of dualism in analytic philosophy in the late 20^th century, New Epiphenomenalism (itself a more sophisticated re-articulation of 19^th century Epiphenomenalism), is rightly seen by most in analytic philosophy as dualism’s last gasp.

Fine Words Better No People: Aboriginal Health and Constitutional Change

Australian society is a beautiful youth with a disfiguring scar. It is a scar that shames us most because it was inflicted by our forebears. Yet our gaze will not be averted: repeated surgery has failed to fade it; no amount of make-up or finery conceals it. We are on show with it to ourselves and the world.

That scar is the problem of Aboriginal Health.

It is not the only wound on the Australian body politic, but it is surely the one that most disturbs and disgraces us.

If ever there was a case study for the social determinants of health, Australia’s failure over Aboriginal Health is it: a young, rich, successful, first world nation-state, with an enviable health, medical and scientific system. And what do have? By far the worst indigenous health of all the OECD nations built on colonising occupation.

In reality, the problem of Aboriginal Health is strictly neither an Aboriginal problem nor a Health problem. It is a malaise much deeper and wider than that.

It’s as much a calamity of obstinate unemployment, woeful literacy and education, lamentable housing, destructive drug and other addictions, dire child abuse and neglect, and incorrigible violence, crime and incarceration rates – in short, a compound of underclass social indicators. It’s just that atrocious health will do as the key exemplar and proxy for all Aboriginal ill-being.

As a function of colonisation it is at bottom a social problem. And as a social problem it has been tackled principally through economic and technical means – by pouring resources into it. Nevertheless the Aboriginal Health glass remains neither half full nor half empty; after decades of filling and refilling, of overflowing the sides and soaking coasters, it contains only dregs.

Clearly it is not the right type of receptacle to satisfy the thirst for wellbeing.

This is not to deride the hard won advances in some areas – many good people, black, white and otherwise, have worked hard for decades with small but encouraging improvements in their area of Aboriginal Health, often only to see them falter and regress as attention is diverted to other initiatives.

But as an overall program Aboriginal Health has been an almost unmitigated failure, indeed quite literally a tragic one. It is a tragedy not simply because of its origins but because of the tolerance of it by non-indigenous Australians and our refusal to root out the deeper causes.

*             *             *

Those causes ultimately are ones of attitude – their resolution thus can occur only by social, political and legal means; by us changing the way we look at ourselves and each other.

We need a gestalt shift; we need to see the course of history not as a scar but as a birthmark. This can happen only if we recast the origins of the Australian nation as a birth that blends the qualities of two peoples – indigenous and non-indigenous.

Perhaps to that end, Australia now has before it a report by the Great and Good to the Prime Minister* recommending a referendum to amend the Constitution so that, inter alia, it recognises Aboriginal people as the first Australians.

Why then do many people long concerned about this issue feel palpably underwhelmed?

By way of explanation we need a little recent history.

After the 1967 referendum, the most important events for indigenous Australians were the Mabo and Wik decisions of the High Court in the 1990s. They went some distance in specific ways regarding land law and the status of Aboriginal legal systems and by dispensing with the legal fiction of terra nullius, and even then excited such conservative reaction as to sour those sweet little victories.

Paul Keating’s Redfern speech in 1992 and Kevin Rudd’s apology to the stolen generation in 2008 were good and worthy gestures too, though limited in effect and historically ephemeral: they had no legal and institutional significance.

Aboriginal wellbeing demands a bold and enduring change: something like the treaty that has been sought for the 40 years the Aboriginal tent embassy has been pitched on the grounds of old Parliament House.

Yet the lawyers tell us we may not in strictness have a treaty – these are made between separate nations. It is only at the creation of a colony or with the resolution of war that peoples may make treaties (as was the case in Canada and New Zealand).

We can however have a compact – a special sort of agreement with institutional gravity, in standing somewhere between a treaty and a contract – that may form part of the Constitution.

But alas, in the proposal now before us, we don’t have the option even of a compact. We have just proposed amendments to constitutional provisions with three new sections.

Meritorious though these proposals may mostly be, they are not enough. Fine words about first Australians are still just words.

*             *             *

Aboriginal people are not just the first Australians, they are the quintessential Australians. It is an ineluctable historical truth that without Aboriginal people preceding us we would not be the Australians we are; we would be some other colonising mob.

There thus needs to be a practical recognition of the standing of Aboriginal Australians; one by which we say not only, ‘you were here first’, but ‘you are special’.

Indeed Aboriginal people are special: when they talk of being of (not just in) the land, or being one with the land, they are not being wholly metaphoric. The term ‘indigenous’ emerged in English in the 1640s, having come originally from the Latin, indigena, meaning "sprung from the land”.

As a nation of blow-ins and boat people, we struggle with this idea. But we shouldn’t. After all, ultimately we all come from stock indigenous to somewhere or other.

It is ironic that the Australian ’no-special-cases’ view of fairness as a crude and basic equality – born of tough times in a hot, hard land – impedes a subtle understanding of equity that treats people in the light of their peculiar circumstances and history.

But special cases demand special treatment: average Aboriginal life expectancy is almost two decades shorter than that of non-indigenous Australians, more than double the gap experienced by indigenous peoples in comparable countries like New Zealand, Canada and the USA.

No more money, no more effort, but much better health outcomes elsewhere. What could be the variables driving this substantial difference in life expectancy?

Constitutional status and recognition, matched by dedicated political representation. What is needed is a compact with Aboriginal Australia as part of the Constitution bolstered with material political symbols of that compact.

We should adopt the approach of New Zealand with indigenous seats in Parliament – in Australia this could be readily accommodated by two senate seats (as were added for the ACT and the Northern Territory) for whom indigenous people could vote as an alternative to their state or territory senators.

 

Would it work? Who knows?

Will it help improve Aboriginal Health? It might, if the life expectancy and health outcome experiences in New Zealand, Canada and even the USA are any guide.

We’ve tried everything else imaginable and none of it has worked. Maybe this will.

What’s the harm in trying? It beats fine words.

*Recognising Aboriginal and Torres Strait Islander Peoples in the Constitution: Report of the Expert Panel

Adultery: A Guide for Managing Ministers of the Crown

Policy Circular: 2011/969	Date: 19 December 2011
Issued By:	Department of the Cabinet
Distribution:	All Portfolios
Access:	Ministers’ Chiefs of Staff and Principal Media Advisors Chief Executives and Agency Senior Executives (upper tier)
Status:	Strictly Confidential – Not for wider distribution or citation
Effective:	Immediately

(NB This Circular replaces Policy Directive 2005/696: Handling Media Inquiries Regarding Ministers’ Private Lives.)

Senior public officers will be aware of some regrettable incidents that have in recent times come to light involving the personal conduct of now former Government Ministers. While these sorts of matters have historically been handled discretely and with minimal fuss, there has been a worrying trend in recent years for the media, doubtless spurred on by competition from new digital services and ready access to social networks, to focus anew on the more tawdry nether regions of public life.

Yet it is concerning to see so many of those in the public eye in their forties or even fifties who, in spite of these developments, persistently indulge in questionable behaviour in their ‘private’ lives with little care, thought or planning. If executives of more mature bearing can help in any way, it is to guide those who follow on the merits of Ministers behaving badly not just with a touch of style and saviour faire, but also with a modicum of caution.

For these reasons, the Acting Secretary-General of Cabinet has authorised preparation of this Confidential Policy Circular for the most senior levels of Government to address the important topic of philandering by Ministers of the Crown.

First, however, a cautionary note: In no way should this Circular be interpreted as recommending that criminal or corrupt conduct be condoned or covered up, particularly where those deeds allegedly involve young people of pre-consensual age. Those are matters for the appropriate legal authorities. The Government, after all, is not the Catholic Church.

This Policy deals only with issues of public morality involving consenting adults – not solely with adultery, but with all philandering in which there is either a spouse or partner potentially affected or where some form of secretiveness or duplicity is involved, and which may have deleterious political consequences for the Government were it to be exposed.

To that end a handy set of three case studies has been prepared to help illustrate the relevant points. In considering them, the reader should of course be mindful of there being many Ministers these days who are women, and more than a few who are gay or bisexual.

The examples given should therefore be seen as far as practicable as ‘gender neutral’, notwithstanding the fact that married male Ministers will unquestionably continue to pose the chief management challenge for those public officials concerned.

NB A warning – Ministers must at all costs be dissuaded from ‘screwing with the crew’. Neither public service nor ministerial staff are permitted to have sexual relations of any kind (not even the Clintonian kind) with the Minister to whom they report.

Should any such activity be detected, the staff member concerned will be transferred immediately to a far less attractive portfolio (and Minister).

Case Studies:

The inevitable affair with the younger woman

Husbands are chiefly good lovers when they are betraying their wives.

Marilyn Monroe

As Ms Monroe knew famously and too well, it is a truth universally acknowledged that a middle-aged husband in possession of a powerful job must be in want of a mistress...or at least an attractive young woman on the side. ‘Twas ever thus and ‘twill ever be.

Tell-tale signs of sexual distraction are legion and are similar to those signifying the pursuit of higher office: unusually careful attention to the ministerial appearance; smart contemporary attire; significant weight loss; and a hitherto unobserved interest in the gym, cycling and exercise generally. All that being so, how does a dedicated and responsible senior executive or staffer deal with the entirely foreseeable ministerial peccadillo?

Well, with careful management and planning, of course.

As with all senior appointments, identifying and weeding out unsuitable candidates for ministerial amore is an effort that will repay the careful bureaucrat or political staffer over and over again. Crucially, the Minister must be persuaded of the ground-rules for the affair. They are these:

• Never pursue a woman who is closer to your children’s age than to your own, or who is chronologically capable of being your daughter. This effectively means a maximum of about 14 years younger than the Minister – certainly, 15 years plus is dangerous territory
• Carefully vet the woman’s personality – vulnerable or psychologically unstable types can be alluring to an older man, but loopy babes are a media minefield – the time-honoured tradition of selecting an experienced (and, preferably, divorced) woman should be actively encouraged
• Be fully informed. Explore all you (lawfully) can about the Minister’s partner and their current relationship – is it open? Is she the jealous and vengeful type? Might she be playing away from home herself? (All the better if she is!); and finally
• The Minister should be strongly discouraged from choosing someone who is just a younger and more attractive version of his spouse, especially if their names are similar. There will inevitably be tears and potentially restraining orders as the girlfriend attempts to displace the wife entire, and not just her affections.

The notionally religious family man with a penchant for trade

Love is a game in which one always cheats.

Honore de Balzac

Here one dwells upon unhappy and troubling ground that necessitates a light tread but a firm hand. It is this example that throws into starkest relief the prevalent attitude of the media to personal privacy; about which, it is fair to say, tabloid journalists and editors take a view akin to sex workers’ position on celibacy. For the socially conservative married man with a taste for younger men, cheating is lamentable but unavoidable, and so is gristle for the media grinder.

Assuming as one must that a Minister’s off-duty sexual practices, coupled with his religious affiliation and marital status, will excite the most prurient of interest from anyone armed with a smart-phone and built-in camera, how does one protect the Government from unwanted and unwarranted denigration? Secrecy and deception is how: fight a smear with a smear of the lens.

The Minister must never visit young men at their haunts: no gay bars; no steam rooms; no ‘dance’ clubs; certainly no beats. His assignations will befit his station, to be conducted in quiet comfort away from the public gaze. And never let the Minister drive his own Government car alone after hours. That’s when real damage can be done.

It is an unwelcome liberalisation that Government drivers have been dispensed with in the small hours. Incorrigible gossips they may be, but they rarely go on the public record (unless they themselves are involved in the sexual shenanigans – but see the edict about staff above).

The engagement and use of sex-workers

My sexual preference is often.

Author Unknown

The advantages of employing prostitutes to satisfy the baser needs of public figures are well-known and need no great elaboration here. They are flexible, responsive, usually prompt and available on a fee-for-service basis – female, male or transsexual for clients straight, gay or bi. Thus services can be conveniently tailored to meet the needs of the busy and stressed Minister of the Crown.

Yet, even in these days of successful public health initiatives, there are traps of which every senior public officer supervising ministerial conduct should make him or herself aware. Much of the risk is down not to the sex-workers, but to others typically involved in the transaction, notably the Ministers themselves. This is especially the case where the Minister in question is a boorish, pompous or otherwise unattractive specimen – unfortunately, an all too common state of affairs.

Attentive observers will be aware of the unedifying spectacle of a call-girl recently being interviewed in the press about an alleged liaison with an erstwhile Government Minister. While one has a degree of sympathy for attractive and stylish young women being asked to engage (even when handsomely rewarded) in some form of sexual congress with particularly unappealing examples of Homo politicus, our principal concern here is the reputational risk to the Minister, not to his loins.

Where were the then Minister’s staffers? Why was a Minister of the Crown having a long ‘lunch’ without a senior staff member present?

Ministers need to be tightly-tracked and time-managed. They cannot be allowed, after an afternoon’s boozy lunch with prominent party donors, to have themselves quietly whisked off by mysterious third parties for a ‘neck massage’, no matter its putative therapeutic benefit.

If a Minister requires attention to any part of his or her anatomy, with or without a happy ending, it is crucial for senior staff to ensure that the right source is deployed to provide the service. Reliability and discretion are paramount. Payment methods need to be resolved that do not reflect ill on the Government: cash is good. In any event, arrangements of this kind need to be taken out of the hands of the Minister, let alone the clutches of lobbyists or their entourages.

It is with this advice that the care of good government is entrusted to all Chief Executives and Chiefs of Staff, now and in the future.

Dr Enrico Brik

A/Secretary-General

Department of the Cabinet

DEREGULATING MATRIMONY: FOR GAYS, STRAIGHTS, WHOMEVER...

Marriage is a great institution, but who wants to live in an institution?

Variations attributed to Groucho Marx and Mae West

Having myself been institutionalised twice – first, religiously, in my twenties and again, secularly, in my thirties – and also being somewhat bisexual, I feel uncommonly well-placed to comment on the current absorption with the topic of gay marriage.

Now, it is I think fair at once to stake out my default position – gay men and lesbians (and, for that matter, transsexuals et alia) should enjoy the same benefits as do heterosexual couples when it comes to matrimony: legitimate children; adultery; and ultimately, divorce.

Scholars of matrimony will know that the term originated circa 1300 from the Old French, matremoine, and before that from the Latin, matrimonium, meaning ‘wedlock, marriage’, which comes from the nominative matrem, meaning ‘mother’ + -monium, a suffix signifying ‘action, state, condition’. Thus the origin of ‘matrimony’ is the action, state or condition of, or bringing about, mothering. (In fact the Catholic Church, a trifle oddly, defines matrimony as ‘the office of motherhood’.)

Clearly then, the link between marriage and begetting of (legitimate) children is etymologically intimate.

While adultery and divorce are long-revered states and themselves need no defence, the motivation for legitimate children these days is so thin as to barely amount to a rationale at all: there must be many thousands of schools across the western world where the challenge would be to find a pupil born in wedlock whose parents were still co-habiting.

So, the deep desire for matrimony now is surely due to something far beyond the legitimising of children. But what might that be? Not being a lawyer, I thought hard about it and, in search of a deeper understanding of the status of matrimony, resorted to an incontrovertible source – Wikipedia. There I learnt that:

Marriage (or wedlock) is a social union or legal contract between people that creates kinship. It is an institution in which interpersonal relationships, usually intimate and sexual, are acknowledged in a variety of ways, depending on the culture or subculture in which it is found. Such a union...may also be called matrimony. Marriage usually creates normative or legal obligations between the individuals involved.

Well, that’s pretty broad. Nothing excluding queers there. But I’m still not clear on why so many people want to say ‘we do’ to gay marriage. After all, it’s scarcely paradise on earth for straights.

While it’s hard to explain the continuing attraction of matrimony in the modern world, the risks are easier to identify: At the advent of one’s first marriage, it would do well beforehand to hear the American proverb: The most dangerous food is wedding cake. Beyond that, why not consult Samuel Johnson on second marriages: they are the triumph of hope over experience. (And so a third or subsequent betrothal is surely the surrender of hope to delusion.)

Thus, one of the great advantages of being homosexual is, in my view, the avoidance of any general expectation of matrimony. Being gay, why would one want to marry at all? It is rather like, having been told one has a natural immunity to a particularly nasty and long-lasting disease (say, hepatitis C), electing nevertheless to go through the onerous and unpleasant treatment regime.

* * *

The Commonwealth Marriage Act, 1961 defines ‘marriage’ as, the union of a man and a woman to the exclusion of all others, voluntarily entered into for life. This definition, incidentally, was added by the Parliament not in the previous millennium but in 2004, explicitly to exclude those you-know-whos...

But leaving aside the whole a-man-and-a-woman thing, have you ever in all your days heard or read anything so preposterous? To the exclusion of all others? Entered into for life? What nonsense this is.

Haven’t these parliamentarians experienced any adultery and divorce? Don’t they watch TV or the movies or read blogs and books? Can’t they Google like the rest of us?

They need to get out more. Much, much more. And soon: well before they get to vote on any proposed amendment to the Commonwealth Marriage Act.

Indeed all this debate raises an important prior question: Why is there a Commonwealth Marriage Act at all?

The historical answer is constitutional. Here I am indebted to the Australian Parliamentary Library – the Commonwealth's power regarding marriage comes from section 51(xxi) of the Australian Constitution, which states:

The Parliament shall...have power to make laws for the peace, order, and good government of the Commonwealth with respect to: Marriage.

The effect of the Marriage Act 1961 and the Constitution is that the Commonwealth has exclusive jurisdiction over the formation of marriages in Australia – there is no room for States to legislate (although State laws may govern civil unions and de facto relationships). This however does not mean there must be a Marriage Act. There is no reason that section 51(xxi) of the Australian Constitution could not lie fallow, as do some other sections of the Constitution.

Tangentially, the Family Court in a 2001 case (Re Kevin) found that a post-operative female-to-male transsexual had validly married; but that this does not affect the current orthodoxy that a marriage has to be between members of the opposite sex.

Hold on. Does this mean the case-law applies only to post-operative transsexuals?

Hell, maybe then a pre-operative transsexual man-to-woman can’t marry her boyfriend unless she goes through gender re-assignment surgery. Gee, that seems a bit harsh. It’s expensive, painful and potentially dangerous, you know. And the guy might love her precisely because she’s a chick-with-a-dick. (Addendum - See comment below on recent High Court case).

But who honestly cares? In reality, the contemporary social edifice of matrimony is hypocritical tripe – just contemplate if you dare the nowadays routine occurrence of multiply-divorced parents happily escorting their adult children for the first time down the sorry old aisle. In my experience gay men and lesbians are on the whole far too sensible to be seduced by such drivel.

Yet, having said that, why should we accept and expect the lives of innocent heterosexuals to be traduced by such tradition?

What’s the point? Legally, it could all be done through de facto relationship/civil union legislation, with default provisions for couples over 20 and co-habiting for more than two years, or for less time if they have children from the relationship, and a sunset/re-negotiation clause that could come into effect after, say, 10 years, but would not be triggered as long as (mutual) love shall last: what in effect we have today with the legal architecture of marriage and divorce.

This wouldn’t preclude the important business of weddings, by the way. It would just make them legally otiose. Love-struck couples no doubt continuing to be so inclined, they would still be able to indulge in their religious, secular or simply bizarre ceremonies on land, at sea or in the air. Women (and indeed men) could still play princess for a day at the inordinate expense of their families.

Yep, the solution to the ‘problem’ of gay marriage is self-evident: repeal the Commonwealth Marriage Act, 1961 and replace it with...nothing.

Now, If only there were a (pre-operative) transsexual parliamentarian I could interest in my proposal.

An edited version of this piece appears on the online journal New Matilda at http://newmatilda.com/2011/12/09/repeal-marriage-act