#Why didn’t you just study instead of joining legal clinic

[yemme]

Law School ~ I can see everything.

#Why didn’t you just study instead of joining legal clinic? #Law School #Han Joon Hwi #Kang Sol A #I did not sign up for this #Look at them #SMH #Murder #Mystery #Crime #Drama #I DON'T HAVE TIME FOR THIS #They are so cute when they fight and call each other out #Netflix #Kim Bum #Hye-young Ryu #k drama #kdrama #korean drama #Law School Netflix

[brackenfrond]

Let’s Talk About Anders

Before you read this, I should mention I’m very much pro-Anders, anti-chantry and pro-mage. There isn’t any anti-Templar hate, per se, except from an Anders perspective, but this is in no way villainising Anders. I’m trying to keep it mostly from Anders’ POV so it shouldn’t be too apologetic or biased, but I’m still mentioning it to avoid anyone who is violently anti-Anders.

I’m also going with a non gender specific Hawke. I honestly cannot remember what default!Hawke thought about the Chantry explosion or what happened with Anders, because I play with my custom world state, so I’m trying to keep the whole aftermath pretty much unspecific. Also I cut down the DA2 plot MASSIVELY because this was bordering on Too Much. As in, nearly 2 A4 pages worth in size 12 font.

TW: The usual DA stuff regarding treatment of mages in Circles. Also references to suicide, especially heavy when discussing The Chantry Incident. Also references the Exalted Marches, if that’s something that triggers you.

Anders is twelve when the Templars take him away, and his mother screams and cries and he doesn't know why at first. The Templars were meant to protect mages, so why would his mother be crying?

Then he is in Fereldan, and he understands why.

At first, he doesn't try to run. He tries to make friends, focuses on his studies, but he doesn't get any letters from his mother, and he finds a letter he wrote to her almost burned away in a fireplace.

He's twelve and in a different country, with words that are broken and no letters, just like he now has no name, and he just wants his mother.

He runs, and they catch him and drag him back, even as he cries and begs to see his mum.

He keeps trying to run - once more to see his mother, and after because he hates being trapped. He has heard whispers of mages flinging themselves from the tallest windows, of trying to kill themselves, and he doesn't want to become like that. He refuses to become like that.

Anders is not going to lose all hope, only to be found dead one morning and be another faceless victim amongst the many. He is going to survive.

The sixth almost-successful escape from the Circle lands him in solitary for a year, and Anders is sure it’s going to drive him mad, this time. He had been beaten and bruised, threatened the other times, and he’d laughed in their faces, in the face of a fate worse than death, because he would be successful one day.

Now, he wonders, if that is even possible, when he fears that he forgets the sound of Karl’s voice, his face, the feel of sunlight on his skin.

The seventh attempt? He stays out of the Circle, recruited by a commander who yells at the Templars, who conscripts him. It’s like another cage, the Wardens, but at least he’s free to walk, to go outside in the rain and laugh with the joy of being able to do so legally.

He makes friends amongst the Wardens, even if it’s more tentative than it ever has been. He doesn’t sleep with any, but he flirts and hides his hurts with jokes and humour. Sometimes it works and Nathaniel rolls his eyes, but sometimes he must sound too bitter, and the commander looks at him. Anders isn’t sure if the look is concern or something more malicious.

He decides it’s better not to ask, and continue as though he isn’t breaking apart inside.

Then the Templar comes, nearly kills him, would have if not for Justice, and he tears them all apart, blood and body pieces scattered when he comes to, and Anders vomits, before he does what he does best.

He runs. All the way to Kirkwall.

It’s a shithole, and the Templars are more vigilant, but Anders blends in with the refugees easily enough, heads to Darktown and decides he will do some good. He opens up a clinic, treats people without thought of money, and sometimes gives what food he has to people who look far too thin, whose bones are too visible beneath their skin. He stays there, keeps his head down as much as possible. He gets letters smuggled out of the Gallows to him, from Karl, and almost cries at the familiar writing, the way his letters form a reminder of times before he had a spirit rattling around in his head. He had never been happy, they had not been happier times, but it was easy to say they had been easier.

Then Hawke comes, and that’s when everything seems to go wrong.

He can’t blame Hawke for it, and Anders knows it’s cruel to say that when Hawke showed up things got worse, but the correlation is there, coincidental as it seems. Karl is made Tranquil, and Anders kills him and he sees the blood on the knife, on his hands, and he can’t speak, chokes on his words and his breath. For a second he wants to join Karl in nothing, in death. Then he squares his shoulders, takes a breath and raises his head.

Never again, he vows. Never again shall they touch another mage. No more Karls will happen, not if he has any say in the matter.

The mage underground starts, and he and others smuggle mages out of the gallows. He’s surprised to get help from Templars - he recognises Thrask, the man who asked them to save those from the Starkhaven Circle, and Keran, the one kidnapped by a blood mage - but it makes sense that even Templars can see that things have reached a breaking point.

The Tranquil Solution reaches his ears, and there is a plan to draw him out, to see if there is proof. Hawke comes with him, and Justice takes over and he nearly killed that girl, nearly tore her apart…

He wants to be sick. He isn't, but it is a close thing.

The Qunari try to occupy Kirkwall, the Qunari fall at Hawke’s hand. The viscount is dead, there is no man upon the seat, and Meredith grows worse and worse. The mage underground is destroyed, and Orsino rallies support in the streets, only to be quelled by the woman he is trying to oppose and the one woman who could put an end to the terror of the Circle has the gall to play neutral. To act as though Meredith is a little girl, and not the monster Anders sees in his sleep, joined by Templars from his past and a sunburst burned onto the head of his past lover.

This cannot stand. If Elthina won’t take action, Anders will, and it breaks his heart to do so.

But first, he has to make sure they don’t know, and that? That is harder to do than planting a bomb in the Chantry.

Because Hawke and their friends seem to care, like maybe a few Wardens did, and Anders wants to hold onto that. Wants to keep them close to him, because his friends have never stayed as long as these ones have and he cares for them, too.

But he can’t keep them. It will only end in heartbreak.

He pushes them away. He acts surly and moody and refuses to answer questions. If they hate him, it will make it easier. Easier to look at him and see a monster. Easier to do what needs to be done. They can't know, can't even suspect, because either they will stop it, or they will be accused.

He still dreams of a starburst brand, and sees it on their forehead and it just solidifies his judgement.

The final nail in the coffin is Danarius, and he lets out words that suggest he wants Fenris to go back to him.

He goes home, not walked back, and throws up his meager lunch and hopefully the poisonous words that had dripped from his tongue with it.

Then there is the final straw, the last argument between Meredith and Orsino, and the Chantry explodes, bright as the sun, and Anders can only watch. He feels numb, instead of triumphant.

He never wanted it to come to this, but it was the only way. They speak of compromise when there is none. There can be no peace.

Hawke has the task of dealing with him after, and Anders doesn’t plead for his life, pretends he can’t feel the hatred and betrayal from them and their friends. Theirs, not his. They were never his friends, even if he wanted to believe it. Karl had cared, and maybe the commander, but thinking that hurts too much, so he doesn’t.

His eyes hurt from staring at the flames, the bright flash. He wonders what angers them more - that he blew up a building, or that he left no chance of a (false) compromise.

'Why?' Asks Hawke, voice shaky. 'The Chantry is a place of peace.'

Anders wants to scream. What about the Exalted Marches, Halamshiral? What about the elven boy tortured for information? The hundreds of thousands of mages dying at the hands of those ordered around by the Chantry? Rivain? Was any of that peaceful? He killed a few to save the many. He wonders if the Divine can say the same about the millions slaughtered at her command, can look at the trees in The Emerald Graves, and say it was just.

He blew up a building after giving chance after chance for Elthina to save his people, the Chantry has blown up men and women and children and danced on the ashes.

Instead, he says nothing, other than if he is destined for the head man's axe, then swing it and be done with it.

Sometimes Hawke does, and Anders dies on the steps of the Chantry, blood staining the stone and becoming a victim he swore he’d never be.

Sometimes? Sometimes he lives, and though he thanks Hawke, he hates them for it. He was ready to die - wanted to - and the Chantry was his note and Hawke didn't have the decency to let it be. He doesn't yell at them, doesn't try to get close again. He joins his people in the fight, and some look at him like he has signed their death certificate.

If only they knew that they were dead the moment magic flickered to life in their hands.

And then he runs. He runs and sometimes stops and then runs when they suspect. He runs and runs and runs.

After all, Anders thinks, he has always been good at running.

#dragon age #da anders #anders #pro-anders #anti-chantry #character analysis #Dragon Age II

[themerrymutants]

Long ass “what if Aragorn and crew were hipsters” modern au headcanons

@loyalservants​ - since you’d asked to see :)

Under a cut because there’s.. a lot. Also there’s a bit of canon breaking here but what’s a good au without a bit of canon breaking?

Elrond works as head doctor at the local trauma clinic. Having been alive as long as he has he's amassed quite a fortune which he uses to cover the cost of medical care for those who can't afford it himself.

He returned to Middle Earth when word reached him that Aragorn had passed on but his daughter hadn’t. It killed him to leave his wife a second time but, not knowing the fate of his sons, he couldn’t bear the thought of leaving her alone so he pleaded to be allowed to go back and join her and was eventually granted permission on the condition that if he or any others who inevitably follow suit do they will never be able to return. 

Celebrían eventually rejoins her husband and children on December 24th 2008 (modern calendar). In March of 2009 she contacted her parents, with a bit of help from her children, via text pretending to be Arwen. She wasn’t even able to get a simple “hello” out before she was pulled into a tear filled bear hug

Galadriel is a self defense course instructor at the Y and a very active environmental activist and human rights activist because for the love of Eru she’s way too old for your shenanigans humanity and someone has to fix it. humans are cute but by the valar are they dumb. Galadriel is still very much someone nobody wants to f*ck with and those stupid enough to still try anyway end up regretting it dearly. Rule #1 of telepaths: don’t piss off a telepath.

Her husband is a historian and has long since worked with his colleagues to help preserve Elven heritage sites.

Legolas looks wise looks like what would happen if you shoved him and Skrillex in a blender and put it on “puree” and already has a degree as a veterinarian (specializing in exotics) and is a biology and environmental studies dual major.

 Aragorn is a history major and is starting to get the memories of his past life back though he keeps this quiet because he rather enjoys his classes.

Gimli is dual majoring engineering and economics, Pippin and Merry are general studies majors and honestly have no idea what they’re doing half the time but hey at least they’re having fun doing it!

Arwyn, as she spells it in modern day to try and stay lower key, works at a tattoo parlor and has a total Kat Von D look going on which drives her dad up the wall.

Sam and Frodo are ex marines that were on the same squad (only survivors after an IED went off) they are roomies they were honorably discharged and earned a purple heart. Sam is blind in his left eye and Frodo was paralyzed from the waist down both suffer from PTSD. They've got two labs named Samson and Delilah who think they are lap dogs. Samson is a service dog washout (he was supposed to be Sam's dog but he just didn't have the right drive for it) and Delilah is Frodo's service dog. Currently Sam is looking for new candidates. In this AU Frodo died at mount doom so I can have him reincarnate with Sam since there was no way in hell Frodo would come back to middle earth after the sh*t he went through.

Legolas has a blind albino reticulated python named Lucy who was a rescue from a mass breeder. She's a bit off in more ways than one but is as sweet a noodle as possible Legolas often takes in special needs herps that his rescue can't home for various reasons 

Gandalf is the history professor and has become resigned to the fact that humans are dumb af and kind of need perpetual babysitting (races and magic and shit have remained unchanged just because it's more fun that way)

Thranduil is tough as nails and gives 0 fucks. if something needs done to keep those in his territory safe he will do it regardless of legality Cops don't bother coming because it's a cesspool and they've got less taxing things to do He's kind of a mob boss archetype but good and does good well except when he kicks some faces in but they always deserve it. He’s kind of the head of his own lil section of an as of yet unnamed city. He's not like crime or mob boss so much as "police don't do sh*t so we keep the peace instead". Police are happy to do so because the area is basically Gotham crime wise and nobody wants to touch it with a 40 ft pole I love the idea that Thranduil ended up blinded after his run in with Smaug he ended up staying in middle earth the entire time god bless his poor soul. In modern era he ran into a gangster with a fondness for flame throwers and got toasty again. Received extensive burns but survived because 1 Thranduil, and 2 like hell he was gonna die now when sh!t still needs to be kept in order.

Elves did sail to the west but it was less going back home and more "FUCK THIS SHIT I'M OUT" Eventually they come back and first land in ireland becoming the basis of the Tuatha Dé Danann Because I will die on the hill that elves are somehow involved with celtic mythology in the universe of LOTR and yes I know it's not earth but come on The geography actually kind of matches ...no I did not have an embarassing phase where I was way too obsessed with LOTR and calculated this stuff for funsies

I'm also super fond for immortals watching throughout history and just going "why did I do this again?" Also Elrond getting even more done with humanity gives me life

Merry is addicted to idle games and half the storage space on his phone is filled with them. 

Pippin has won a few Pokemon tournaments and even got a scholarship from one of them. He enjoys building teams from "useless" Pokemon and wiping the floor with them. His favorite pokemon to use is Pachirisu because no one expects to have their ass handed to them by a pika clone.

In this AU Aragorn is reincarnated over and over and over again and Arwen somehow manages to find him each time. Sometimes they’re lovers other times they’re just friends and every once in a while she’ll only manage to briefly brush past him before he’s gone again. Her father tried to convince her to go be with her mother but she found that even the short amount of time she got to spend with her love each time was worth the sorrow of losing him again, and again, and again.

Elrond and Celebrían renewed their vows in 2015 after learning of the practice and finding it fitting. Their first dance was to Like I’m Gonna Lose You

#ooc #lord of the rings #ngl i was tempted to make this a fic or an au blog

[gordonwilliamsweb]

Getting a Prescription to Die Remains Tricky Even as Aid-in-Dying Bills Gain Momentum

Linda Heim knew her dad didn’t plan to wait for the cancer to kill him. For decades, he’d lived in Montana, which they’d thought was one of the few places where terminally ill people could get a prescription to end their life.

This story also ran on Time. It can be republished for free.

After two years of being sick, Heim’s dad got the diagnosis in 2019: stage 4 kidney cancer. His physician offered treatments that might extend his life by months. Instead, the 81-year-old asked the doctor for help dying. Heim said her parents left the appointment in their hometown of Billings with two takeaways: The legality of medically assisted death was questionable in Montana, and her father’s physician didn’t seem willing to risk his career to put that question to the test.

“My parents knew when they left there that was the end of that conversation,” said Heim, now 54. “My dad was upset and mad.”

The day after the appointment, Heim’s mother went grocery shopping. While she was gone, Heim’s dad went to the backyard and fatally shot himself. (Heim asked that her father’s name not be published due to the lingering stigma of suicide.)

About a decade earlier, in 2009, the Montana Supreme Court had, in theory, cracked open the door to sanctioned medically assisted death. The court ruled physicians could use a dying patient’s consent as a defense if charged with homicide for prescribing life-ending medication.

However, the ruling sidestepped whether terminally ill patients have a constitutional right to that aid. Whether that case made aid in dying legal in Montana has been debated ever since. “There is just no right to medical aid in dying in Montana, at least no right a patient can rely on, like in the other states,” said former state Supreme Court Justice Jim Nelson. “Every time a physician does it, the physician rolls the dice.”

Every session of the biennial Montana state legislature since then, a lawmaker has proposed a bill to formally criminalize physician-assisted death. Those who back the bills say the aid is morally wrong while opponents say criminalizing the practice would be a backstep for patients’ rights. But so far, lawmakers haven’t gained enough support to pass any legislation on the issue, though it has been close. The latest effort stalled on March 1, on a split vote.

Even the terminology to describe the practice is disputed. Some say it’s “suicide” anytime someone intentionally ends their life. Others say it’s “death with dignity” when choosing to expedite a painful end. Such debates have gone on for decades. But Montana remains the sole state stuck in a legal gray zone, even if the practice can still seem taboo in many states with clear laws. Such continued uncertainty makes it especially hard for Montana patients like Heim’s dad and their doctors to navigate what’s allowed.

“Doctors are risk-averse,” said Dr. David Orentlicher, director of the health law program at the University of Nevada-Las Vegas, who helped write clinical aid-in-dying guidelines published in the Journal of Palliative Medicine in 2016. “The fear of being sued or prosecuted is still there.”

Despite that, access to medical aid in dying is gaining momentum across the U.S. Outside Montana, eight states and the District of Columbia allow the life-ending aid — six of them since 2014. So far in 2021, legislators in at least 19 states have pushed aid-in-dying bills, most seeking to legalize the practice and some seeking to drop barriers to existing aid such as expanding which medical professionals can offer it. Many are repeat legalization efforts with some, like in New York, dating as far back as 1995. Only the Montana bill this year specifically sought to criminalize it.

<![CDATA[ window.addEventListener('message', function(event) { if (typeof event.data['datawrapper-height'] !== 'undefined') { var iframes = document.querySelectorAll('iframe'); for (var chartId in event.data['datawrapper-height']) { for (var i=0; i

North Dakota considered legislation to legalize medically assisted death for the first time. Rep. Pamela Anderson, a Democrat from Fargo who proposed the measure after hearing from a cancer patient, said she wasn’t surprised when the bill failed in February in a 9-85 vote. The state’s medical association said it was “incompatible with the physician’s role as healer.” Angry voters called Anderson asking why she wanted to kill people.

“But I heard from just as many people that this was a good bill,” Anderson said. “There is momentum to not let this concept go away.”

Back in Montana, now retired state Supreme Court Justice Nelson said he has always regretted joining the majority in the case that allowed the practice because the narrow ruling focused on physicians’ legal defense, not patients' rights. Having watched a friend die slowly from disease, Nelson, 77, wants the choice himself if ever needed.

Despite — or because of — the court decision, some Montana doctors do today feel that they can accommodate such patient decisions. For example, Dr. Colette Kirchhoff, a hospice and palliative care physician, said until she retired from private practice last year she considered patients’ requests for life-ending drugs.

Physicians who help in such cases follow well-established guidelines set by other states, Kirchhoff said. A patient must have six months or less to live — a fact corroborated by a second physician; can’t be clinically depressed; needs to ask for the aid; and be an adult capable of making health care decisions, which is determined by the attending physician. They must also administer the life-ending medication themselves.

“You’re obviously not going to do a case that is vague or nebulous or has family discord,” Kirchhoff said. “The doctors who are prescribing have felt comfortable and that they’re doing the right thing for their patient, alleviating their suffering.” Of her few patients who qualified for a prescription, she said, none actually took the drugs. Kirchhoff noted that, in some cases, getting the prescription seemed to provide comfort to her patients — it was enough knowing they had the option if their illness became unbearable.

For the past six legislative sessions — dating to 2011 — a Montana lawmaker has proposed a bill to clarify that state law doesn't allow physician-assisted death. Republican Sen. Carl Glimm picked up that effort the past two sessions. Glimm said the current status, based on the more than decade-old court decision, sends a mixed message in a state that the Centers for Disease Control and Prevention ranks as having among the nation’s highest suicide rates. Glimm said allowing someone to end their life because of pain from a terminal illness could normalize suicide for people living with depression, which is also a form of pain.

“It’s really hard because I do sympathize with them,” Glimm said. “What it boils down to is, if you’re going to take your own life, then that’s suicide.”

Kim Callinan, president and CEO of national nonprofit Compassion & Choices, said the comparison to suicide is frustrating. “People who are seeking medical aid in dying want to live, but they are stricken with a life-ending illness,” she said.

Glimm and his bill’s supporters say that some patients could be pressured into it by family members with something to gain, and doctors could prescribe it more often than they should.

But Callinan, whose group advocates for aid in dying, said that since Oregon first legalized it in 1997, no data has shown any merit to the warnings about abuse and coercion. One study showed no evidence of heightened risk of abuse within the practice for vulnerable populations such as the elderly. But critics have said states aren’t doing enough to track the issue.

By now, Leslie Mutchler, 60, knows most of the people on all sides of the debate after years of testifying in support of protecting aid in dying. Her dad, Bob Baxter, was a plaintiff in the case that eventually led to the 2009 Montana Supreme Court decision on medically assisted death. After leukemia whittled his body for years, he died in 2008 without the option, the same day a lower court ruled in his favor.

Mutchler said she didn’t understand how complicated the Supreme Court’s ultimate ruling was until her son TJ was diagnosed with terminal metastatic pancreatic cancer in 2016.

He was 36 and lived in Billings, Montana. By then, the 6-foot-5 man had lost 125 pounds off what had been a 240-pound frame. He couldn’t keep food down and needed a feeding tube for medicine and water. TJ Mutchler wanted to have the choice his grandfather never got. But when he went to his physician and asked for aid in dying, the response was it wasn’t legal. Eventually, Mutchler found a doctor to evaluate her son and write the prescriptions for phenobarbital and amitriptyline. TJ took the drugs more than two months later and died.

“People contact me asking how to find someone and it’s difficult,” Mutchler said. “That’s why people end up taking matters into their own hands.” Research into terminally ill populations is limited, but one national study published in 2019 found the risk of someone with cancer taking their own life is four times higher than the general population.

For Roberta King, another one of Baxter’s daughters, the ongoing fight over aid in dying in Montana means she knows every other winter she’ll make the more than 200-mile round trip from her Missoula home to the state capital. King, 58, has testified against all six bills that sought to ban aid in dying following her dad’s case. She memorized a speech about how her dad became so thin after his medicine stopped working that it hurt for him to sit.

“It’s still terrible, you still have to get up there in front of everybody and they know what you’re going to say because it’s the same people doing the same thing,” King said. But skipping a hearing doesn't feel like an option. “If something were to happen to this and I didn’t try, I would never forgive myself,” she said.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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This story can be republished for free (details).

Getting a Prescription to Die Remains Tricky Even as Aid-in-Dying Bills Gain Momentum published first on https://nootropicspowdersupplier.tumblr.com/

[stephenmccull]

Getting a Prescription to Die Remains Tricky Even as Aid-in-Dying Bills Gain Momentum

Linda Heim knew her dad didn’t plan to wait for the cancer to kill him. For decades, he’d lived in Montana, which they’d thought was one of the few places where terminally ill people could get a prescription to end their life.

This story also ran on Time. It can be republished for free.

After two years of being sick, Heim’s dad got the diagnosis in 2019: stage 4 kidney cancer. His physician offered treatments that might extend his life by months. Instead, the 81-year-old asked the doctor for help dying. Heim said her parents left the appointment in their hometown of Billings with two takeaways: The legality of medically assisted death was questionable in Montana, and her father’s physician didn’t seem willing to risk his career to put that question to the test.

“My parents knew when they left there that was the end of that conversation,” said Heim, now 54. “My dad was upset and mad.”

The day after the appointment, Heim’s mother went grocery shopping. While she was gone, Heim’s dad went to the backyard and fatally shot himself. (Heim asked that her father’s name not be published due to the lingering stigma of suicide.)

About a decade earlier, in 2009, the Montana Supreme Court had, in theory, cracked open the door to sanctioned medically assisted death. The court ruled physicians could use a dying patient’s consent as a defense if charged with homicide for prescribing life-ending medication.

However, the ruling sidestepped whether terminally ill patients have a constitutional right to that aid. Whether that case made aid in dying legal in Montana has been debated ever since. “There is just no right to medical aid in dying in Montana, at least no right a patient can rely on, like in the other states,” said former state Supreme Court Justice Jim Nelson. “Every time a physician does it, the physician rolls the dice.”

Every session of the biennial Montana state legislature since then, a lawmaker has proposed a bill to formally criminalize physician-assisted death. Those who back the bills say the aid is morally wrong while opponents say criminalizing the practice would be a backstep for patients’ rights. But so far, lawmakers haven’t gained enough support to pass any legislation on the issue, though it has been close. The latest effort stalled on March 1, on a split vote.

Even the terminology to describe the practice is disputed. Some say it’s “suicide” anytime someone intentionally ends their life. Others say it’s “death with dignity” when choosing to expedite a painful end. Such debates have gone on for decades. But Montana remains the sole state stuck in a legal gray zone, even if the practice can still seem taboo in many states with clear laws. Such continued uncertainty makes it especially hard for Montana patients like Heim’s dad and their doctors to navigate what’s allowed.

“Doctors are risk-averse,” said Dr. David Orentlicher, director of the health law program at the University of Nevada-Las Vegas, who helped write clinical aid-in-dying guidelines published in the Journal of Palliative Medicine in 2016. “The fear of being sued or prosecuted is still there.”

Despite that, access to medical aid in dying is gaining momentum across the U.S. Outside Montana, eight states and the District of Columbia allow the life-ending aid — six of them since 2014. So far in 2021, legislators in at least 19 states have pushed aid-in-dying bills, most seeking to legalize the practice and some seeking to drop barriers to existing aid such as expanding which medical professionals can offer it. Many are repeat legalization efforts with some, like in New York, dating as far back as 1995. Only the Montana bill this year specifically sought to criminalize it.

<![CDATA[ window.addEventListener('message', function(event) { if (typeof event.data['datawrapper-height'] !== 'undefined') { var iframes = document.querySelectorAll('iframe'); for (var chartId in event.data['datawrapper-height']) { for (var i=0; i

North Dakota considered legislation to legalize medically assisted death for the first time. Rep. Pamela Anderson, a Democrat from Fargo who proposed the measure after hearing from a cancer patient, said she wasn’t surprised when the bill failed in February in a 9-85 vote. The state’s medical association said it was “incompatible with the physician’s role as healer.” Angry voters called Anderson asking why she wanted to kill people.

“But I heard from just as many people that this was a good bill,” Anderson said. “There is momentum to not let this concept go away.”

Back in Montana, now retired state Supreme Court Justice Nelson said he has always regretted joining the majority in the case that allowed the practice because the narrow ruling focused on physicians’ legal defense, not patients' rights. Having watched a friend die slowly from disease, Nelson, 77, wants the choice himself if ever needed.

Despite — or because of — the court decision, some Montana doctors do today feel that they can accommodate such patient decisions. For example, Dr. Colette Kirchhoff, a hospice and palliative care physician, said until she retired from private practice last year she considered patients’ requests for life-ending drugs.

Physicians who help in such cases follow well-established guidelines set by other states, Kirchhoff said. A patient must have six months or less to live — a fact corroborated by a second physician; can’t be clinically depressed; needs to ask for the aid; and be an adult capable of making health care decisions, which is determined by the attending physician. They must also administer the life-ending medication themselves.

“You’re obviously not going to do a case that is vague or nebulous or has family discord,” Kirchhoff said. “The doctors who are prescribing have felt comfortable and that they’re doing the right thing for their patient, alleviating their suffering.” Of her few patients who qualified for a prescription, she said, none actually took the drugs. Kirchhoff noted that, in some cases, getting the prescription seemed to provide comfort to her patients — it was enough knowing they had the option if their illness became unbearable.

For the past six legislative sessions — dating to 2011 — a Montana lawmaker has proposed a bill to clarify that state law doesn't allow physician-assisted death. Republican Sen. Carl Glimm picked up that effort the past two sessions. Glimm said the current status, based on the more than decade-old court decision, sends a mixed message in a state that the Centers for Disease Control and Prevention ranks as having among the nation’s highest suicide rates. Glimm said allowing someone to end their life because of pain from a terminal illness could normalize suicide for people living with depression, which is also a form of pain.

“It’s really hard because I do sympathize with them,” Glimm said. “What it boils down to is, if you’re going to take your own life, then that’s suicide.”

Kim Callinan, president and CEO of national nonprofit Compassion & Choices, said the comparison to suicide is frustrating. “People who are seeking medical aid in dying want to live, but they are stricken with a life-ending illness,” she said.

Glimm and his bill’s supporters say that some patients could be pressured into it by family members with something to gain, and doctors could prescribe it more often than they should.

But Callinan, whose group advocates for aid in dying, said that since Oregon first legalized it in 1997, no data has shown any merit to the warnings about abuse and coercion. One study showed no evidence of heightened risk of abuse within the practice for vulnerable populations such as the elderly. But critics have said states aren’t doing enough to track the issue.

By now, Leslie Mutchler, 60, knows most of the people on all sides of the debate after years of testifying in support of protecting aid in dying. Her dad, Bob Baxter, was a plaintiff in the case that eventually led to the 2009 Montana Supreme Court decision on medically assisted death. After leukemia whittled his body for years, he died in 2008 without the option, the same day a lower court ruled in his favor.

Mutchler said she didn’t understand how complicated the Supreme Court’s ultimate ruling was until her son TJ was diagnosed with terminal metastatic pancreatic cancer in 2016.

He was 36 and lived in Billings, Montana. By then, the 6-foot-5 man had lost 125 pounds off what had been a 240-pound frame. He couldn’t keep food down and needed a feeding tube for medicine and water. TJ Mutchler wanted to have the choice his grandfather never got. But when he went to his physician and asked for aid in dying, the response was it wasn’t legal. Eventually, Mutchler found a doctor to evaluate her son and write the prescriptions for phenobarbital and amitriptyline. TJ took the drugs more than two months later and died.

“People contact me asking how to find someone and it’s difficult,” Mutchler said. “That’s why people end up taking matters into their own hands.” Research into terminally ill populations is limited, but one national study published in 2019 found the risk of someone with cancer taking their own life is four times higher than the general population.

For Roberta King, another one of Baxter’s daughters, the ongoing fight over aid in dying in Montana means she knows every other winter she’ll make the more than 200-mile round trip from her Missoula home to the state capital. King, 58, has testified against all six bills that sought to ban aid in dying following her dad’s case. She memorized a speech about how her dad became so thin after his medicine stopped working that it hurt for him to sit.

“It’s still terrible, you still have to get up there in front of everybody and they know what you’re going to say because it’s the same people doing the same thing,” King said. But skipping a hearing doesn't feel like an option. “If something were to happen to this and I didn’t try, I would never forgive myself,” she said.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Getting a Prescription to Die Remains Tricky Even as Aid-in-Dying Bills Gain Momentum published first on https://smartdrinkingweb.weebly.com/

[mizjoely]

Once upon a time at 221BCon ‘15...

...the sherlollians did a roundtable fic that came out pretty darn good if I do say so myself. Here is the link if you want to know which person wrote which part!

List of Authors in Alphabetical Order:

Allthebellsinvenice AND Mr. Bells

Bassfanimation

Geekyangie

Just-Mindy

liathwen-slays-dragons

minirose96

MizJoely (2 parts)

Mollyandherjumper

Sherlollyandspoilers

Sincerelydayyy

Body Language

"Never underestimate the importance of body language."

Molly gave Sherlock a confused look. "Um, what?"

He moved closer. "You heard me, Molly. Body language. Subtext. The things people say without actually speaking. Something I've studied my entire life."

This time she raised an eyebrow. "Really? Mr. 'human, no' and 'nature, no'? You're trying to tell me you can analyze body language?"

He gave her an affronted look. "Of course I can. And I can prove it."

Molly stared at Sherlock. "What did you have in mind?"

Sherlock stepped closer again, staring down at her. "How do you think I deduce you? It's not just your charity shop sweater and your too-big trousers. I read your body language. For instance, right now I can tell that you're uncomfortable with me being this close to you." He stepped closer again.

Molly took a stuttering breath and stepped back, attempting to increase the space between she and Sherlock. She was stopped by the counter behind her, and Sherlock quickly closed the space between them.

"Sh-Sherlock-"

Behind her, the door banged, and gratefully Molly twisted in the little space he'd left her to face whomever had just entered the laboratory.

"Oh, hello Molls, Sherlock," said John, glancing between them, betraying the slightest raise of an eyebrow. Behind her, Molly sensed Sherlock stepping back rather hastily.

"He's doing it again, isn't he," said John.

"Doing what?!" said Molly and Sherlock, simultaneously.

John made his eyes go wide and let his arms dangle awkwardly. "Paying attention to someone else so intently that he forgets to control his own stance and expression. That's when he's easiest to read, himself."

"Oh really?" said Molly, a small smile appearing on her face.

"Of course." John leaned forward, conspiratorially. "He's not as mysterious as he likes to think he is."

"And that's enough of that!" Sherlock made a move towards the door. "Don't we have a case?"

"No." John smiled and leaned against a table casually. "The perpetrator turned himself in a half hour ago. Greg just texted me."

"Greg?" Sherlock asked, brows furrowed in confusion.

"Lestrade," replied both John and Molly.

"So I've got plenty of time to explain how to read you to Molly," John said with a wicked grin.

Molly couldn't help but smile at Sherlock's blank expression. She didn't need John to tell her that Sherlock really did not want this conversation, even if he had been taking great pleasure in reading her just moments ago.

John's expression shifted into a smirk.

"Sherlock's nervous right now, because he's hiding something," he announced, sounding quite proud of himself.

"I am not!" Sherlock defended, scowling.

It was then that Molly saw it too, and she was forced to bite her lip to stop a grin.

"And something he is desperate to keep to himself."

"Yes." Molly said giving into her grin. "Something he is very desperate to keep to himself."

"John." Both their heads snapped back up to his face – Sherlock glaring at John. "I need to talk to Molly."

"You are." They both said in unison.

"Alone." Sherlock's eyes flickered to Molly's face but looked down when she locked eyes with him.

"Fine." John grabbed the door handle and flung the door open. "Molly – call if he gets out of hand."

Molly smiled gratefully at John and jumped back slightly when she turned around and Sherlock was mere inches from her face again.

"Why are you smiling? You were uncomfortable a moment ago." Sherlock frowned.

"You tell me, Molly. You're the expert."

She nervously touched the surface behind her, unable to move further. "I wou-wouldn't call myself an expert, exactly."

"Of course you are," Sherlock hovered his hands over Molly's hips, "you always see me, so," he leaned closer, not quite touching her cheek as he lowered his voice, "deduce me, Molly."

"You're not touching me," she began hesitantly, but then she felt her confidence growing, "but you desperately want to. You're not as confident as you want me to think. The smile was fake, but not disingenuous," she frowned. "You don't have to put on a front for me, Sherlock."

Leaning in a little closer, Molly grasped his hands, placing them on her hips. "So, tell me what you want."

Sherlock didn't lose his nerve. Hiding a barely there smile. He had a lot of ideas. Too many if he had to be absolutely honest. "Come with me." He mumbled, taking her hand and rushing out of the room.

Sherlock flicked the lights on as he hurriedly led Molly into the cold room. It was a room with only one purpose, one they both knew well.

"This is rather unorthodox, Sherlock," Molly quipped, "also, it's freezing."

The detective sent her a soft grin as he glided over to the exam table, "I'm sorry it's chilly," he said, his voice lower than it's typical timbre, "it won't be for long."

"Oh?"

"Mhm," Sherlock hummed. Molly would've had to be blind to miss the brief but heated look that crossed his face before his expression turned neutral. Clinical, even.

"What do you have planned, then?" she asked, trying her best to mirror his calm, detached demeanor but failing quite miserably.

The look she received in return to her question was positively wolfish. She felt a flush rush over her, starting in the apples of her cheeks and travelling all the way down to the tips of her toes.

"Up on the table, Molly."

Heart pounding, Molly did as Sherlock asked. She sat with her legs dangling over the edge of the table, hands clasped tightly in her lap. "What next?" she asked when the silence stretched and grew, the weight of Sherlock's gaze a nearly physical sensation on her chilled flesh.

He paced in front of her, hands behind his back, head lowered as he studied her. She shifted nervously and he began to speak, the words coming in a rush. "You're nervous still, but not nearly as nervous as you were when we began this little experiment. No, you gained confidence when you put my hands…" He pulled them from behind his back and held them up in front of his face, stopping in front of her. "…when you put my hands on your hips." He took a few steps forward and stopped, his hands hovering over her body but not touching until she gave a tiny nod. Giving permission. His hands settled on her thighs, moving slowly, sensuously, sliding up to come to rest on her hips. "You're right, I wanted to touch you. And you wanted me to touch you. You've wanted me to touch you like this…" His hands slid up her sides, stopping just short of her breasts. "…for a long time. Even after you convinced yourself that you'd moved on." His gaze was intense, his eyes boring into hers, pupils blown back as he purred, "But you never did, Molly. You never moved on."

"And you never wanted me to," she whispered as realization dawned. Her own eyes were surely as dark with desire as his.

He shook his head, not breaking eye contact. "No. And now…" Instead of finishing the sentence, he lowered his head to hers, confident of her response as he pressed his lips to hers. Molly's hands slid up his chest and came to rest on his shoulders as she melted into the kiss, loving the sensation of their joined bodies and knowing very well where this all would end.

As Sherlock joined her on the table, pulling her down to lie in his arms, she smiled and murmured against his lips, "Are you sure this is legal?"

#sherlolly #sherlolly fic #just felt like sharing this again #it was so much fun to write!

[goodheartedfool]

Nat’s Verses

Here are the already existing verses I have for Nathanael. They are in the order of how much they have been used. Top four has links to more detailed pages/posts.

Marvel: Nathanael has the ability to manipulate ‘life force’, giving him the ability to heal, but also to drain life from others. No, he didn’t acquire the skill, he was born with it. In some threads, he works for S.H.I.E.L.D., in others, he tries to go unnoticed, not trusting what others would do if they found out about his abilities. In this verse, like most others, he’s a paramedic.

Star Trek: Here Nat is a half-bajoran Starfleet medical doctor. AOS is my to go to verse, but any of the movies or series works too.

Ancient/Spartacus: Here Nat, or Lucius as the Romans named him (real name is Narding), is a slave. He came from a Germanic tribe and were captured around the age of seven. Sold to a man with the liking for boys, it was eventually discovered that he had a natural talent for healing wound and illness. As his Dominus had lost most of his interest for him, but still wished to make his slave useful (and hos Dominus is a bit of a hypochondriac as well), he made sure he got the training needed to become a medicus. What happened after this is verse dependent, but his Dominus has a liking for gamble, wine and games.

Camp Halfblood/Demigod: In this verse, Nat is a halfblood, a demigod, and his godly parent is Apollo (which obviously mean his mum is human. If preferred, this verse can also take place in ancient times.

Modern: Not much to say about this. It’s modern time and Nat is a paramedic. he got bullied as a kid and his mum refuse to speak with him since he came out as homosexual.

Supernatural: Nat is a paramedic here too and he’s seen some rather weird stuff due to that. One night he happened to get in the middle of couple of hunters fighting a demon. One of them were severely injured, but Nat helped save him. Since he’d seen that whatever they had killed hadn’t been fully human, he kept asking what it had been and he was then introduced to the world of hunters. Instead of being a hunter himself, he continued to work as a paramedic, but helping hunter with various injuries on his free time.

Criminal Minds: In this verse, Nat studied psychology instead of emergency medicine, ending up with a PhD in Forensic Psychology (yes, he’s young, but considerably smarter than many give him credit for). Since he’s not really of the ambitious kind, having studied what he did because he genuinely wants to help people, his skills went by quite unnoticed as a consultant for the local law enforcement, until the BAU encountered him during a case. Ten months later he got an invitation to join the team and he accepted.

The Expanse: Originally born on Earth to a rather wealthy family, Nat didn’t see much suffering until he could roam around the streets on his own. Having always been of a sensitive nature, he got an intense need to help once he realized the amount of suffering around him. Once he had finished his medical degree, he wanted to put his knowledge to use where it was most needed, the Belt. But being an Earther in the Belt is usually not an easy thing, not even when you offer free (or rather pay what you can, meaning free for some, but not all) medical care.

Killjoys (SyFy): Nat was born on a planet governed by the United Republic. He was never much for school, being too restless for sitting still for so many hours at a time, though he has always liked learning new things. When he was eleven, their town were attacked, but the IMUR came to their help. Having been separated from his family, he was taken to a refugee camp and it was there that he got to witness how a doctor seemed to miraculously (at least in his eyes) making people better, even calming those who were distressed. Since then, he had as goal to become a doctor himself and tried to work harder in school so he could get a scholarship to the university. Unfortunately, he didn’t manage it, so to be able to afford becoming a doctor, he signed a contract with the Marines. If he agreed to work five years for them, they would pay his education. Once he had finished medical school, instead of doing his Residency at a hospital, he did it on board a IMUR ship. However, he never got to finish it. After nearly eight months on board, they were attacked and eventually boarded by space pirates. One of the ‘things’ taken by the pirates were Nat, a doctor would be valuable to them. Being who he is, he agreed on helping them, even though he don’t approve of their methods, but they don’t trust him and put a tracking anklet on him, making him unable to flee even when they are on a station or planet side.

POI/Leverage/Crime 1: Nat made one small mistake and took a fall he’d never expected to do, which included losing his license to practice medicine. He’s now working as a night cashier at a local convenience store, a job he hate. However, he also has a side job, he help those who, for some reason, can’t go to a legal clinic when needing medical care. Some of them, illegal immigrants and homeless people, he treat for free or for a very low fee, but he also treats people he maybe shouldn’t treat, criminals. Why? They pay well, unlike his ‘real’ job, and he can’t just let someone bleed to death, criminal or not. Nat also has a habit he need to maintain. He’s addicted to opioids.

POI/Leverage/Crime 2: Back in the States after having worked in Pakistan for MSF (doctors w/o borders) for a years, Nat’s life is put in danger. Unaware about it, he have seen something he shouldn’t have seen and someone wants him dead.

If you belong to another fandom than these, feel free to contact me if you’re interested in roleplaying. Most things in the different verses are not ‘set in stones’, in other words, I’m okay with changing some of it depending on the thread.

Each verse will get more backstory and an own page when needed.

#verses

[mrsteveecook]

mandatory flu shots at work, helping a coworker through an international flight, and more

It’s five answers to five questions. Here we go…

1. Can our employer require us to get an in-office flu shot?

In years past, my office has offered an in-office flu clinic for employees who were interested. As flu season is upon us, our office reached out about the flu clinic again, but this time they are saying participation is required from everyone, and if you don’t sign up for a time, one will be assigned to you for the clinic.

No one in the office is anti-vaccination by any means, but several of us are concerned because we prefer to get our flu shots elsewhere or do not want to disclose medical reasons for avoiding the shot. A few of us have tried to tactfully notify the VP running the clinic that we don’t want to participate, but she only responds with pressure to get the shot in-office and asking directly why we don’t want the shot in the office.

Are employers allowed to mandate participation in programs like this? And if not, what is your advice for discussing with a VP who seems to be pushing for pretty personal reasons as to why we’d like to get the shot elsewhere (or if at all)?

In most circumstances, employers can indeed require that employees receive flu shots (and it’s especially common for health care workers, to protect patients from flu-infected workers). There’s something of a growing backlash against this though, and some states have introduced legislation to ban this practice so you should check to see if you have more state-level protections than federal law gives you. But for most people, the answer is yes, employers can to this, although they’re legally required to accommodate you if you need an exemption for medical or religious reasons.

If you prefer to get your flu shot from your own doctor, I’d try saying to your pushy VP, “My doctor asks that I get the shot from her at my yearly physical, which is coming up soon, and I don’t want to ignore her instructions.” If you have medical reasons for not getting it, try saying, “My doctor has instructed me not to get the flu shot. I’m sure you know that some people with certain conditions are advised against it, but I don’t want to discuss private medical details at work.” If she pushes, you may need to offer to bring in documentation from your doctor (which only needs to say you can’t have the shot, not the reasons why).

And ideally someone — or even better, a group of you — would point out to her or to someone above you that it’s great to offer the flu shot to employees, but pushing for private medical details isn’t okay.

2. I’m anxious about helping a coworker through an international flight

I will be traveling internationally for work soon. A colleague who has an impairment to one of their senses will now be joining this trip and began asking me about traveling over on the same flight so I could help them navigate the arrival process, which includes visas and a special exception they had to get in relation to their management of their impairment.

I can’t empathize fully with their situation, I know that. I can sympathize with the challenges of life with this impairment, but I have not had those same challenges myself. I know my take on this is selfish. But being given the responsibility to navigate someone else through a foreign visa entry process feels completely overwhelming and is making me panic. Part of the context here is that I am anxious about travel in general, and particularly when it’s international travel with visas et al. I also know from recent travel experience where I had to get special accommodations for entry that that additional element may spiral me into an anxiety attack. I prefer traveling solo in order to control how much time I have to get to the airport, how I plan to get places, have responsibility for only my own stuff, etc. I understand work travel is different, so I try to just get over those elements that make me anxious when I travel for work.

They haven’t booked their flight yet, so it’s unclear if we’ll be on the same one. I suggested that perhaps they should contact the airline directly to get assistance upon entry rather than relying on my ability to help them navigate, given that I may not be able to assist them properly. Regardless of whether we’re on the same flight, I genuinely feel that their getting official assistance makes more sense so I don’t accidentally mess up some aspect of their entry process. Selfishly, this also would alleviate my anxiety about navigating them through this process.

Am I being an asshole to suggest that they get airline assistance regardless? Should I be completely fine with navigating this colleague through this process myself? I’m sure I’m seeking validation in requesting a response, but I’m torn on whether I’m completely in the wrong here or if this is actually the responsible thing to do.

If you weren’t dealing with anxiety and you just didn’t feel like doing this because it sounded like a pain or you wanted to be able to have a carefree flight with no responsibilities besides yourself, then yes, I’d say you were being callous and unkind.

But it sounds like you’re dealing with your own medical issue — anxiety. And to be clear, if this were just “eh, I’m a little anxious about being responsible for someone other than myself,” I’d tell you to put that aside in the interest of helping someone who has a genuine need for help. But if you’re truly worried about an anxiety attack, then that’s different — and frankly, if you’re at risk of an anxiety attack, you’re not well positioned to help your colleague anyway.

I do worry, though, that even if you explain the situation to your coworker, it may come across as “I can’t be bothered to do this.” I don’t know if there’s anything that can be to mitigate that, other than just sounding as kind and empathetic as possible when you talk to them, and emphasizing that the airline will provide assistance.

3. Asking an interviewer how performance problems are handled

I’m interviewing for a new job this week. In my current job, problem employees are pretty much not disciplined at all and are left alone as long as they do the bare minimum. It’s killing morale. I’m wondering if there’s a good way to ask what kind of consequences are enforced for problem employees, without it sounding like I’m asking because I am a problem employee myself looking to avoid getting in trouble. Help?

I’m thinking I could ask the “what’s your management style” question and then ask a follow-up question like “how do you address problems when they come up?” if it’s not covered, but maybe that’s too vague to really get at the heart of what I want to know.

I wish there were a good way to find out about this in an interview, but there isn’t really a direct question that will reliably get at it. Bad managers are notoriously bad at assessing their own management style and are very likely to give you a reasonable-sounding, textbook-y answer to this that doesn’t reflect how things really play out. And people who do this aren’t generally trying to be deceptive; they really believe what their saying — except that the problem is in the details. Someone might tell you they have a very structured process for addressing problems, use progressive discipline and performance improvement plans, etc. — and that could all be true, but it might also be true that you’d have to kick the CEO in the face before they’d actually use that process.

Really, what would be great is if you could ask, “Who’s the lowest performer on your team, what makes you say that, how long has that been your assessment, what have you done about it so far, and why are they still here?” That would tell you a ton. But you can’t ask that.

Instead, the best way to find out about whether a manager actually manages is to do due diligence outside of the interview, like using your network to find people who have worked at the company or with the manager before and talking to them. You’re far more likely to get candid, accurate information that way.

4. Participating in medical research when you’re in HR

I work in academia in HR. I’m not in an employee relations role, but it is a small department and we all pitch in as needed. The school is reaching out to employees (and the public in general) for voluntary participation in a study specific to a medical issue I qualify for and would have real interest in talking about. (Nothing that I’d make a trip to the doctor for, but it does impact my day-to-day life in an annoying way.) The researchers involved are said to be making real strides in this area. The study would involve a pelvic exam.

I don’t know anyone involved in the study, and everything is confidential, but I have a knee-jerk reaction that employees shouldn’t see my insides, no matter how much I’d like to participate. Am I off-base?

I think it’s totally up to you and what you’re comfortable with! If you worked with the researchers, I’d advise more caution (although even then, a lot of people would tell you that people who do pelvic exams as part of their routine work wouldn’t be weirded out by doing one on someone they know). But in this case, where you don’t even know the people involved in the study, it’s really about your own comfort level with it. There’s no established protocol that being in HR would make this off-limits to you. I mean, if the details here were different and it was possible that you could be in a meeting helping to fire the person who was examining you while you were in stirrups the day before, that would be far more awkward — but it doesn’t sound like your job has you doing that kind of thing. I think you can go for it if you want to.

5. Should I mention that I could start a new job right away rather than needing to give two weeks notice?

I’m not working except for the occasional short-term contract. The agency I work for is fine with me leaving if I get a full-time job. In short, I’m available to start a permanent job right away. Is this something I should bring up in an interview? I think it could be a factor an potential employer might consider a plus, but perhaps it might also make someone wonder if I’m some sort of problem child.

I wouldn’t volunteer it unless your interview specifically asks when you can start or it otherwise seems really relevant. That’s because most employers are planning on people needing to give a notice period, and aren’t going to be hugely swayed by hearing you don’t need one. There are some employers who would be excited that you could start earlier, but not enough of them to make this worth raising on its own unless there’s an obvious reason to.

But if it does come up on its own or you’re asked about it, you can say, “I’m on a short-term contract right now, and my end date is flexible. I could do the standard two weeks, but I could also probably wrap up sooner than that if you needed me to.”

You may also like:

we get a daily memo with feedback on everyone’s performance, mandatory flu shots, and more

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mandatory flu shots at work, helping a coworker through an international flight, and more was originally published by Alison Green on Ask a Manager.

from Ask a Manager https://ift.tt/2PLsE67

[sherristockman]

From Nuremberg to California: Why Informed Consent Matters in the 21st Century none By Barbara Loe Fisher Since I was asked to make a presentation about vaccine exemptions in 1997 at the Department of Health and Human Services in Washington, D.C., I have publicly defended the informed consent principle, which was defined as a human right at the Doctors Trial at Nuremberg in 1947.1 Informed consent means you have the right to be fully informed about the benefits and risks of a medical intervention and the freedom to make a voluntary decision about whether or not to accept those risks without being coerced or punished for the decision you make. Informed consent applies not just to risks taken by participants in scientific experiments, but also to risks taken by patients under the care of physicians.2,3,4,5 Informed Consent Principle Applies to All Medical Risk-Taking Today, when a person publicly advocates for informed consent protections in vaccine laws, an "anti-vaccine" label is usually immediately applied to shut down any further conversation.6,7 Perhaps because a conversation about ethics opens up a wider conversation about freedom. The right and responsibility for making a decision about risk-taking rightly belongs to the person taking the risk. When you become informed and think rationally about a risk that you or your minor child may take — and then follow your conscience — you own that decision. And when you own it, you can defend it. And once you can defend it, you will be ready to do whatever it takes to fight for your freedom to make it, no matter who tries to prevent you from doing that. Never Do Anything Against Conscience Albert Einstein, who risked arrest in Germany in the 1930s when he spoke out against censorship and persecution of minorities, said, "Never do anything against conscience even if the state demands it."8 There is no liberty more fundamentally a natural, inalienable right than the freedom to think independently and follow your conscience when choosing what you are willing to risk your life or your child's life for. The journey we take on this earth is defined by the choices we make. If we are not free to make choices, the journey is not our own. The choices we make that involve risk of harm to our physical body, which houses our mind and spirit, are among the most profound choices we make in this life. Vaccine Risks Are Not Borne Equally by Everyone in Society Vaccination must remain a choice because it is a medical intervention performed on the body of a healthy person that carries a risk of injury or death.9,10 And while we are all born equal, with equal rights under the law, we are not born identical. Each one of us is born with different genes and a unique microbiome influenced by epigenetics that affects how we respond to the environments we live in.11,12 We do not all respond the same way to pharmaceutical products like vaccines, so vaccine risks are not being borne equally by everyone in society. Why should the lives of those vulnerable to vaccine complications be valued any less than those vulnerable to complications of infections? And why should people not be free to choose to stay healthy in ways that pose far fewer risks? Vaccines Carry Risks and Do Not Guarantee Protection The act of vaccination involves the deliberate introduction of killed, live attenuated or genetically engineered microbes into the body of a healthy person, along with varying amounts of chemicals, metals, human and animal RNA and DNA and other ingredients13 that atypically manipulate the immune system to mount an inflammatory response that stimulates artificial immunity.14 There is no guarantee that vaccination will not compromise biological integrity or cause the death of a healthy or vaccine vulnerable person either immediately or in the future. There is also no guarantee that vaccination will protect a person from getting an infection with or without symptoms and transmitting it to others.15 Vaccine Science Gaps; Doctors Cannot Predict Who Will React Despite large gaps in scientific knowledge, government health officials direct physicians to vaccinate 99.99 percent of children regardless of known or unknown risks.16,17 Reports published by physician committees at the Institute of Medicine confirm that vaccines, like infections, can injure and kill people, and that: Very little is known about how vaccines or microbes act at the cellular and molecular level in the human body18,19,20 The Institute of Medicine confirms that an unknown number of us have certain genetic, biological and environmental susceptibilities that make us more vulnerable to being harmed by vaccines, but doctors cannot accurately predict who we are21,22 Clinical trials of experimental vaccines are too small to detect serious reactions before they are licensed23,24 The U.S. recommended child vaccine schedule through age 6 has not been adequately studied to rule out an association with allergies, autoimmunity, learning and behavior disorders, seizures, autism and other brain and immune dysfunction25 Government Licensed Vaccines Are 'Unavoidably Unsafe' For these reasons, vaccination is a medical procedure that can be termed experimental each time it is performed on a person. By extension, "no exceptions" mandatory vaccination laws create a de facto uncontrolled, population-based scientific experiment that enrolls every child at birth and never ends, sacrificing an unknown number of vaccine vulnerable children. Further, the U.S. Congress and Supreme Court have declared federally licensed vaccines to be "unavoidably unsafe," removing civil liability from doctors who give vaccines and drug companies that sell vaccines in what has become a very lucrative multibillion-dollar business in the U.S.26,27 At the same time, the federal vaccine injury compensation program created by Congress in 1986 that was supposed to be a no-fault alternative to a lawsuit — not instead of a lawsuit — has been gutted by federal agencies so that, today, almost no child receives compensation when they are hurt by vaccines.28 Now, a global vaccine injury compensation program is being created to shield multinational corporations from liability for injuries caused by the hundreds of new genetically engineered vaccines governments will mandate in the future.29,30,31,32,33,34 All this, while medical trade groups affiliated with industry and government join forces to lobby for removal of flexible medical, conscientious and religious belief exemptions from state health laws,35 as was done in California in 2015,36 so that those who refuse government endorsed vaccines for themselves or their minor children can be denied an education, employment, health care and other civil rights. Utilitarianism Should Not Be Foundation of Public Health Law In 1996, when I was in the Holocaust Museum in Washington, D.C., attending a conference on the role of physicians and scientists implementing public health policy during the Third Reich, I looked up and saw an inscription that took my breath away. It said, "The first to perish were the children … from these a new dawn might have risen." This commentary, which I originally presented in March 2017 at the inaugural meeting of Physicians for Informed Consent in California,37 is dedicated to mothers and fathers whose children died or became brain injured when the risks of vaccination turned out to be 100 percent. I am arguing that the consequentialist theory of utilitarianism38,39,40 is a pseudo-ethic that must be rejected as the moral foundation of public health policy and law so it can be replaced with a compassionate ethic grounded in respect for the human right to autonomy and informed consent to medical risk-taking, including vaccine risk-taking. Pediatrician Censored for Reporting Infant Deaths After DPT Shots I remember the day in the spring of 1982, when I was a young mother with a 4-year-old son struggling with the effects of a serious DPT vaccine reaction. I had just seen the NBC television documentary "DPT: Vaccine Roulette"41 and was networking with parents of DPT vaccine injured children in the Washington, D.C., area when I decided to attend a press conference at the American Academy of Neurology to hear a young pediatric neurologist talk about his study in which two-thirds of the babies, whose deaths were classified sudden infant death syndrome (SIDS), had died within three weeks of a DPT shot. This pediatrician was concerned that DPT vaccine may be a major unrecognized cause of early childhood death, including SIDS, and he suggested that more research be done. As soon as he finished, his physician colleagues launched a vicious attack on his professional expertise and personal integrity that left him physically trembling in a cold sweat. I had never seen anything like it. During the break, I was approached by a Ph.D. scientist who, at the time, worked for the National Academy of Sciences. This scientist asked me why I was there and I told him I wanted to know more about DPT vaccine because, when I was taking my baby to be vaccinated, I had no idea that vaccines — which were supposed to keep children healthy — could actually kill them. He got this quizzical look on his face and said something to the effect that it only happens once in a million kids. And instinctively I said, but if a vaccine kills even one, how can all children be legally required to get it? He looked surprised, uncomfortable, and walked away mumbling something about vaccine benefits far outweigh the risks, and sometimes we have to make sacrifices for the greater good. And I thought to myself, "But the benefits didn't outweigh the risks for my child, or for the babies who died after DPT shots in the study that young doctor tried to talk about before he was figuratively lynched for suggesting that DPT vaccine benefits might notoutweigh the risks." Why was my child's health sacrificed without my knowledge or permission, and what is "the good" that is made greater by child sacrifice, and who defines it as "good?" Playing DPT Vaccine Roulette With My Son's Life When I became a mother in 1978, my son, Chris, was the light of my life. Happy, healthy and precocious, he was saying words at 7 months, speaking in full sentences by age 2 and identifying words in the books we read together every day. One doctor told me he was cognitively gifted. Everything changed in 1980 when, within hours of his fourth DTP shot, I witnessed the eyes of my 2-and-a-half-year-old son roll back in his head and his head fall to his shoulder as if he had fallen asleep sitting up. I carried him, pale and limp, to his bed, where he did not move for hours. I thought to myself, "Oh, he is tired and just taking a really long nap, or maybe he is coming down with a cold." When I finally was able to wake him he couldn't sit up or walk or speak coherently; when he had terrible diarrhea and only stayed conscious for a few minutes before falling into 12 more hours of deep sleep, I did not understand I had witnessed a classic post-DPT vaccine convulsion and "hypotonic/hyporesponsive reaction and brain inflammation."42,43,44,45 Chris was not just taking a really long nap; he was unconscious in his bed and could have died that day. I did not know because my pediatrician had told me nothing about how to recognize a vaccine reaction, including symptoms of encephalitis — brain inflammation that has been a well-documented complication of vaccination for two centuries.46,47,48,49 I did not know that the unusual local reaction after his third DPT shot was a warning sign, or that our family history of severe allergies and autoimmune disorders could increase vaccine risks.50,51,52,53,54,55,56 Misplaced Trust Even though I came from a family of doctors and nurses, had a college degree and had worked at a teaching hospital — like most parents back then I believed that vaccines were 100 percent safe and effective. And in the following days and weeks, when Chris could no longer concentrate or do what he could do before, when his personality changed and he was constantly sick with ear and respiratory infections, diarrhea, new food allergies and severe weight loss, my family and I could not understand why Chris had regressed physically, mentally and emotionally and become a totally different child. His doctors told us there was no explanation and said I should take him home and love him. Eighteen months later, when I, and millions of other parents in America, watched the Emmy award-winning "DPT Vaccine Roulette,"57 I called the TV station and asked if I could have copies of the medical literature used to anchor the documentary. As I read case history descriptions of DPT vaccine injury and death in the pages ofPediatrics,58,59,60 the British Medical Journal61,62,63 and New England Journal of Medicine 64 that exactly matched the symptoms of brain inflammation I witnessed my son suffer that day, it was then I knew that physicians had been talking in medical journals for more than 50 years about the fact that pertussis vaccine could brain damage children, but no one had informed the mothers dutifully bringing their children for DPT shots legally required to go to school. The Walking Wounded As I tried to help my son cope with multiple learning disabilities that included dyslexia, fine and gross motor skill delay, auditory processing and attention deficit, and short-term memory delays so severe they confined him to a special ed classroom throughout his public school education, and as I interviewed hundreds of mothers for the book "DPT: A Shot in the Dark," I came to know many families whose children had died or were much more severely vaccine injured than my child.65,66 Chris has worked hard to compensate for his learning disabilities and he is a productive member of society today; but many vaccine injured children, tragically, are not.67 My son is among the walking wounded in what has become an unprecedented and still unexplained chronic disease and disability epidemic now plaguing millions of children and young adults in America.68 It is an epidemic of learning disabilities, ADHD, asthma, seizures, autism, diabetes, depression and other types of brain and immune dysfunction marked by chronic inflammation in the body that has perfectly coincided with the tripling of the numbers of vaccines given to children — from 23 doses of seven vaccines starting at 2 months through age 6 in the early 1980s — to the current 69 doses of 16 vaccines starting on the day of birth with 50 doses given before age 6.69,70 In 1982, it was my curiosity about the truth of the matter that pushed me to research the science, policy, law, ethics, history and politics of vaccination and spend two decades participating in public engagement projects at the Institute of Medicine and Department of Health and Human Services, where I served as a consumer member on vaccine advisory committees at the U.S. Food and Drug Administration and Centers for Disease Control and Prevention,71 a journey that has now spanned half my life. So, I offer you my perspective from that vantage point. Philosophy: Love of Wisdom Here we are in the 21st century, where the electronic communications revolution has created a virtual global public square on the World Wide Web, where more than 3 billion people are talking to — and sometimes yelling at — each other about ideas, values and beliefs, just like they did in the public squares of ancient Athens and Rome, and in universities, newspapers, and on radio and television since then. Throughout recorded history, people have disagreed with each other about how to answer big questions, like: Where do we come from? Are we only physical matter or do we have an immortal soul, a consciousness that survives physical death? What is truth and how can we know it? What is ethical behavior and how can we define it? Most of the formal debates about these questions have been described in the history of philosophy,72 which the ancient Greeks defined as "love of wisdom," that included study of knowledge; reasoning; nature of being or metaphysics; aesthetics and ethics. The philosophy of science emerged as a separate discipline in the 18th and 19h centuries after mathematicians and astronomers mounted a successful challenge to the authority of organized religion. Science Now Dominates, Affecting Cultural Values and Laws Since then, science has invaded and dominated every other branch of philosophy. As we are reminded every day in so many ways, science and math rule, and scientific evidence determines what is true and what is not. In fact, those who practice and submit to the authority of science insist that not only must science be used to define ALL truth, but leaders in science and medicine are authorities who should define "the good," that is, define moral behavior and what kind of cultural values we should have, and what kind of beliefs we should be allowed to hold and teach our children, and what kind of laws should be passed in order to limit the ability of individuals to make "unscientific" choices that presumably endanger the public health and welfare.73 That's a whole lot of pressure for many physicians, who do not want to be put on a pedestal and required to exercise that kind of authority over the lives of fellow human beings because — first and foremost — it interferes with developing a relationship with patients based on mutual respect, trust and shared decision making. But, the stark reality is that the scientification of every branch of philosophy has elevated prominent scientists and physicians promoting "consensus science" into positions of authority, whose judgment should never be questioned. Long held cultural values, such as respect for freedom of thought, speech, conscience and religious belief are being called into question, which in turn affects court decisions and the making of laws. Nowhere is this more visible than in public health law using the materialist philosophy of utilitarianism to legally require all Americans to use an increasing number of vaccines without their voluntary informed consent. So how did we get here? How did science come to dominate how we define what is true and good for the individual and society in the 21st century? Old Arguments About What Is True and Good Although conversations about the meaning of life and what is good started before written history and is embedded in tenets of five surviving major religions — Hinduism, Buddhism, Islam, Judaism and Christianity — it was the classical Greek philosophers who began recording the debate. Socrates, Plato and Aristotle believed that we are physical matter animated by a vital spirit, and we can use innate knowledge and reason to perceive what is good. Epicurus disagreed and said humans are only physical matter and have no spirit or innate knowledge and that seeking pleasure and avoiding pain is the highest good and guide to moral behavior. For 1,500 years following the birth of Christ, the highest good was defined as knowing and loving God in western cultures adopting Judeo-Christian moral values — until the Scientific Revolution when 15th and 16th century scientists Copernicus, Galileo, Newton and Francis Bacon developed methods for determining what is true that put the existence of God on trial, along with the definition of what is good. Although between the 16th and 19th centuries, Descartes, Locke, Kant, Hegel and other philosophers argued that humans are both physical matter and spirit and can use reason to understand scientific truth, as well as to perceive the natural law that serves as a guide to what is good, the materialist philosophers Hobbes, Hume, Bentham, Comte, Marx and Nietzsche argued that science proves there is no God or human spirit because we are only physical matter, and there are no absolute moral values but, rather, science can be used to define what is true and good. This included the idea that a mathematical equation can be used to judge whether or not an individual action, government policy or law is moral. The authors of the U.S. Declaration of Independence agreed with the philosophers who argued that humans have a physical body animated by a soul or spirit, and that we can use reason given to us by God to perceive the natural law, which includes natural rights, that belong to all individuals and limit the authority of government. Utilitarianism: Mathematics, Vaccination and Public Health Rising The Bill of Rights in the U.S. Constitution contains strong language protecting exercise of natural rights.74 These have been defined internationally as human rights, including freedom of thought, speech, conscience and religious belief.75,76 But today, it is not respect for natural rights that guides public health policy in the U.S., it is the philosophy of utilitarianism, created by Jeremy Bentham, a 19th century British attorney and social reformer.77,78 Bentham mocked the U.S. Constitution for mentioning God and affirming natural rights protected in the First Amendment. Like Comte, Marx and Nietzsche who followed him, Bentham did not believe that man has a soul or innate intelligence, so he returned to the hedonistic Epicurean philosophy of maximizing pleasure and minimizing pain to define what is good. Bentham's utilitarianism uses a mathematical equation that judges the rightness or wrongness of an action by its consequences. Bentham said that an action is only moral or ethical if it results in the greatest happiness for the greatest number of people. With its emphasis on numbers of people, Bentham created utilitarianism primarily as a guide to state legislative policy, and vaccine cost-benefit analyses are rooted in utilitarianism. Bentham was a contemporary of British physician Edward Jenner, who took pus from a cowpox lesion and scratched it onto the arm of a young boy in an effort to prevent smallpox. Jenner's experiment, repeated over and over again in lots of people, created a live human-cow hybrid virus called vaccinia.79 The new chemical industry took that vaccinia virus, added some chemicals and bottled it, selling it to doctors and governments. The mass smallpox vaccine campaigns that followed expanded the authority of a new branch of medicine focusing on population-based disease control, called public health.80 Nineteenth century physicians were enlisted by government to give infants and children smallpox vaccine and were persuaded to look the other way when some of them died or were left permanently disabled after developing raging vaccinia virus infections and inflammation of the brain. Fully embracing the utilitarian rationale, public health officials viewed individual smallpox vaccine casualties as necessary losses to achieve the greatest good for the greatest number of people. Utilitarianism Codified Into US Law: Jacobson v. Massachusetts (1905) At the turn of the 20th century, utilitarianism was fashionable in intellectual and political circles. It was the philosophical argument used by attorneys in 1905 to persuade the U.S. Supreme Court to issue a utilitarian ruling in Jacobson v. Massachusetts.81 Lutheran pastor Henning Jacobson and his son had suffered severe reactions to previous smallpox vaccinations and Jacobsen argued that genetic predisposition placed him at high risk for dying or being injured if he was forced to get revaccinated. The court dismissed Jacobson's concern for his own health and life. In a split decision with two dissenting votes, the Court that included Oliver Wendell Holmes, issued an opinion that would affirm the legal right for U.S. state legislatures to assign police powers to public health officials to restrict or eliminate individual liberty in order to "secure the general comfort, health and prosperity of the state."82 The Court maintained that all citizens can be compelled to receive smallpox vaccinations because the happiness and welfare of the majority outweigh the happiness and welfare of a minority. In other words, individual human sacrifice is ethical and legal if it is done for the common good. Georgetown law professor and mandatory vaccination proponent Lawrence Gostin has described it as the most important Supreme Court opinion in the history of American public health law.83 Eugenics: Eradicating the 'Unfit' in Buck v. Bell (1927) In 1927, then Chief Supreme Court Justice Oliver Wendell Holmes used the Jacobsonruling to give the state of Virginia the green light to sterilize Carrie Buck, a 17-year-old young single mother who doctors and state social workers had incorrectly judged to be mentally retarded, "just like her daughter and mother," they said.84 Self-identifying as a Darwinian atheist and utilitarian, Chief Justice Holmes' admiration for exercise of power is reflected in his legal opinions.85 Holmes did not believe in the concept of natural rights and said, "Between two groups of people who want to make inconsistent kinds of worlds, I see no remedy but force."86 He believed scientific knowledge should be used to improve the human race and said, "I can imagine a future in which science shall take control of life, and condemn at once with instant execution what now is left up to nature to destroy."87 And, so, when it came to Carrie Buck, Holmes, the eugenicist, coldly proclaimed: "The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes."88 In this merciless 1927 Supreme Court decision, just as in the 1905 Jacobson v. Massachusetts decision, Holmes achieved his goal of stripping cultural values and ethical principles from U.S. law. His logic was that if utilitarianism could be used to ensure the common good and protect society from infections through compulsory vaccination laws, then forced sterilization laws could be used to immunize society against becoming infected with bad genes. Social Darwinism and Eugenics in America Inspired Hitler Darwin's theory of natural selection led to Social Darwinism89 and eugenics that was viewed as a new science by U.S. intellectuals during the 1920s and 1930s.90 American biologist Charles Davenport had founded the Eugenics Record Office at Cold Spring Harbor Laboratory on Long Island in 191091 to improve the human race and soon courses on eugenics were offered at Harvard, Columbia, Cornell, Brown and other universities. The National Education Association had a Committee on Racial Well-Being to help teachers integrate eugenics content into public school textbooks.92 By 1932, California and 28 other states had passed compulsory sterilization laws and the practice of eugenics was endorsed by leading U.S. scientists, medical doctors, lawyers, professors, businessmen, politicians, philanthropists, and social reformers like Margaret Sanger. The next year, in 1933, Hitler adopted eugenics as a central piece of his plan to protect the common good by eliminating individuals he considered to be a threat to the health, security and economic well-being of the state. By the time eugenics became politically incorrect in the 1940s, physicians implementing government health policy had performed more than 60,000 involuntary sterilizations on mentally disabled or chronically ill Americans.93 Hitler was influenced by Marx and Nietzsche and inspired by U.S. eugenics laws. He blended utilitarianism with social Darwinism and nationalism to create a view of the State as one biological entity or body that must be kept healthy and free from disease and threats from unfit individuals. Enlisting the assistance of physicians and public health officials, the first minority considered unfit and expendable were severely handicapped children, the chronically sick and mentally ill — the so-called "useless eaters." And when the reasons for why a person was identified as a threat to the health, economic stability or security of the State grew longer to include minorities who were too old or too Jewish or too Catholic or too opinionated or simply unwilling to believe what those in control of the State said was true — as the list of those the state branded as persons of interest to be demonized, feared, tracked, isolated and eliminated grew — so did the collective denial of those who had yet to be put on that list. Doctors' Crimes Against Humanity: Judgment at Nuremberg When doctors were charged with crimes against humanity at the Doctor's Trial at Nuremberg for carrying out horrific scientific experiments on captive children and adults in the concentration camps, including vaccine experiments, they pointed to U.S. eugenics laws and invoked a utilitarian defense, claiming it was moral to sacrifice the health and lives of individuals to advance scientific knowledge that could save the lives of many more.94,95 Out of the Doctors Trial at Nuremberg came the Nuremberg Code, of which the late Yale law professor and physician Jay Katz said, "if not explicitly then at least implicitly, commanded that the principle of the advancement of science bow to a higher principle: protection of individual inviolability. The rights of individuals to thoroughgoing self-determination and autonomy must come first."96 The First Principle of the Nuremberg Code is: "The voluntary consent of the human subject is absolutely essential."97 The Doctor's Trial at Nuremberg put a human face on individual victims of immoral government health policies. The Nuremberg Code stands as an uncompromising affirmation of the value of every human life and the natural right to self-determination, a timeless guide to ethical behavior by scientists and physicians. While post-World War II Europe had to process what they had learned from The Doctor's Trial at Nuremberg and the Holocaust, things were very different in America. In our country, prominent members of our society who had promoted and participated in the practice of eugenics were never required to look in the mirror and reflect upon what they had done, or face public disgrace.98 They just went underground. Science and Math Rule: History of Philosophy Forgotten Our perception of what is true and good is very much influenced by the prism through which we are taught to view the world. In today's public schools, education is focused on science and math. The study of philosophy and its impact on human history is not valued or taught that often. There is no discussion about the kind of utilitarian thinking that made eugenics acceptable in America. Few Gen Xers and millennials, who will steer our nation into the second half of the 21nd century, understand the ramifications of allowing utilitarianism to guide public health policy and law, even as the specter of genetic engineering to change what it means to be human is already underway.99,100,101 Do they understand the influence of utilitarian philosophers like Dr. Peter Singer, professor of bioethics at Princeton, who says it is ethical to euthanize disabled babies in the first 30 days of life, and it is ethical to euthanize elderly and disabled persons who are not aware they serve no useful purpose in society because, he says, the life of a severely intellectually disabled person has no greater value than that of a dog or pig?102 Dr. Paul Offit, and other contemporary utilitarians who develop vaccines, make vaccine policy and promote "no exceptions" mandatory vaccination laws103 are forcing us to kneel before them at an altar reminiscent of the one that a 19th century August Comte built for his Religion of Humanity. We are not allowed to talk about what is true or good in the public square unless we have medical or academic credentials and even then, only if we strictly adhere to promoting their consensus science, a code word for censorship that delegitimizes freedom of thought and dissent. Debate About Forced Vaccination Transcends Vaccination Today, everybody knows somebody who was healthy, got vaccinated and was never healthy again. But the vaccine science is settled, say the utilitarians, who refuse to compare the health of vaccinated children to unvaccinated children. Vaccines do not injure and kill, they say, or — if they do — it is so rare that requiring some children to sacrifice their lives without their parent's informed consent is ethical in order to enforce mandatory vaccination laws that serve the greater good. It is for this reason that the debate about vaccination transcends vaccination. It is the tip of the spear in a much larger war that is being waged on cultural values and beliefs in America, which is why I call it The Vaccine Culture War. Because if the state can tag, track down and force citizens against their will to be injected with biologicals of known and unknown toxicity today, there will be no limit on which individual freedoms the state can take away in the name of the greater good tomorrow. Today the battlefield of the 200-year war on microbes is littered with human casualties far too numerous to count while, in a natural fight to survive, the microbes have evolved to evade the vaccines.104 And the scientists and physicians in leadership positions determined to win that war continue to fire away, stepping around the bodies of vaccine-damaged children lying on the ground. Do I think that public health officials flying the science flag with a utilitarian star on it wake up every day and say to themselves, "I want to hurt a child today?" Of course not. Most doctors and scientists want to help, not harm people. Do I think they have lost their way, blinded by a utilitarian pseudo-ethic that makes it easy to ignore the bodies lying on the ground so they can allow themselves to believe that human sacrifice is ethical when it serves the greater good? Yes, I do. They have forgotten to ask themselves this question: "When one individual is considered expendable for the good of society, how many more can be considered expendable? Is it 500, 5,000, 50 million — or more? How many is too many to sacrifice for the happiness of the rest, and who gets to decide which ones among us are expendable?" Holocaust survivor Elie Weisel said, "When you take an idea or concept and turn it into an abstraction, that opens the way to take human beings and turn them, also, into abstractions. When people are turned into abstractions, what is left?"105 He is right. Abstractions are much easier to write off as coincidences. Abstractions are easier to add up in a column when there is no name or a face put to them. Abstractions do not live or breathe, bleed or convulse, scream or die. Abstractions can be dismissed and buried in files where nobody ever has to look. Rejecting Utilitarianism and Embracing an Authentic Ethic After surviving four concentration camps, physician Viktor Frankl called on mankind to reject the materialist view that a person only has value if he is useful to society, which makes him a slave to the state. Frankl said: "The gas chambers of Auschwitz were the ultimate consequence of the theory that man is nothing but the product of heredity and environment — or, as the Nazis liked to say, of 'Blood and Soil.' I am absolutely convinced that the gas chambers of Auschwitz, Treblinka and Majdanek were ultimately prepared not in some Ministry or other in Berlin, but rather at the desks and in the lecture halls of nihilistic scientists and philosophers."106 Transcending the horror of what he had witnessed, Frankl was able to see that, "Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom." It is this spiritual freedom — which cannot be taken away — that makes life meaningful and purposeful. In the 21st century, all of us are called upon to choose whether or not we will embrace what Albert Schweitzer called "a reverence for life."107 It requires us to turn away from materialist philosophers like Hobbes, Bentham, Comte, Marx, Nietzsche and Singer, who say that individual life does not matter, that life has no meaning, and that morality can be reduced to a mathematical equation. Enlightened physicians and scientists with compassion and courage are called upon to take back leadership of their professions from those who have lost their way. Even as those, who have been victims of utilitarian health policies, must continue to witness in the public square. Only then can we reject utilitarianism as a guide to the practice of medicine so consensus science orthodoxy will give way to real science that yields the truth about vaccination and health. Only then can we transcend the horror of what has happened to far too many children in the name of the greater good and adopt an authentic ethic, one that values individual autonomy and freedom of thought, speech and conscience — civil liberties that have been an antidote to tyranny in its many forms throughout human history. Our mission continues. No forced vaccination. Not in America.

#VitalityPath

[isaacscrawford]

Our Guide to “Pre-Approval” Access to Drugs For Both Doctors & Patients

By ALISON-BATEMAN HOUSE

Patients (and physicians) trying to access an unapproved drug outside of a clinical trial can feel as though they’re navigating uncharted waters. Many physicians don’t know that the FDA permits the use of unapproved drugs outside of clinical trials; those who do know often have no idea how to access such drugs for their patients. Those physicians who know about pre-approval access are largely specialists in certain areas—often, oncology or rare diseases—and they are generally self-taught: they didn’t learn about pre-approval access in medical school or in their residencies. Thus, while some physicians have become very accustomed to requesting pre-approval access to drugs, the majority lacks this knowledge. In this essay, I use a fictional case to trace the process for requesting access to an unapproved drug. I hope to explode several myths about the process, especially the beliefs that the FDA is the primary decision-maker in granting access to unapproved drugs and that physicians must spend 100 hours or more completing pre-approval access paperwork.

Imagine you are a physician, and you have a pregnant patient who has tested positive for the Zika virus. She is only mildly ill, but she’s terrified that the virus, which has been linked with microcephaly and other abnormalities, will harm her unborn child. She’s so concerned that she is contemplating an abortion, even though she and her husband have been trying to have a child and were overjoyed to learn she was pregnant.

Last night, you saw a news story about a pharmaceutical company with a drug in development that, in theory, could minimize the impact of Zika on fetuses. The story, while focused on the hope of a way to prevent fetal harm from Zika, also discussed the ethical concerns raised by the prospect of testing a new drug on pregnant women and their fetuses. Watching the story, you had thought it might be impossible to ethically test this drug in people, but now, with a distraught patient before you, you wonder if you can find a way for her to try this investigational drug.

In the best-case scenario, you would remember the name of the company developing the drug. After contacting the company, you would learn that it is enrolling participants in a well-designed clinical trial, that your patient is eligible for the trial, and that there is a trial site convenient to her. She would decide to enroll in the trial and have a healthy child — either because of the drug or because the infection did not affect the fetus — and her participation would aid in the development of a drug that may help others who find themselves in her situation. There are numerous reasons, however, why this best-case scenario may not come to pass. For example, you may be unable to recall or figure out which company is developing the drug you heard about; your patient may be uninterested in participating in a clinical trial; or she may be interested but is ineligible because of medical or geographic factors.

For the purposes of this essay, imagine that you cannot remember the name of the pharmaceutical company. So, you go to ClinicalTrials.gov and search the trials listed there using the keyword “Zika.” You look through the various trials listed, but, unfortunately, none of them will work for your patient because they have already completed enrollment or because she matches certain exclusion criteria or is unable to travel to a clinical trial site.

You know the FDA allows expanded access (its term) or compassionate use (the more colloquial term) of investigational drugs when patients without other treatment options are not eligible for clinical trials, but you’ve heard that it is a complicated and time-consuming process. You wonder whether it is even an option for your patient, who would need to decide quickly if she is going to have an abortion. Nevertheless, you decide to try. You do an internet search for “FDA expanded access” and send a message to the FDA email address you find. You quickly get a response informing you that you need to contact the company whose drug you wish to try on your patient to see if it is willing to provide its drug; if so, then you will work with that company to prepare an application for FDA review.

As you don’t remember the name of the company that was developing the drug, you can’t just directly contact it. Instead, on ClinicalTrials.org, you search for “expanded access” and get 719 results. You then try “compassionate use,” getting 602 results, and “pre-approval access,” with 4 results. Unfortunately, when you add “Zika” to your search, you get zero results, regardless of whether you use “expanded access,” “compassionate use,” or “pre-approval access.” Rather than giving up, you do a search using just the keyword “Zika,” intending to call all the listed clinical trials to see if one of the trial sponsors can help your patient, even though she isn’t eligible to join their trial.

The first clinical trial listed is run by Big Successful Pharmaceutical. You go to its website and see that its pre-approval policy posted there. The policy directs you to send an email to a specified address or call a certain number. You call, and the person who answers takes down your request and says you will get a response within 5 business days.

It used to be rare for a company to make its pre-approval access policy public. According to an October 2016 report by Avalere Health, a search of 100 publicly traded pharmaceutical and biotechnology companies found that only 19 companies included their pre-approval access policies on their websites. However, legislation enacted in December 2016 (the 21st Century Cures Act) mandated that “the manufacturer or distributor of one or more investigational drugs for the diagnosis, monitoring, or treatment of one or more serious diseases or conditions make publicly available” its pre-approval access policy. This policy must include (1) contact information for the drug company; (2) procedures for making requests; (3) the general criteria the company uses to evaluate both the requests and its responses to such requests; (4) how long the company will take to acknowledge receipt of requests; and (5) a link or other reference to information about clinical trials for the drug. When Avalere re-ran its study in March 2017, it found that the number of companies with publicly available pre-approval access policies had more than doubled.

The impetus for this legislative requirement was the desire to make the pre-approval access process more patient-friendly. Prior to the 21st Century Cures provision, not only was information about how to submit pre-approval requests to specific companies lacking, but some companies simply did not respond to inquiries. The new rule requires companies to be more forthcoming about their policies and give requesters a timeline for when they can expect an answer. Importantly, the policy mandates that companies have a policy; however, this does not mean that they necessarily offer access: a company’s pre-approval access policy can be that it does not grant pre-approval access to its drugs.

In June 2017, another new tool was unveiled. This is the Expanded Access Navigator (http://navigator.reaganudall.org/), which offers physician- and patient-specific instructions on how to pursue expanded access. In addition to information about how to search ClinicalTrials.gov to find drugs that may be relevant, the Expanded Access Navigator has an alphabetical company directory with links the companies’ websites and information about their expanded access policies and contact information for placing a request. Thus far the Expanded Access Navigator mainly has information relevant to oncology, but it will be adding additional companies and expanding into different therapeutic areas.

One of the reasons that it is important for you to have a designated contact is because different pharmaceutical companies delegate pre-approval decision-making to different people. It could be the chief medical officer, the regulatory liaison, the CEO, the head of the team developing the new drug, the legal team, or some other staff member. Just as there is no industry-wide consensus on who should respond to such requests, there is no agreement on what the answer should be. Some companies feel strongly that they shouldn’t provide unapproved drugs to patients outside of clinical trials, while others are willing to do so as long as it wouldn’t interfere with their trials. Some companies may be willing to provide access in theory but do not have enough drug to make provision a reality, and still others might have policies stipulating that access will be granted only after a certain point in the clinical testing of the drug — for example, after it has been proven relatively effective in a Phase 2 trial, or perhaps after the trials are complete and the drug is under review by the FDA. Yet another area where there is no industry-wide consensus is what to do with patients who appeal a denial. These are the patients who might turn to the media, online petitions, and Twitter and Facebook to try to pressure a company into granting access to its unapproved drugs.

In your case, you get a response the next day informing you that  the company has received so many requests for their investigational drug that it has decided to open an expanded access program (EAP). This is like a clinical trial, in that it collects some data, but its inclusion criteria are less demanding than those of the “real” trials. Your patient, who couldn’t participate in the clinical trial because she has difficulty traveling and lived several hours away from the closest trial location, can participate in the EAP. Because the EAP is collecting less data than is the trial, your patient’s pre- and postnatal visits can be conducted at your hospital instead of her having to travel to the trial site.

Just as you’re breathing a sigh of relief about how easy the process turned out to be, you get bad news. Although the EAP is in the process of being set up, it will not be started in time for your patient, who needs treatment urgently, as she has decided that she would rather have an abortion that give birth to a Zika-affected child. The company informs you that it is still willing to provide its drug to your patient, but you’ll have to go through what is called the single-patient IND route.

Your contact at the company instructs you to complete form FDA 3926, which is available online. You say that you’ve heard that it can take 100 or more hours to complete and that your patient doesn’t have that kind of time. But your company contact tells you that the 100-hour estimate applied to the drug company, when it completed paperwork prior to beginning clinical trials. The form you need to submit, with the company’s help if necessary, should take 45 minutes, at most, to complete.

Once the form is filled out, you send it to the FDA, which will review it to see if it raises any red flags or if the agency has any suggestions on how to improve your proposed treatment plan. By law, the FDA must respond within 30 days; however, its reviewers understand that these requests are often time-sensitive, so they screen them as quickly as possible. In fact, emergency requests are typically reviewed in one day or less and non-emergency requests are usually reviewed within four days. Furthermore, the company tells you that historically the FDA has approved the vast majority of requests for expanded access. Indeed, online you find FDA statistics showing that it approves 99% of pre-approval access requests.

The next morning you get a call from the FDA: the agency will permit you to try the investigational drug on your patient and her fetus. However, there is one more step to take before you can do so—you need to get permission from your hospital’s institutional review board (IRB). The IRB is charged with reviewing research projects proposed to be conducted at the institution, making sure they are ethically acceptable before human subjects can be enrolled. In this case, what they are reviewing is not a research project (even though it involves an investigational drug) but clinical care, albeit of a new, innovative sort that may not actually work. As such, you are not sure how to present your plan for trying this investigational drug to the IRB.

You call the drug company for advice, and a representative offers to send you its clinical trial consent form. You modify the form, removing language about the trial but keeping information about the potential risks and benefits of the drug to mother and fetus. You then call your hospital’s IRB and explain that you wish try an unapproved drug on one of your patients, as she has no approved therapeutic options; that the company is willing to provide the drug; that the FDA is willing to let the request proceed; and that now you need the IRB’s approval. The IRB staff member tells you to send him your proposed informed consent form and that the board will review it as quickly as possible. You know it normally takes a while for your IRB to review submissions, so you are relieved to hear that they will review it quickly. You are also a bit skeptical! Later that day, you call again to check on your submission and to emphasize its time-sensitivity, and you are informed that you’ll have an answer tomorrow. You call your patient to update her and then do the same to the pharmaceutical company, which tells you it will express ship the drug to you so you can use it as soon as you have permission from the IRB.

In our scenario, it all works out:  the IRB approves your submission, the drug arrives on time, the patient consents to receive the drug and takes it with no problems, and she goes on to deliver a healthy child. You have new, hard-won knowledge about how to request unapproved investigational drugs. Very likely you think the process was more complicated that it should be, especially given the time-sensitivity of your request, but upon reflection you realize that the biggest problem you encountered was figuring out what to do and in what order. You vow to share your knowledge with your colleagues and students. Overall, however, you are appreciative of the guidance provided by the company, the FDA, and your IRB, and your patient is grateful that you went above and beyond to try to help her have a healthy child.

The purpose of walking through the above scenario has been to demystify the process of seeking access to an investigational drug outside of a clinical trial through the FDA’s Expanded Access Program. Secondarily, the above scenario was intended to quash several myths. One such myth is that it requires 100 hours or more to complete the FDA’s expanded access paperwork. Another such myth is that the FDA has ultimate control over access to investigational drugs via expanded access. In this case, access to the drug hinged on the company’s willingness to provide it. If the company had said no, the FDA cannot “force” the company to provide an investigational drug. Once the company agreed to provide the drug, the FDA does have approval power, but over 99% of the time, the agency permits pre-approval access requests to proceed. The FDA review is no rubber stamp, however. The agency does important work reviewing the proposal and providing feedback on such issues as dosage, dose schedule, etc. Furthermore, the FDA requires that physicians notify them of any severe or unexpected adverse events that occur in the patient after the drug is administered. This allows the FDA staff to have better understanding of what may happen with the drug should it receive another request to use it in a patient. The physician’s IRB also has approval power over the plan to use an investigational drug in a patient.

Obviously, the above scenario is idealized. Despite recent efforts like the Expanded Access Navigator, physicians (particularly those who are not researchers) may not be able to figure out what investigational drugs may be promising or which company to contact for a specific drug. The company may not post its access policy (despite federal regulations requiring it to do so), or it may not respond to a request. Misunderstanding how to obtain access to investigational drugs outside of clinical trials may result in physicians spending time petitioning the FDA for access when, in reality, it is the companies that have the initial and most significant role in deciding whether to grant requests for access. And, as mentioned before, there is no industry-wide consensus on how to handle appeals when companies deny a request for access.

One byproduct of the lack of understanding of how to seek pre-approval access has been the proliferation of so-called “Right to Try” laws on the state level and, currently, as bills before Congress. Right to Try advocates incorrectly identify the FDA as the sticking point in efforts to obtain non-trial access to investigational medical products. Seeking to remedy the perceived problem, these laws state that FDA approval is not needed to use the products under certain circumstances (most commonly, in terminally ill patients, with informed consent, and on a doctor’s recommendation). The state laws raise constitutional issues in their effort to wrest from the federal government the power to regulate the use of unapproved medical products. More important, these laws fail to acknowledge that any obstacle to a patient achieving pre-approval access is far more likely to arise from companies being unwilling to give out their drugs than from the FDA refusing a submission.

The libertarian Goldwater Foundation is the architect and main proponent of the Right to Try movement. This group continues to cite the 100-plus-hours-to-complete FDA-forms assertion in explaining why it has targeted the FDA. Although that figure was never accurate, in 2016 the FDA rolled out form FDA 3926, which was created only for single-patient requests and takes just 45 minutes to complete. Supporters of Right to Try laws also frequently say that the problem with the FDA is that it is slow: that patients are dead or too ill to be helped by the time the FDA approves a submission. While there may be a range of FDA response times to requests, by law the agency must respond within 30 days or the request is allowed to proceed. As mentioned above, the FDA normally reviews emergency requests in a day or less and non-emergency requests in a median of four days. Thus, FDA foot-dragging is not a problem. The right to try movement’s identification of the FDA as the chief obstacle to patients being able to access investigational drugs outside of clinical trials is the product of libertarian anti-regulatory ideology rather than fact.

It may be that the main barrier to patients getting access to pre-approval drugs is lack of familiarity with the process. Hopefully this essay has illuminated and demystified that process. However, seeking investigational drugs outside of clinical trials will still be challenging, and there is much work to be done: educating patients and physicians, guiding the pharmaceutical industry in the development of best practices concerning how to respond to requests, and assisting IRBs in providing appropriate and timely reviews of proposals. But the mere fact that this article needed to be significantly updated a year after publication is indication that change is happening quickly.

Author’s Note:

In April 2016, I published guidance (http://thehealthcareblog.com/blog/2016/04/17/far-from-evidence-based-prescribing-the-world-of-compassionate-use/), in the form of a mock case study, on how to access a drug before it has been approved by the FDA—what’s known as pre-approval (or expanded or compassionate) access. This is an updated version of that guidance, reflecting multiple important changes in the pre-approval landscape over the past year. In particular, the FDA rolled out a new, streamlined form for single-patient requests, and Congress passed the 21st Century Cures Act, which, among many other things, mandated that certain pharmaceutical companies provide public information about their pre-approval access policies.

Article source:The Health Care Blog

[queerstorypodcast]

Episode 2- Magnus Hirschfeld

Hello and  a good gay to ya’ll today! Welcome to Queer Story Podcast, I’m your host oso and I’m here with Jaz.

(thoughts on the show Transparent and the ties tothe story of Magnus Hirschfeld’s life.

Thank you to the ancestors for bringing us to this place, without you we wouldn’t be here.

Today’s episode is all about the godfather of all the gays and trans folks of the world: Dr. Magnus Hirschfeld. Who once said this quote: “The woman who needs to be liberated most is the woman in every man, & the man who needs to be liberated most is the man in every woman.”  

One of the best tauruses to ever live, in my humble taurean opinion. Lets dive right into today’s Queerstory

Story:

Once upon a time in Germany, there was a man, an openly gay Ashkenazi Jewish man, who fully believed that being gay is a reasonable human experience. This man spent his entire life fighting for "Justice through science", for homosexual and transgender people to be recognized.

-He studied philosophy in undergrad. In 1892 he earned his doctoral degree

-He started a naturopathic practice in Magdeburg; in 1896 he moved his practice to Berlin-Charlottenburg.

-In 1896 he issued a pamphlet, Sappho and Socrates, on homosexual love under the pseudonym Th. Ramien

-In 1897, Hirschfeld founded the Scientific Humanitarian Committee with the publisher Max Spohr, the lawyer Eduard Oberg, and the writer Franz Joseph von Bülow.

- The Scientific Humanitarian Committee focused their work on defending the rights of homosexuals and to repeal Paragraph 175, the section of the German penal code that since 1871 had criminalized homosexuality. They argued that the law encouraged blackmail. Their motto was "Justice through science"

- This reflected Hirschfeld's belief that a better scientific understanding of homosexuality would eliminate social hostility toward homosexuals.

-Under Hirschfeld's leadership, the Scientific-Humanitarian Committee gathered over 5000 signatures from prominent Germans on a petition to overturn Paragraph 175. Notable folks who signed this: Albert Einstein, Ranier Maria Rilke, and Herman Hesse.

-The bill was brought before the Reichstag in 1898, but was supported only by a minority from the Social Democratic Party of Germany. Hirschfeld considered what would, in a later era, be described as "outing": forcing out of the closet some of the prominent and secretly homosexual lawmakers who had remained silent on the bill. He arranged for the bill to be reintroduced and in the 1920s it began to make some progress, before the takeover of the Nazis ended hopes for this support of homosexual communities.

 One of the most prominent parts of Magnus’ career was his involvement with the homosexual sex scandal that emerged in Kaiser Wilheim II’s cabinet in 1907-1909. This was known as the Harden Eulenberg Affair. This affair was such a scandal it could be compared to the trial of Oscar Wilde 20 years earlier. We won’t get into the details of the accusations and the accused, lets just stay focused on Magnus’ involvement.

 Like Oscar WIlde’s original trials, this one was in regards to suing for libel.In 1907 when General Kuno von Moltke sued the journalist Maximilian Harden after the journalist had run an article accusing Moltke of having a homosexual relationship with the politically powerful Prince Philipp von Eulenburg, who was the Kaiser's best friend. Hirschfeld testified for the journalist, Harden. Hirschfeld in his role as an expert witness testified that Moltke was gay, and thus what Harden had written was true. This had alot to do with Magnus’ personal agenda— as he was a gay scientist who passionately wanted to make homosexuality legal in Germany — he believed that proving that Army officers like Moltke were gay would help his case for legalization, and as such he also testified that he believed there was nothing wrong with Moltke. Hirschfeld testified that "homosexuality was part of the plan of nature and creation just like normal love." This caused OUTRAGE all over Germany. Various newspapers called him out as "a freak who acted for freaks” (thanks dear Dr for being for us freaks!) in the name of pseudoscience" and "Dr. Hirschfeld makes public propaganda under the cover of science which does nothing but poison our people. Real science should fight against this!" one of the newspaper’s stated.

SInce this isn’t a podcast on the Harden Eulenberg trial, I will move on to some other aspects of Hirshfeld’s career and work.

In 1921 Hirschfeld organised the First Congress for Sexual Reform, which led to the formation of the World League for Sexual Reform. Congresses were held in Copenhagen (1928), London (1929), Vienna (1930).

In 1904, Hirschfeld joined the Bund für Mutterschutz (League for the Protection of Mothers), the feminist organization founded by Helene Stöcker. He campaigned for the decriminalisation of abortion, and against policies that banned female teachers and civil servants from marrying or having children.

So, the Wiemer Republic is considering a bit more liberal than past German governments, during that time- between WW1 and WW2- Magnus created his magnum opus- Institut für Sexualwissenschaft (Institute of Sexual Research). It was opened on July 6th, 1919.

In Germany, the Reich government made laws, but the Länder governments enforced the laws, meaning it was up to the Länder governments to enforce Paragraph 175. Magnus’ villa purchased for the institute was technically in Prussia, where the lander did not enforce Paragraph 175. This is how Prussia became a homosexual hot spot of the time.

 As for Magnus and his institute- it thrived. It was where Hirschfeld's immense archives and library on sexuality and provided educational services and medical consultations; the clinical staff included psychiatrists, a gynecologist, a dermatologist/ endocrinologist, and a dermatologist. The institute was also where you could find The Museum of Sex, an educational museum that was visited by schools.

It was a place intellectuals, writers, and general people came to understand their own sexuality- without discrimination and with full support. Their expertiences were validated and even recorded, to provide future validation and proof regarding various experiences of gender and sexuality.

In addition, a number of noted individuals lived for longer or shorter periods of time in the various rooms available for rent or as free accommodations in the Institute complex. Among the residents were Isherwood and Turville-Petre; literary critic and philosopher Walter Benjamin; actress and dancer Anita Berber; Marxist philosopher Ernst Bloch. Dörchen Richter, one of the first transgender patients to receive gender confirmation surgery pioneered at the institute. at the Institute. Lili Ilse Elvenes, better known as Lili Elbe , was a Danish transgender woman who also received gender confirmation surgery and treatment. Her autobiography was release 2 years after her death: Man into Woman.

 It was while he was on an international tour for the League,had attracted over 130,000 members by 1930, that Hirschfeld was forced into exile. National Socialists in Berlin had launched a campaign to cleanse the city's libraries of 'un-German' material.

May 6, 1933 a crowd of students, backed by gestapo, stormed the Institute's offices. The they stole the contents of the library and it culminated in a public bonfire that destroyed 10,000-plus books, articles, magazines, and research material that the Institute had collected and produced.

In 1933 Magnus went into exile in France and by 1935 on his birthday passed away.

Documentation of concentration camps destroyed, no way to gauge how many homo sexual and transgender people died in the Houlcaust.

  Bump: You’re listening to Queerstory

 Music: The song ‘Wenn die beste Freundin’ ( When My Best Girlfriend)- Marlene Dietrich and Margo Lion 1928

 Lyrics in english!

 When the best girlfriend

Duet:

When the best girlfriend

With the best girlfriend

To do some shopping,

To do some shopping,

To get some exercise,

Wander through the streets,

Blabbing about everything,

Says the best girlfriend

To the best girlfriend:

My best, my best girlfriend!

Oh my best girlfriend,

Oh my pretty girlfriend,

Oh my faithful girlfriend,

Oh my sweet girlfriend!

Walks the best girlfriend

With the best girlfriend,

says to the best girlfriend

to the best girlfriend:

My best, my best girlfriend.

Spoken:

1. Girlfriend: Yes, what does the best girlfriend say? Tell me what crosses your mind!

2. Girlfriend: Well, I can only tell you one thing, if I didn’t have you ...

We get along so well …

1. Girlfriend: Yes, we get along so terribly well. How well we get along together!

2. Girlfriend: It's just hardly bearable, how well we both get along together.

1. Girlfriend: There's just one person I get along with equally well, and that is my cute, little husband.

2. Girlfriend: Yes, with your cute, little husband

Duet, sung:

Yes, my husband is a man!

Such a man, like my husband!

Like the husband of the woman,

like the husband of the woman!

We used to have paramours,

but that's all past!

Today, instead of paramours,

we have girlfriends!

Spoken:

2. Girlfriend: Your little man is a bit pushy!

1. Girlfriend: Really?

2. Girlfriend: Yes.

1. Girlfriend: Why?

2. Girlfriend: Well, I think so

1. Girlfriend: Well, why?

2. Girlfriend: Why I think so …?

1. Girlfriend: Why you think so?

2. Girlfriend: He does such things …

1. Girlfriend: I don't like it.

2. Girlfriend: Helloo!

Husband: What's this?

1. Girlfriend: You cheated on me with her.

Husband: Because you cheated on me with her.

2. Girlfriend: And you cheated on with him

1. Girlfriend: Because cheated on me with him

Husband: What's this for intricate family relations! Don't we want to get along?

2. Girlfriend: Yes, we would rather get along.

Husband: Stupid, silly love.

Husband accompanies with:

mmm - da-ta-ta-ta-ta-ta

When the best girlfriend

With the best girlfriend

To do some shopping,

To do some shopping,

To get some exercise,

Wander through the streets,

Blabbing about everything,

Says the best girlfriend

To the best girlfriend:

My best, my best girlfriend!

Oh my best girlfriend,

Oh my pretty girlfriend,

Oh my faithful girlfriend,

Oh my sweet girlfriend!

Walks the best girlfriend

With the best girlfriend,

says to the best girlfriend

to the best girlfriend:

My best, my best girlfriend!

 Bump: You’re listening to Queerstory, a podcast about the histories of LGBTQ people, hidden from us in school, brought to you by me: oso and the Queer elders and ancestors that came before me.

 The song you just heard is called ‘ Wenn die beste Freundin’. This song came out of a 1928 cabaret set in a department store. The scene this song was in featured a relatively still unknown Marlene Dietrich duetting with rising-star Margo Lion. The pair play two affluent women on a shopping trip. As the song unfolds it becomes  clear that they are both dissatisfied with their husbands and their relationship with each other is more than a little intimate. Was a big hit and became an anthem for German lesbians in the late 20′s and early 30′s.

 Dialogue:

 We are now at the part of the show when we have a lil’ conversation about what we just learned. This is _____ my friend.

 (conversation)

 Thanks for reading Queer Story Podcast! Be well!

#transcript

[newstfionline]

He robbed banks and went to prison. His time there put him on track for a new job: Georgetown law professor.

By Susan Svrluga, Washington Post, April 21, 2017

During a break in a basketball game to raise money for charity, Shon Hopwood told some of his Georgetown law students it felt different than the last time he was on a court: When he played basketball in federal prison, he had to carry a shank in case his team started to lose.

Hopwood’s new job as a tenure-track faculty member at the Georgetown University Law Center is only the latest improbable twist in a remarkable life: In the last 20 years, he has robbed banks in small towns in Nebraska, spent 11 years in federal prison, written a legal petition for a fellow inmate so incisive that the U.S. Supreme Court agreed to hear the case, done that again, earned undergraduate and law degrees and extremely competitive clerkships, written a book, married his hometown crush and started a family.

But this could be his most compelling role yet. His time in prison gave him an unusual perspective on the law that allows him to see things other lawyers overlook, and a searing understanding of the impact of sentencing and the dramatic growth in incarceration in the United States.

“It’s one of the big social-justice issues of our time,” he said. The United States has 5 percent of the world’s population but 25 percent of its prisoners. “Between prison, jail, home confinement, probation, parole, combined it’s about 10 million people. It’s a big number.” And almost three-quarters of released prisoners are back in custody five years later. He hopes to change some of that.

“The story’s still writing itself,” he said in his office recently, marveling while students hurried to class outside. “I feel like I’m living someone else’s life quite often these days.”

Shon Hopwood’s life didn’t start out as remarkable. It began with a happy childhood in a town of 2,500 people in Nebraska. His dad managed a cattle feed yard, and his parents helped found a church. He was friendly and well-liked, uninterested in school, and best known for his skill on the basketball court.

An athletic scholarship to college ended when he got kicked out for not going to class. After two years in the U.S. Navy, he drifted back to Nebraska, depressed, drinking, doing some drugs, living in his parents’ basement and working 12-hour shifts on a cattle farm, shoveling manure.

One night his best friend turned to him in a bar and suggested that they rob a bank.

In August 1997, Hopwood walked into a bank, sweating, heart racing, dropped a metal toolbox to the floor with a bang and pulled a rifle from his coveralls. With the terrified customers and tellers locked into a vault, he sped away with $50,000 of other people’s money and his friend, who knew every bit as well as he did that what they had done was horribly wrong.

His friend suggested sending the money back, with a note. Instead, Hopwood went on to rob four more banks.

At his sentencing, 30 family members stood behind him, most of them crying. He was 23 years old. Judge Richard Kopf thought he was a punk. He had not forgotten Nebraska’s history of violent bank robberies. When Hopwood told him he was going to turn his life around, Kopf said something disdainful like: I guess we’ll see in about 13 years.

His first morning in federal prison, Hopwood got up early to work out and watched as two inmates yanked another one from a pullup bar, knocked him to the ground and stomped on the man with steel-toe boots leaving bits of teeth in pools of blood.

Working in the prison law library sounded like a good idea.

At first, he just checked books out. But in the summer of 2000, a Supreme Court decision caught inmates’ attention: Essentially, Hopwood explained, “things that can increase your sentence need to be proven to a jury, or you need to plead guilty to them.” He had been sentenced based on guidelines for armed robbery, even though he had pleaded guilty to unarmed robbery. A technicality, maybe, but he began dreaming of getting out early. Among all the other reasons to leave, he had begun a friendship, by mail, with a girl from back home.

After two months of research, he mailed off a brief and quickly got a response: He had filed it to the wrong court.

And when he redirected his appeal, Kopf denied it; the new decision did not apply retroactively in his case.

Still, something had clicked. Trying to figure out a solution to the legal puzzle was the first academic thing Hopwood had ever enjoyed. And it came easy. Soon he was sending memos to other inmates’ lawyers, suggesting strategies. Then he was writing briefs.

He was finding errors, often from overworked public defenders, like a young man sentenced to 16-and-a-half years for possessing less than a handful of crack cocaine because he had mistakenly been labeled a career offender. With Hopwood’s help, his sentence was reduced by more than 10 years.

The third brief he ever wrote was for a friend whose appeal had been denied. Hopwood spent months learning about the Supreme Court and habeas petitions, and one night he realized how he could frame an argument using the Sixth Amendment rather than the Fifth. After many drafts, honed by conversations with fellow inmates that forced him to distill the legal issues into simple, compelling logic, he typed out a petition for certiorari and mailed it off.

Months later, he was working out early one morning when a prisoner came running toward him, screaming that Hopwood was going to die. He tensed for a fight; he had recently survived a situation in which he fully expected to be stabbed to death by gang members.

But the man was holding a newspaper, with the story of the Supreme Court accepting a petition from a federal prisoner.

The odds of that happening are maybe 1 in 10,000, said Seth Waxman, the former solicitor general of the United States who agreed to argue the case for free. He read the petition with amazement. “It was incredibly good. It really identified, in sort of a crystalline form, the questions presented. It explained the conflict, it explained the importance.”

He immediately wanted to talk to the bank robber who could write such a thing, and thus began a friendship that would help change the trajectory of Hopwood’s life.

Now Hopwood was spending his time doing things such as reading a 1,650-page textbook on criminal procedure. Twice. He was taking college classes, and paralegal studies. And with new sentencing guidelines, he was busy churning out work for other inmates, taking on 10 or more cases at a time. “I was running a law firm in prison,” he said lightly. Because he was now convinced that sentences beyond about five years didn’t make sense for any but the most dangerous criminals, because he was upset by the disparities in sentences, because he saw prison more often hardening people or cutting off their chances for reform than turning their lives around, he enjoyed seeing people packing for home. He had another petition granted by the Supreme Court.

When he walked out of prison in October 2008, he was 33 and overwhelmed with anxiety about rebuilding his life. He knew no one was clamoring to hire felons. He wanted to get married and go to college, and he had no money. He was working at a carwash when he had another moment of grace: A family-run legal printing business in Omaha agreed, after getting some reassurance from Waxman, to hire him to help with their Supreme Court briefs. “If that doesn’t happen, none of this does,” he said.

A story in the New York Times unleashed a flood of invitations to speak, and a book deal. Still it was difficult, given his résumé, to get into law school. But the University of Washington granted him a full scholarship that made it possible--even with a little boy at home, and a girl born on the first day of law school--to attend.

He startled his former probation officer in the elevator of the courthouse one morning two months after his supervised release ended. He was not there for his mandatory check-in this time. He was arriving for work, clerking for a federal judge.

As he was studying 12 hours a day, he was wondering: Would he be granted a law license at the end of all this, or would they reject him because of his criminal record? The hearing was long, but in the end, the vote was unanimous. And in April 2015, after he passed the bar exam, he was sworn in as a lawyer by the D.C. Circuit judge who had chosen him for a prestigious clerkship.

He joined Georgetown on a teaching fellowship about a year and a half ago, working with students on cases in the appellate clinic. He sees issues others don’t, strategies that others don’t, said Steven Goldblatt, director of appellate litigation.

“He understands the problems of incarceration in a way that somebody who just studies them as an academic is not able to get,” said William Treanor, the law school’s dean.

Many colleagues were struck by his academic writing, Goldblatt said. Hopwood wrote about the rule of lenity, which he described as designed to protect citizens from getting caught in vague laws, and argued it must be revitalized to push Congress to write with more precision when drafting laws that take away liberty.

It’s not a theoretical issue, Goldblatt said. It’s fundamental. “It symbolizes what Shon is all about,” he said. “Why wasn’t there more written about it? Damned if I know.”

The surreal moments continue. Recently Hopwood helped his former criminal defense attorney practice a case to be argued in front of the Supreme Court. He also spoke on an academic panel with Kopf, the judge who sentenced him. It was an emotional meeting for both. Kopf gave Hopwood a gift that had great meaning for him, a leather briefcase Kopf had received from a former prisoner whom he had defended. It was a recognition, Kopf said, that he and Hopwood were both trying to emulate justice.

“I don’t know if it was atonement as much as it was, ‘Carry on--keep doing what you’re doing,’” Kopf said, thinking out loud. “I would do anything for Shon.”

Hopwood is still, at 41, haunted by guilt and regret for his crimes. But he is an optimist by nature, and he has accepted that he can only change the future. Now his primary goal is to help people, whether by serving as a reminder that you can turn your life around, by giving students an understanding of the real impact of the law, or, he hopes, by influencing the criminal justice system.

So while he kept the letter from a law firm offering him $400,000 a year, it was just as a curiosity. The money would be nice, but influence is what he wants. The Capitol dome is literally in view from campus, and most days he walks right past the Federal Bureau of Prisons’ headquarters.

Even now, preparing to start a new position at Georgetown on July 1 as an associate professor of law, with a young family, and all the gratitude he has for the friends along the way, he doesn’t feel like he’s made it.

“I’ll feel that way when the federal government passes a bill that gets rid of federal mandatory sentences,” he said. “That will be the moment for me.”

#Shon Hopwood #ex-con law professor