A muscle cramp is a sudden and involuntary contraction of one or more of your muscles. If you’ve ever been awakened in the night or stopped in your tracks by a sudden charley horse, you know that muscle cramps can cause severe pain. Though generally harmless, muscle cramps can make it temporarily impossible to use the affected muscle.
Long periods of exercise or physical labor, particularly in hot weather, can lead to muscle cramps. Some medications and certain medical conditions also may cause muscle cramps. You usually can treat muscle cramps at home with self-care measures.
Symptoms
Most muscle cramps develop in the leg muscles, particularly in the calf. Besides the sudden, sharp pain, you might also feel or see a hard lump of muscle tissue beneath your skin.
When to see a doctor
Muscle cramps usually disappear on their own and are rarely serious enough to require medical care. However, see your doctor if your cramps:
Cause severe discomfort
Are associated with leg swelling, redness or skin changes
Are associated with muscle weakness
Happen frequently
Don’t improve with self-care
Aren’t associated with an obvious cause, such as strenuous exercise
Overuse of a muscle, dehydration, muscle strain or simply holding a position for a prolonged period can cause a muscle cramp. In many cases, however, the cause isn’t known.
Although most muscle cramps are harmless, some may be related to an underlying medical condition, such as:
Inadequate blood supply. Narrowing of the arteries that deliver blood to your legs (arteriosclerosis of the extremities) can produce cramp-like pain in your legs and feet while you’re exercising. These cramps usually go away soon after you stop exercising.
Nerve compression. Compression of nerves in your spine (lumbar stenosis) also can produce cramp-like pain in your legs. The pain usually worsens the longer you walk. Walking in a slightly flexed position — such as you would use when pushing a shopping cart ahead of you — may improve or delay the onset of your symptoms.
Mineral depletion. Too little potassium, calcium or magnesium in your diet can contribute to leg cramps. Diuretics — medications often prescribed for high blood pressure — also can deplete these minerals.
Risk factors
Factors that might increase your risk of muscle cramps include:
Age. Older people lose muscle mass, so the remaining muscle can get overstressed more easily.
Dehydration. Athletes who become fatigued and dehydrated while participating in warm-weather sports frequently develop muscle cramps.
Pregnancy. Muscle cramps also are common during pregnancy.
Medical conditions. You might be at higher risk of muscle cramps if you have diabetes, or nerve, liver or thyroid disorders.
Prevention
These steps may help prevent cramps:
Avoid dehydration. Drink plenty of liquids every day. The amount depends on what you eat, your sex, your level of activity, the weather, your health, your age and medications you take. Fluids help your muscles contract and relax and keep muscle cells hydrated and less irritable. During activity, replenish fluids at regular intervals, and continue drinking water or other fluids after you’re finished.
Stretch your muscles. Stretch before and after you use any muscle for an extended period. If you tend to have leg cramps at night, stretch before bedtime. Light exercise, such as riding a stationary bicycle for a few minutes before bedtime, also may help prevent cramps while you’re sleeping.
You could be out for a run or drifting off to sleep when it happens: The muscles of your calf or foot suddenly become hard, tight, and painful. You are having a muscle cramp.
How can you stop it and prevent another one from happening?
Sometimes called “charley horses” — particularly when they’re in the calf muscles – cramps are caused by muscle spasms – involuntary contractions of one or more muscles.
Almost everyone gets a muscle cramps, which come without warning. What causes them, and what can you do to relieve them?
What Causes Muscle Cramps?
Many things can trigger a muscle cramp. They include:
For a charley horse in the calf or a cramp in the back of the thigh (hamstring), try this stretch: Put your weight on the affected leg and bend your kneeslightly. Or, sit or lie down with your leg out straight and pull the top of your foot toward your head.
For a cramp in the front of the thigh (quadriceps), hold on to a chair to steady yourself and pull your foot back toward your buttock.
You can also massage the muscle, ice it, or try taking a bath with Epsom salt.
In most cases, you can take care of a leg cramp. It will likely stop within minutes. But if you get them often and for no clear reason, tell your doctor.
http://bit.ly/AdrenalBodyTypeKit Take Dr. Berg’s Advanced Evaluation Quiz: http://bit.ly/EvalQuiz Your report will then be sent via email analyzing 104 potential symptoms, giving you a much deeper insight into the cause-effect relationship of your body issues. It’s free and very enlightening. Dr. Berg talks about the Adrenal Body Type. This type has a series of symptoms: 1. Belly Fat 2. Low tolerance to stress 3. Asthma 4. Allergies 5. High blood pressure 6. Low vitamin D 7. Buffalo hump 8. Diabetes 9. Inflammation 10. Acid reflux Here’s what to do: 1. Low intensity exercise 2. Sleep more 3. No sugar 4. Lots of greens (7-10 cups of vegetables) 5. Protein 3-6oz 6. The Adrenal Body Type Kit Dr. Eric Berg DC Bio: Dr. Berg, 51 years of age is a chiropractor who specializes in weight loss through nutritional and natural methods. His private practice is located in Alexandria, Virginia. His clients include senior officials in the U.S. government and the Justice Department, ambassadors, medical doctors, high-level executives of prominent corporations, scientists, engineers, professors, and other clients from all walks of life. He is the author of The 7 Principles of Fat Burning, published by KB Publishing in January 2011. Dr. Berg trains chiropractors, physicians and allied healthcare practitioners in his methods, and to date he has trained over 2,500 healthcare professionals. He has been an active member of the Endocrinology Society, and has worked as a past part-time adjunct professor at Howard University. DR. BERG’S VIDEO BLOG: http://www.drberg.com/blog FACEBOOK: http://www.facebook.com/DrEricBerg TWITTER: http://twitter.com/DrBergDC YOUTUBE: https://www.youtube.com/user/drericbe… ABOUT DR. BERG: http://www.drberg.com/dr-eric-berg/bio DR. BERG’S SEMINARS: http://www.drberg.com/seminars DR. BERG’S STORY: http://www.drberg.com/dr-eric-berg/story DR. BERG’S CLINIC: https://www.drberg.com/dr-eric-berg/c… DR. BERG’S HEALTH COACHING TRAINING: http://www.drberg.com/weight-loss-coach DR. BERG’S SHOP: http://shop.drberg.com/ DR. BERG’S REVIEWS: http://www.drberg.com/reviews
What To Do If You Have Adrenal Fatigue
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Breathing Exercises For Sleep
How to Sleep Super Fast – MUST WATCH!
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Barry Sears, Ph.D. (born June 6, 1947, Long Beach, California)[1] is an American biochemist and author, best-known for creating and promoting the Zone diet, a fad diet which is not well supported by medical evidence.[2]
As stated in several of his books, the Zone diet was born of his desire to avoid an early death from a premature heart attack, a fate of which all other men in his family had been early victims. In more recent years, Sears has popularized the use of high-dose Omega-3 fatty acids and polyphenols to further reduce inflammation. He recently revealed in an interview that he began studying lipids primarily because of their complexity.[3]
He released his first book in 1995, The Zone: A Dietary Road Map. It went on to sell over 2 million hardback copies and was a #1 New York Times bestseller. Since then he has frequently appeared in the United States media, including CNN, Forbes and Good Morning America.
Career & Zone diet
Sears began his business career in 1976, as the founder and president of one of the first biotechnology startup companies in Massachusetts developing lipid-based delivery systems for cancer drugs.[1] In 1982, the Nobel Prize in medicine was awarded for the discoveries of the role that specialized hormones, known as eicosanoids that are derived from lipids, play in the development of cardiovascular disease, diabetes, auto-immune diseases, and cancer. Sears believed that the drug delivery principles could be applied to diet, in order to control the levels of eicosanoids to ultimately control inflammation.[4]
In 1995, Sears released his first book, The Zone: A Dietary Road Map.[5]
The Zone, went on to become a #1 New York Times best-seller and sold over 2 million copies in the United States. In 1997, Sears released his second book, Mastering the Zone. The book again went on to become another New York Times bestseller and sold over 1 million copies in the United States.[4]
Sears continued to apply his dietary approach to other areas of health influenced by inflammation, and published his first book on anti-aging, The Anti-Aging Zone, in 1999.[4][6][7]
Over the next decade, Sears studied and released a number of books based on what he said was the linkage between diet and inflammation.[8]
In 2008, he released the book Toxic Fat: When Good Fat Turns Bad that described obesity as a form of cancer. Sears released his most recent book, The Mediterranean Zone in 2014, focusing on the role of polyphenols in the inflammatory response.[5] Currently, Sears has published 15 books that have sold more than 6 million copies in the United States. Sears continues his research as the President of the non-profit Inflammation Research Foundation in Peabody, Massachusetts.[4]
Jump up^DeBruyne L, Pinna K, Whitney E (2011). “Chapter 7: Nutrition in practice — Fad Diets”. Nutrition and Diet Therapy. Nutrition and Diet Therapy. Cengage Learning. p. 209. ISBN1-133-71550-8. “a fad diet by any other name would still be a fad diet.” And the names are legion: the Atkins Diet, the Cheater’s Diet, the South Beach Diet, the Zone Diet. Year after year, “new and improved” diets appear …
Inflammation (from Latininflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants,[1]and is a protective response involving immune cells, blood vessels, and molecular mediators. The function of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and to initiate tissue repair.
The classical signs of inflammation are heat, pain, redness, swelling, and loss of function. Inflammation is a generic response, and therefore it is considered as a mechanism of innate immunity, as compared to adaptive immunity, which is specific for each pathogen.[2] Too little inflammation could lead to progressive tissue destruction by the harmful stimulus (e.g. bacteria) and compromise the survival of the organism. In contrast, chronic inflammation may lead to a host of diseases, such as hay fever, periodontitis, atherosclerosis, rheumatoid arthritis, and even cancer (e.g., gallbladder carcinoma). Inflammation is therefore normally closely regulated by the body.
Inflammation can be classified as either acute or chronic. Acute inflammation is the initial response of the body to harmful stimuli and is achieved by the increased movement of plasma and leukocytes (especially granulocytes) from the blood into the injured tissues. A series of biochemical events propagates and matures the inflammatory response, involving the local vascular system, the immune system, and various cells within the injured tissue. Prolonged inflammation, known as chronic inflammation, leads to a progressive shift in the type of cells present at the site of inflammation, such as mononuclear cells, and is characterized by simultaneous destruction and healing of the tissue from the inflammatory process.
Inflammation is not a synonym for infection. Infection describes the interaction between the action of microbial invasion and the reaction of the body’s inflammatory response — the two components are considered together when discussing an infection, and the word is used to imply a microbial invasive cause for the observed inflammatory reaction. Inflammation on the other hand describes purely the body’s immunovascular response, whatever the cause may be. But because of how often the two are correlated, words ending in the suffix -itis (which refers to inflammation) are sometimes informally described as referring to infection. For example, the word urethritis strictly means only “urethral inflammation”, but clinical health care providers usually discuss urethritis as a urethral infection because urethral microbial invasion is the most common cause of urethritis.
It is useful to differentiate inflammation and infection as there are many pathological situations where inflammation is not driven by microbial invasion – for example, atherosclerosis, type III hypersensitivity, trauma, ischaemia. There are also pathological situations where microbial invasion does not result in classic inflammatory response—for example, parasitosis, eosinophilia.
All the above signs may be observed in specific instances, but no single sign must, as a matter of course, be present.[5]These are the original, or “cardinal signs” of inflammation.[5]*
Functio laesa is an apocryphal notion, as it is not unique to inflammation and is a characteristic of many disease states.[6]**
Infected ingrown toenail showing the characteristic redness and swelling associated with acute inflammation
Acute inflammation is a short-term process, usually appearing within a few minutes or hours and begins to cease upon the removal of the injurious stimulus.[7] It involves a coordinated and systemic mobilisation response locally of various immune, endocrine and neurological mediators of acute inflammation. In a normal healthy response, it becomes activated, clears the pathogen and begins a repair process and then ceases.[8] It is characterized by five cardinal signs:[9]
An acronym that may be used to remember the key symptoms is “PRISH”, for pain, redness, immobility (loss of function), swelling and heat.
The traditional names for signs of inflammation come from Latin:
The first four (classical signs) were described by Celsus (ca. 30 BC–38 AD),[11] while loss of function was added later by Galen[12] even though the attribution is disputed and the origination of the fifth sign has also been ascribed to Thomas Sydenham[13] and Virchow.[7][9]
Redness and heat are due to increased blood flow at body core temperature to the inflamed site; swelling is caused by accumulation of fluid; pain is due to the release of chemicals such as bradykinin and histamine that stimulate nerve endings. Loss of function has multiple causes.[9]
At the onset of an infection, burn, or other injuries, these cells undergo activation (one of the PRRs recognize a PAMP or DAMP) and release inflammatory mediators responsible for the clinical signs of inflammation. Vasodilation and its resulting increased blood flow causes the redness (rubor) and increased heat (calor). Increased permeability of the blood vessels results in an exudation (leakage) of plasma proteins and fluid into the tissue (edema), which manifests itself as swelling (tumor). Some of the released mediators such as bradykinin increase the sensitivity to pain (hyperalgesia, dolor). The mediator molecules also alter the blood vessels to permit the migration of leukocytes, mainly neutrophils and macrophages, outside of the blood vessels (extravasation) into the tissue. The neutrophils migrate along a chemotactic gradient created by the local cells to reach the site of injury.[7] The loss of function (functio laesa) is probably the result of a neurological reflex in response to pain.
In addition to cell-derived mediators, several acellular biochemical cascade systems consisting of preformed plasma proteins act in parallel to initiate and propagate the inflammatory response. These include the complement system activated by bacteria and the coagulation and fibrinolysis systems activated by necrosis, e.g. a burn or a trauma.[7]
The acute inflammatory response requires constant stimulation to be sustained. Inflammatory mediators are short-lived and are quickly degraded in the tissue. Hence, acute inflammation begins to cease once the stimulus has been removed.[7]
Vascular component
Vasodilation and increased permeability
As defined, acute inflammation is an immunovascular response to an inflammatory stimulus. This means acute inflammation can be broadly divided into a vascular phase that occurs first, followed by a cellular phase involving immune cells (more specifically myeloid granulocytes in the acute setting). The vascular component of acute inflammation involves the movement of plasma fluid, containing important proteins such as fibrin and immunoglobulins (antibodies), into inflamed tissue.
Upon contact with PAMPs, tissue macrophages and mastocytes release vasoactive amines such as histamine and serotonin, as well as eicosanoids such as prostaglandin E2 and leukotriene B4 to remodel the local vasculature. Macrophages and endothelial cells release nitric oxide. These mediators vasodilate and permeabilize the blood vessels, which results in the net distribution of blood plasma from the vessel into the tissue space. The increased collection of fluid into the tissue causes it to swell (edema). This exuded tissue fluid contain various antimicrobial mediators from the plasma such as complement, lysozyme, antibodies, which can immediately deal damage to microbes, and opsonise the microbes in preparation for the cellular phase. If the inflammatory stimulus is a lacerating wound, exuded platelets, coagulants, plasmin and kinins can clot the wounded area and provide haemostasis in the first instance. These clotting mediators also provide a structural staging framework at the inflammatory tissue site in the form of a fibrin lattice – as would construction scaffolding at a construction site – for the purpose of aiding phagocytic debridement and wound repair later on. Some of the exuded tissue fluid is also funnelled by lymphatics to the regional lymph nodes, flushing bacteria along to start the recognition and attack phase of the adaptive immune system.
Acute inflammation is characterized by marked vascular changes, including vasodilation, increased permeability and increased blood flow, which are induced by the actions of various inflammatory mediators. Vasodilation occurs first at the arteriole level, progressing to the capillary level, and brings about a net increase in the amount of blood present, causing the redness and heat of inflammation. Increased permeability of the vessels results in the movement of plasma into the tissues, with resultant stasis due to the increase in the concentration of the cells within blood – a condition characterized by enlarged vessels packed with cells. Stasis allows leukocytes to marginate (move) along the endothelium, a process critical to their recruitment into the tissues. Normal flowing blood prevents this, as the shearing force along the periphery of the vessels moves cells in the blood into the middle of the vessel.
The kinin system generates proteins capable of sustaining vasodilation and other physical inflammatory effects.
The coagulation system or clotting cascade, which forms a protective protein mesh over sites of injury.
The fibrinolysis system, which acts in opposition to the coagulation system, to counterbalance clotting and generate several other inflammatory mediators.
Cleaves to produce C3a and C3b. C3a stimulates histamine release by mast cells, thereby producing vasodilation. C3b is able to bind to bacterial cell walls and act as an opsonin, which marks the invader as a target for phagocytosis.
Stimulates histamine release by mast cells, thereby producing vasodilation. It is also able to act as a chemoattractant to direct cells via chemotaxis to the site of inflammation.
A protein that circulates inactively, until activated by collagen, platelets, or exposed basement membranes via conformational change. When activated, it in turn is able to activate three plasma systems involved in inflammation: the kinin system, fibrinolysis system, and coagulation system.
A complex of the complement proteins C5b, C6, C7, C8, and multiple units of C9. The combination and activation of this range of complement proteins forms the membrane attack complex, which is able to insert into bacterial cell walls and causes cell lysis with ensuing bacterial death.
Cleaves the soluble plasma protein fibrinogen to produce insoluble fibrin, which aggregates to form a blood clot. Thrombin can also bind to cells via the PAR1 receptor to trigger several other inflammatory responses, such as production of chemokines and nitric oxide.
Cellular component
The cellular component involves leukocytes, which normally reside in blood and must move into the inflamed tissue via extravasation to aid in inflammation. Some act as phagocytes, ingesting bacteria, viruses, and cellular debris. Others release enzymatic granules that damage pathogenic invaders. Leukocytes also release inflammatory mediators that develop and maintain the inflammatory response. In general, acute inflammation is mediated by granulocytes, whereas chronic inflammation is mediated by mononuclear cells such as monocytes and lymphocytes.
Leukocyte extravasation
Neutrophils migrate from blood vessels to the infected tissue via chemotaxis, where they remove pathogens through phagocytosis and degranulation
Various leukocytes, particularly neutrophils, are critically involved in the initiation and maintenance of inflammation. These cells must be able to move to the site of injury from their usual location in the blood, therefore mechanisms exist to recruit and direct leukocytes to the appropriate place. The process of leukocyte movement from the blood to the tissues through the blood vessels is known as extravasation, and can be broadly divided up into a number of steps:
Leukocyte margination and endothelial adhesion: The white blood cells within the vessels which are generally centrally located move peripherally towards the walls of the vessels.[14] Activated macrophages in the tissue release cytokines such as IL-1 and TNFα, which bind to their respective G protein-coupled receptors on the endothelial wall. Signal transduction induces the immediate expression of P-selectin on endothelial cell surfaces. This receptor binds weakly to carbohydrate ligands on the surface of leukocytes and causes them to “roll” along the endothelial surface as bonds are made and broken. Cytokines from injured cells induce the expression of E-selectin on endothelial cells, which functions similarly to P-selectin. Cytokines also induce the expression of integrin ligands such as ICAM-1 and VCAM-1 on endothelial cells, which mediate the adhesion and further slow leukocytes down. These weakly bound leukocytes are free to detach if not activated by chemokines produced in injured tissue. Activation increases the affinity of bound integrin receptors for ICAM-1 and VCAM-1 on the endothelial cell surface, firmly binding the leukocytes to the endothelium.
Migration across the endothelium, known as transmigration, via the process of diapedesis: Chemokine gradients stimulate the adhered leukocytes to move between adjacent endothelial cells. The endothelial cells retract and the leukocytes pass through the basement membrane into the surrounding tissue using adhesion molecules such as ICAM-1.[14]
Movement of leukocytes within the tissue via chemotaxis: Leukocytes reaching the tissue interstitium bind to extracellular matrix proteins via expressed integrins and CD44 to prevent them from leaving the site. A variety of molecules behave as chemoattractants, for example, C3a or C5, and cause the leukocytes to move along a chemotactic gradient towards the source of inflammation.
Upon endocytic PRR binding, actin–myosincytoskeletal rearrangement adjacent to the plasma membrane occurs in a way that endocytoses the plasma membrane containing the PRR-PAMP complex, and the microbe. Phosphatidylinositol and Vps34–Vps15–Beclin1 signalling pathways have been implicated to traffic the endocytosed phagosome to intracellular lysosomes, where fusion of the phagosome and the lysosome produces a phagolysosome. The reactive oxygen species, superoxides and hypochlorite bleach within the phagolysosomes then kill microbes inside the phagocyte.
Phagocytic efficacy can be enhanced by opsonization. Plasma derived complement C3b and antibodies that exude into the inflamed tissue during the vascular phase bind to and coat the microbial antigens. As well as endocytic PRRs, phagocytes also express opsonin receptors Fc receptor and complement receptor 1 (CR1), which bind to antibodies and C3b, respectively. The co-stimulation of endocytic PRR and opsonin receptor increases the efficacy of the phagocytic process, enhancing the lysosomal elimination of the infective agent.
These cells contain a large variety of enzymes that perform a number of functions. Granules can be classified as either specific or azurophilic depending upon the contents, and are able to break down a number of substances, some of which may be plasma-derived proteins that allow these enzymes to act as inflammatory mediators.
Stored in preformed granules, histamine is released in response to a number of stimuli. It causes arteriole dilation, increased venous permeability, and a wide variety of organ-specific effects.
Antiviral, immunoregulatory, and anti-tumour properties. This interferon was originally called macrophage-activating factor, and is especially important in the maintenance of chronic inflammation.
Able to mediate leukocyte adhesion and activation, allowing them to bind to the endothelium and migrate across it. In neutrophils, it is also a potent chemoattractant, and is able to induce the formation of reactive oxygen species and the release of lysosomal enzymes by these cells.
These three Cysteine-containing leukotrienes contract lung airways, increase micro-vascular permeability, stimulate mucus secretion, and promote eosinophil-based inflammation in the lung, skin, nose, eye, and other tissues.
Potent stimulator of neutrophil chemotaxis, lysosome enzyme release, and reactive oxygen species formation; monocyte chemotaxis; and with even greater potency eosinophil chemotaxis, lysosome enzyme release, and reactive oxygen species formation.
Metabolic precursor to 5-Oxo-eicosatetraenoic acid, it is a less potent stimulator of neutrophil chemotaxis, lysosome enzyme release, and reactive oxygen species formation; monocyte chemotaxis; and eosinophil chemotaxis, lysosome enzyme release, and reactive oxygen species formation.
Potent vasodilator, relaxes smooth muscle, reduces platelet aggregation, aids in leukocyte recruitment, direct antimicrobial activity in high concentrations.
Both affect a wide variety of cells to induce many similar inflammatory reactions: fever, production of cytokines, endothelial gene regulation, chemotaxis, leukocyte adherence, activation of fibroblasts. Responsible for the systemic effects of inflammation, such as loss of appetite and increased heart rate. TNF-α inhibits osteoblast differentiation.
Morphologic patterns
Specific patterns of acute and chronic inflammation are seen during particular situations that arise in the body, such as when inflammation occurs on an epithelial surface, or pyogenic bacteria are involved.
Granulomatous inflammation: Characterised by the formation of granulomas, they are the result of a limited but diverse number of diseases, which include among others tuberculosis, leprosy, sarcoidosis, and syphilis.
Fibrinous inflammation: Inflammation resulting in a large increase in vascular permeability allows fibrin to pass through the blood vessels. If an appropriate procoagulative stimulus is present, such as cancer cells,[7] a fibrinous exudate is deposited. This is commonly seen in serous cavities, where the conversion of fibrinous exudate into a scar can occur between serous membranes, limiting their function. The deposit sometimes forms a pseudomembrane sheet. During inflammation of the intestine (Pseudomembranous colitis), pseudomembranous tubes can be formed.
Purulent inflammation: Inflammation resulting in large amount of pus, which consists of neutrophils, dead cells, and fluid. Infection by pyogenic bacteria such as staphylococci is characteristic of this kind of inflammation. Large, localised collections of pus enclosed by surrounding tissues are called abscesses.
Serous inflammation: Characterised by the copious effusion of non-viscous serous fluid, commonly produced by mesothelial cells of serous membranes, but may be derived from blood plasma. Skin blisters exemplify this pattern of inflammation.
Ulcerative inflammation: Inflammation occurring near an epithelium can result in the necrotic loss of tissue from the surface, exposing lower layers. The subsequent excavation in the epithelium is known as an ulcer.
Inflammatory disorders
Inflammatory abnormalities are a large group of disorders that underlie a vast variety of human diseases. The immune system is often involved with inflammatory disorders, demonstrated in both allergic reactions and some myopathies, with many immune system disorders resulting in abnormal inflammation. Non-immune diseases with causal origins in inflammatory processes include cancer, atherosclerosis, and ischaemic heart disease.[7]
A large variety of proteins are involved in inflammation, and any one of them is open to a genetic mutation which impairs or otherwise dysregulates the normal function and expression of that protein.
Examples of disorders associated with inflammation include:
Atherosclerosis, formerly considered a bland lipid storage disease, actually involves an ongoing inflammatory response. Recent advances in basic science have established a fundamental role for inflammation in mediating all stages of this disease from initiation through progression and, ultimately, the thrombotic complications of atherosclerosis. These new findings provide important links between risk factors and the mechanisms of atherogenesis. Clinical studies have shown that this emerging biology of inflammation in atherosclerosis applies directly to human patients. Elevation in markers of inflammation predicts outcomes of patients with acute coronary syndromes, independently of myocardial damage. In addition, low-grade chronic inflammation, as indicated by levels of the inflammatory marker C-reactive protein, prospectively defines risk of atherosclerotic complications, thus adding to prognostic information provided by traditional risk factors. Moreover, certain treatments that reduce coronary risk also limit inflammation. In the case of lipid lowering with statins, this anti-inflammatory effect does not appear to correlate with reduction in low-density lipoprotein levels. These new insights into inflammation in atherosclerosis not only increase our understanding of this disease but also have practical clinical applications in risk stratification and targeting of therapy for this scourge of growing worldwide importance.[15]
Allergies
An allergic reaction, formally known as type 1 hypersensitivity, is the result of an inappropriate immune response triggering inflammation, vasodilation, and nerve irritation. A common example is hay fever, which is caused by a hypersensitive response by mast cells to allergens. Pre-sensitised mast cells respond by degranulating, releasing vasoactive chemicals such as histamine. These chemicals propagate an excessive inflammatory response characterised by blood vessel dilation, production of pro-inflammatory molecules, cytokine release, and recruitment of leukocytes.[7] Severe inflammatory response may mature into a systemic response known as anaphylaxis.
Other hypersensitivity reactions (type 2 and type 3) are mediated by antibody reactions and induce inflammation by attracting leukocytes that damage surrounding tissue.[7]
Myopathies
Inflammatory myopathies are caused by the immune system inappropriately attacking components of muscle, leading to signs of muscle inflammation. They may occur in conjunction with other immune disorders, such as systemic sclerosis, and include dermatomyositis, polymyositis, and inclusion body myositis.[7]
Leukocyte defects
Due to the central role of leukocytes in the development and propagation of inflammation, defects in leukocyte functionality often result in a decreased capacity for inflammatory defense with subsequent vulnerability to infection.[7] Dysfunctional leukocytes may be unable to correctly bind to blood vessels due to surface receptor mutations, digest bacteria (Chédiak–Higashi syndrome), or produce microbicides (chronic granulomatous disease). In addition, diseases affecting the bone marrow may result in abnormal or few leukocytes.
Pharmacological
Certain drugs or exogenous chemical compounds are known to affect inflammation. Vitamin A deficiency causes an increase in inflammatory responses,[16] and anti-inflammatory drugs work specifically by inhibiting the enzymes that produce inflammatory eicosanoids. Certain illicit drugs such as cocaine and ecstasy may exert some of their detrimental effects by activating transcription factors intimately involved with inflammation (e.g. NF-κB).[17][18]
Cancer
Inflammation orchestrates the microenvironment around tumours, contributing to proliferation, survival and migration.[19] Cancer cells use selectins, chemokines and their receptors for invasion, migration and metastasis.[20] On the other hand, many cells of the immune system contribute to cancer immunology, suppressing cancer.[21] Molecular intersection between receptors of steroid hormones, which have important effects on cellular development, and transcription factors that play key roles in inflammation, such as NF-κB, may mediate some of the most critical effects of inflammatory stimuli on cancer cells.[22] This capacity of a mediator of inflammation to influence the effects of steroid hormones in cells, is very likely to affect carcinogenesis on the one hand; on the other hand, due to the modular nature of many steroid hormone receptors, this interaction may offer ways to interfere with cancer progression, through targeting of a specific protein domain in a specific cell type. Such an approach may limit side effects that are unrelated to the tumor of interest, and may help preserve vital homeostatic functions and developmental processes in the organism.
According to a review of 2009, recent data suggests that cancer-related inflammation (CRI) may lead to accumulation of random genetic alterations in cancer cells.[23]
HIV and AIDS
It has long been recognized that infection with HIV is characterized not only by development of profound immunodeficiency but also by sustained inflammation and immune activation.[24][25][26] A substantial body of evidence implicates chronic inflammation as a critical driver of immune dysfunction, premature appearance of aging-related diseases, and immune deficiency.[24][27] Many now regard HIV infection not only as an evolving virus-induced immunodeficiency but also as chronic inflammatory disease.[28] Even after the introduction of effective antiretroviral therapy (ART) and effective suppression of viremia in HIV-infected individuals, chronic inflammation persists. Animal studies also support the relationship between immune activation and progressive cellular immune deficiency: SIVsm infection of its natural nonhuman primate hosts, the sooty mangabey, causes high-level viral replication but limited evidence of disease.[29][30] This lack of pathogenicity is accompanied by a lack of inflammation, immune activation and cellular proliferation. In sharp contrast, experimental SIVsm infection of rhesus macaque produces immune activation and AIDS-like disease with many parallels to human HIV infection.[31]
Delineating how CD4 T cells are depleted and how chronic inflammation and immune activation are induced lies at the heart of understanding HIV pathogenesis––one of the top priorities for HIV research by the Office of AIDS Research, National Institutes of Health. Recent studies demonstrated that caspase-1-mediated pyroptosis, a highly inflammatory form of programmed cell death, drives CD4 T-cell depletion and inflammation by HIV.[32][33][34] These are the two signature events that propel HIV disease progression to AIDS. Pyroptosis appears to create a pathogenic vicious cycle in which dying CD4 T cells and other immune cells (including macrophages and neutrophils) release inflammatory signals that recruit more cells into the infected lymphoid tissues to die. The feed-forward nature of this inflammatory response produces chronic inflammation and tissue injury.[35] Identifying pyroptosis as the predominant mechanism that causes CD4 T-cell depletion and chronic inflammation, provides novel therapeutic opportunities, namely caspase-1 which controls the pyroptotic pathway. In this regard, pyroptosis of CD4 T cells and secretion of pro-inflmammatory cytokines such as IL-1β and IL-18 can be blocked in HIV-infected human lymphoid tissues by addition of the caspase-1 inhibitor VX-765,[32] which has already proven to be safe and well tolerated in phase II human clinical trials.[36] These findings could propel development of an entirely new class of “anti-AIDS” therapies that act by targeting the host rather than the virus. Such agents would almost certainly be used in combination with ART. By promoting “tolerance” of the virus instead of suppressing its replication, VX-765 or related drugs may mimic the evolutionary solutions occurring in multiple monkey hosts (e.g. the sooty mangabey) infected with species-specific lentiviruses that have led to a lack of disease, no decline in CD4 T-cell counts, and no chronic inflammation.
Resolution of inflammation
The inflammatory response must be actively terminated when no longer needed to prevent unnecessary “bystander” damage to tissues.[7] Failure to do so results in chronic inflammation, and cellular destruction. Resolution of inflammation occurs by different mechanisms in different tissues. Mechanisms that serve to terminate inflammation include:[7][37]
Acute inflammation normally resolves by mechanisms that have remained somewhat elusive. Emerging evidence now suggests that an active, coordinated program of resolution initiates in the first few hours after an inflammatory response begins. After entering tissues, granulocytes promote the switch of arachidonic acid–derived prostaglandins and leukotrienes to lipoxins, which initiate the termination sequence. Neutrophil recruitment thus ceases and programmed death by apoptosis is engaged. These events coincide with the biosynthesis, from omega-3 polyunsaturated fatty acids, of resolvins and protectins, which critically shorten the period of neutrophil infiltration by initiating apoptosis. As a consequence, apoptotic neutrophils undergo phagocytosis by macrophages, leading to neutrophil clearance and release of anti-inflammatory and reparative cytokines such as transforming growth factor-β1. The anti-inflammatory program ends with the departure of macrophages through the lymphatics.[48]
”
— Charles Serhan
Connection to depression
There is evidence for a link between inflammation and depression.[49] Inflammatory processes can be triggered by negative cognitions or their consequences, such as stress, violence, or deprivation. Thus, negative cognitions can cause inflammation that can, in turn, lead to depression.[50][51][dubious– discuss] In addition there is increasing evidence that inflammation can cause depression because of the increase of cytokines, setting the brain into a “sickness mode”.[52] Classical symptoms of being physically sick like lethargy show a large overlap in behaviors that characterize depression. Levels of cytokines tend to increase sharply during depressive episodes in manics and drop off during remission.[53] Furthermore, it has been shown in clinical trials that anti-inflammatory medicines taken in addition to antidepressants not only significantly improves symptoms but also increases the proportion of subjects positively responding to treatment.[54] Inflammations that lead to serious depression could be caused by common infections such as those caused by a virus, bacteria or even parasites.[55]
Systemic effects
An infectious organism can escape the confines of the immediate tissue via the circulatory system or lymphatic system, where it may spread to other parts of the body. If an organism is not contained by the actions of acute inflammation it may gain access to the lymphatic system via nearby lymph vessels. An infection of the lymph vessels is known as lymphangitis, and infection of a lymph node is known as lymphadenitis. When lymph nodes cannot destroy all pathogens, the infection spreads further. A pathogen can gain access to the bloodstream through lymphatic drainage into the circulatory system.
When inflammation overwhelms the host, systemic inflammatory response syndrome is diagnosed. When it is due to infection, the term sepsis is applied, with the terms bacteremia being applied specifically for bacterial sepsis and viremia specifically to viral sepsis. Vasodilation and organ dysfunction are serious problems associated with widespread infection that may lead to septic shock and death.
Inflammation often affects the numbers of leukocytes present in the body:
Leukocytosis is often seen during inflammation induced by infection, where it results in a large increase in the amount of leukocytes in the blood, especially immature cells. Leukocyte numbers usually increase to between 15 000 and 20 000 cells per microliter, but extreme cases can see it approach 100 000 cells per microliter.[7] Bacterial infection usually results in an increase of neutrophils, creating neutrophilia, whereas diseases such as asthma, hay fever, and parasite infestation result in an increase in eosinophils, creating eosinophilia.[7]
With the discovery of interleukins (IL), the concept of systemic inflammation developed. Although the processes involved are identical to tissue inflammation, systemic inflammation is not confined to a particular tissue but involves the endothelium and other organ systems.
Chronic inflammation is widely observed in obesity.[56][57] The obese commonly have many elevated markers of inflammation, including:[58][59]
Low-grade chronic inflammation is characterized by a two- to threefold increase in the systemic concentrations of cytokines such as TNF-α, IL-6, and CRP.[62] Waist circumference correlates significantly with systemic inflammatory response.[63] A predominant factor in this correlation is due to the autoimmune response triggered by adiposity, whereby immune cells may mistake fatty deposits for intruders. The body attacks fat similar to bacteria and fungi. When expanded fat cells leak or break open, macrophages mobilize to clean up and embed into the adipose tissue. Then macrophages release inflammatory chemicals, including TNF-α and IL-6. TNF’s primary role is to regulate the immune cells and induce inflammation. White blood cells then assist by releasing more cytokines. This link between adiposity and inflammation has been shown to produce 10–35% of IL-6 in a resting individual, and this production increases with increasing adiposity.[64]
In the obese mouse models, inflammation and macrophage-specific genes are upregulated in white adipose tissue (WAT). There were also signs of dramatic increase in circulating insulin level, adipocyte lipolysis and formation of multinucleate giant cells.[66] The fat-derived protein called angiopoietin-like protein 2 (Angptl2) elevates in fat tissues. Higher than normal Angptl2 level in fat tissues develop inflammation as well as insulin and leptin resistance. Stored fat secretes Leptin to signal satiety. Leptin resistance plays a role in the process where appetite overrules the message of satiety. Angptl2 then starts an inflammatory cascade causing blood vessels to remodel and attract macrophages. Angptl2 is an adipocyte-derived inflammatory mediator linking obesity to systemic insulin resistance.[67] It is possible that, as an inflammatory marker, leptin responds specifically to adipose-derived inflammatory cytokines.
C-reactive protein (CRP) is generated at a higher level in obese people. It raises when there is inflammation throughout the body. Mild elevation in CRP increase risk of heart attacks, strokes, high blood pressure, muscle weakness and fragility.[citation needed]
Hyperglycemia induces IL-6 production from endothelial cells and macrophages.[68] Meals high in saturated fat, as well as meals high in calories have been associated with increases in inflammatory markers.[69][70]While the inflammatory responses are acute and arise in response to overeating, the response may become chronic if the overeating is chronic.
Bente Klarlund Pedersen wrote in 2013 that interstitial abdominal adiposity (also referred to as accumulated intra-abdominal fat) is a major and possibly primary factor in increasing systemic risk for multiple inflammatory diseases. However, she indicates that this is mediated via TNF-α, rather than Interleukin 6, which she identified as a myokine in 2003.[71] Dr. Pedersen concludes: “Until the beginning of this millennium, it was commonly thought that the increase in IL-6 during exercise was a consequence of an immune response due to local damage in the working muscles and it was hypothesized that macrophages were responsible for this increase. However, an early study demonstrated that IL-6 mRNA in monocytes did not increase as a result of exercise.”[72]
Dr. Pedersen continues (in the same article): “Patients with diabetes have a high protein expression of TNF-α in skeletal muscle and increased TNF-α levels in plasma, and it is likely that adipose tissue, which produces TNF-α, is the main source of the circulating TNF-α. In vitro studies demonstrate that TNF-α has direct inhibitory effects on insulin signaling. In addition, TNF-α infusion in healthy humans induces insulin resistance in skeletal muscle, without an effect on EGP [endogenous glucose production]. It has also been proposed that TNF-α causes insulin resistance indirectly in vivo by increasing the release of FFAs from adipose tissue. TNF-α increases lipolysis in human and 3T3-L1 adipocytes. However, TNF-α has no effect on muscle fatty acid oxidation, but increases fatty acid incorporation into diacylglycerol, which may be involved in the development of the TNF-α-induced insulin resistance in skeletal muscle. In addition, evidence suggests that TNF-α plays a direct role in linking insulin resistance to vascular disease. Moreover, in CVDs, activated immune cells also play major roles, particularly in the etiology of atherosclerosis. Importantly, also tumor initiation, promotion, and progression is stimulated by systemic elevation of proinflammatory cytokines.”[72]
Outcomes
Scars present on the skin, evidence of fibrosis and healing of a wound
The outcome in a particular circumstance will be determined by the tissue in which the injury has occurred and the injurious agent that is causing it. Here are the possible outcomes to inflammation:[7]
Resolution
The complete restoration of the inflamed tissue back to a normal status. Inflammatory measures such as vasodilation, chemical production, and leukocyte infiltration cease, and damaged parenchymal cells regenerate. In situations where limited or short-lived inflammation has occurred this is usually the outcome.
Fibrosis
Large amounts of tissue destruction, or damage in tissues unable to regenerate, cannot be regenerated completely by the body. Fibrous scarring occurs in these areas of damage, forming a scar composed primarily of collagen. The scar will not contain any specialized structures, such as parenchymal cells, hence functional impairment may occur.
Abscess formation
A cavity is formed containing pus, an opaque liquid containing dead white blood cells and bacteria with general debris from destroyed cells.
Chronic inflammation
In acute inflammation, if the injurious agent persists then chronic inflammation will ensue. This process, marked by inflammation lasting many days, months or even years, may lead to the formation of a chronic wound. Chronic inflammation is characterised by the dominating presence of macrophages in the injured tissue. These cells are powerful defensive agents of the body, but the toxins they release (including reactive oxygen species) are injurious to the organism’s own tissues as well as invading agents. As a consequence, chronic inflammation is almost always accompanied by tissue destruction.
Examples
Inflammation is usually indicated by adding the suffix “itis“, as shown below. However, some conditions such as asthma and pneumonia do not follow this convention. More examples are available at list of types of inflammation.
The Dietary Inflammatory Index (DII) is a score (number) that describes the potential of diet to modulate systemic inflammation within the body. As stated chronic inflammation is linked to most chronic diseases including arthritis, many types of cancer, cardiovascular diseases, inflammatory bowel diseases, and diabetes.[73]
It has been known for many decades both that inflammation is linked to health and that diet is a major determinant of inflammation. Until the invention of the DII by scientists led by James R. Hébert at the Statewide South Carolina Cancer Prevention and Control Program in the University of South Carolina,[74] no indicator of diet-related inflammation had ever been devised. The DII is unique among dietary indices in that it is based on results of studies published in the peer-reviewed literature and not any of the three methods typically used to create a dietary index; i.e., Basing it on 1) a particular cuisine or foodway (e.g., the Mediterranean, Macrobiotic or South Asian diet); 2) dietary guidelines (e.g., the Healthy Eating Index, which is based on the US Dietary Guidelines); or 3) results from a particular study (which reflect biases related to sample selection, response set biases such as social desirability). By contrast, the DII: 1) is grounded in peer-reviewed literature focusing specifically on inflammation (thus obviating idiosyncrasies of specific dietary assessment methods and limitations of exposure differences within populations); 2) can be adapted to virtually any dietary assessment method capable of providing estimates of nutrient intake; and 3) has been standardized to dietary intake from representative populations around the world, thus facilitating easy quantitative comparisons across studies.
Since its invention in 2004 and the publication of a now-defunct earlier-version of the DII in December 2009,[75] the DII went through a major overhaul, resulting in a new version that replaced the old version, published first on-line in 2013 and then in hard copy in 2014.[76] This new version is superior to the earlier one in a number of ways: 1) it is based on a larger, more robust literature (see Derivation/ Computation) of 1,943 (vs. 927) articles that were reviewed and scored; 2) creation of a global dataset based on intake measures from populations in 11 countries around the world, thus allowing comparison of results from studies conducted anywhere in the world; and 3) scoring such that lower, more negative, scores indicate anti-inflammation, while higher, more positive, scores are more pro-inflammatory.[76]
This new, improved version of the DII has been subjected to construct validation, which tested (and subsequently confirmed) its ability to predict blood levels of inflammatory markers. The first of these tests showed the DII could predict repeat measures of c-reactive protein (CRP) from the Seasonal Variation of Blood Cholesterol, an intensive follow-up study of 559 adult men and women conducted in Massachusetts.[77][78] The second, based on data from 2,567 women across the USA participating in the Women’s Health Initiative Observational Study from 1993–1998, showed the DII’s ability to predict levels of interleukin (IL)-6 and tumor necrosis factor-alpha receptor-2 (TNFα-R2) and a combined inflammatory biomarker score (consisting of IL-6, TNFα-R2, and CRP).[79] Subsequently, the DII has been shown to have positive associations with IL-6 and homocysteine in the Asklepios Study in Belgium,[80][81] CRP among police officers in Buffalo, NY, USA[82] and inversely correlated with SNP rs2243250 in IL-4 among controls in the Bellvitge Colorectal Cancer Study in Spain.[83]
Derivation and computation
Briefly, based on a search of the literature from 1950 to the end of 2010, 45 food parameters were identified among foods, nutrients, and other food components that were associated with 6 plasma inflammatory markers (IL-1β, IL-4, IL-6, IL-10, TNF-α and CRP). A specific article inflammatory effect score for each food parameter on the basis of the literature review and taking into account the quality and number of published papers (1,943 articles were reviewed and scored). For each study participant in a study, the dietary data is first linked to a global database that was developed based on 11 datasets from around the world (US – NHANES; UK – The National Diet & Nutrition Survey; Bahrain – National Nutrition Survey for Adult Bahrainis; Mexico – Mexican National Health and Nutrition Survey; Australia – National Nutrition Survey; South Korea – KNHANES; Taiwan – Nutrition and Health Survey in Taiwan; India – Indian Diet Study; New Zealand – National Nutrition Survey) and thus provides a robust estimate of the mean and the standard deviation of these 45 parameters.2 Each subject’s exposure relative to the “standard global mean” is expressed as a z-score that is derived by subtracting the “standard global mean” from the amount reported, and dividing this value by its standard deviation. To minimize the effect of “right skewing”, this value was then converted to a centered percentile score. The subject’s DII score was computed by multiplying these values by the specific article inflammatory effect score for each food parameter and then summing together all these 45 values according to the following formula, DII=b1*n1+b2*n2………..b45*n45, where bi refers to the literature-derived inflammatory effect score for each of the evaluated food parameter and ni refers to the food parameter-specific centered percentile, which were derived from the dietary data, per each i from 1 to 45.[76]
Accuracy
The DII is uniquely and strongly based on empirical evidence available in the peer-reviewed literature on the relationships between dietary factors and important inflammatory markers (see Derivation/ Computation). It is important to note, however, that, as an index that superimposes on a method of dietary assessment, the DII is dependent on the accuracy of the dietary assessment method used. The DII cannot make up for deficiencies/ inaccuracies in measuring dietary intake.
Disease prevention and causation
Besides studies focusing on markers of inflammation in blood, the DII has been associated with a large number of actual health outcomes including:
components of the metabolic syndrome, in a Spanish cohort[84] and among US police officers;[84]
lung cancer and other respiratory conditions in Italy;[86]
esophageal cancer in Sweden,[87] Italy,[88] and Iran;[89]
colorectal cancer, in two populations of US women,[90][91] Italian men and women,[92] men and women in the National Institutes of Health-American Association of Retired Persons Diet and Health Study[93] and a case-control study in Spain;[93]
female breast cancer in Germany[94] and Sweden;[95]
cardiovascular diseases, in the PREvencio´n con DIeta MEDiterra´nea (PREDIMED) Trial[99] and the Seguimiento Universidad de Navarra (SUN) cohort[100] in Spain, and a follow-up study of Australian men;[101]
Besides dietary factors, physical activity, fitness, sleep, shift work, and stress can affect inflammation. Also, there are auto-immune and other conditions that can influence inflammation. It has been shown that these other factors also may be related to the DII.[107]
Advantages and disadvantages of the DII
Advantages of the DII over other indices include that it: 1) focuses on a particular and very important mechanism of how dietary components affect health through inflammation; 2) is grounded in peer-reviewed literature focusing specifically on inflammatory markers known to affect health well-being; 3) can be adapted to virtually any dietary assessment method that provides estimates of nutrient intake; and 4) is standardized to dietary intake from representative populations around the world, thus facilitating easy quantitative comparisons across studies.
Disadvantages include that: 1) it is dependent on the quality of the dietary assessment upon which the computation is based (it cannot make up for deficiencies in the methods of obtaining the dietary data); and 2) it is not focused specifically on other effects of diet, though it is correlated (r (correlation coefficient) around │0.50│) with other diet indices that purport to assess diet quality.[84][103][108]
Criticism and alternatives
Criticisms include that the DII is not up to date. It must be noted that though the index was refined by the inclusion of three more years (from 2008 through 2010) of publications and more than doubling of the literature base, no major change in the overall thrust of the literature base was evident.
Exercise and inflammation
Exercise-induced acute inflammation
Acute inflammation of the muscle cells, as understood in exercise physiology,[109] can result after inducedeccentric and concentric muscle training. Participation in eccentric training and conditioning, including resistance training and activities that emphasize eccentric lengthening of the muscle including downhill running on a moderate to high incline can result in considerable soreness within 24 to 48 hours, even though blood lactate levels, previously thought to cause muscle soreness, were much higher with level running. This delayed onset muscle soreness (DOMS) results from structural damage to the contractile filaments and z-disks, which has been noted especially in marathon runners whose muscle fibers revealed remarkable damage to the muscle fibers after both training and marathon competition[citation needed]. The onset and timing of this gradient damage to the muscle parallels the degree of muscle soreness experienced by the runners.
Z-disks are the point of contact for the contractile proteins. They provide structural support for transmission of force when muscle fibers are activated to shorten. However, in marathon runners and those who subscribe to the overload principle to enhance their muscles, show moderate Z-disk streaming and major disruption of thick and thin filaments in parallel groups of sarcomeres as a result of the force of eccentric actions or stretching of tightened muscle fibers.
This disruption of muscle fibers triggers white blood cells to increase following induced muscle soreness, leading to the inflammatory response observation from induced muscle soreness. Elevations in plasma enzymes, myoglobinemia, and abnormal muscle histology and ultrastructure are concluded to be associated with inflammatory response. High tension in the contractile-elastic system of muscle results in structural damage to the muscle fiber and plasmalemma and its epimysium, perimysium, and/or endomysium. The mysium damage disrupts calcium homeostasis in injured fibers and fiber bundles, resulting in necrosis that peaks about 48 hours after exercise. The products of macrophage activity and intracellular contents (such as histamines, kinins, and K+) accumulate outside cells. These substances then stimulate free nerve endings in the muscle; a process that appears accentuated by eccentric exercise, in which large forces are distributed over a relatively small cross-sectional area of the muscle[citation needed].
Post-inflammatory muscle growth and repair
There is a known relationship between inflammation and muscle growth.[110] For instance, high doses of anti-inflammatory medicines (e.g., NSAIDs) are able to blunt muscle growth.[111][112] Cold therapy has been shown to negatively affect muscle growth as well. Reducing inflammation results in decreased macrophage activity and lower levels of IGF-1[113] Acute effects of cold therapy on training adaptations show reduced satellite cell proliferation.[114] Long term effects include less muscular hypertrophy and an altered cell structure of muscle fibers.[115]
It has been further theorized that the acute localized inflammatory responses to muscular contraction during exercise, as described above, are a necessary precursor to muscle growth.[116] As a response to muscular contractions, the acute inflammatory response initiates the breakdown and removal of damaged muscle tissue.[117] Muscles can synthesize cytokines in response to contractions,[118][119][120] such that the cytokines interleukin-1 beta (IL-1β), TNF-α, and IL-6 are expressed in skeletal muscle up to 5 days after exercise.[117]
In particular, the increase in levels of IL-6 (interleukin 6), a myokine, can reach up to one hundred times that of resting levels.[120] Depending on volume, intensity, and other training factors, the IL-6 increase associated with training initiates about 4 hours after resistance training and remains elevated for up to 24 hours.[121][122][123]
These acute increases in cytokines, as a response to muscle contractions, help initiate the process of muscle repair and growth by activating satellite cells within the inflamed muscle. Satellite cells are crucial for skeletal muscle adaptation to exercise.[124] They contribute to hypertrophy by providing new myonuclei and repair damaged segments of mature myofibers for successful regeneration following injury- or exercise-induced muscle damage;[125][126][127] high-level powerlifters can have up to 100% more satellite cells than untrained controls.[128][129]
A rapid and transient localization of the IL-6 receptor and increased IL-6 expression occurs in satellite cells following contractions.[121] IL-6 has been shown to mediate hypertrophic muscle growth both in vitro and in vivo.[124] Unaccustomed exercise can increase IL-6 by up to sixfold at 5 hours post-exercise and threefold 8 days after exercise.[130] Also telling is the fact that NSAIDs can decrease satellite cell response to exercise,[111] thereby reducing exercise-induced protein synthesis.[112]
The increase in cytokines (myokines) after resistance exercise coincides with the decrease in levels of myostatin, a protein that inhibits muscle differentiation and growth.[123] The cytokine response to resistance exercise and moderate-intensity running occur differently, with the latter causing a more prolonged response, especially at the 12–24 hour mark.[123]
Developing research has demonstrated that many of the benefits of exercise are mediated through the role of skeletal muscle as an endocrine organ. That is, contracting muscles release multiple substances known as myokines, including but not limited to those cited in the above description, which promote the growth of new tissue, tissue repair, and various anti-inflammatory functions, which in turn reduce the risk of developing various inflammatory diseases. The new view that muscle is an endocrine organ is transforming our understanding of exercise physiology and with it, of the role of inflammation in adaptation to stress.[72]
Chronic inflammation and muscle loss
Both chronic and extreme inflammation are associated with disruptions of anabolic signals initiating muscle growth. Chronic inflammation has been implicated as part of the cause of the muscle loss that occurs with aging.[110][131] Increased protein levels of myostatin have been described in patients with diseases characterized by chronic low-grade inflammation.[132] Increased levels of TNF-α can suppress the AKT/mTOR pathway, a crucial pathway for regulating skeletal muscle hypertrophy,[133] thereby increasing muscle catabolism.[134][135][136] Cytokines may antagonize the anabolic effects of insulin-like growth factor 1 (IGF-1).[137][138] In the case of sepsis, an extreme whole body inflammatory state, the synthesis of both myofibrillar and sarcoplasmic proteins are inhibited, with the inhibition taking place preferentially in fast-twitch muscle fibers.[137][139] Sepsis is also able to prevent leucine from stimulating muscle protein synthesis.[118] In animal models, when inflammation is created, mTOR loses its ability to be stimulated by muscle growth.[140]
Exercise as a treatment for inflammation
Regular physical activity is reported to decrease markers of inflammation,[141][142][143] although the correlation is imperfect and seems to reveal differing results contingent upon training intensity. For instance, while baseline measurements of circulating inflammatory markers do not seem to differ greatly between healthy trained and untrained adults,[144][145] long-term training may help reduce chronic low-grade inflammation.[146]On the other hand, levels of the anti-inflammatory myokine IL-6 (interleukin 6) remained elevated longer into the recovery period following an acute bout of exercise in patients with inflammatory diseases, relative to the recovery of healthy controls.[146] It may well be that low-intensity training can reduce resting pro-inflammatory markers (CRP, IL-6), while moderate-intensity training has milder and less-established anti-inflammatory benefits.[144][147][148][149] There is a strong relationship between exhaustive exercise and chronic low-grade inflammation.[150] Marathon running may enhance IL-6 levels as much as 100 times over normal and increases total leuckocyte count and neturophil mobilization.[150]
Regarding the above, IL-6 had previously been classified as a proinflammatory cytokine. Therefore, it was first thought that the exercise-induced IL-6 response was related to muscle damage.[151] However, it has become evident that eccentric exercise is not associated with a larger increase in plasma IL-6 than exercise involving concentric “nondamaging” muscle contractions. This finding clearly demonstrates that muscle damage is not required to provoke an increase in plasma IL-6 during exercise. As a matter of fact, eccentric exercise may result in a delayed peak and a much slower decrease of plasma IL-6 during recovery.[152]
Recent work has shown that both upstream and downstream signalling pathways for IL-6 differ markedly between myocytes and macrophages. It appears that unlike IL-6 signalling in macrophages, which is dependent upon activation of the NFκB signalling pathway, intramuscular IL-6 expression is regulated by a network of signalling cascades, including the Ca2+/NFAT and glycogen/p38 MAPK pathways. Thus, when IL-6 is signalling in monocytes or macrophages, it creates a pro-inflammatory response, whereas IL-6 activation and signalling in muscle is totally independent of a preceding TNF-response or NFκB activation, and is anti-inflammatory.[153]
Several studies show that markers of inflammation are reduced following longer-term behavioural changes involving both reduced energy intake and a regular program of increased physical activity, and that, in particular, IL-6 was miscast as an inflammatory marker. For example, the anti-inflammatory effects of IL-6 have been demonstrated by IL-6 stimulating the production of the classical anti-inflammatory cytokines IL-1ra and IL-10.[153] As such, individuals pursuing exercise as a means to treat the causal factors underlying chronic inflammation are pursuing a course of action strongly supported by current research, as an inactive lifestyle is strongly associated with the development and progression of multiple inflammatory diseases. Note that cautions regarding over-exertion may apply in certain cases, as discussed above, though this concern rarely applies to the general population.
Signal-to-noise theory
Given that localized acute inflammation is a necessary component for muscle growth, and that chronic low-grade inflammation is associated with a disruption of anabolic signals initiating muscle growth, it has been theorized that a signal-to-noise model may best describe the relationship between inflammation and muscle growth.[154] By keeping the “noise” of chronic inflammation to a minimum, the localized acute inflammatory response signals a stronger anabolic response than could be achieved with higher levels of chronic inflammation.
Non-steroidal anti-inflammatory drugs (NSAIDs) alleviate pain by counteracting the cyclooxygenase (COX) enzyme. On its own, COX enzyme synthesizes prostaglandins, creating inflammation. In whole, the NSAIDs prevent the prostaglandins from ever being synthesized, reducing or eliminating the pain.
Some common examples of NSAIDs are aspirin, ibuprofen, and naproxen. The newer specific COX-inhibitors are not classified together with the traditional NSAIDs even though they presumably share the same mode of action.
On the other hand, there are analgesics that are commonly associated with anti-inflammatory drugs but that have no anti-inflammatory effects. An example is paracetamol (known as acetaminophen in the U.S). As opposed to NSAIDs, which reduce pain and inflammation by inhibiting COX enzymes, paracetamol has – as early as 2006 – been shown to block the reuptake of endocannabinoids,[1][2] which only reduces pain, likely explaining why it has minimal effect on inflammation; paracetamol is sometimes combined with an NSAID (in place of an opioid) in clinical practice to enhance the pain relief of the NSAID while still receiving the injury/disease modulating effect of NSAID-induced inflammation reduction (which is not received from opioid/paracetamol combinations).[3]
Side-effects
Long-term use of NSAIDs can cause gastric erosions, which can become stomach ulcers and in extreme cases can cause severe haemorrhage, resulting in death. The risk of death as a result of GI bleeding caused by the use of NSAIDs is 1 in 12,000 for adults aged 16–45.[4] The risk increases almost twentyfold for those over 75.[4] Other dangers of NSAIDs are exacerbating asthma and causing kidney damage.[4] Apart from aspirin, prescription and over-the-counter NSAIDs also increase the risk of myocardial infarction and stroke.[5]
ImSAIDs are a class of peptides being developed by IMULAN BioTherapeutics, LLC, which were discovered to have diverse biological properties, including anti-inflammatory properties. ImSAIDs work by altering the activation and migration of inflammatory cells, which are immune cells responsible for amplifying the inflammatory response.[10][11] The ImSAIDs represent a new category of anti-inflammatory and are unrelated to steroid hormones or non-steroidal anti-inflammatories.
The ImSAIDs were discovered by scientists evaluating biological properties of the submandibular gland and saliva. Early work in this area demonstrated that the submandibular gland released a host of factors that regulate systemic inflammatory responses and modulate systemic immune and inflammatory reactions. It is now well accepted that the immune, nervous, and endocrine systems communicate and interact to control and modulate inflammation and tissue repair. One of the neuroendocrine pathways, when activated, results in the release of immune-regulating peptides from the submandibular gland upon neuronal stimulation from sympathetic nerves. This pathway or communication is referred to as the cervical sympathetic trunk-submandibular gland (CST-SMG) axis, a regulatory system that plays a role in the systemic control of inflammation.[12]
Early work in identifying factors that played a role in the CST-SMG axis lead to the discovery of a seven amino acidpeptide, called the submandibular gland peptide-T. SGP-T was demonstrated to have biological activity and thermoregulatory properties related to endotoxin exposure.[13] SGP-T, an isolate of the submandibular gland, demonstrated its immunoregulatory properties and potential role in modulating the cervical sympathetic trunk-submandibular gland (CST-SMG) axis, and subsequently was shown to play an important role in the control of inflammation.
One SGP-T derivative is a three-amino acid sequence shown to be a potent anti-inflammatory molecule with systemic effects. This three-amino acid peptide is phenylalanine–glutamine–glycine (FEG) and its D-isomeric form (feG) have become the foundation for the ImSAID category.[14] Cellular Effects of feG: The cellular effects of the ImSAIDs are characterized in a number of publications. feG and related peptides are known to modulate leukocyte (white blood cells) activity by influencing cell surface receptors to inhibit excessive activation and tissue infiltration.
One lead ImSAID, the tripeptide FEG (Phe-Glu-Gly) and its D-isomer feG are known to alter leukocyte adhesion involving actions on αMβ2 integrin, and inhibit the binding of CD16b (FCyRIII) antibody to human neutrophils.[15] feG has also been shown to decrease circulating neutrophil and eosinophil accumulation, decrease intracellular oxidative activity, and reduce the expression of CD49d after antigen exposure.[16][17][18]
Bioactive compounds
Many bioactive compounds showed anti-inflammatory activities on albino rat. Anti-inflammatory activity of Plumbago zeylanica consists of Bioactive compound Plumbagin showed high activity in very low concentration.[19] More recently plumericin from the Amazonian plant Himatanthus sucuuba has been described as a potent anti-inflammatory agent in vitro and in vivo.[20]
Long-term effects
Anti-inflammatory treatment trials for existing Alzheimer’s disease have typically shown little to no effect on halting or reversing the disease.[21][22] Research and clinical trials continue.[23] Two studies from 2012 and 2013 found regular use of aspirin for over ten years is associated with an increase in the risk of macular degeneration.[24][25]
Ice treatment
Applying ice, or even cool water, to a tissue injury has an anti-inflammatory effect and is often suggested as an injury treatment and pain management technique for athletes. One common approach is rest, ice, compression and elevation. Cool temperatures inhibit local blood circulation, which reduces swelling in the injured tissue.
Coal tar has been used for centuries for its anti-inflammatory and analgesic effects. Oral administration for central effects is now rare as coal tar also contains a range of dangerous and carcinogenic compounds, and does not allow for the administration of standardized doses, although some doctors readily utilize coal tar preparations for topical administration (ex. Denorex, Psoriasin) in the treatment of skin conditions such as eczema and atopic dermatitis. Many modern analgesics and anti-inflammatory agents (ex. paracetamol, and its previously used predecessor phenacetin) are derived from compounds which were originally discovered during studies to elucidate the chemicals responsible for the tars reputed health benefits.[29][30]
Prostaglandins are hormone-like substances that affect the body in variety of ways, also regulating inflammatory mediation. An anti-flammatory diet includes fewer foods that create inflammation-causing prostaglandins (PGE2) in the body, and more foods that create anti-inflammatory prostaglandins (PGE1 and PGE3).[31][not in citation given]
Suggested diets to reduce inflammation include those rich in vegetables and low in simple carbohydrates and fats, such as saturated fats and trans fats.[32] Anti-inflammatory foods include most colorful fruits and vegetables, oily fish (which contain higher levels of omega-3 fatty acids), nuts, seeds, and certain spices, such as ginger, garlic and cayenne. Extra-virgin olive oil contains the chemical oleocanthal that acts similarly to ibuprofen. Those following an anti-inflammatory diet will avoid refined oils and sugars, and show a preference for so-called anti-inflammatory foods in their meal choices.[33][34]
Omega-3 fatty acids have been shown to disrupt inflammation cell signaling pathways by binding to the GPR120 receptor.[35] This benefit however can be inhibited or even reversed if the ratio of Omega-6/Omega-3 is too high as Omega-6 serves as a precursor to inflammatory chemicals (prostaglandin and leukotriene eicosanoids) in the body.[36][37] A high proportion of omega-6 to omega-3 fat in the diet shifts the physiological state in the tissues toward the pathogenesis of many diseases: prothrombotic, proinflammatory and proconstrictive.[36] Omega-6 competes with Omega-3 for the same rate limiting factor which is required for the health-benefits of Omega-3, directly reducing the action of Omega-3 in addition to pharmacologically counteracting Omega-3 benefits through its own action as a pro-inflammatory agent.
Developing research has demonstrated that many of the benefits of exercise are mediated through the role of skeletal muscle as an endocrine organ. That is, contracting muscles release multiple substances known as myokines which promote the growth of new tissue, tissue repair, and various anti-inflammatory functions, which in turn reduce the risk of developing various inflammatory diseases.[38]
Interactions with NSAIDs
Patients on NSAIDs should seek to avoid excessive consumption of Omega-6 containing foods. Although many such foods contain the anti-inflammatory Omega-3 as well, low doses of Omega-6 interfere with Omega-3’s ability to reduce inflammation, while higher doses are capable of completely inhibiting the effects of most currently-used anti-inflammatory agents (cyclooxygenase 1 inhibitors, cyclooxygenase 2 inhibitors, and antileukotrienes).[39][40][41]
The concomitant use of NSAIDs with alcohol and/or tobacco products significantly increases the already elevated risk of peptic ulcers during NSAID therapy.[42]
NSAID painkillers may interfere with and reduce the efficacy of SSRI antidepressants through inhibiting TNFα and IFNγ, both of which are cytokine derivatives.[43]
Scott Carl Sigler is a contemporary American author of science fiction and horror as well as an avid podcaster. Scott is the New York Times #1 bestselling author of sixteen novels, six novellas, and dozens of short stories. He is the co-founder of Empty Set Entertainment, which publishes his young adult Galactic Football League series. He lives in San Diego.
Life and work
Raised in Cheboygan, Michigan Sigler’s father passed his love of classic monster films along to his son. His mother, a school teacher, encouraged his reading offering him any book he wanted.[1] Sigler wrote his first monster story, “Tentacles”, at the age of eight.[2] Sigler didn’t travel far for college having attended Olivet College (Olivet, MI) and Cleary College (Ann Arbor, MI) where he earned a BA in Journalism and a BS in Marketing. Scott has had a varied career path having worked fast food, picking fruit, shoveling horse manure, a sports reporter, director of marketing for a software company, software startup founder, marketing consultant, guitar salesman, bum in a rock band,[3] and currently as a social media strategist. He now resides in San Diego, California with his dog, Reesie.
EarthCore was originally published in 2001 by iPublish, an AOL/Time Warner imprint.[4] With the novel doing well as a promotional ebook, Time Warner was planning on publishing the novel. With the economic slump following September 11, 2001 terrorist attacks, Time Warner did away with the imprint in 2004. Scott then decided to start podcasting his novel in March, 2005 as the world’s first podcast-only novel[5] to build hype and garner an audience for his work. Sigler considered it a “no brainer” to offer the book as a free audio download. Having searched for podcast novels and finding none, Sigler decided to be the first.[6][7] Sigler was able to get EarthCore offered as a paid download on iTunes in 2006.[8] After EarthCore’s success (EarthCore had over 10,000 subscribers[9]), Sigler released Ancestor, Infected, The Rookie, Nocturnal, and Contagious via podcast.[10]
Sigler released an Adobe PDF version of Ancestor in March 2007 through Sigler’s own podcast as well as others. Ancestor was released on April 1, 2007 to much internet hype and, despite having been released two weeks earlier as a free ebook, reached #7 on Amazon.com‘s best-seller list and #1 on Sci-Fi, Horror and Genre-Fiction on the day of release.[11] Sigler is leveraging new media to keep in-touch with his fans, regularly talking with them using social networking sites, via email, and IM. Scott Sigler was featured in a New York Times article on March 1, 2007 by Andrew Adam Newman, which was covering authors using podcasting innovations to garner a broader audience.[12]
In March 2014, Executive Editor Mark Tavani at Ballantine Bantam Dell bought World Rights to a science fiction trilogy by Sigler. In the first book, Alive, a young woman awakes trapped in a confined space with no idea who she is or how she got there. She soon frees other young adults in the room and together they find that they are surrounded by the horrifying remains of a war long past … and matched against an enemy too horrible to imagine. Further adventures will follow in two more books, Alight and Alone. The books will be published under the Del Rey imprint.[13] On Wednesday, July 15, 2016, it was announced that Alive made #1 on the New York Times Bestseller list in the Young Adult E-Book category.[14]
Sigler calls Stephen King a “‘master craftsman’, who writes from the ‘regular guy’ strata from which he hails. His older stuff had no pretense, no ‘higher message,’ no ‘I’m extremely important’ attitude, just rock-solid storytelling and character development. He also would whack any character at any time, and that’s what hooked you in – when characters got into trouble, you didn’t know if they’d live, unlike 99% of the books out there that are trying to develop franchise characters.” According to Sigler, Jack London‘s “The Sea Wolf totally changed my views on life”. Sigler saw King Kong (1976 version) when he was a little kid. He said it, “Scared the crap out of me. I hid behind my dad’s shoulder and begged to leave the theatre. As soon as we were out, I asked when we could see it again – that was the moment I knew I wanted to tell monster stories. I wanted to have that same impact on other people.”
Awards
Sigler has been a runner up in both the 2006 and 2007 Parsec Awards. In 2006 Sigler was a runner up for his short story Hero in the Best Fiction (Short) category and for Infected in the Best Fiction (Long) category. In 2007 Sigler was a runner up for The Rookie in the Best Speculative Fiction Story (Novel Form) category. In 2008 Sigler’s Contagious, the sequel to Infected was listed at 33 on the New York Times best sellers list.
In 2008 Sigler broke through and won the Parsec Award for Red Man in the Best Speculative Fiction Story (Short Form) category. He followed up with another win in 2009 for Eusocial Networking in the Best Speculative Fiction Story (Novella Form) category. 2010 saw him continue to win in the Best Speculative Fiction Story (Short Form) category with his podcast, The Tank, and in 2011 he again took out the Best Speculative Fiction Story (Novella Form) category with Kissyman & the Gentleman.
On July 31, 2015, Scott was inducted into the inaugural class of the Academy of Podcasters Hall of Fame at a ceremony in Fort Worth, Texas.[15]
See the Scott Sigler bibliography page for more detailed information about the above novels and his many other works, including novellas related to the Galactic Football League series, short story collections, other short stories, upcoming projects, etc.
Adaptations
Film
In May, 2007 the novel Infected was optioned by Rogue Pictures and Random House Films;[17] however, the option lapsed in April 2010.[citation needed] The short story Sacred Cow was made into an online only mini-film by StrangerThings.tv and was Stranger Things debut episode.[18] “Cheating Bastard”, a short film about a couple in love with football and their obsession with it, was created by Brent Weichsel and released via Sigler’s RSS feed.
Graphic novel
In 2010 work began on a graphic novel adaptation of Sigler’s Infected.[19] The first issue was released August 1, 2012,[20]but the series was put on hold indefinitely due to delays with subsequent issues.[21]
Recordings
Albums
The Crucible (2016) by Separation Of Sanity. Scott’s original spoken word appears on four tracks: The Pact, Pandemic (inspired by his novel of the same name), Bag Of Blood (his major appearance on the album), and End Of Days.
Readings
Scott reads Union Dues – Off White Lies by Jeffrey R. DeRego on Escape Pod, Episode 49, on April 13, 2006.
Scott reads Reggie vs. Kaiju Storm Chimera Wolf by Matthew Wayne Selznick on Escape Pod, Episode 117, on August 2, 2007.
The Pronk Pops Show 551, October 12, 2015, Story 1: President Obama Stalls Islamic State While He Runs Out The Clock On His Failed Presidency — Who is next? President Trump — Obama A Real Loser — Leading On Climate Change — Give Me A Break! — Videos
60 Minutes in 60 Seconds (Day 36)
Obama talks Russia’s escalation in Syria on “60 Minutes”
“60 Minutes” interview: President Obama
Dr David Evans on Global Warming
50 to 1 Project – David Evans Interview
Freeman Dyson on the Global Warming Hysteria April, 2015
High Hopes and Missed Opportunities in Iraq
Emma Sky: “The Unraveling”
Reflections on the Future of War with Gen. Raymond Odierno
Thomas Barnett: Rethinking America’s military strategy
Donald Trump Iran Deal FULL SPEECH, Against Iran Nuclear Agreement at Tea Party Rally Sept. 9, 2015
The Iran Nuclear Deal
Iran and the Bomb
Climate Change in 12 Minutes – The Skeptic’s Case
Climategate: What They Aren’t Telling You!
Krauthammer: ‘Sputtering’ Obama Admin Has No Idea What to Do About Russia, Syria
Donald Trump Fox & Friends RIPS Obama 60 Minute Interview & Biden’s Low Poll Numbers FULL Interview
Donald trump Meet The Press FULL Interview 10/4/2015
60 Minutes Host Destroys Barack Obama On Syria
60 Minutes Host Embarrasses Barack Obama On Syria II
Background Articles and Videos
MAJOR REDUCTIONS IN CARBON EMISSIONS ARE NOT WORTH THE MONEY DEBATE: PETER HUBER
MAJOR REDUCTIONS IN CARBON EMISSIONS ARE NOT WORTH THE MONEY DEBATE: PHILIP STOTT
Professor Fred Singer on Climate Change Pt 1
Professor Fred Singer on Climate Change Pt 2
Global Warming, Lysenkoism & Eugenics Prof Richard Lindzen
Interview with Professor Richard Lindzen
Richard Lindzen, Ph.D. Lecture Deconstructs Global Warming Hysteria (High Quality Version)
Global Warming – Michael Crichton
Michael Crichton | States of Fear: Science or Politics?
Dr Roy Spencer on Global Warming Part 1 of 6
Dr Roy Spencer on Global Warming Part 2 of 6
Dr Roy Spencer on Global Warming Part 3 of 6
Dr Roy Spencer on Global Warming Part 4 of 6
Dr Roy Spencer on Global Warming Part 5 of 6
Dr Roy Spencer on Global Warming Part 6 of 6
Global warming and the Carbon Tax Scam
The Great Global Warming Swindle Full Movie
Global Warming: How Hot Air and Bad Science Will Give YOU Staggeringly Higher Taxes and Prices
Sen. Inhofe To Investigate ClimateGate
Lou Dobbs: ‘Who The Hell Does The President Think He Is?’
The Free-Market Case for Green
ManBearPig, Climategate and Watermelons: A conversation with author James Delingpole
James Delingpole: Great Britain, the Green Movement, and the End of the World
George Carlin on Global Warming
Americans Skeptical of Science Behind Global Warming
“…Most Americans (52%) believe that there continues to be significant disagreement within the scientific community over global warming.
While many advocates of aggressive policy responses to global warming say a consensus exists, the latest Rasmussen Reports national telephone survey finds that just 25% of adults think most scientists agree on the topic. Twenty-three percent (23%) are not sure. …”
Steve Kroft: The last time we talked was this time last year, and the situation in Syria and Iraq had begun to worsen vis-Ã -vis ISIS. You had just unveiled a plan to provide air support for troops in Iraq, and also some air strikes in Syria, and the training and equipping of a moderate Syrian force. You said that this would degrade and eventually destroy ISIS.
President Barack Obama: Over time.
Steve Kroft: Over time. It’s been a year, and–
President Barack Obama: I didn’t say it was going to be done in a year.
Steve Kroft: No. But you said…
President Barack Obama: There’s a question in here somewhere.
…
Steve Kroft: Who’s going to get rid of them?
President Barack Obama: Over time, the community of nations will all get rid of them, and we will be leading getting rid of them. But we are not going to be able to get rid of them unless there is an environment inside of Syria and in portions of Iraq in which local populations, local Sunni populations, are working in a concerted way with us to get rid of them.
On the “moderate opposition” in Syria:
Steve Kroft: You have been talking about the moderate opposition in Syria. It seems very hard to identify. And you talked about the frustrations of trying to find some and train them. You got a half a billion dollars from Congress to train and equip 5,000, and at the end, according to the commander CENTCOM, you got 50 people, most of whom are dead or deserted. He said four or five left?
President Barack Obama: Steve, this is why I’ve been skeptical from the get go about the notion that we were going to effectively create this proxy army inside of Syria. My goal has been to try to test the proposition, can we be able to train and equip a moderate opposition that’s willing to fight ISIL? And what we’ve learned is that as long as Assad remains in power, it is very difficult to get those folks to focus their attention on ISIL.
Steve Kroft: If you were skeptical of the program to find and identify, train and equip moderate Syrians, why did you go through the program?
President Barack Obama: Well, because part of what we have to do here, Steve, is to try different things. Because we also have partners on the ground that are invested and interested in seeing some sort of resolution to this problem. And–
Steve Kroft: And they wanted you to do it.
President Barack Obama: Well, no. That’s not what I said. I think it is important for us to make sure that we explore all the various options that are available.
Steve Kroft: I know you don’t want to talk about this.
President Barack Obama: No, I’m happy to talk about it.
Steve Kroft: I want to talk about the– this program, because it would seem to show, I mean, if you expect 5,000 and you get five, it shows that somebody someplace along the line did not– made– you know, some sort of a serious miscalculation.
President Barack Obama: You know, the– the– Steve, let me just say this.
Steve Kroft: It’s an embarrassment.
President Barack Obama: Look, there’s no doubt that it did not work. And, one of the challenges that I’ve had throughout this heartbreaking situation inside of Syria is, is that– you’ll have people insist that, you know, all you have to do is send in a few– you know, truckloads full of arms and people are ready to fight. And then, when you start a train-and-equip program and it doesn’t work, then people say, “Well, why didn’t it work?” Or, “If it had just started three months earlier it would’ve worked.”
Steve Kroft: But you said yourself you never believed in this.
President Barack Obama: Well– but Steve, what I have also said is, is that surprisingly enough it turns out that in a situation that is as volatile and with as many players as there are inside of Syria, there aren’t any silver bullets. And this is precisely why I’ve been very clear that America’s priorities has to be number one, keeping the American people safe. Number two, we are prepared to work both diplomatically and where we can to support moderate opposition that can help convince the Russians and Iranians to put pressure on Assad for a transition. But that what we are not going to do is to try to reinsert ourselves in a military campaign inside of Syria. Let’s take the situation in Afghanistan, which I suspect you’ll ask about. But I wanted to use this as an example.
Steve Kroft: All right. I feel like I’m being filibustered, Mr. President.
President Barack Obama: No, no, no, no, no. Steve, I think if you want to roll back the tape, you’ve been giving me long questions and statements, and now I’m responding to ’em. So let’s– so– if you ask me big, open-ended questions, expect big, open-ended answers. Let’s take the example of Afghanistan. We’ve been there 13 years now close to 13 years. And it’s still hard in Afghanistan. Today, after all the investments we have there, and we still have thousands of troops there. So the notion that after a year in Syria, a country where the existing government hasn’t invited us in, but is actively keeping us out, that somehow we would be able to solve this quickly– is–
Steve Kroft: We didn’t say quickly.
President Barack Obama: –is– is– is an illusion. And– and–
Steve Kroft: Nobody’s expecting that, Mr. President.
President Barack Obama: Well, the– no, I understand, but what I’m– the simple point I’m making, Steve, is that the solution that we’re going to have inside of Syria is ultimately going to depend not on the United States putting in a bunch of troops there, resolving the underlying crisis is going to be something that requires ultimately the key players there to recognize that there has to be a transition to new government. And, in the absence of that, it’s not going to work.
On Russia:
Steve Kroft: One of the key players now is Russia.
President Barack Obama: Yeah.
Steve Kroft: A year ago when we did this interview, there was some saber-rattling between the United States and Russia on the Ukrainian border. Now it’s also going on in Syria. You said a year ago that the United States– America leads. We’re the indispensible nation. Mr. Putin seems to be challenging that leadership.
President Barack Obama: In what way? Let– let’s think about this– let– let–
Steve Kroft: Well, he’s moved troops into Syria, for one. He’s got people on the ground. Two, the Russians are conducting military operations in the Middle East for the first time since World War II–
President Barack Obama: So that’s–
Steve Kroft: –bombing the people– that we are supporting.
President Barack Obama: So that’s leading, Steve? Let me ask you this question. When I came into office, Ukraine was governed by a corrupt ruler who was a stooge of Mr. Putin. Syria was Russia’s only ally in the region. And today, rather than being able to count on their support and maintain the base they had in Syria, which they’ve had for a long time, Mr. Putin now is devoting his own troops, his own military, just to barely hold together by a thread his sole ally. And in Ukraine–
Steve Kroft: He’s challenging your leadership, Mr. President. He’s challenging your leadership–
President Barack Obama: Well Steve, I got to tell you, if you think that running your economy into the ground and having to send troops in in order to prop up your only ally is leadership, then we’ve got a different definition of leadership. My definition of leadership would be leading on climate change, an international accord that potentially we’ll get in Paris. My definition of leadership is mobilizing the entire world community to make sure that Iran doesn’t get a nuclear weapon. And with respect to the Middle East, we’ve got a 60-country coalition that isn’t suddenly lining up around Russia’s strategy. To the contrary, they are arguing that, in fact, that strategy will not work.
Steve Kroft: My point is– was not that he was leading, my point is that he was challenging your leadership. And he has very much involved himself in the situation. Can you imagine anything happening in Syria of any significance at all without the Russians now being involved in it and having a part of it?
President Barack Obama: But that was true before. Keep in mind that for the last five years, the Russians have provided arms, provided financing, as have the Iranians, as has Hezbollah.
Steve Kroft: But they haven’t been bombing and they haven’t had troops on the ground–
President Barack Obama: And the fact that they had to do this is not an indication of strength, it’s an indication that their strategy did not work.
Steve Kroft: You don’t think–
President Barack Obama: You don’t think that Mr. Putin would’ve preferred having Mr. Assad be able to solve this problem without him having to send a bunch of pilots and money that they don’t have?
Steve Kroft: Did you know he was going to do all this when you met with him in New York?
President Barack Obama: Well, we had seen– we had pretty good intelligence. We watch–
Steve Kroft: So you knew he was planning to do it.
President Barack Obama: We knew that he was planning to provide the military assistance that Assad was needing because they were nervous about a potential imminent collapse of the regime.
Steve Kroft: You say he’s doing this out of weakness. There is a perception in the Middle East among our adversaries, certainly and even among some of our allies that the United States is in retreat, that we pulled our troops out of Iraq and ISIS has moved in and taken over much of that territory. The situation in Afghanistan is very precarious and the Taliban is on the march again. And ISIS controls a large part of Syria.
President Barack Obama: I think it’s fair to say, Steve, that if–
Steve Kroft: It’s– they– let me just finish the thought. They say your–
President Barack Obama: You’re–
Steve Kroft: –they say you’re projecting a weakness, not a strength–
President Barack Obama: –you’re saying “they,” but you’re not citing too many folks. But here–
Steve Kroft: No, I’ll cite– I’ll cite if you want me, too.
President Barack Obama: –here– yes. Here–
Steve Kroft: I’d say the Saudis. I’d say the Israelis. I’d say a lot of our friends in the Middle East. I’d say everybody in the Republican party. Well, you want me to keep going?
President Barack Obama: Yeah. The– the– if you are– if you’re citing the Republican party, I think it’s fair to say that there is nothing I’ve done right over the last seven and a half years. And I think that’s right. It– and– I also think what is true is that these are the same folks who were making an argument for us to go into Iraq and who, in some cases, still have difficulty acknowledging that it was a mistake. And Steve, I guarantee you that there are factions inside of the Middle East, and I guess factions inside the Republican party who think that we should send endless numbers of troops into the Middle East, that the only measure of strength is us sending back several hundred thousand troops, that we are going to impose a peace, police the region, and– that the fact that we might have more deaths of U.S. troops, thousands of troops killed, thousands of troops injured, spend another trillion dollars, they would have no problem with that. There are people who would like to see us do that. And unless we do that, they’ll suggest we’re in retreat.
Steve Kroft: They’ll say you’re throwing in the towel–
President Barack Obama: No. Steve, we have an enormous presence in the Middle East. We have bases and we have aircraft carriers. And our pilots are flying through those skies. And we are currently supporting Iraq as it tries to continue to build up its forces. But the problem that I think a lot of these critics never answered is what’s in the interest of the United States of America and at what point do we say that, “Here are the things we can do well to protect America. But here are the things that we also have to do in order to make sure that America leads and America is strong and stays number one.” And if in fact the only measure is for us to send another 100,000 or 200,000 troops into Syria or back into Iraq, or perhaps into Libya, or perhaps into Yemen, and our goal somehow is that we are now going to be, not just the police, but the governors of this region. That would be a bad strategy Steve. And I think that if we make that mistake again, then shame on us.
Steve Kroft: Do you think the world’s a safer place?
President Barack Obama: America is a safer place. I think that there are places, obviously, like Syria that are not safer than when I came into office. But, in terms of us protecting ourselves against terrorism, in terms of us making sure that we are strengthening our alliances, in terms of our reputation around the world, absolutely we’re stronger.
On Friday, the Pentagon ended the program to train-and-equip Syrian rebels that the president told us did not work. In a moment, he talks about Donald Trump, Hillary Clinton’s emails and Joe Biden’s possible run for president.
Steve Kroft: OK. Mr. President, there are a lot of serious problems with the world right now, but I want to ask you a few questions about politics.
President Barack Obama: Yeah, go ahead.
Steve Kroft: What do you think of Donald Trump?
President Barack Obama: Well, I think that he is a great publicity-seeker and at a time when the Republican party hasn’t really figured out what it’s for, as opposed to what it’s against. I think that he is tapped into something that exists in the Republican party that’s real. I think there is genuine anti-immigrant sentiment in the large portion of at least Republican primary voters. I don’t think it’s uniform. He knows how to get attention. He is, you know, the classic reality TV character and, at this early stage, it’s not surprising that he’s gotten a lot of attention.
Steve Kroft: You think he’s running out of steam? I mean, you think he’s going to disappear?
President Barack Obama: You know, I’ll leave it up to the pundits to make that determination. I don’t think he’ll end up being president of the United States.
Steve Kroft: Did you know about Hillary Clinton’s use of private email server–
President Barack Obama: No.
Steve Kroft: –while she was Secretary of State?
President Barack Obama: No.
Steve Kroft: Do you think it posed a national security problem?
President Barack Obama: I don’t think it posed a national security problem. I think that it was a mistake that she has acknowledged and– you know, as a general proposition, when we’re in these offices, we have to be more sensitive and stay as far away from the line as possible when it comes to how we handle information, how we handle our own personal data. And, you know, she made a mistake. She has acknowledged it. I do think that the way it’s been ginned-up is in part because of– in part– because of politics. And I think she’d be the first to acknowledge that maybe she could have handled the original decision better and the disclosures more quickly. But–
Steve Kroft: What was your reaction when you found out about it?
President Barack Obama: This is one of those issues that I think is legitimate, but the fact that for the last three months this is all that’s been spoken about is an indication that we’re in presidential political season.
Steve Kroft: Do you agree with what President Clinton has said and Secretary Clinton has said, that this is not– not that big a deal. Do you agree with that?
President Barack Obama: Well, I’m not going to comment on–
Steve Kroft: You think it’s not that big a deal–
President Barack Obama: What I think is that it is important for her to answer these questions to the satisfaction of the American public. And they can make their own judgment. I can tell you that this is not a situation in which America’s national security was endangered.
Steve Kroft: This administration has prosecuted people for having classified material on their private computers.
President Barack Obama: Well, I– there’s no doubt that there had been breaches, and these are all a matter of degree. We don’t get an impression that here there was purposely efforts– on– in– to hide something or to squirrel away information. But again, I’m gonna leave it to–
Steve Kroft: If she had come to you.
President Barack Obama: I’m going to leave it to Hillary when she has an interview with you to address all these questions.
Steve Kroft: Right now, there’s nobody on either side of the aisle that is exactly running on your record. Do you want Joe Biden to get in the race and do it?
President Barack Obama: You know, I am going to let Joe make that decision. And I mean what I say. I think Joe will go down as one of the finest vice presidents in history, and one of the more consequential. I think he has done great work. I don’t think there’s any politician at a national level that has not thought about being the president. And if you’re sitting right next to the president in every meeting and, you know wrestling with these issues, I’m sure that for him he’s saying to himself, “I could do a really good job.”
Steve Kroft: I do want to talk a little bit about Congress. Are you going to miss John Boehner?
President Barack Obama: John Boehner and I disagreed on just about everything. But the one thing I’ll say about John Boehner is he did care about the institution. He recognized that nobody gets 100 percent in our democracy. I won’t say that he and I were ideal partners, but he and I could talk and we could get some things done. And so I am a little concerned that the reason he left was because there are a group of members of Congress who think having somebody who is willing to shut down the government or default on the U.S. debt is going to allow them to get their way 100 percent of the time.
Steve Kroft: Do you think you’re going to be able to get anything through Congress?
President Barack Obama: Well, given that– this Congress hasn’t been able to get much done at all over the last year and a half, two years, for that matter for the last four, it would be surprising if we were able to make huge strides on the things that are important. But I have a more modest goal, which is to make sure that Congress doesn’t do damage to the economy.
The president says that means avoiding another budget crisis and another round of threats to shut down the government, which could happen as early as December. Even with congressional Republicans in disarray, he’s hoping to reach a deal with Congress as he did two years ago, to lift some spending caps in defense and other areas while continuing to reduce the deficit.
President Barack Obama: Right now, our economy is much stronger relative to the rest of the world. China, Europe, emerging markets, they’re all having problems. And so, if we provide another shock to the system by shutting down the government, that could mean that the progress we have made starts going backwards instead of forwards. We have to make sure that we pass a transportation bill. It may not be everything that I want. We should be being much more aggressive in rebuilding America right now. Interest rates are low, construction workers need the work, and our economy would benefit from it. But if we can’t do a big multiyear plan, we have to at least do something that is robust enough– so that we are meeting the demands of a growing economy.
Steve Kroft: A few months back, at a fundraiser, you made a point of saying that the first lady was very pleased that you can’t run again.
President Barack Obama: Yeah, she is.
Steve Kroft: Do you feel the same way?
President Barack Obama: You know, it’s interesting. I– you go into your last year and I think it’s bittersweet. On the one hand, I am very proud of what we’ve accomplished and it makes me think, I’d love to do some more. But by the time I’m finished, I think it will be time for me to go. Because there’s a reason why we considered George Washington one of our greatest presidents. He set a precedent, saying that when you occupy this seat, it is an extraordinary privilege, but the way our democracy is designed, no one person is indispensable. And ultimately you are a citizen. And once you finish with your service, you go back to being a citizen. And I– and I think that– I think having a fresh set of legs in this seat, I think having a fresh perspective, new personnel and new ideas and a new conversation with the American people about issues that may be different a year from now than they were when I started eight years ago, I think that’s all good for our democracy. I think it’s healthy.
Steve Kroft: Do you think if you ran again, could run again, and did run again, you would be elected?
Story 1: Planned Parenthood’s Evil of Killing, Butchering and Selling Baby Parts Regrets Their Tone Not Their Actions– Reminds Me of The Nazis (National Socialist German Workers’ Party) Discussing The Final Solution for The Jewish Question — The Killing of Babies Supported By Barack Obama, Democratic Party, Progressives and Ruling Political Elites — Stop Killing Babies And Lying To The American People — Videos
He that is kind is free, though he is a slave; he that is evil is a slave, though he be a king.
~Saint Augustine
The only thing necessary for the triumph of evil is for good men to do nothing.
~Edmund Burke
There are a thousand hacking at the branches of evil to one who is striking at the root.
~Henry David Thoreau
The resolution to avoid an evil is seldom framed till the evil is so far advanced as to make avoidance impossible.
~Thomas Hardy
The Holocaust was the most evil crime ever committed.
~Stephen Ambrose
The sad truth is that most evil is done by people who never make up their minds to be good or evil.”
~Hannah Arendt
Planned Parenthood: Cecile Richards’ Official Video Response
Brenda Lee – I’m Sorry
Senator Lankford Speaks about the Planned Parenthood Video on the Senate Floor
Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
What So-Called Pro-Choicers Cannot Watch From Start To Finish
The Silent Scream (Full Length)
FULL FOOTAGE: Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
Abby Johnson Exposes The Lie of Planned Parenthood
Planned Parenthood CEO Cecile Richards’ Attempt To Dismiss Viral Video Backfires!
Caught on Camera: Planned Parenthood Harvesting Babies Organs
Die Wannseekonferenz (1984)
A real time recreation of the 1942 Wannsee Conference, in which leading SS and Nazi Party officials led by SS-General Reinhard Heydrich gathered to discuss the “Final Solution to the Jewish Question”.
MAAFA 21 THE BLACK HOLOCAUST
Abortion Inc: Promoting Black Genocide in US?
Planned Parenthood Banks on Fraud
Planned Parenthood’s New Image
Fit vs. UnFit, Eugenics, Planned Parenthood & Psychology, Mind Control Report
Sex Control Police State, Eugenics, Galton, Kantsaywhere, Mind Control Report
Mind Control Hate Propaganda, Hate Speech & Crime, Black PR
Mind Control, Psychology of Brainwashing, Sex & Hypnosis
Margaret Sanger: Eugenicist (1/3)
Margaret Sanger: Eugenicist (2/3)
Margaret Sanger: Eugenicist (3/3)
Eugenics Glenn Beck w/ Edwin Black author of “War Against the Weak” talk Al Gore & Margaret Sanger
Margaret Sanger, Planned Parenthood’s Racist Founder
Justice Antonin Scalia talks about Roe v. Wade
Auschwitz The Nazis and the Final Solution complete
Auschwitz: The Nazi and the Final Solution (1/5)
AUSHWITZ:THE FINAL SOLUTION CLIP 2/5
Auschwitz: The Nazi and the Final Solution (3/5)
Auschwitz: The Nazi and the Final Solution (4/5)
Auschwitz: The Nazi and the Final Solution (5/5)
Science and the Swastika: The Deadly Experiment
Sterilizing Undesirables: Did The USA Inspire The Nazis?
Keeping Dems Honest: CNN’s Anderson Cooper Puts Truth First and Challenges DNC Abortion Lies
Glenn Beck : Agenda 21 is not a fiction, it’s implemented right now in US and all over the World !
Glenn Beck – Ted Cruz Discusses the Evils of Agenda 21
Bill Whittle What We Believe Full Version
Brenda Lee – I’m Sorry (Live from Canada 1980)
Planned Parenthood head apologizes for ‘tone’ of doctor in covert video
The president of Planned Parenthood Federation of America on Thursday apologized for remarks captured on video that show Deborah Nucatola, an executive of the organization, casually discussing abortion techniques aimed at preserving the internal organs of fetuses for use in research.
In a video posted on Planned Parenthood’s Web site, Cecile Richards called the tenor of the remarks “unacceptable,” and said the organization strives as its top priority to provide compassionate care.
“In the video, one of our staff members speaks in a way that does not reflect that compassion,” she said. “This is unacceptable, and I personally apologize for the staff member’s tone and statements.”
But Richards also emphatically defended the organization’s tissue donation program, which she said is purely voluntary for the women and does not yield a profit for Planned Parenthood. And she condemned the group that covertly recorded Nucatola’s remarks, which she said heavily edited the video to make “outrageous claims.”
“We know the real agenda of organizations behind videos like this, and they have never been concerned with protecting the health and safety of women,” she said. “Their mission is to ban abortion completely and cut women off from care at Planned Parenthood and other health centers.”
Richards’s apology came a day after a little-known anti-abortion group called the Center for Medical Progress unveiled the video as part of what its leader said was a 30-month investigation into Planned Parenthood’s tissue donation program. The group alleges Planned Parenthood illegally sells fetal body parts to companies that use the tissue for research.
While the video did not prove this claim, it still painted Planned Parenthood in an unflattering light that reignited controversy over the women’s health organization, the nation’s largest abortion provider and a longtime target of anti-abortion activism. It showed Nucatola, the organization’s senior director of medical services, discussing graphically the ways in which abortions can be completed to preserve a fetus’s liver, lungs, heart and other materials for research.
“I’d say a lot of people want liver,” she says in the video, drinking wine and eating salad with anti-abortion activists posing as medical company representatives.
Later in the video, she continues: “We’ve been very good at getting heart, lung, liver, because we know that, so I’m not gonna crush that part, I’m gonna basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact.”
The Center for Medical Research distilled the video into a nine-minute clip, but also posted a longer cut lasting more than two-and-a-half hours showing a fuller context of the discussion. It also posted some supporting documents on its site, and the group’s leader has promised more evidence in the coming weeks.
Planned Parenthood’s president apologized Thursday for a top official’s tone in a controversial video, but she also denied the clip’s allegation that her organization profits from tissue donation.
“Our top priority is the compassionate care that we provide. In the video, one of our staff members speaks in a way that does not reflect that compassion. This is unacceptable, and I personally apologize for the staff member’s tone and statements,” said Cecile Richards, the group’s president, in a video out Thursday. “As always, if there is any aspect of our work that can be strengthened, we want to know about it, and we take swift action to address it.”
Since the video’s release on Breitbart earlier this week, conservative elected officials have slammed its contents and called for congressional hearings on the incident, including House Speaker John Boehner and House Majority Leader Kevin McCarthy.
“I hope that everyone in the country watches it,” said Rep. Ann Wagner, R-Missouri, who called the video “the most horrifying and heartbreaking undercover video I have ever seen” during a Capitol Hill news conference on Wednesday.
But allegations that Planned Parenthood sells baby body organs and tissue are unfounded, she said.
“I want to be really clear: The allegation that Planned Parenthood profits in any way from tissue donation is not true. Our donation programs — like any other high-quality health care providers — follow all laws and ethical guidelines.”
On Wednesday, Richards used Twitter to criticize lawmakers and presidential candidates
“GOP leaders, including most of the ’16 field, are tripping over themselves to attack PP because they think that’s how to win elections,” organization president Cecile Richards said in a series of related tweets Wednesday. Her comments were her first addressing a video showing one of the organization’s top officials discussing the organs and tissue or aborted fetuses.
President of Planned Parenthood Federation of America Cecile Richards speaks during day two of the Democratic National Convention on September 5, 2012 in Charlotte, North Carolina.
Congressional leaders and Republican presidential hopefuls slammed Planned Parenthood on Wednesday and called for congressional hearings on the incident.
Richards said political attacks are nothing new for her organization, the country’s largest abortion provider.
“Spreading false information is an age-old strategy of people hell-bent on denying women care & shaming them for exercising their rights,” she tweeted.
Several Republican candidates have promised to defund federal dollars to Planned Parenthood if elected. Richards argued that would keep millions from breast exams, sexually transmitted infection exams and sex education.
“Reminder: 1 out of every 5 women has been to PP in her life. Threatening our patients’ care & rights will get politicians nowhere real fast,” she tweeted. “We’ve fought for our patients before, and we’ll fight for them again and again.”
Planned Parenthood exec, fetal body parts subject of controversial video
By Steve Almasy and Eliott C. McLaughlin, CNN
An anti-abortion group has released an online video that it says documents how Planned Parenthood is selling fetal organs for a profit, a felony, while violating medical ethics by altering normal abortion procedures so as to preserve the organs.
Planned Parenthood has countered that it donates the tissue for scientific research and receives only reimbursement for its expenses, which is legal. The group also says it helps people donate tissue “with full, appropriate consent from patients and under the highest ethical and legal standards,” according to a statement from spokesman Eric Ferrero.
Later, Ferrero issued another statement saying, “These outrageous claims are flat-out untrue, but that doesn’t matter to politicians with a longstanding political agenda to ban abortion and defund Planned Parenthood. Women and families who make the decision to donate fetal tissue for lifesaving scientific research should be honored, not attacked and demeaned.”
The group leveling the accusation, the Irvine, California-based Center for Medical Progress, says it shot the video a year ago at a California restaurant. On it, two people purporting to be with a human biologics company speak with a Planned Parenthood doctor over what appears to be a lunch meeting. The Center for Medical Progress says the pair, who are off-camera and never seen, are paid actors.
“Planned Parenthood’s criminal conspiracy to make money off of aborted baby parts reaches to the very highest levels of their organization,” said statement from David Daleiden, who led the undercover project.
The video has drawn the ire of GOP lawmakers in Washington, with House Speaker John Boehner calling for hearings on Planned Parenthood’s abortion practices.
“When anyone diminishes an unborn child, we are all hurt, irreversibly so. When an organization monetizes an unborn child — and with the cavalier attitude portrayed in this horrific video — we must all act,” he said.
On the video, Dr. Deborah Nucatola, the senior director of medical services at Planned Parenthood Federation of America, is seen talking matter-of-factly about the organization’s participation in tissue-donation programs.
Though Planned Parenthood has described the Center for Medical Progress footage as a hit piece by “a well-funded group established for the purpose of damaging Planned Parenthood’s mission and services,” Nucatola acknowledges in the video that Planned Parenthood’s national office sees the potential for controversy.
“So, we tried to do this, and at the national office we have a Litigation and Law Department that just really doesn’t want us to be the middle people for this issue right now,” she said. “And so we had a conversation, and we said, ‘What if we go out and find everyone who is doing this and present everybody with a menu?’ And at the end of the day they just decided that right now, it’s just too touchy an issue for us to be an official middleman.”
In another part of the video, the doctor tells the undercover actors that “behind closed doors,” Planned Parenthood’s affiliates are discussing how to handle the matter.
“Every provider has had patients who want to donate their tissue, and they absolutely want to accommodate them. They just want to do it in a way that is not perceived as ‘This clinic is selling tissue. This clinic is making money off of this,’ ” she said.
The edited version of the video appears to be missing important context that’s provided in the longer video. For instance, one of the actors asks Nucatola about prices for the organs.
“OK, so when you are, or the (Planned Parenthood) affiliate is determining what that monetary … so that it doesn’t raise any question of ‘This is what it’s about; this is the main,’ what price range would you …” the woman asks, her question trailing off.
Nucatola responds that the price would be between $30 and $100 per specimen, with consideration for what facility is used and “what’s involved.” It’s not clear if a specimen constitutes the entire organ or only samples of it.
Nucatola doesn’t specifically say that the price is for the purchase of the tissue, but the comment troubled bioethicist Art Caplan of New York University, who said after watching the edited version of the video it sounds like Planned Parenthood might be trying to make a profit.
But in the longer version of the video, Nucatola elaborates and appears to say the price is related to the cost of performing the procedure and shipping.
“It just has to do with space issues. Are you sending someone there who is going to be doing everything or is their staff going to be doing it? What exactly are they going to be doing? Is there shipping involved or is someone coming to pick it up?”
Selling fetal body parts — or any body parts — is against federal law, but Planned Parenthood said it makes no profit.
“In some instances, actual costs, such as the cost to transport tissue to leading research centers, are reimbursed, which is standard across the medical field,” the group said.
Another part of the video also raised concerns for Caplan. Nucatola talks about doctors performing abortions in which ultrasound is used to ascertain the best location to grab the fetus with forceps.
“We’ve been very good at getting heart, lung, liver because we know that, I’m not going to crush that part,” she says.
Altering procedures in order to get tissue in the best condition would be a “big no-no,” the bioethicist said, because the patient’s health is paramount and that should be the only concern for doctors. Caplan did not comment specifically on whether the ultrasound procedure would endanger the mother, but he made it clear that any deviation from normal procedures is unacceptable.
“In abortion the primary goal is to give the safest abortion possible,” Caplan said. “Your sole concern has to be the mother and her health.”
There’s a parallel in patient care, he said. When someone is dying, doctors shouldn’t change how they treat the patient in order to harvest good tissue for donation after death.
Doctors should treat the patient as they normally would, and then use whatever is available after death. If a provider is considering how to get the tissue that’s in the best shape, “that’s a huge conflict of interest. … If you modify how someone dies, that’s unethical.”
The Center for Medical Progress also alleges that Nucatola describes a method — using ultrasound to manipulate the fetus so it comes out feet first, or breech presentation, instead of head first, or vertex presentation — that “is the hallmark of the illegal partial-birth abortion procedure.”
Partial birth abortions are illegal, according to U.S. law, which defines them as procedures “in which the person performing the abortion deliberately and intentionally vaginally delivers a living fetus until, in the case of a head-first presentation, the entire fetal head is outside the body of the mother, or, in the case of breech presentation, any part of the fetal trunk past the navel is outside the body of the mother, for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus.”
On the video, Nucatola describes the best strategy to extract calavarium, or skulls, intact, but it is not clear if she is speaking in general terms or if she is describing Planned Parenthood’s methods. And then, she says nothing about whether the fetus is still alive when it’s delivered.
“And with the calvarium, in general, some people will actually try to change the presentation so that it’s not vertex, because when it’s vertex presentation, you never have enough dilation at the beginning of the case, unless you have real, huge amount of dilation to deliver an intact calvarium. So if you do it starting from the breech presentation, there’s dilation that happens as the case goes on, and often, the last, you can evacuate an intact calvarium at the end.”
The Center for Medical Progress responded to Planned Parenthood’s written statement about the video and accused Planned Parenthood of lying about obtaining consent from patients and not making a profit on the tissue transactions. It did not offer any further evidence of either claim.
Planned Parenthood, meanwhile, said the anti-abortion group was the one that was lying.
“A well-funded group established for the purpose of damaging Planned Parenthood’s mission and services has promoted a heavily edited, secretly recorded videotape that falsely portrays Planned Parenthood’s participation in tissue donation programs that support lifesaving scientific research,” it said.
The statement continued, “Similar false accusations have been put forth by opponents of abortion services for decades. These groups have been widely discredited and their claims fall apart on closer examination, just as they do in this case.”
Planned Parenthood Federation of America (PPFA), commonly shortened to Planned Parenthood, is the U.S. affiliate of the International Planned Parenthood Federation (IPPF) and one of its larger members. PPFA is a non-profit organization providing reproductive health and maternal and child health services. The Planned Parenthood Action Fund, Inc. (PPAF) is a related organization which lobbies for pro-choice legislation, comprehensive sex education, and access to affordable health care in the United States. In recent years, Planned Parenthood has begun to move away from the pro-choice label to words and phrases that more accurately reflect the entire range of women’s health and economic issues.[3]
Planned Parenthood is the largest U.S. provider of reproductive health services, including cancer screening, HIV screening and counseling, contraception, and abortion.[4][5][6] Contraception accounts for 34% of PPFA’s total services and abortions account for 3%; PPFA conducts roughly 300,000 abortions each year, among 3 million people served.[7][8][9]
The organization has its roots in Brooklyn, New York, where Margaret Sanger opened the country’s first birth-control clinic. Sanger founded the American Birth Control League in 1921, which in 1942 became part of the Planned Parenthood Federation of America. Since then, Planned Parenthood has grown to have over 820 clinic locations in the U.S., with a total budget of US $1 billion. PPFA provides an array of services to over three million people in the United States, and supports services for over one million clients outside the United States.
Margaret Sanger (1922), the first president and founder of Planned Parenthood
The origins of Planned Parenthood date to October 16, 1916 when Margaret Sanger, her sister Ethel Byrne, and Fania Mindell opened the first birth control clinic in the U.S. in the Brownsville section of Brooklyn, New York.[10] All three women were immediately arrested and jailed for violating provisions of the Comstock Act– for distributing “obscene materials” at the clinic. The “Brownsville trials” brought national attention and support to their cause, and although Sanger and her co-defendants were convicted, their convictions were eventually overturned. Their campaign led to major changes in the laws governing birth control and sex education in the United States.[11]
In 1938, the clinic was organized into the American Birth Control League, which became part of the only national birth control organization in the US until the 1960s, but the title was found too offensive and “against families” so the League began discussions for a new name.[12] By 1941, the organization was operating 222 centers and had served 49,000 clients.[13] By 1942 the League had become part of what became the Planned Parenthood Federation of America.[12]
By 1960, the Federation’s grassroots volunteers had provided family planning counseling in hundreds of communities across the country.[13] Planned Parenthood was one of the founding members of the International Planned Parenthood Federation when it was launched at a conference in Bombay, India in 1952.[13][14]
After Sanger
Following Margaret Sanger, Alan Frank Guttmacher became president of Planned Parenthood and served from 1962 till 1974.[15] During his tenure, the Food and Drug Administration approved the sale of the original birth control pill, giving rise to new attitudes towards women’s reproductive freedom.[13] Also during his presidency, Planned Parenthood lobbied the federal government to support reproductive health, culminating with President Richard Nixon‘s signing of Title X to provide governmental subsidies for low-income women to access family planning services.[16] The Center for Family Planning Program Development was also founded as a semi-autonomous division during this time.[17] The center became an independent organization and was renamed the Guttmacher Institute in 1977.[17]
Faye Wattleton was the first woman named president of the Planned Parenthood Federation of America in 1978 and served till 1992.[18] She was the first African-American to serve as president, and the youngest president in Planned Parenthood’s history.[19] During her term, Planned Parenthood grew to become the seventh largest charity in the country, providing services to four million clients each year through its 170 affiliates whose activities were spread across 50 states.[20]
A Planned Parenthood supporter participates in a demonstration in support of the organization.
From 1996 to 2006, Planned Parenthood was led by Gloria Feldt.[21][22] Feldt activated the Planned Parenthood Action Fund, the organization’s political action committee, launching what was the most far reaching electoral advocacy effort in its history.[23] She also launched the Responsible Choices Action Agenda, a nationwide campaign to increase services to prevent unwanted pregnancies, improve quality of reproductive care and ensure access to safe and legal abortions.[13] Another initiative was the commencement of a “Global Partnership Program” with the aim of building a vibrant activist constituency in support of family planning.[13]
On February 15, 2006, Cecile Richards became president of the organization.[24]
PPFA is a federation of 85 independent Planned Parenthood affiliates around the U.S.[1] These affiliates together operate more than 820 health centers in all 50 states and the District of Columbia.[1][32] The largest of these facilities, a $26 million, 78,000-square-foot (7,200 m2) structure was completed in Houston, Texas in May 2010.[33] This serves as a headquarters for 12 clinics in Texas and Louisiana.[33] Together, they are the largest family planning services provider in the U.S. with over four million activists, supporters and donors.[34][35][36] Planned Parenthood is staffed by 27,000 staff members and volunteers.[37]
They serve over five million clients a year, 26% of which are teenagers under the age of 19.[38] According to Planned Parenthood, 75% of their clients have incomes at or below 150 percent of the federal poverty level.[37]
In 2009, Planned Parenthood provided 4,009,549 contraceptive services (35% of total), 3,955,926 sexually transmitted disease services (35% of total), 1,830,811 cancer related services (16% of total), 1,178,369 pregnancy/prenatal/midlife services (10% of total), 332,278 abortion services (3% of total), and 76,977 other services (1% of total), for a total of 11,383,900 services.[9][37][39][40][41][42] The organization also said its doctors and nurses annually conduct 1 million screenings for cervical cancer and 830,000 breast exams.
Planned Parenthood has received federal funding since 1970, when President Richard Nixon signed into law the Family Planning Services and Population Research Act, amending the Public Health Service Act. Title X of that law provides funding for family planning services, including contraception and family planning information. The law enjoyed bipartisan support from liberals who saw contraception access as increasing families’ control over their lives, and conservatives who saw it as a way to keep people off welfare. Nixon described Title X funding as based on the premise that “no American woman should be denied access to family planning assistance because of her economic condition.”[43]
In the fiscal year ending June 30, 2011, total (consolidated) revenue was $201 million: clinic revenue totaling $2 million, grants and donations of $190 million, investment income of $2 million, and $7 million other income.[44] Approximately two-thirds of the revenue is put towards the provision of health services, while non-medical services such as sex education and public policy work make up another 16%; management expenses, fundraising, and international family planning programs account for most of the rest.
Planned Parenthood receives about a third of its money in government grants and contracts (about $360 million in 2009).[45] By law, federal funding cannot be allocated for abortions,[46] but some opponents of abortion have argued that allocating money to Planned Parenthood for the provision of other medical services “frees up” funds to be re-allocated for abortion.[4][47]
A coalition of national and local pro-life groups have lobbied federal and state government to stop funding Planned Parenthood, and as a result, Republican federal and state legislators have proposed legislation to reduce the funding levels.[46][48] Some six states have gone ahead with such proposals.[4][49][50][51] In some cases, the courts have overturned such actions, citing conflict with federal or other state laws, and in others, the federal executive branch has provided funding in lieu of the states.[50][51][52] In other cases, complete or partial defunding of Planned Parenthood has gone through successfully.[53][54]
Planned Parenthood is also funded by private donors, with a membership base of over 700,000 active donors whose contributions account for approximately one quarter of the organization’s revenue.[55] Large donors also contribute a substantial portion of the organization’s budget; past donors have included the Bill & Melinda Gates Foundation, Buffett Foundation, Ford Foundation, Turner Foundation, the Cullmans and others.[56][57][58][59] The Bill & Melinda Gates Foundation’s contributions to the organization have been specifically marked to avoid funding abortions.[56] Some, such as the Buffett Foundation, have supported reproductive health that can include abortion services.[56] Pro-life groups have advocated the boycott of donors to Planned Parenthood.[60]
Stand on political and legal issues
Planned Parenthood and its predecessor organizations have provided and advocated for access to birth control. The modern organization of Planned Parenthood America is also an advocate for reproductive rights.[61] This advocacy includes contributing to sponsorship of abortion rights and women’s rights events[62] and assisting in the testing of new contraceptives.[63] The Federation opposes restrictions on women’s reproductive health services, including parental consent laws. Planned Parenthood has cited the case of Becky Bell, who died following a septic abortion after failing to seek parental consent, to justify their opposition.[64][65] Planned Parenthood also takes the position that laws requiring parental notification before an abortion is performed on a minor are unconstitutional on privacy grounds.[66] The organization also opposes laws requiring ultrasounds before abortions, stating that their only purpose is to make abortions more difficult to obtain.[67] Planned Parenthood has also opposed initiatives that require waiting periods before abortions,[68] and bans on late-term abortions including intact dilation and extraction, which has been illegal in the U.S. since 2003.[69]
Planned Parenthood argues for the wide availability of emergency contraception (EC) measures.[70] It opposes conscience clauses, which allow pharmacists to refuse to dispense drugs against their beliefs. In support of their position, they have cited cases where pharmacists have refused to fill life saving drugs under the laws.[71] Planned Parenthood has also been critical of hospitals that do not provide access to EC for rape victims.[72] Planned Parenthood supports and provides FDA-approved abortifacients such as mifepristone.[73]
Citing the need for medically accurate information in sex education, Planned Parenthood opposes abstinence-only education in public schools. Instead, Planned Parenthood is a provider of, and endorses, comprehensive sex education, which includes discussion of both abstinence and birth control.[74]
Planned Parenthood also has a political action committee called Planned Parenthood Action Fund. The committee was founded in 1996 by then new president Gloria Feldt for the purpose of maintaining reproductive health rights and supporting political candidates of the same mindset. In 2012 election cycle the committee gained prominence based on its effectiveness of spending on candidates.[75]
Before the U.S. Supreme Court
Former Planned Parenthood President Gloria Feldt with Congressman Albert Wynn in front of the U.S. Supreme Court
Planned Parenthood regional chapters have been active in the American courts. A number of cases in which Planned Parenthood has been a party have reached the U.S. Supreme Court. Notable among these cases is the 1992 case Planned Parenthood v. Casey, the case that sets forth the current constitutional abortion standard. In this case, “Planned Parenthood” was the Southeast Pennsylvania Chapter, and “Casey” was Robert Casey, the governor of Pennsylvania. The ultimate ruling was split, and Roe v. Wade was narrowed but upheld in an opinion written by Sandra Day O’Connor, Anthony Kennedy, and David Souter. Harry Blackmun and John Paul Stevens concurred with the main decision in separately written opinions. The Supreme Court struck down spousal consent requirements for married women to obtain abortions, but found no “undue burden”—an alternative to strict scrutiny which tests the allowable limitations on rights protected under the Constitution—from the other statutory requirements. Dissenting were William Rehnquist, Antonin Scalia, Clarence Thomas, and Byron White. Blackmun, Rehnquist, and White were the only justices who voted on the original Roe v. Wade decision in 1973 who were still on the Supreme Court to rule on this case, and their votes on this case were consistent with their votes on the original decision that legalized abortion.[76] Only Blackmun voted to maintain Roe v. Wade in its entirety.
Other related cases include:
Planned Parenthood of Central Missouri v. Danforth (1976). Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, spousal consent, clinic bookkeeping and allowed abortion methods. Portions of the challenged law were held to be constitutional, others not.[77]
Planned Parenthood Association of Kansas City v. Ashcroft (1983). Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, clinic record keeping, and hospitalization requirements. Most of the challenged law was held to be constitutional.[78]
Planned Parenthood v. ACLA (2001). The American Coalition of Life Activists (ACLA) released a flier and “Wanted” posters with complete personal information about doctors who performed abortions. A civil jury and the Ninth Circuit Court of Appeals both found that the material was indeed “true threats” and not protected speech.[79]
Gonzales v. Planned Parenthood (2003). Planned Parenthood sued Attorney General Gonzales for an injunction against the enforcement of the Partial-Birth Abortion Ban Act of 2003. Planned Parenthood argued the act was unconstitutional because it violated the Fifth Amendment, namely in that it was overly vague, violated women’s constitutional right to have access to abortion, and did not include language for exceptions for the health of the mother. Both the district court and the US Court of Appeals for the Ninth Circuit agreed,[80][81] but that decision was overturned in a 5–4 ruling by the Supreme Court.[82]
Ayotte v. Planned Parenthood of Northern New England (2006). Planned Parenthood et al. challenged the constitutionality of a New Hampshire parental notification law related to access to abortion.[83][84] In Sandra Day O’Connor’s final decision before retirement, the Supreme Court sent the case back to lower courts with instructions to seek a remedy short of wholesale invalidation of the statute. New Hampshire ended up repealing the statute via the legislative process.[85]
Controversy and criticism
Abortion
Planned Parenthood has occupied a central position in the abortion debate in the U.S., and has been among the most prominent targets of U.S. pro-life activists for decades. Congressional Republicans have attempted since the 1980s to defund the organization,[45] nearly leading to a government shutdown over the issue in 2011.[86] The federal money received by Planned Parenthood is not used to fund abortion services, but pro-life activists have argued that the funding frees up other resources which are, in turn, used to provide abortions.[45]
Planned Parenthood is the largest single provider of abortions in the U.S.[7] In 2009, Planned Parenthood performed 332,278 abortions (for comparison, 1.21 million abortions were performed in the US in 2008[87]), from which it derives about $164,154,000, or 15% of its annual revenue as of their 2008–2009 calculations.[88] According to PPFA’s own estimates, its contraceptive services prevent approximately 612,000 unintended pregnancies and 291,000 abortions annually.[37][89] Planned Parenthood president Cecile Richards has argued that the organization’s family planning services reduce the need for abortions.[90] Megan Crepeau of the Chicago Tribune said that, because of its birth control and family planning services, PPFA could be “characterized as America’s largest abortion preventer.”[91] Anti-abortion activists dispute the evidence that greater access to contraceptives reduces abortions.[92]
In the 1920s various theories of eugenics were popular among intellectuals in the United States. For example, 75% of colleges offered courses on eugenics.[93] Sanger, in her campaign to promote birth control, teamed with eugenics organizations such as the American Eugenics Society, although she argued against many of their positions.[94][95][96] Scholars describe Sanger as believing that birth control, sterilization and abortion should be voluntary and not based on race.[97] She advocated for “voluntary motherhood”—the right to choose when to be pregnant—for all women, as an important element of women’s rights.[98][99] Opponents of Planned Parenthood often refer to Sanger’s connection with supporters of eugenics to discredit the organization by associating it, and birth control, with the more negative modern view of eugenics.[100][101] Planned Parenthood has responded to this effort directly in a leaflet acknowledging that Sanger agreed with some of her contemporaries who advocated the voluntary hospitalization or sterilization of people with untreatable, disabling, hereditary conditions, and limits on the immigration of the diseased. The leaflet also states that Planned Parenthood “finds these views objectionable and outmoded” but says that it was compelled to discuss the topic because “anti-family planning activists continue to attack Sanger . . . because she is an easier target” than Planned Parenthood.[102]
Periodically pro-life activists have tried to demonstrate that Planned Parenthood does not follow applicable state or federal laws. The groups called or visited a Planned Parenthood health center posing as victims of statutory rape,[103] minors who would need parental notification for abortion,[104][105] racists seeking to earmark donations for abortions for black women to abort black babies,[106] or pimps who want abortions for child prostitutes.[107] Edited video and audio productions of these dialogues seem to capture employees being sympathetic to potentially criminal acts, leading to allegations that the health centers in question are violating the law. An official federal inspection in 2005 by the Bush administration‘s Department of Health and Human Services “yielded no evidence of clinics around the nation failing to comply with laws on reporting child abuse, child molestation, sexual abuse, rape or incest.”[104]
In 2011, the organization Live Action released a series of videos that they said showed Planned Parenthood employees at multiple affiliates actively assisting or being complicit in aiding the underage prostitution ring of actors posing as a pimp and a prostitute. Planned Parenthood conducted a frame-by-frame analysis of the recordings, and said they found instances of “editing that dramatically alter[ed] the meaning of the recorded conversations.”[108]
None of these stings have led to criminal conviction.[109] However, a small number of Planned Parenthood employees and volunteers were fired for not following procedure, and the organization committed to retraining its staff.[106][110]
State and local court cases against Planned Parenthood
In some states, anti-abortion Attorneys General have subpoenaed medical records of patients treated by Planned Parenthood. Planned Parenthood has gone to court to keep from turning over these records, citing medical privacy and concerns about the motivation for seeking the records.[111]
In 2006, Kansas Attorney General Phill Kline, a strongly anti-abortion Republican, released some sealed patient records obtained from Planned Parenthood to the public. His actions were described as “troubling” by the state Supreme Court, but ultimately Planned Parenthood was compelled to turn over the medical records, albeit with more stringent court-mandated privacy safeguards for the patients involved.[111] In 2007, Kline’s successor, Paul J. Morrison, notified the clinic that no criminal charges would be filed after a three-year investigation, as “an objective, unbiased and thorough examination” showed no wrongdoing. Morrison stated that he believed Kline had politicized the attorney general’s office.[112] In 2012, a Kansas district attorney dropped all of the remaining criminal charges against the Kansas City-area Planned Parenthood clinic accused of performing illegal abortions, citing a lack of evidence of wrongdoing.[113] In all, the Planned Parenthood clinic had faced 107 criminal charges from Kline and other Kansas prosecutors, all of which were ultimately dropped for lack of evidence.[113]
In Indiana, Planned Parenthood was not required to turn over its medical records in an investigation of possible child abuse.[114] In October 2005, Planned Parenthood Minnesota/North Dakota/South Dakota was fined $50,000 for violating a Minnesota state parental consent law.[115]
On December 31, 2012, Judge Gary Harger ruled Texas may exclude otherwise qualified doctors and clinics from receiving state funding if they advocate for abortion rights.[116]
In 1994, John Salvi entered a Brookline, Massachusetts Planned Parenthood clinic and opened fire, murdering receptionist Shannon Elizabeth Lowney and wounding three others. He fled to another Planned Parenthood clinic where he murdered Leane Nichols and wounded two others.[128]
Planned Parenthood “dates its beginnings to 1916” but a predecessor, the American Birth Control League, was not founded until 1921 and the organization did not adopt its name until 1942.
William Sanger (1902–1921)[note 1]
James Noah H. Slee (1922–1943).
Margaret Higgins Sanger (September 14, 1879 – September 6, 1966) was an American birth control activist, sex educator, and nurse. Sanger popularized the term birth control, opened the first birth control clinic in the United States, and established organizations that evolved into the Planned Parenthood Federation of America. Sanger was also a writer. She used this method to help promote her way of thinking. She was prosecuted for her book Family Limitation under the Comstock Act in 1914. She was afraid of what would happen, so she fled to Britain until she knew it was safe to return to the US.[citation needed] Sanger’s efforts contributed to several judicial cases that helped legalize contraception in the United States. Sanger is a frequent target of criticism by opponents of abortion and has also been criticized for supporting eugenics, but remains an iconic figure in the American reproductive rights movement.[2]
In 1916, Sanger opened the first birth control clinic in the United States, which led to her arrest for distributing information on contraception. Her subsequent trial and appeal generated controversy. Sanger felt that in order for women to have a more equal footing in society and to lead healthier lives, they needed to be able to determine when to bear children. She also wanted to prevent unsafe abortions, so-called back-alley abortions, which were common at the time because abortions were usually illegal. She believed that while abortion was sometimes justified it should generally be avoided, and she considered contraception the only practical way to avoid the use of abortions.[citation needed]
In 1921, Sanger founded the American Birth Control League, which later became the Planned Parenthood Federation of America. In New York City, she organized the first birth control clinic staffed by all-female doctors, as well as a clinic in Harlem with an entirely African-American staff. In 1929, she formed the National Committee on Federal Legislation for Birth Control, which served as the focal point of her lobbying efforts to legalize contraception in the United States. From 1952 to 1959, Sanger served as president of the International Planned Parenthood Federation. She died in 1966, and is widely regarded as a founder of the modern birth control movement.
Life
Early life
Sanger was born Margaret Louise Higgins in 1879 in Corning, New York,[3] to Michael Hennessey Higgins, an Irish-born stonemason and free-thinker, and Anne Purcell Higgins, a Catholic Irish-American. Michael Hennessey Higgins had emigrated to the USA at age 14 and joined the U.S. Army as a drummer at age 15, during the Civil War. After leaving the army, Michael studied medicine and phrenology, but ultimately became a stonecutter, making stone angels, saints, and tombstones.[4] Michael H. Higgins was a Catholic who became an atheist and an activist for women’s suffrage and free public education.[5] Anne Higgins went through 18 pregnancies (with 11 live births) in 22 years before dying at the age of 49. Sanger was the sixth of eleven surviving children,[6] and spent much of her youth assisting with household chores and caring for her younger siblings. Anne’s parents took their children and emigrated to Canada when she was a child, due to the Potato Famine.
Supported by her two older sisters, Margaret Higgins attended Claverack College and Hudson River Institute, before enrolling in 1900 at White Plains Hospital as a nurse probationer. In 1902, she married the dashing architect William Sanger and gave up her education.[7] Though she was plagued by a recurring active tubercular condition, Margaret Sanger bore three children, and the couple settled down to a quiet life in Westchester, New York.
Sanger with sons Grant and Stuart, c. 1919
Social activism
In 1911, after a fire destroyed their home in Hastings-on-Hudson, the Sangers abandoned the suburbs for a new life in New York City. Margaret Sanger worked as a visiting nurse in the slums of the East Side, while her husband worked as an architect and a house painter. Already imbued with her husband’s leftist politics, Margaret Sanger also threw herself into the radical politics and modernist values of pre-World War IGreenwich Village bohemia. She joined the Women’s Committee of the New York Socialist party, took part in the labor actions of the Industrial Workers of the World (including the notable 1912 Lawrence Textile Strike and the 1913 Paterson Silk Strike) and became involved with local intellectuals, left-wing artists, socialists and social activists, including John Reed, Upton Sinclair, Mabel Dodge and Emma Goldman.[8]
Sanger’s political interests, emerging feminism and nursing experience led her to write two series of columns on sex education entitled “What Every Mother Should Know” (1911–12) and “What Every Girl Should Know” (1912-13) for the socialist magazine New York Call. By the standards of the day, Sanger’s articles were extremely frank in their discussion of sexuality, and many New York Call readers were outraged by them. Other readers, however, praised the series for its candor, one stated that the series contained “a purer morality than whole libraries full of hypocritical cant about modesty.[9] Both were later published in book form in 1916.[10]
During her work among working class immigrant women, Sanger was exposed to graphic examples of women going through frequent childbirth, miscarriage and self-induced abortion for lack of information on how to avoid unwanted pregnancy. Access to contraceptive information was prohibited on grounds of obscenity by the 1873 federal Comstock law and a host of state laws. Searching for something that would help these women, Sanger visited public libraries, but was unable to find information on contraception.[11] These problems were epitomized in a (possibly fictional) story that Sanger would later recount in her speeches: while Sanger was working as a nurse, she was called to the apartment of a woman, “Sadie Sachs,” who had become extremely ill due to a self-induced abortion. Afterward, “Sadie” (whose marital status Sanger never mentioned) begged the attending doctor to tell her how she could prevent this from happening again, to which the doctor simply advised her to remain abstinent. A few months later, Sanger was called back to “Sadie’s” apartment — only this time, “Sadie” died shortly after Sanger arrived. She had attempted yet another self-induced abortion.[12][13] Sanger would sometimes end the story by saying, “I threw my nursing bag in the corner and announced … that I would never take another case until I had made it possible for working women in America to have the knowledge to control birth.” Although “Sadie Sachs” was possibly a fictional composite of several women Sanger had known, this story marks the time when Sanger began to devote her life to help desperate women before they were driven to pursue dangerous and illegal abortions.[13][14]
Accepting the connection proposed between contraception and working-class empowerment by radicals such as Emma Goldman, Sanger came to believe that only by liberating women from the risk of unwanted pregnancy would fundamental social change take place. She proceeded to launch a campaign to challenge governmental censorship of contraceptive information. She would set up a series of confrontational actions designed to challenge the law and force birth control to become a topic of public debate. Sanger’s trip to France in 1913 exposed her to what Goldman had been saying. Sanger’s experience during her trip to France directly influence The Women Rebel newsletter. The trip to France was also the beginning of the end of her marriage with William Sanger.[15]
In 1914, Sanger launched The Woman Rebel, an eight-page monthly newsletter which promoted contraception using the slogan “No Gods, No Masters“.[16][note 2][17] Sanger, collaborating with anarchist friends, popularized the term “birth control” as a more candid alternative to euphemisms such as “family limitation”[18] and proclaimed that each woman should be “the absolute mistress of her own body.”[19] In these early years of Sanger’s activism, she viewed birth control as a free-speech issue, and when she started publishing The Woman Rebel, one of her goals was to provoke a legal challenge to the federal anti-obscenity laws which banned dissemination of information about contraception.[20][21] Though postal authorities suppressed five of its seven issues, Sanger continuing publication, all the while preparing, Family Limitation, an even more blatant challenge to anti-birth control laws. This 16-page pamphlet contained detailed and precise information and graphic descriptions of various contraceptive methods. In August 1914 Margaret Sanger was indicted for violating postal obscenity laws by sending the The Woman Rebel through the postal system. Instead of standing trial, she jumped bail and fled to Canada. Then, under the alias “Bertha Watson”, sailed for England. En route she ordered her labor associates to release copies of the Family Limitation.[22]
Margaret Sanger spent much of her 1914 exile in England, where contact with British neo-Malthusianists helped refine her socioeconomic justifications for birth control. She was also profoundly influenced by the liberation theories of British sexual theorist Havelock Ellis. Under his tutelage she formulated a new rationale that would liberate women not just by making sexual intercourse safe, but also pleasurable. It would, in effect, free women from the inequality of sexual experience. Early in 1915, Margaret Sanger’s estranged husband, William Sanger, was entrapped into giving a copy of Family Limitation to a representative of anti-vice crusader Anthony Comstock. William Sanger was tried and convicted, he spent thirty days in jail, while also escalating interest in birth control as a civil liberties issue.[23][24][25]
This page from Sanger’s Family Limitation, 1917 edition, describes a cervical cap.
Some countries in northwestern Europe had more liberal policies towards contraception than the United States at the time, and when Sanger visited a Dutch birth control clinic in 1915, she learned about diaphragms and became convinced that they were a more effective means of contraception than the suppositories and douches that she had been distributing back in the United States. Diaphragms were generally unavailable in the United States, so Sanger and others began importing them from Europe, in defiance of United States law.[8]
On October 16, 1916, Sanger opened a family planning and birth control clinic at 46 Amboy St. in the Brownsville neighborhood of Brooklyn, the first of its kind in the United States.[26] Nine days after the clinic opened, Sanger was arrested. Sanger’s bail was set at $500 and she went back home. Sanger continued seeing some women in the clinic until the police came a second time. This time Sanger and her sister, Ethel Byrne, were arrested for breaking a New York state law that prohibited distribution of contraceptives, Sanger was also charged with running a public nuisance.[27] Sanger and Ethel went to trial in January 1917.[28] Byrne was convicted and sentenced to 30 days in a workhouse but went on hunger strike. She was the first woman in the US to be force fed.[29] Only when Sanger pledged that Byrne would never break the law, she was pardoned after ten days.[30] Sanger was convicted; the trial judge held that women did not have “the right to copulate with a feeling of security that there will be no resulting conception.”[31] Sanger was offered a more lenient sentence if she promised to not break the law again, but she replied: “I cannot respect the law as it exists today.”[32] For this, she was sentenced to 30 days in a workhouse.[32] An initial appeal was rejected, but in a subsequent court proceeding in 1918, the birth control movement won a victory when Judge Frederick E. Crane of the New York Court of Appeals issued a ruling which allowed doctors to prescribe contraception.[33] The publicity surrounding Sanger’s arrest, trial, and appeal sparked birth control activism across the United States, and earned the support of numerous donors, who would provide her with funding and support for future endeavors.[34]
Sanger became estranged from her husband in 1913, and the couple’s divorce was finalized in 1921.[35] Sanger’s second husband was Noah Slee. He followed Sanger around the world and provided much of Sanger’s financial assistance. The couple got married in September 1922, but the public did not know about it until February 1924. They supported each other with their pre-commitments.[36]
American Birth Control League
Sanger published the Birth Control Review from 1917 to 1929.[note 4]
After World War I, Sanger shifted away from radical politics, and she founded the American Birth Control League (ABCL) in 1921 to enlarge her base of supporters to include the middle class.[37] The founding principles of the ABCL were as follows:[38]
We hold that children should be (1) Conceived in love; (2) Born of the mother’s conscious desire; (3) And only begotten under conditions which render possible the heritage of health. Therefore we hold that every woman must possess the power and freedom to prevent conception except when these conditions can be satisfied.
Sanger’s appeal of her conviction for the Brownsville clinic secured a 1918 court ruling that exempted physicians from the law that prohibited the distribution of contraceptive information to women—provided it was prescribed for medical reasons—she established the Clinical Research Bureau (CRB) in 1923 to exploit this loophole.[8][39] The CRB was the first legal birth control clinic in the United States, and it was staffed entirely by female doctors and social workers.[40] The clinic received a large amount of funding from John D. Rockefeller Jr. and his family, which continued to make donations to Sanger’s causes in future decades, but generally made them anonymously to avoid public exposure of the family name,[41] and to protect family member Nelson Rockefeller‘s political career since openly advocating birth control could have led to the Catholic Church opposing him politically.[42] John D. Rockefeller Jr. donated five thousand dollars to her American Birth Control League in 1924 and a second time in 1925.[43] In 1922, she traveled to China, Korea, and Japan. In China she observed that the primary method of family planning was female infanticide, and she later worked with Pearl Buck to establish a family planning clinic in Shanghai.[44] Sanger visited Japan six times, working with Japanese feminist Kato Shidzue to promote birth control.[45] This was ironic since ten years earlier Sanger had accused Katō of murder and praised an attempt to kill her.[46]
In 1926, Sanger gave a lecture on birth control to the women’s auxiliary of the Ku Klux Klan in Silver Lake, New Jersey.[47] She described it as “one of the weirdest experiences I had in lecturing,” and added that she had to use only “the most elementary terms, as though I were trying to make children understand.”[47] Sanger’s talk was well received by the group, and as a result, “a dozen invitations to similar groups were proffered.”[47]
In 1928, conflict within the birth control movement leadership led Sanger to resign as the president of the ABCL and take full control of the CRB, renaming it the Birth Control Clinical Research Bureau (BCCRB), marking the beginning of a schism in the movement that would last until 1938.[48]
Sanger invested a great deal of effort communicating with the general public. From 1916 onward, she frequently lectured—in churches, women’s clubs, homes, and theaters—to workers, churchmen, liberals, socialists, scientists, and upper-class women.[49] She wrote several books in the 1920s which had a nationwide impact in promoting the cause of birth control. Between 1920 and 1926, 567,000 copies of Woman and the New Race and The Pivot of Civilization were sold.[50] She also wrote two autobiographies designed to promote the cause. The first, My Fight for Birth Control, was published in 1931 and the second, more promotional version, Margaret Sanger: An Autobiography, was published in 1938.
During the 1920s, Sanger received hundreds of thousands of letters, many of them written in desperation by women begging for information on how to prevent unwanted pregnancies.[51][52] Five hundred of these letters were compiled into the 1928 book, Motherhood in Bondage.[53][54]
Sanger’s Birth Control Clinical Research Bureau operated from this New York building from 1930 to 1973.
In 1929, Sanger formed the National Committee on Federal Legislation for Birth Control in order to lobby for legislation to overturn restrictions on contraception.[55] That effort failed to achieve success, so Sanger ordered a diaphragm from Japan in 1932, in order to provoke a decisive battle in the courts. The diaphragm was confiscated by the United States government, and Sanger’s subsequent legal challenge led to a 1936 court decision which overturned an important provision of the Comstock laws which prohibited physicians from obtaining contraceptives.[56] This court victory motivated the American Medical Association in 1937 to adopt contraception as a normal medical service and a key component of medical school curriculums.[57]
This 1936 contraception court victory was the culmination of Sanger’s birth control efforts, and she took the opportunity, now in her late 50s, to move to Tucson, Arizona, intending to play a less critical role in the birth control movement. In spite of her original intentions, she remained active in the movement through the 1950s.[57]
In 1937, Sanger became chairman of the newly formed Birth Control Council of America, and attempted to resolve the schism between the ABCL and the BCCRB.[58] Her efforts were successful, and the two organizations merged in 1939 as the Birth Control Federation of America.[59][note 5] Although Sanger continued in the role of president, she no longer wielded the same power as she had in the early years of the movement, and in 1942, more conservative forces within the organization changed the name to Planned Parenthood Federation of America, a name Sanger objected to because she considered it too euphemistic.[60]
In 1946, Sanger helped found the International Committee on Planned Parenthood, which evolved into the International Planned Parenthood Federation in 1952, and soon became the world’s largest non-governmental international family planning organization. Sanger was the organization’s first president and served in that role until she was 80 years old.[61] In the early 1950s, Sanger encouraged philanthropist Katharine McCormick to provide funding for biologist Gregory Pincus to develop the birth control pill which was eventually sold under the name Enovid.[62]
Long after her death, Sanger has continued to be regarded as a leading figure in the battle for American women’s rights. Sanger’s story has been the subject of several biographies, including an award-winning biography published in 1970 by David Kennedy, and is also the subject of several films, including Choices of the Heart: The Margaret Sanger Story.[65] Sanger’s writings are curated by two universities: New York University‘s history department maintains the Margaret Sanger Papers Project,[66] and Smith College‘s Sophia Smith Collection maintains the Margaret Sanger Papers collection.[67]
Sanger has been recognized with many important honors. In 1957, the American Humanist Association named her Humanist of the Year. Government authorities and other institutions have memorialized Sanger by dedicating several landmarks in her name, including a residential building on the Stony Brook University campus, a room in Wellesley College’s library,[68] and Margaret Sanger Square in New York City’s Greenwich Village.[69] In 1993, the Margaret Sanger Clinic—where she provided birth control services in New York in the mid twentieth century—was designated as a National Historic Landmark by the National Park Service.[70] In 1966, Planned Parenthood began issuing its Margaret Sanger Awards annually to honor “individuals of distinction in recognition of excellence and leadership in furthering reproductive health and reproductive rights.”[71]
While researching information on contraception Sanger read various treatises on sexuality in order to find information about birth control. She read The Psychology of Sex by the English psychologist Havelock Ellis and was heavily influenced by it.[74] While traveling in Europe in 1914, Sanger met Ellis.[75] Influenced by Ellis, Sanger adopted his view of sexuality as a powerful, liberating force.[76] This view provided another argument in favor of birth control, as it would enable women to fully enjoy sexual relations without the fear of an unwanted pregnancy.[77] Sanger also believed that sexuality, along with birth control, should be discussed with more candor.[76]
However, Sanger was opposed to excessive sexual indulgence. She stated “every normal man and woman has the power to control and direct his sexual impulse. Men and women who have it in control and constantly use their brain cells thinking deeply, are never sensual.”[78][79] Sanger said that birth control would elevate women away from a position of being an object of lust and elevate sex away from purely being for satisfying lust, saying that birth control “denies that sex should be reduced to the position of sensual lust, or that woman should permit herself to be the instrument of its satisfaction.”[80] Sanger wrote that masturbation was dangerous. She stated: “In my personal experience as a trained nurse while attending persons afflicted with various and often revolting diseases, no matter what their ailments, I never found any one so repulsive as the chronic masturbator. It would not be difficult to fill page upon page of heart-rending confessions made by young girls, whose lives were blighted by this pernicious habit, always begun so innocently.”[81] She believed that women had the ability to control their sexual impulses, and should utilize that control to avoid sex outside of relationships marked by “confidence and respect.” She believed that exercising such control would lead to the “strongest and most sacred passion.”[82] However, Sanger was not opposed to homosexuality and praised Ellis for clarifying “the question of homosexuals… making the thing a—not exactly a perverted thing, but a thing that a person is born with different kinds of eyes, different kinds of structures and so forth… that he didn’t make all homosexuals perverts—and I thought he helped clarify that to the medical profession and to the scientists of the world as perhaps one of the first ones to do that.”[83] Sanger believed sex should be discussed with more candor, and praised Ellis for his efforts in this direction. She also blamed the suppression of discussion about it on Christianity.[83]
Eugenics
Sanger’s 1920 book endorsed eugenics.
As part of her efforts to promote birth control, Sanger found common cause with proponents of eugenics, believing that they both sought to “assist the race toward the elimination of the unfit.”[84] Sanger was a proponent of negative eugenics, which aims to improve human hereditary traits through social intervention by reducing the reproduction of those who were considered unfit. In “The Morality of Birth Control,” a 1921 speech, she divided society into three groups: the educated and informed class that regulated the size of their families, the intelligent and responsible who desired to control their families however did not have the means or the knowledge and the irresponsible and reckless people whose religious scruples “prevent their exercising control over their numbers.” Sanger concludes “there is no doubt in the minds of all thinking people that the procreation of this group should be stopped.”[85] Sanger’s eugenic policies included an exclusionary immigration policy, free access to birth control methods and full family planning autonomy for the able-minded, and compulsory segregation or sterilization for the “profoundly retarded”.[86][87] In her book The Pivot of Civilization, she advocated coercion to prevent the “undeniably feeble-minded” from procreating.[88] Although Sanger supported negative eugenics, she asserted that eugenics alone was not sufficient, and that birth control was essential to achieve her goals.[89][90][91]
In contrast with eugenicist William Robinson, who advocated euthanasia for the unfit,[note 8] Sanger wrote, “we [do not] believe that the community could or should send to the lethal chamber the defective progeny resulting from irresponsible and unintelligent breeding.”[92] Similarly, Sanger denounced the aggressive and lethal Nazi eugenics program.[87] In addition, Sanger believed the responsibility for birth control should remain in the hands of able-minded individual parents rather than the state, and that self-determining motherhood was the only unshakable foundation for racial betterment.[89][93]
Sanger also supported restrictive immigration policies. In “A Plan for Peace”, a 1932 essay, she proposed a congressional department to address population problems. She also recommended that immigration exclude those “whose condition is known to be detrimental to the stamina of the race,” and that sterilization and segregation be applied to those with incurable, hereditary disabilities.[86][87][94]
Sanger’s writings echoed her ideas about inferiority and loose morals of particular races. In one “What Every Girl Should Know” commentary, she references popular opinion that Aboriginal Australians were “just a step higher than the chimpanzee” with “little sexual control,” as compared to the “normal man and Woman.”[78] Elsewhere she bemoaned that traditional sexual ethics “… have in the past revealed their woeful inability to prevent the sexual and racial chaos into which the world has today drifted.”[93]
Such attitudes did not keep her from collaborating with African-American leaders and professionals who saw a need for birth control in their communities. In 1929, James H. Hubert, a black social worker and leader of New York’s Urban League, asked Sanger to open a clinic in Harlem.[96] Sanger secured funding from the Julius Rosenwald Fund and opened the clinic, staffed with black doctors, in 1930. The clinic was directed by a 15-member advisory board consisting of black doctors, nurses, clergy, journalists, and social workers. The clinic was publicized in the African-American press and in black churches, and it received the approval of W. E. B. Du Bois, founder of the NAACP.[97] In 1939 Sanger wrote, “We should hire three or four colored ministers, preferably with social-service backgrounds, and with engaging personalities. The most successful educational approach to the Negro is through a religious appeal. We don’t want the word to go out that we want to exterminate the Negro population, and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.” She did not tolerate bigotry among her staff, nor would she tolerate any refusal to work within interracial projects.[98] Sanger’s work with minorities earned praise from Martin Luther King, Jr., in his 1966 acceptance speech for the Margaret Sanger award.[99]
From 1939 to 1942 Sanger was an honorary delegate of the Birth Control Federation of America, which included a supervisory role—alongside Mary Lasker and Clarence Gamble—in the Negro Project, an effort to deliver birth control to poor black people.[100] Sanger wanted the Negro Project to include black ministers in leadership roles, but other supervisors did not. To emphasize the benefits of involving black community leaders, she wrote to Gamble “we do not want word to go out that we want to exterminate the Negro population and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.” This quote has been cited by Angela Davis to support her claims that Sanger wanted to exterminate black people.[101] However, New York University’s Margaret Sanger Papers Project, argues that in writing that letter, “Sanger recognized that elements within the black community might mistakenly associate the Negro Project with racist sterilization campaigns in the Jim Crow South, unless clergy and other community leaders spread the word that the Project had a humanitarian aim.”[102]
Freedom of speech
Sanger opposed censorship throughout her career, with a zeal comparable to her support for birth control. Sanger grew up in a home where iconoclastic orator Robert Ingersoll was admired.[103] During the early years of her activism, Sanger viewed birth control primarily as a free-speech issue, rather than as a feminist issue, and when she started publishing The Woman Rebel in 1914, she did so with the express goal of provoking a legal challenge to the Comstock laws banning dissemination of information about contraception.[21] In New York, Emma Goldman introduced Sanger to members of the Free Speech League, such as Edward Bliss Foote and Theodore Schroeder, and subsequently the League provided funding and advice to help Sanger with legal battles.[104]
Over the course of her career, Sanger was arrested at least eight times for expressing her views during an era in which speaking publicly about contraception was illegal.[105] Numerous times in her career, local government officials prevented Sanger from speaking by shuttering a facility or threatening her hosts.[106] In Boston in 1929, city officials under the leadership of James Curley threatened to arrest her if she spoke—so she turned the threat to her advantage and stood on stage, silent, with a gag over her mouth, while her speech was read by Arthur M. Schlesinger, Sr.[107]
Abortion
Sanger’s family planning advocacy always focused on contraception, rather than abortion.[108][note 9] It was not until the mid-1960s, after Sanger’s death, that the reproductive rights movement expanded its scope to include abortion rights as well as contraception.[note 10] Sanger was opposed to abortions, both because she believed that life should not be terminated after conception, and because they were dangerous for the mother in the early 20th century. In her book Woman and the New Race, she wrote: “while there are cases where even the law recognizes an abortion as justifiable if recommended by a physician, I assert that the hundreds of thousands of abortions performed in America each year are a disgrace to civilization.”[111]
Historian Rodger Streitmatter concluded that Sanger’s opposition to abortion stemmed from concerns for the dangers to the mother, rather than moral concerns.[112] However, in her 1938 autobiography, Sanger noted that her opposition to abortion was based on the taking of life: “[In 1916] we explained what contraception was; that abortion was the wrong way no matter how early it was performed it was taking life; that contraception was the better way, the safer way—it took a little time, a little trouble, but was well worth while in the long run, because life had not yet begun.”[113] And in her book Family Limitation, Sanger wrote that “no one can doubt that there are times when an abortion is justifiable but they will become unnecessary when care is taken to prevent conception. This is the only cure for abortions.”[114]
Works
Books and pamphlets
What Every Mother Should Know – Originally published in 1911 or 1912, based on a series of articles Sanger published in 1911 in the New York Call, which were, in turn, based on a set of lectures Sanger gave to groups of Socialist party women in 1910–1911.[115] Multiple editions published through the 1920s, by Max N. Maisel and Sincere Publishing, with the title What Every Mother Should Know, or how six little children were taught the truth …Online(1921 edition, Michigan State University)
Family Limitation – Originally published 1914 as a 16-page pamphlet; also published in several later editions. Online (1917, 6th edition, Michigan State University)
What Every Girl Should Know – Originally published 1916 by Max N. Maisel; 91 pages; also published in several later editions. Online (1920 edition); Online (1922 ed., Michigan State University)
The Case for Birth Control: A Supplementary Brief and Statement of Facts – May 1917, published to provide information to the court in a legal proceeding. Online (Internet Archive)
Woman and the New Race, 1920, Truth Publishing, foreword by Havelock Ellis. Online (Harvard University); Online (Project Gutenberg); Online (Internet Archive); Audio on Archive.org
An Autobiography. New York, NY: Cooper Square Press. 1938. ISBN0-8154-1015-8.
Fight for Birth Control, 1916, New York] [1] (The Library of Congress)
Birth Control A Parent’s Problem or Women’s?” The Birth Control Review, Mar. 1919, 6-7.
Periodicals
The Woman Rebel – Seven issues published monthly from March 1914 to August 1914. Sanger was publisher and editor.
Birth Control Review – Published monthly from February 1917 to 1940. Sanger was Editor until 1929, when she resigned from the ABCL.[116] Not to be confused with Birth Control News, published by the London-based Society for Constructive Birth Control and Racial Progress.
Collections and anthologies
Sanger, Margaret, The Selected Papers of Margaret Sanger, Volume 1: The Woman Rebel, 1900–1928, Esther Katz, Cathy Moran Hajo, Peter Engelman (eds), University of Illinois Press, 2003
Sanger, Margaret, The Selected Papers of Margaret Sanger, Volume 2: Birth Control Comes of Age, 1928–1939, Esther Katz, Cathy Moran Hajo, Peter Engelman (eds), University of Illinois Press, 2007
Sanger, Margaret, The Selected Papers of Margaret Sanger, Volume 3: The Politics of Planned Parenthood, 1939–1966, Esther Katz, Cathy Moran Hajo, Peter Engelman (eds), University of Illinois Press, 2010
Story 1: Democrats and Progressives Support Planned Parenthood’s Big Business of Abortions, Baby Butchering and Selling Baby Body Parts For Money — Moral Bankruptcy of The Lying Lunatic Left — Killing Black, Hispanic and White Babies and Selling Their Baby Parts For Money — Progressive Eugenics Today –Stop Killing Babies! — Videos
SHOCK VIDEO: Planned Parenthood sells dead baby body parts
Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
BUSTED! Proof Planned Parenthood Sells Dead Babies to Anyone Willing to Buy! LEAKED FOOTAGE!
REP STANDS UP TO BABY PARTS BROKERS of PLANNED PARENTHOOD SATANISTS
Planned Parenthood Exposed
FULL FOOTAGE: Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
The Rolling Stones – You Can’t Always Get What You Want (lyrics)
Rolling Stones – You Can’t Always Get What You Want (The David Frost Show 1969)
The Silent Scream (Full Length)
The Silent Scream Complete Version – Abortion as Infanticide
Dr. Bernard Nathanson’s classic video that shocked the world. He explains the procedure of a suction abortion, followed by an actual first trimester abortion as seen through ultrasound. The viewer can see the child’s pathetic attempts to escape the suction curette as her heart rate doubles, and a “silent scream” as her body is torn apart. A great tool to help people see why abortion is murder. The most important video on abortion ever made. This video changed opinion on abortion to many people.
Introduction by Dr. Bernard Nathanson, host. Describes the technology of ultrasound and how, for the first time ever, we can actually see inside the womb. Dr. Nathanson further describes the ultrasound technique and shows examples of babies in the womb. Three-dimensional depiction of the developing fetus, from 4 weeks through 28 weeks. Display and usage of the abortionists’ tools, plus video of an abortionist performing a suction abortion.
Dr. Nathanson discusses the abortionist who agreed to allow this abortion to be filmed with ultrasound. The abortionist was quite skilled, having performed more than 10,000 abortions. We discover that the resulting ultrasound of his abortion so appalled him that he never again performed another abortion.
The clip begins with an ultrasound of the fetus (girl) who is about to be aborted. The girl is moving in the womb; displays a heartbeat of 140 per minute; and is at times sucking her thumb. As the abortionist’s suction tip begins to invade the womb, the child rears and moves violently in an attempt to avoid the instrument. Her mouth is visibly open in a “silent scream.” The child’s heart rate speeds up dramatically (to 200 beats per minute) as she senses aggression. She moves violently away in a pathetic attempt to escape the instrument. The abortionist’s suction tip begins to rip the baby’s limbs from its body, ultimately leaving only her head in the uterus (too large to be pulled from the uterus in one piece). The abortionist attempts to crush her head with his forceps, allowing it to be removed. In an effort to “dehumanize” the procedure, the abortionist and anesthesiologist refer to the baby’s head as “number 1.” The abortionist crushes “number 1” with the forceps and removes it from the uterus.
Abortion statistics are revealed, as well as who benefits from the enormously lucrative industry that has developed. Clinics are now franchised, and there is ample evidence that many are controlled by organized crime. Women are victims, too. They haven’t been told about the true nature of the unborn child or the facts about abortion procedures. Their wombs have been perforated, infected, destroyed, and sterilized. All as a result of an operation about which they they have had no true knowledge.
Films like this must be made part of “informed consent.” NARAL (National Abortion Rights Action League) and Planned Parenthood are accused of a conspiracy of silence, of keeping women in the dark about the reality of abortion. Finally, Dr. Nathanson discusses his credentials. He is a former abortionist, having been the director of the largest clinic in the Western world.
Margaret Sanger’s “Negro Project” & Barack Obama’s Planned Parenthood
Planned Parenthood Exposed
Obama Tells Planned Parenthood-God Bless You – YouTube
A message to Planned Parenthood Supporters from President Obama
Barack Obama Addresses Planned Parenthood
Obama In ’03: No On Banning Late Term Abortions
Obama’s Barbaric Views on Partial Birth Abortion and Infanticide
MAAFA 21 [A documentary on eugenics and genocide]
Hitler`s Biological Soldiers / Science and the Swastika (EUGENICS)
Eugenics Glenn Beck w/ Edwin Black author of “War Against the Weak” talk Al Gore & Margaret Sanger
OVERPOPULATION
What’s Wrong With Socialism?
Eugenics, Planned Parenthood & Psychology, Mind Control
Mind Control, Psychology of Brainwashing, Sex & Hypnosis
Sex Addiction, Restless Legs Syndrome, PMS & Drug, Mind Control Report
Margaret Sanger, Planned Parenthood’s Racist Founder
Margaret Sanger: Eugenicist (1/3)
Margaret Sanger: Eugenicist (2/3)
Margaret Sanger: Eugenicist (3/3)
Pro-Lifer Mark Crutcher & Alex Jones: Eugenics is The Heart of The Globalists Religion 1/3
Pro-Lifer Mark Crutcher & Alex Jones: Eugenics is The Heart of The Globalists Religion 2/3
Pro-Lifer Mark Crutcher & Alex Jones: Eugenics is The Heart of The Globalists Religion 3/3
Slow Kill Holocaust: Proof the Government is Killing You
War on the Weak: Eugenics in America
Eugenics: Science In History
Bill O’Reilly Calls Planned Parenthood An “Abortion Mill”
Eugenics: alive and well in the USA
Scientific Racism The Eugenics of Social Darwinism
Eugenics, Population Control, and the NWO
Agenda 21 & Eugenics – Bill Gates Depopulation Plans Exposed
The Depopulation Agenda For a New World Order Agenda 21 ☁☢☁☰☰☰☰☰✈
George Carlin – List of people who ought to be killed
The Rolling Stones – Angie – OFFICIAL PROMO (Version 1)
Undercover video shows Planned Parenthood official discussing fetal organs used for research
By Sandhya Somashekhar and Danielle Paquette
An antiabortion group on Tuesday released an undercover video of an official at Planned Parenthood discussing in graphic detail how to abort a fetus to preserve its organs for medical research — as well as the costs associated with sharing that tissue with scientists.
Over lunch at a Los Angeles restaurant, two antiabortion activists posing as employees from a biotech firm met with Deborah Nucatola, Planned Parenthood’s senior director of medical research. Armed with cameras, the activists recorded Nucatola talking about Planned Parenthood’s work donating fetal tissue to researchers and pressed her on whether the clinics were charging for the organs.
The Center for Medical Progress, which recorded and edited the video, says the footage proves that Planned Parenthood is breaking the law by selling fetal organs. But the video does not show Nucatola explicitly talking about selling organs. The Planned Parenthood official says the organization is “very, very sensitive” about being perceived as illegally profiting from organ sales and charges only for the cost, for instance, of shipping the tissue.
[Congressional and state investigations into the video have begun]
The video threatens to reignite a long-standing debate over the use of fetal tissue harvested through abortions and could add fuel to efforts seeking to ban abortions after 20 weeks of pregnancy.
In a statement, a spokesman for Planned Parenthood said the video misrepresents the organization’s work. Planned Parenthood clinics, with a patient’s permission, may sometimes donate fetal tissue for use in stem cell research, said the spokesman, who added that the group’s affiliates, which operate independently, do not profit from these donations.
“At several of our health centers, we help patients who want to donate tissue for scientific research, and we do this just like every other high-quality health-care provider does — with full, appropriate consent from patients and under the highest ethical and legal standards,” spokesman Eric Ferrero said. “In some instances, actual costs, such as the cost to transport tissue to leading research centers, are reimbursed, which is standard across the medical field.”
He accused the Center for Medical Progress of mounting a misleading attack similar to those by other groups that have tried to mount undercover “stings” targeting Planned Parenthood.
But antiabortion groups said the video shows that Planned Parenthood is essentially selling fetal organs and that Congress and other authorities should investigate.
Buying and selling human fetal tissue is illegal in the United States. Federal regulations also prohibit anyone from altering the timing or method of an abortion for the sole purpose of later using the tissue in research. Donating the tissue for research, however, is legal with a woman’s consent.
Antiabortion groups also said the callous nature of the discussion captured on film should tug at viewers’ consciences — particularly when Nucatola apparently describes “crushing” the fetus in ways that keep its internal organs intact and her remarks about researchers’ desire for lungs and livers.
“I’d say a lot of people want liver,” she says in the video posted on the Center for Medical Progress’s Web site, between bites of salad. “And for that reason, most providers will do this case under ultrasound guidance so they’ll know where they’re putting their forceps.”
She continues: “We’ve been very good at getting heart, lung, liver, because we know that, so I’m not gonna crush that part, I’m gonna basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact.”
It’s hard to assess exactly what happened at the lunch with Nucatola. The antiabortion group had complete control over the filming and editing of the footage. The group also posted a nearly three-hour version of the video that it’s calling the “full footage,” though there is no way to verify that the video is truly complete.
Key moments from the undercover recording with Planned Parenthood executive(7:56)
The anti-abortion group Center for Medical Progress posted a long version of the conversation between a Planned Parenthood executive and undercover actors on YouTube along with an shorter version that has been shared widely. These are excerpts of the longer version. (CenterforMedicalProgress.org)
The unidentified activists, a man and a woman, told Nucatola they worked for a biotech firm that aimed to snare “a competitive advantage” by providing local samples for researchers who would like to avoid lengthy trips between clinic and lab. They said they worked in Norwalk, a suburb.
“Every provider has patients who want to donate their tissue, and they want to accommodate them,” says Nucatola. “They just want to do it in a way that is not perceived as: This clinic is selling tissue. This clinic is making money off this. In the Planned Parenthood world, they’re very, very sensitive to that. Some affiliates might do it for free. They want to come to a number that looks like a reasonable number for the effort that is allotted on their part . . . ”
One activist asks, “Okay, so, when you are — or when the affiliate is — determining what that monetary . . . So that it doesn’t raise the question of . . . ‘This is what it’s about’ — What price range would you . . . ?”
“You know, I would throw a number out, I would say it’s probably anywhere from $30 to $100, depending on the facility and what’s involved,” says Nucatola. “It just has to do with space issues, are you sending someone there that’s going to be doing everything . . . is there shipping involved? Is someone going to be there to pick it up?”
In order to film the footage, the activists wore “police-quality undercover cameras,” said David Daleiden, who ran the project for the Center of Medical Progress. (He refused to elaborate: “I don’t answer questions about our undercover costumes.”)
The “sting” unfolded over three years, Daleiden said, because it takes time to build up a front as a biotech company and gain access to Planned Parenthood executives. The lunch, he said, is just the beginning: The Center for Medical Progress plans to release a new video every week for the next few months.
Daleiden rejects Nucatola’s claim that costs associated with fetal tissue donation involve shipping and staff hours. “Literally the only thing the clinic is doing is carrying the fetus from the operation to the tech,” he said.
The Center for Medical Progress was established by Daleiden, a controversial antiabortion activist who previously worked with Live Action, another antiabortion group known for its “stings” of Planned Parenthood using actors and undercover videos.
The group is a non-profit organization that describes itself on its Web site as “a group of citizen journalists dedicated to monitoring and reporting on medical ethics and advances.”
“The promotional video mischaracterizing Planned Parenthood’s mission and services is made by a long time anti-abortion activist that has used deceptive and unethical video editing, and that has created a fake medical website as well as a fake human tissue website that purports to provide services to stem cell researchers,” Planned Parenthood said in a statement Tuesday.
Daleiden also alleges that the procedure described by Nucatola is similar to “intact dilation and extraction,” referred to by opponents as partial-birth abortion, which Congress outlawed in 2003. The Supreme Court upheld the law’s constitutionality four years later.
In the 1980s and 1990s, researchers considered fetal tissue transplants a budding treatment for Parkinson’s disease and diabetes. Some believed they held the potential to prevent autism.
As different kind of stem cells — embryonic stem cells — gain prominence in research, fetal tissue donations today are often used to gain deeper anatomical understanding of fetuses, said Arthur Caplan, director of New York University’s Division of Medical Ethics. The practice, however, is problematic if an abortion provider goes into a procedure with the primary intention of preserving a liver, he said. In the video, Nucatola appears to allude to methods for carefully extracting the organs.
“I think the only relevant goal of an abortion clinic is to provide a safe and least risky abortion to a woman,” Caplan said. “If you’re starting to play with how it’s done, and when it’s done, other things than women’s health are coming into play. You’re making a huge mountain of conflict of interest around a period for many people is morally difficult.”
A number of Republicans, including a few presidential candidates, reacted Tuesday to the video.
“This latest news is tragic and outrageous,” Carly Fiorina wrote on Facebook.
“This is a shocking and horrific reminder that we must do so much more to foster a culture of life in America,” said Jeb Bush on Twitter.
As politicians responded to the video, a bill to increase funding for breast cancer research was pulled from the House floor after abortion critics linked it to Planned Parenthood. The Breast Cancer Awareness Commemorative Coin Act would have raised as much as $4.75 million in research funds for Susan G. Komen for the Cure—an organization that has a longstanding alliance with Planned Parenthood to fund preventative cancer screenings. The bill was expected to pass easily, but House Republican leaders pulled it from consideration after the conservative group Heritage Action objected.
Whether the video Tuesday shows illegal activity could ultimately be irrelevant. For years, antiabortion groups promoted their cause by highlighting the sometimes disturbing details of abortion procedures and painting abortion providers as callous and unethical.
They have argued against allowing abortions later in pregnancy by suggesting that older fetuses can feel pain and they are pushing for a federal ban on the procedure at 20 weeks of pregnancy.
The accusation that Planned Parenthood is illegally selling the organs of fetuses is not new among antiabortion advocates. The controversy gained national attention in 2000, after the publication of an undercover investigation by a Texas-based antiabortion group, Life Dynamics, which was also involved in Tuesday’s video release.
The investigation’s conclusion, that a Kansas clinic affiliated with Planned Parenthood was participating in a scheme to profit from the sale of fetal tissues, prompted a 20/20 hidden camera investigation on the subject, and a hearing of the Subcommittee on Health and Environment in the House of Representatives.
The FBI also investigated the Kansas clinic for any wrongdoing, but later concluded that it did not break any laws.
Story 1: Supreme Court Obamacare Attack On American Consumer Sovereignty and Individual Freedom — Big Government Tyranny and Coercion — Videos
“The state is that great fiction by which everyone tries to live at the expense of everyone else.”
“Each of us has a natural right, from God, to defend his person, his liberty, and his property.”
~ Frederic Bastiat
“Liberty is always freedom from the government.”
“The fact is that, under a capitalistic system, the ultimate bosses are the consumers.
The sovereign is not the state, it is the people.”
“The common man is the sovereign consumer whose buying or abstention from buying ultimately determines what should be produced and in what quantity and quality.”
“It is important to remember that government interference always means either violent action or the threat of such action.
The funds that a government spends for whatever purposes are levied by taxation.
And taxes are paid because the taxpayers are afraid of offering resistance to the tax gatherers.
They know that any disobedience or resistance is hopeless.
As long as this is the state of affairs, the government is able to collect the money that it wants to spend.
Government is in the last resort the employment of armed men, of policemen, gendarmes, soldiers, prison guards, and hangmen.
The essential feature of government is the enforcement of its decrees by beating, killing, and imprisoning.
Those who are asking for more government interference are asking ultimately for more compulsion and less freedom.”
~Ludwig von Mises
“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined —’to say what the law is.’ … That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”
~Chief Justice John Roberts
“Today’s interpretation is not merely unnatural; it is unheard of. Who would ever have dreamt that ‘Exchange established by the State’ means ‘Exchange established by the State or the Federal Government’? Little short of an express statutory definition could justify adopting this singular reading.”
“We should start calling this law SCOTUScare.”
~Justice Antonin Scalia
Watch: Stunned Judge Napolitano Reveals How Supreme Court Just Pulled The Wool Over America’s Eyes
Some Republicans Relieved by Supreme Court Ruling on Obamacare
Cruz Slams ‘Lawless’ Supreme Court After Obamacare Ruling
Rand Paul Warns GOP Leadership: Don’t Give Us ‘Obamacare Lite’
Republicans Plot Next Steps After Supreme Court Upholds Obamacare Subsidies
US President Obama on Supreme Court decision on Obamacare | Affordable Care Act here to stay
Newsmax Now | Nick Tate discusses SCOTUS upholding the Obamacare Subsidies
The Hard Line | F.H. Buckley the Supreme Court’s ruling to uphold Obamacare subsidies
Supreme Court upholds Obamacare subsidies in 6-3 ruling
5 Takeaways From Today’s Supreme Court Ruling on Obamacare
How Americans are reacting to the Supreme Court’s ACA decision
G. Edward Griffin: The Collectivist Conspiracy
A Powerful Documentary: G Edward Griffin ‒ The Capitalist Conspiracy
The Truth About Obamacare
In Upholding Obamacare’s Subsidies, Justice Roberts Rewrites the Law—Again
Time to start calling the Affordable Care Act SCOTUScare.
By Peter Suderman
Supreme Court Chief Justice John Roberts has rewritten the law to save Obamacare—again.
Roberts’ majority opinion today in King v. Burwell, which ruled that the Obama administration’s decision to allow health insurance subsidies flow through the law’s federal exchanges, leaves no doubt that Roberts considers it his duty to keep the law afloat.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he writes. “If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”
And so Roberts decided that a law which explicitly and repeatedly states that subsidies are limited to exchanges “established by a State,” and which defines “State” as one of the 50 states or the District of Columbia, actually allows subsidies in exchanges established by a State or the federal government. Roberts’ decision does not interpret Obamacare; it adds to it and reworks it, and in the process transforms it into something that it is not.
Roberts has not merely tweaked the law; he has rewritten it to mean the opposite of what it clearly means. Why include the phrase “established by a State under Section 1311″—the section dealing with state-based exchanges—except to limit the subsidies to those particular exchanges? Roberts’ opinion reconceptualizes this limiting language as inclusive.
The Chief Justice frames his decision as a form of respectful deference to congressional intent. As my colleague Damon Root noted earlier, his opinion cautions that in “every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan.”
But Roberts’ opinion is far more than a fair reading of the legislative plan; it is a Court-imposed decision as to what that plan must be.
As Justice Antonin Scalia writes in a scathing dissent, Roberts presumes, with no definitive evidence, that his interpretation is the one that Congress intended. “What makes the Court so sure that Congress ‘meant’ tax credits to be available everywhere?” Scalia asks. “Our only evidence of what Congress meant comes from the terms of the law, and those terms show beyond all question that tax credits are available only on state Exchanges.”
Roberts’ opinion declares its intent to uphold the law’s basic policy scheme, arguing that there would be adverse insurance market effects to a decision in favor of the challengers. In other words, there would have been policy implications to a ruling for the plaintiffs. That is almost certainly true, but it is not an excuse to rewrite the clear language of the law.
As Scalia says in the dissent, “The Court protests that without the tax credits, the number of people covered by the individual mandate shrinks, and without a broadly applicable individual mandate the guaranteed-issue and community-rating requirements ‘would destabilize the individual insurance market.’ If true, these projections would show only that the statutory scheme contains a flaw; they would not show that the statute means the opposite of what it says.” The majority has decided how Obamacare’s policy scheme should work, and redrafted the statute accordingly.
If Roberts had truly wanted to defer to Congress, he could have ruled that the law means what says rather than what it does not, and effectively handed the issue back to the legislature, letting Congress decide whether and how to update the law in accordance with its own wishes. Instead, Roberts made the choice for Congress—taking its power to craft law for itself. As Scalia writes, “the Court’s insistence on making a choice that should be made by Congress both aggrandizes judicial power and encourages congressional lassitude.”
This is not the first time that Roberts has rewritten the law in order to uphold it. In 2012, he declared that the law’s individual mandate to purchase insurance was unconstitutional under the Constitution’s Commerce Clause—and yet upheld it by declaring that the law’s penalty was instead permissible as a tax. In the same decision, he also found that the law’s threat to revoke all federal Medicaid funding from states that decline to participate in Obamacare’s expansion of the program was unconstitutionally coercive. But rather than strike the whole thing down, Roberts rewrote it, allowing the Medicaid expansion, and the rest of the law, to continue but without the same threat to state budgets.
In his dissent, Scalia argues that there’s a pattern to these rulings. “Under all the usual rules of interpretation, in short, the Government should lose this case. But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved.”
If anything, it’s even worse. What Roberts has saved is not the law so much as the Obama administration’s dubious, textually unsupported interpretation and implementation of Obamacare. This is not judicial restraint. It is judicial hubris.
And while it would be overstatement to say that this damages the legitimacy of the Court, it certainly reflects on the legacy and status of the law. As even Roberts admits in his opinion, the law “contains more than a few examples of inartful drafting” and generally “does not reflect the type of care and deliberation that one might expect of such significant legislation.” It is a shoddy, messy piece of legislation, held together, barely, by Supreme Court duct tape.
At this point, then, the law is as much a joint project between the administration and the Roberts court as it is a creation of Congress. As Scalia snarks at the end of his dissent, “we should start calling this law SCOTUScare.” Regardless of what we call it, that’s effectively what it has become.
The U.S. Supreme Court on Thursday handed the Obama administration a major victory on health care, ruling 6-3 that nationwide subsidies called for in the Affordable Care Act are legal.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” the court’s majority said in the opinion, which was written by Chief Justice John Roberts. But they acknowledged that “petitioners’ arguments about the plain meaning … are strong.”
The majority opinion cited the law’s “more than a few examples of inartful drafting,” but added, “the context and structure of the Act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”
Roberts was joined by the court’s liberal justices, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan, as well as by Anthony Kennedy.
In his dissent, Justice Antonin Scalia said: “We should start calling this law SCOTUScare,” an apparent reference to the fact the Supreme Court has now saved the Affordable Care Act twice. Scalia called the majority’s reading of the text “quite absurd, and the court’s 21 pages of explanation make it no less so.”
As NPR’s Nina Totenberg reported in March, opponents of the law contended “that the text of the law does not authorize subsidies to make mandated insurance affordable in 34 states.”
At issue were six words in one section of the law. As Nina pointed out: “Those words stipulate that for people who cannot afford health coverage, subsidies are available through ‘an exchange established by the state.’ ” She added:
“The government [contended] that those words refer to any exchange, whether it is set up by the state itself or an exchange run for the state by the federal government in accordance with individual state insurance laws and regulations. The challengers [said] the statute means what it says and no more.”
The court agreed Thursday with the government’s position.
The decision comes three years after a bitterly divided high court upheld the Affordable Care Act as constitutional by a 5-4 vote.
President Obama made a statement on the ruling late Thursday morning, saying the Affordable Care Act “is here to stay.”
SCOTUS rules 6-3 in favor of administration in major defeat for critics of the health law.
Peter Suderman
Obamacare’s health insurance subsidies will live, thanks to the Supreme Court.
The High Court has ruled 6-3 in favor of the administration to uphold the subsidies in Obamacare’s federal exchanges. The case challenged the administration’s decision, through the Internal Revenue Service, to allow subsidies in the 36 exchanges run by the federal government under the law.
The challengers argued that the plain text of the law, which states that subsidies are only available in an exchange “established by a State,” defining “State” to mean the 50 states or the District of Columbia, prohibited subsidies in the federal exchanges. The administration argued that the IRS rule allowing those subsidies was consistent with the overall structure of the law, and with congressional intent.
Writing for the majority, Chief Justice John Roberts sided with the administration’s position, saying that although the health law contains “more than a few examples of inartful drafting,” the Court nevertheless believes that the relevant section of the law “can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt.” The complete ruling can be read here.
Basically, the Supreme Court, decided they’d rather squint at the law and look at its general shape rather than bother too much with the plain meaning of the relevant text.
This is a major victory fo the administration and backers of the health law, whose decision to ignore the plain text of the law has been blessed by the Court. It’s also a big loss for critics of Obamacare, who hoped to see the law’s implementation restrained by its legislative text, and for straightforward interpretation of congressional statute.
What it means is that the crazy array of post-King scenarios that many had speculated about over the last few months will never come to pass. Obamacare stays the same, in terms of both policy and politics. It’s a ruling for the status quo.
Reason will have much more on this throughout the day.
Supreme Court Allows Nationwide Health Care Subsidies
The Supreme Courtruled on Thursday that President Obama’s health care law allows the federal government to provide nationwide tax subsidies to help poor and middle-class people buy health insurance, a sweeping vindication that endorsed the larger purpose of Mr. Obama’s signature legislative achievement.
The 6-to-3 ruling means that it is all but certain that the Affordable Care Act will survive after Mr. Obama leaves office in 2017. For the second time in three years, the law survived an encounter with the Supreme Court. But the court’s tone was different this time. The first decision, in 2012, was fractured and grudging, while Thursday’s ruling was more assertive.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice John G. Roberts Jr. wrote for a united six-justice majority. In 2012’s closely divided decision, Chief Justice Roberts also wrote the controlling opinion, but that time no other justice joined it in full.
Photo
Demonstrators expressed their support for the Affordable Care Act outside of the Supreme Court on Thursday.CreditDoug Mills/The New York Times
In dissent on Thursday, Justice Antonin Scalia called the majority’s reasoning “quite absurd” and “interpretive jiggery-pokery.”
He announced his dissent from the bench, a sign of bitter disagreement. His summary was laced with notes of incredulity and sarcasm, sometimes drawing amused murmurs in the courtroom as he described the “interpretive somersaults” he said the majority had performed to reach the decision.
“We really should start calling this law Scotus-care,” Justice Scalia said, to laughter from the audience.
In a hastily arranged appearance in the Rose Garden on Thursday morning, a triumphant Mr. Obama praised the ruling. “After multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay,” he said, adding: “What we’re not going to do is unravel what has now been woven into the fabric of America.”
The ruling was a blow to Republicans, who have been trying to gut the law since it was enacted. But House Speaker John A. Boehner vowed that the political fight against it would continue.
“The problem with Obamacare is still fundamentally the same: The law is broken,” Mr. Boehner said. “It’s raising costs for American families, it’s raising costs for small businesses and it’s just fundamentally broken. And we’re going to continue our efforts to do everything we can to put the American people back in charge of their health care and not the federal government.”
The case concerned a central part of the Affordable Care Act that created marketplaces, known as exchanges, to allow people who lack insurance to shop for individual health plans. Some states set up their own exchanges, but about three dozen allowed the federal government to step in to run them. Across the nation, about 85 percent of customers using the exchanges qualify for subsidies to help pay for coverage, based on their income.
The question in the case, King v. Burwell, No. 14-114, was what to make of a phrase in the law that seems to say the subsidies are available only to people buying insurance on “an exchange established by the state.”
A legal victory for the plaintiffs, lawyers for the administration said, would have affected more than six million people and created havoc in the insurance markets and undermined the law.
Chief Justice Roberts acknowledged that the plaintiffs had strong arguments about the plain meaning of the contested words. But he wrote that the words must be understood as part of a larger statutory plan. “In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”
The court decided in King v. Burwell that tax subsidies are being provided lawfully in three dozen states that have decided not to run the marketplaces for insurance coverage. Full analysis »
6-3
MAJORITY
DISSENT
Sotomayor
Kagan
Ginsburg
Breyer
Kennedy
Roberts
Scalia
Alito
Thomas
This was challenging, he said, in light of the law’s “more than a few examples of inartful drafting,” a consequence of rushed work behind closed doors that “does not reflect the type of care and deliberation that one might expect of such significant legislation.”
But he said the law’s interlocking parts supported a ruling in favor of the subsidies, particularly given that a contrary decision could have given rise to chaos in the insurance markets. A ruling rejecting subsidies in most of the nation would have left in place other parts of the law, including its guarantee of coverage regardless of pre-existing conditions, its requirement that most Americans obtain insurance or pay a penalty, and its expansion of Medicaid.
Without the subsidies, many people would be unable to afford insurance, and healthier consumers would go without coverage, leaving insurers with a sicker, more expensive pool of customers. That would raise prices for everyone, leading to what supporters of the law called death spirals.
“The statutory scheme compels us to reject petitioners’ interpretation,” Chief Justice Roberts wrote, referring to the challengers, “because it would destabilize the individual insurance market in any state with a federal exchange, and likely create the very ‘death spirals’ that Congress designed the act to avoid.”
In dissent, Justice Scalia wrote that the majority had stretched the statutory text too far.
Photo
Copies of the court’s ruling in favor of nationwide health insurance subsidies were rushed to television news reporters.CreditDoug Mills/The New York Times
“I wholeheartedly agree with the court that sound interpretation requires paying attention to the whole law, not homing in on isolated words or even isolated sections,” Justice Scalia wrote. “Context always matters. Let us not forget, however, why context matters: It is a tool for understanding the terms of the law, not an excuse for rewriting them.”
“Reading the act as a whole leaves no doubt about the matter,” he wrote. “ ‘Exchange established by the state’ means what it looks like it means.”
Justice Scalia said the decision had damaged the court’s reputation for “honest jurisprudence.”
The court, he said, had taken into its own hands a matter involving tens of billions of dollars that should have been left to Congress.
“It is up to Congress to design its laws with care,” he added, “and it is up to the people to hold them to account if they fail to carry out that responsibility.”
Justices Clarence Thomas and Samuel A. Alito Jr. joined Justice Scalia’s dissenting opinion.
Chief Justice Roberts rejected the argument that Congress had limited the availability of subsidies in order to encourage states to create their own exchanges, a notion that had occurred to almost no one at the time the law was enacted.
Sixteen states and the District of Columbia have established their own exchanges. Under the law, the federal government has stepped in to run exchanges in the rest of the states.
“The whole point of that provision,” Chief Justice Roberts wrote, “is to create a federal fallback in case a state chooses not to establish its own exchange. Contrary to petitioners’ argument, Congress did not believe it was offering states a deal they would not refuse — it expressly addressed what would happen if a state did refuse the deal.
The case started when four plaintiffs, all from Virginia, sued the Obama administration, saying the phrase meant that the law forbids the federal government to provide subsidies in states that do not have their own exchanges.
The plaintiffs challenged an Internal Revenue Service regulation that said subsidies were allowed whether the exchange was run by a state or by the federal government. They said the regulation was at odds with the Affordable Care Act.
In July, the United States Court of Appeals for the Fourth Circuit, in Richmond, Va., ruled against the challengers.
Judge Roger L. Gregory, writing for a three-judge panel of the court, said the contested phrase was “ambiguous and subject to multiple interpretations.” That meant, he said, that the I.R.S. interpretation was entitled to deference.
The Supreme Court’s ruling was more forceful. “This is not a case for the I.R.S.,” Chief Justice Roberts wrote. “It is instead our task to determine the correct reading.”
In a 6-3 ruling authored by Chief Justice Roberts, the Court held that subsidies are available on the federal exchanges. Those voting in the majority were Roberts, Kennedy, Ginsburg, Breyer, Sotomayor, and Kagan.
Had the court ruled otherwise, it would have put all of Obamacare in jeopardy, since 38 states do not have exchanges and Obamacare is too expensive for most people without a subsidy.
The issue was whether only state-established exchanges could issue tax credits, or whether the federal exchanges could also. Challengers to IRS regulations pointed to the words “established by the State” in the legislation as clear and unambiguous that subsidies were limited to state exchanges.
The Court rejected this assertion:
These provisions suggest that the Act may not always use the phrase “established by the State” in its most natural
sense. Thus, the meaning of that phrase may not be as clear as it appears when read out of context. [at 11.]
As he did in upholding an Obamacare constitutional challenge in 2012, Roberts found a way to read the law so as to save the law:
The upshot of all this is that the phrase “an Exchange established by the State under [42 U. S. C. §18031]” is properly viewed as ambiguous. The phrase may be limited in its reach to State Exchanges. But it is also possible that the phrase refers to all Exchanges—both State and Federal—at least for purposes of the tax credits. If a State chooses not to follow the directive in Section 18031 that it establish an Exchange, the Act tells the Secretary to establish “such Exchange.” §18041. And by using the words “such Exchange,” the Act indicates that State and Federal Exchanges should be the same. But State and Federal Exchanges would differ in a fundamental way if tax credits were available only on State Exchanges—one type of Exchange would help make insurance more affordable by providing billions of dollars to the States’ citizens; the other type of Exchange would not.2 [at 12-13]
The Court found Obamacare so “inartfully drafted” that the Court essentially wrote the law for Congress through “statutory interpretation.”
The Affordable Care Act contains more than a few examples of inartful drafting. (To cite just one, the Act creates three separate Section 1563s. See 124 Stat. 270, 911, 912.) Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through “the traditional legislative process.” Cannan, A Legislative
History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History, 105 L. Lib. J. 131, 163 (2013). And Congress passed much of the Act using a complicated budgetary procedure known as “reconciliation,” which limited opportunities for debate and amendment, and bypassed the Senate’s normal 60-vote filibuster requirement. Id., at 159–167. As a result, the Act does not reflect the type of care and deliberation that one mightexpect of such significant legislation….
Anyway, we “must do our best, bearing in mind the fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme.” Utility Air Regulatory Group, 573 U. S., at ___ (slip op., at 15) (internal quotation marks omitted). After reading Section 36B along with other related provisions in the Act, we cannot conclude that the phrase “an Exchange established by the State under [Section 18031]” is unambiguous. [at 14-15]
Nowhere in any of the opinions is the term “Gruber” mentioned. Jonathan Gruber, one of the architects of the law, stated on numerous occasions that there was a specific purpose of the language to exclude the federal exchange, so as to pressure states to get subsidies for their citizens by establishing exchanges.
Architect of Obamacare: Only get tax credits if buy on state exchanges
The Court rejected the Gruber view of Congressional intent:
The whole point of that provision is to create a federal fallback in case a State chooses not to establish its own Exchange. Contrary to petitioners’ argument, Congress did not believe it was offering States a deal they would not refuse—it expressly addressed what
would happen if a State did refuse the deal.
Having found the term “established by the State” ambiguous, the Court read it in a way such as to save Obamacare and prevent a “death spiral” of the law:
Given that the text is ambiguous, we must turn to the broader structure of the Act to determine the meaning of Section 36B. “A provision that may seem ambiguous in isolation is often clarified by the remainder of the statutory scheme . . . because only one of the permissible meanings produces a substantive effect that is compatible with the rest of the law.” United Sav. Assn. of Tex. v. Timbers of Inwood Forest Associates, Ltd., 484 U. S. 365, 371 (1988). Here, the statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very “death spirals” that Congress designed the Act to avoid. [at 15]
Reliance on context and structure in statutory interpretation is a “subtle business, calling for great wariness lest
what professes to be mere rendering becomes creation and attempted interpretation of legislation becomes legislation itself.” Palmer v. Massachusetts, 308 U. S. 79, 83 (1939). For the reasons we have given, however, such reliance is appropriate in this case, and leads us to conclude that Section 36B allows tax credits for insurance purchased on any Exchange created under the Act. Those credits are necessary for the Federal Exchanges to function like their State Exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid. [at 21]
Roberts and the majority did not want to be the ones to take down Obamacare, and that drove everything:
Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter. Section 36B can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt. [at 21]
Scalia’s dissent, joined by Thomas and Alito, was stinging, and in my opinion correct as to the absurdity of the Court contorting itself to save the law (as Roberts did in the original Obamacare challenge):
The Court holds that when the Patient Protection and Affordable Care Act says “Exchange established by the State” it means “Exchange established by the State or the Federal Government.” That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so. [at 1]
Scalia points out that the words have a plain meaning:
This case requires us to decide whether someone who buys insurance on an Exchange established by the Secretary gets tax credits. You would think the answer would be obvious—so obvious there would hardly be a need for the Supreme Court to hear a case about it. In order to receive any money under §36B, an individual must enroll in an insurance plan through an “Exchange established by the State.” The Secretary of Health and Human Services is not a State. So an Exchange established by the Secretary is not an Exchange established by the State—which means people who buy health insurance through such an Exchange get no money under §36B.
Words no longer have meaning if an Exchange that is not established by a State is “established by the State.” …. [at 2, italics in original]
Scalia argued — persuasively — that the overriding goal seems to be saving Obamacare, not exercising normal judicial interpretation of plain language:
“[T]he plain, obvious, and rational meaning of a statute is always to be preferred to any curious, narrow, hidden sense that nothing but the exigency of a hard case and the ingenuity and study of an acute and powerful intellect would discover.” Lynch v. Alworth-Stephens Co., 267 U. S. 364, 370 (1925) (internal quotation marks omitted). Under all the usual rules of interpretation, in short, the Government should lose this case. But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved. [at 2-3]
Scalia wrote that the majority opinion rewrote the law “with no semblance of shame”:
The Court interprets §36B to award tax credits on both federal and state Exchanges. It accepts that the “most natural sense” of the phrase “Exchange established by the State” is an Exchange established by a State. Ante, at 11. (Understatement, thy name is an opinion on the Affordable Care Act!) Yet the opinion continues, with no semblance of shame, that “it is also possible that the phrase refers to all Exchanges—both State and Federal.” Ante, at 13. (Impossible possibility, thy name is an opinion on the Affordable Care Act!) [at 3]
Scalia then delivered the best line of the day. Looking back over multiple decisions from the Court to rewrite Obamacare in order to save it, Scalia insisted that the law now should be called SCOTUScare:
Today’s opinion changes the usual rules of statutory interpretation for the sake of the Affordable Care Act. That, alas, is not a novelty. In National Federation of Independent Business v. Sebelius, 567 U. S. ___, this Court revised major components of the statute in order to save them from unconstitutionality. The Act that Congress passed provides that every individual “shall” maintain insurance or else pay a “penalty.” 26 U. S. C. §5000A. This Court, however, saw that the Commerce Clause does not authorize a federal mandate to buy health insurance. So it rewrote the mandate-cum-penalty as a tax. 567 U. S., at ___–___ (principal opinion) (slip op., at 15–45).
The Act that Congress passed also requires every State to accept an expansion of its Medicaid program, or else risk losing all Medicaid funding. 42 U. S. C. §1396c. This Court, however, saw that the Spending Clause does not authorize this coercive condition. So it rewrote the law to withhold only the incremental funds associated with the Medicaid expansion. 567 U. S., at ___–___ (principal opinion) (slip op., at 45–58). Having transformed two major parts of the law, the Court today has turned its attention to a third. The Act that Congress passed makes tax credits available only on an “Exchange established by the State.” This Court, however, concludes that this limitation would prevent the rest of the Act from working as well as hoped. So it rewrites the law to make tax credits available everywhere.
We should start calling this law SCOTUScare. [at 20-21, emphasis and hard paragraph breaks added.]
The legacy of this Court, Scalia wrote, will live on just as Obamacare, but in infamy:
Perhaps the Patient Protection and Affordable Care Act will attain the enduring status of the Social Security Act or the Taft-Hartley Act; perhaps not. But this Court’s two decisions on the Act will surely be remembered through the years. The somersaults of statutory interpretation they have performed (“penalty” means tax, “further [Medicaid] payments to the State” means only incremental Medicaid payments to the State, “established by the State” means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.
From ‘Jiggery-Pokery’ to ‘SCOTUScare,’ Read the Best Quotes From Today’s Obamacare Ruling
Justice Antonin Scalia’s flair for the dramatic shines through, while Chief Justice John Roberts plays it straight.
Supporters of the Affordable Care Act react with cheers as the opinion for health care is reported outside of the Supreme Court in Washington on Thursday .
By U.S. News Staff
Thursday’s 6-3 ruling by the Supreme Court upholding the validity of tax credits that help millions of people afford health insurance under the Affordable Care Act came down to a literal matter of interpretation.
At issue were words in the law that subsidies could be distributed for health coverage purchased through “an Exchange established by the State.” The plaintiffs argued the law should be read literally, nullifying subsidies provided through exchanges that relied on the federal government. The Obama administration countered that the law never intended to limit subsidies in such a way.
Chief Justice John Roberts authored the court’s majority opinion, and was countered by Justice Antonin Scalia’s dissent. Here are some select quotes from both.
Roberts:
Chief Justice John Roberts authored the court’s majority opinion.
“The upshot of all this is that the phrase ‘an Exchange established by the State under [42 U. S. C. §18031]’ is properly viewed as ambiguous. The phrase may be limited in its reach to State Exchanges. But it is also possible that the phrase refers to all Exchanges—both State and Federal—at least for purposes of the tax credits.”
“It would be odd indeed for Congress to write such detailed instructions about customers on a State Exchange, while having nothing to say about those on a Federal Exchange.”
“The Affordable Care Act contains more than a few examples of inartful drafting. Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through ‘the traditional legislative process’ … As a result, the Act does not reflect the type of care and deliberation that one might expect of such significant legislation.”
“The statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very ‘death spirals’ that Congress designed the Act to avoid.”
“In petitioners’ view, Congress made the viability of the entire Affordable Care Act turn on the ultimate ancillary provision: a sub-sub-sub section of the Tax Code. We doubt that is what Congress meant to do.”
“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined —’to say what the law is.’ … That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”
Scalia:
Justice Antonin Scalia authored the court’s dissenting opinion.
“Today’s interpretation is not merely unnatural; it is unheard of. Who would ever have dreamt that ‘Exchange established by the State’ means ‘Exchange established by the State or the Federal Government’? Little short of an express statutory definition could justify adopting this singular reading.”
“We should start calling this law SCOTUScare.”
“The Court holds that when the Patient Protection and Affordable Care Act says ‘Exchange established by the State’ it means ‘Exchange established by the State or the Federal Government.’ That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so.”
“Yet the opinion continues, with no semblance of shame, that ‘it is also possible that the phrase refers to all Exchanges—both State and Federal.’ (Impossible possibility, thy name is an opinion on the Affordable Care Act!)”
“The Court’s next bit of interpretive jiggery-pokery involves other parts of the Act that purportedly presuppose the availability of tax credits on both federal and state Exchanges.”
“Much less is it our place to make everything come out right when Congress does not do its job properly. It is up to Congress to design its laws with care, and it is up to the people to hold them to account if they fail to carry out that responsibility.”
“Pure applesauce.”
“The somersaults of statutory interpretation they have performed (‘penalty’ means tax, ‘further [Medicaid] payments to the State’ means only incremental Medicaid payments to the State, ‘established by the State’ means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.”
Decreasing the number of uninsured is a key goal of the Affordable Care Act (ACA), which provides Medicaid coverage to many low-income individuals in states that expand and Marketplace subsidies for individuals below 400% of the poverty line. Baseline estimates show that over 41 million individuals were uninsured in 2013, prior to the start of the major ACA coverage provisions, and early evidence suggests that the ACA has reduced this number. This brief describes trends in coverage leading up to the ACA, reviews early estimates of the impact of the ACA on the uninsured, examines the characteristics of the uninsured population, and summarizes the access and financial implications of not having coverage.
Summary: Key Facts about the Uninsured Population
What was happening to the uninsured leading up to the ACA?
Trends in the uninsured have historically tracked economic conditions, with the number of uninsured people increasing during recessionary periods when people lost their jobs. Public programs provided a safety net during the Great Recession and prevented many from going uninsured. On the eve of the ACA, as the economy stabilized, coverage losses slowed. However, over 41 million people were still without coverage in 2013.
What has been happening to the uninsured under the ACA?
As of 2014, the ACA helps expand coverage to millions of currently uninsured people through the expansion of Medicaid eligibility and establishment of Health Insurance Marketplaces. The ACA also includes reforms to help people maintain coverage and make private insurance affordable and accessible. Early evidence on coverage in the first few months of 2014 indicates that the number of uninsured has declined since the availability of these new provisions.
Why are so many Americans uninsured?
The high cost of insurance has been the main reason why people go without coverage. In 2013, 61% of uninsured adults said the main reason they were uninsured was because the cost was too high or because they had lost their job. Many people do not have access to coverage through a job, and gaps in eligibility for public coverage in the past have left many without an affordable option. Even after ACA coverage expansions, Medicaid eligibility for adults remains limited in states that did not expand their programs.
Who are the uninsured?
Most of the uninsured are in low-income working families. In 2013, nearly 8 in 10 were in a family with a worker, and nearly 6 in 10 have family income below 200% of poverty. Reflecting the more limited availability of public coverage, adults have been more likely to be uninsured than children. People of color are at higher risk of being uninsured than non-Hispanic Whites.
How does the lack of insurance affect access to health care?
People without insurance coverage have worse access to care than people who are insured. Almost a third of uninsured adults in 2013 (30%) went without needed medical care due to cost. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.
What are the financial implications of lack of coverage?
The uninsured often face unaffordable medical bills when they do seek care. In 2013, nearly 40% of uninsured adults said they had outstanding medical bills, and a fifth said they had medical bills that caused serious financial strain. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.
What was happening to the uninsured leading up to the ACA?
The number of uninsured people steadily increased throughout most of the past decade due to decreasing employer sponsored insurance coverage and rising health care costs. The recent recession led to a steep increase in uninsured rates from 2008 to 2010 as a high jobless rate led millions to lose their employer sponsored coverage.1Medicaid and CHIP prevented steeper drops in insurance coverage, as many Americans became newly eligible for these programs when their income declined during the recession. From 2011 to 2013, uninsured rates dropped as the economy improved and early provisions expanding coverage under the ACA went into effect.
Key Details:
The share of the nonelderly population with employer-sponsored coverage declined steadily between 2000 and 2010, dropping nearly ten percentage points over the decade.2 In 2011, this trend ended as the share with employer-sponsored coverage held nearly constant at around 58% between 2011 and 2013. This break in trend was likely due to uptake of the ACA provision that allowed young adults to continue as dependents on parents’ private plans until age 26. It also reflects improving economic conditions. The unemployment rate peaked at 10.0 percent in October 2009. From 2010 on, the unemployment rate improved steadily, corresponding with a drop in the uninsured rate from 2010 to 2013 (Figure 1).
The share of people covered by Medicaid increased significantly during the recent recession due to the weak economy and loss of jobs, which led to declining family incomes and decreasing employer-sponsored coverage among families. Between 2007 and 2013, over 10 million people—primarily children—gained Medicaid coverage. These gains offset some of the loss of employer coverage over the period.
In 2013, the uninsured rate among nonelderly individuals was at 16.7%, a level comparable to pre-recession uninsured rates (Figure 1). Still, many uninsured individuals had been uninsured for long periods, often five years or more,3 indicating that their lack of coverage was related to forces outside the recession. With the major ACA coverage provisions going into effect in 2014, many are newly-insured.
What has been happening to the uninsured under the ACA?
Under the ACA, as of 2014, Medicaid coverage is expanded to nearly all adults with incomes at or below 138% of poverty in states that expand, and tax credits are available for people who purchase coverage through a health insurance Marketplace. Early data suggest that the ACA has helped expand coverage to millions of previously uninsured people, but some—particularly poor adults in states that do not expand Medicaid—are still left without affordable coverage.
Key Details:
As of mid-April 2014 (after the first open enrollment period), over 8 million people selected plans through the federal or state Marketplaces.4 The vast majority of Marketplace enrollees (85%) were eligible for premium tax credits. Many Marketplace enrollees are newly-insured. A survey of people with private non-group plans after open enrollment found that nearly six in ten (57 percent) of those with Marketplace coverage were uninsured prior to purchasing their current plan.5 Other data from insurers suggest a large increase in the individual market in the first quarter attributable to the ACA.6
Enrollment data also show that as of July 2014, Medicaid enrollment has grown by 8 million since the period before open enrollment (which started in October 2013).7 This growth is an increase of 14% in monthly Medicaid enrollment.8 Enrollment increases were higher (20%) among states that chose to expand Medicaid eligibility. These data suggest that Medicaid enrollment growth is related to ACA expansions.9
Early survey data suggest that the uninsured rate is falling. The early release of estimates from the first quarter (January through March) of the 2014 National Health Interview Survey indicates that the uninsured rate dropped for nonelderly individuals in the first quarter of 2014 by a full percentage point relative to the first quarter of the previous year.10 However, the NHIS early results were not likely to have captured most or all of the ACA’s effects, as many people enrolled in coverage after survey data were collected. NHIS early results also show that states that chose to expand Medicaid saw significant declines in uninsured rates among adults from 2013 to the first quarter of 2014 (Figure 2). States that did not choose to expand Medicaid did not see corresponding declines. Several private polls and surveys also indicate that the uninsured rate has been decreasing since the period prior to ACA open enrollment. While these surveys have different methodologies and often have high error margins that make point estimates unreliable, they are all in agreement that the uninsured rate has dropped in 2014.
Even with the availability of new coverage options, millions remain uninsured. Previous analyses show that many poor adults in states that do not expand Medicaid will continue to be at risk to be uninsured.11 People of color, people living in the South,12 and individuals living in rural areas are especially at risk to be left out of ACA coverage expansions.13
Why are so many Americans uninsured?
Insurance is expensive, and few people can afford to buy it on their own. Most Americans obtain health insurance coverage through an employer, but not all workers are offered employer-sponsored coverage. Also, not all who are offered coverage by an employer can afford their share of the premiums. Medicaid and the Children’s Health Insurance Program (CHIP) cover many low-income individuals, particularly children. However, Medicaid eligibility for adults remains limited in some states, and few people can afford to purchase coverage on their own without financial assistance.
Key Details:
Uninsured individuals report that cost poses a major barrier to purchasing coverage. In 2013, 61% of adults said that the main reason they are uninsured is either because the cost is too high or because they lost their job, compared to 1.7% who said they are uninsured because they do not need coverage (Figure 3). Under the ACA, financial assistance is available to help many uninsured people afford coverage.
Not all workers have access to coverage through their job. Most uninsured workers are self-employed or work for small firms where health benefits are less likely to be offered.14 Low-wage workers who are offered coverage often cannot afford their share of the premiums, especially for family coverage.15,16
Workers usually enroll in employer-sponsored health insurance if they are eligible.17 However, it has become increasingly difficult for many workers to afford coverage. In 2014, the average annual total cost of employer-sponsored family coverage was $16,834, and the worker’s share averaging $4,823 per year.18 Between 2004 and 2014, total premiums have increased by 69%, and the worker’s share has increased over 81%.19 Starting in 2015, under the ACA, employers with 50 or more workers will be penalized if they do not offer affordable coverage. As of 2014, the ACA provides Marketplace tax credits or Medicaid coverage for many employees without access to affordable employer-sponsored insurance.20
In 2013, over 51 million nonelderly individuals were covered by Medicaid and CHIP.21 Historically, Medicaid was only available to low-income children, parents, pregnant women, people with disabilities, and the elderly. While states have increasingly expanded eligibility for children over time, eligibility for parents remained much more limited before ACA coverage expansions.22
As of September 2014, 28 states are moving forward or will be moving forward with expanded Medicaid eligibility for most nonelderly individuals under 138% FPL.23 This expansion will fill in historical gaps in eligibility for public coverage. However, in states that do not expand their Medicaid programs, eligibility for adults remains limited: the median eligibility level for parents is just 47% of poverty, and adults without dependent children are ineligible in nearly all states not expanding.
Who are the Uninsured?
The majority of the uninsured are in low-income working families. Reflecting the more limited availability of public coverage, adults are more likely to be uninsured than children. People of color are at higher risk of being uninsured than non-Hispanic Whites.
Key Details:
Based on the most recent data that is available (which reflects coverage prior to the major ACA provisions), over six in ten of the uninsured have at least one full-time worker in their family, and 16% have a part-time worker in the family (Figure 4).
Individuals below poverty are at the highest risk of being uninsured, and this group accounted for 27% of all the uninsured in 2013 (the poverty level for a family of three was $19,530 in 2013). In total, almost nine in ten of the uninsured are in low- or moderate-income families, meaning they are below 400% of poverty (Figure 3).
While a plurality (46%) of the uninsured are White, non-Hispanic, people of color are at higher risk of being uninsured than White non-Hispanics. People of color make up 40% of the population but account for over half of the total uninsured population. The disparity in insurance coverage is especially high for Hispanics, who account for 19% of the total population but more than 30% of the uninsured population. Hispanics and non-Hispanic Blacks have significantly higher uninsured rates (25.6% and 17.3%, respectively) than Whites (11.7%).24
About eight in ten of the uninsured are U.S. citizens and 19.7% are non-citizens. Uninsured non-citizens include both lawfully present and undocumented immigrants. Undocumented immigrants and legal immigrants residing in the U.S. for less than five years are ineligible for federally funded health coverage.
Uninsured rates vary widely by state and by region, with individuals living in the South and West the most likely to be uninsured (Figure 5). This variation reflects different economic conditions, availability of employer-based coverage, demographics, and eligibility for public coverage.
How does the lack of insurance affect access to health care?
Almost a third of uninsured adults (30%) in 2013 went without needed care each year due to cost (Figure 5). Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.25, 26, 27, 28 Research also has suggested that insurance can decrease likelihood of depression and stress.29
Key Details:
Health providers can choose to not provide care to the uninsured. Only emergency departments are required by federal law to screen and stabilize all individuals. However, the uninsured are not necessarily more likely to use the emergency room than those with insurance.30 If the uninsured are unable to pay for care in full, they are often turned away when they seek follow-up care for urgent medical conditions.31
The uninsured receive less preventive care and recommended screenings than the insured. In 2013, only 1 in 3 uninsured adults (33%) reported a preventive visit with a physician in the last year, compared to 74% of adults with employer coverage and 67% of adults with Medicaid.32 Uninsured older adults (ages 50-64) were far less likely than their insured counterparts to report having been screened for cancer in the past five years.33
Receiving needed care is especially important for the uninsured since they are generally not as healthy as those with private coverage. The uninsured are at higher risk for preventable hospitalizations and for missed diagnoses of serious health conditions.34 After a chronic condition is diagnosed, they are less likely to receive follow-up care and as a result are more likely to have their health decline.35 Lack of follow-up attributed to being uninsured can delay the detection of certain cancers, which can result in adverse outcomes.36 It follows that the uninsured also have significantly higher mortality rates than those with insurance.37,38
The uninsured report higher rates of postponing care and forgoing needed care or prescriptions due to cost compared to those enrolled in Medicaid and other public programs (Figure 6). A seminal study of health insurance in Oregon found that the uninsured were less likely to receive care from a hospital or doctor than newly insured Medicaid enrollees.39A follow-up study found that newly insured Medicaid enrollees were much less likely to delay care because of costs than the uninsured.40
What are the financial implications of lack of coverage?
The uninsured often face unaffordable medical bills when they do seek care. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.
Key Details:
Those without insurance for an entire year pay for one-fifth of their care out-of-pocket.41 They are typically billed for any care they receive, often paying higher charges than the insured.42
Medical bills can put great strain on the uninsured and threaten their physical and financial well-being. The uninsured are significantly more likely than individuals covered by employer coverage, non-group insurance or Medicaid to have trouble paying medical bills (Figure 7). Almost 40% of uninsured adults have outstanding medical bills.
A study based on the Oregon Health Insurance Experiment found that the uninsured were more likely to experience financial strain from medical bills and out-of-pocket expenses than those with Medicaid coverage. The uninsured were also more likely than the insured to have to postpone care because of costs.43
The uninsured live with the knowledge that they may not be able to afford to pay for their family’s medical care, which can cause anxiety and potentially lead them to delay or forgo care. Almost three-quarters (70%) of the uninsured are not confident that they can pay for the health care services they think they need, compared to 13% of those with employer coverage and 37% with Medicaid.44
The average uninsured household has no net assets.45 Without sufficient income or assets to pay their medical bills, uninsured individuals often see their debts accumulate while their credit ratings are compromised. Medical debts contribute to almost half of all bankruptcies in the United States.46
Conclusion
Over 41 million nonelderly individuals were uninsured in 2013. This figure represents the baseline against which most changes in the ACA will be measured. While we do not yet know the full effect of the major coverage provisions of the ACA, early evidence indicates that it is working to expand insurance to those who need it.
Going without coverage can have serious health consequences for the uninsured because they receive less preventive care, and delayed care often results in more serious illness requiring advanced treatment. Being uninsured also can have serious financial consequences. The ACA holds promise for many people who will gain access to health insurance coverage, but monitoring how coverage changes and who is left out of coverage expansions is also important.
Story 1: Lying Lunatic Left Gun Grabbers Blame Gun Violence (Nonexistent) and Not Human Violence (Real), Trump and Talk Radio on The Millennial Mass Murderer, Dylann Storm Roof, in Charleston, South Carolina Church Killing of Nine Instead of Drugs and Mental Illness — Videos
Charleston, S.C., shooting suspect Dylann Storm Roof, second from left, is escorted from the Shelby Police Department in Shelby, N.C., Thursday, June 18, 2015. Roof is a suspect in the shooting of several people Wednesday night at the historic The Emanuel African Methodist Episcopal Church in Charleston, S.C. (AP Photo/Chuck Burton)
Charleston, S.C., shooting suspect Dylann Storm Roof, center, is escorted from the Sheby Police Department in Shelby, N.C., Thursday, June 18, 2015. Roof is a suspect in the shooting of several people Wednesday night at the historic The Emanuel African Methodist Episcopal Church in Charleston, S.C. (AP Photo/Chuck Burton)
Dylann Roof: Charleston Church Shooting | True News
Nine people are dead after shooting which occurred 9pm on Wednesday at the Emanuel African Methodist Episcopal Church in Charleston, South Carolina. The congregation, established in 1816, is one of the oldest African American churches in the United States.
Gunman Dylann Roof was attending a bible study meeting at the church and told the worshipers, “I have to do it. You rape our women and you’re taking over our country and you have to go.”
One woman was specifically spared as Roof said, “I’m not going to shoot you because I want you to tell everyone what happened.”
Stefan Molyneux examines the news story, what is known about Dylann Roof, how this incident could have been prevented, incomprehensible parenting, false rape statistics, violence in Rhodesia/Zimbabwe, the call for gun control, the danger of SSRIs and a plea for an honest conversation about race in America.
Gun Control in 47 Seconds
Best 7 minutes on gun control I have ever seen!
In this segment of his Virtual State of the Union, the Virtual President talks about why politicians want to talk about gun control rather than crime control, and delivers the factual evidence and historical truths that make the case for the Second Amendment self-evident.
Dr Susan Gratia-Hupp – Survivor of the 1991 Kileen TX Lubys Shooting Massacre
Hupp and her parents were having lunch at the Luby’s Cafeteria in Killeen in 1991 when the Luby’s massacre commenced. The gunman shot 50 people and killed 23, including Hupp’s parents. Hupp later expressed regret about deciding to remove her gun from her purse and lock it in her car lest she risk possibly running afoul of the state’s concealed weapons laws; during the shootings, she reached for her weapon but then remembered that it was “a hundred feet away in my car.” Her father, Al Gratia, tried to rush the gunman and was shot in the chest. As the gunman reloaded, Hupp escaped through a broken window and believed that her mother, Ursula Gratia, was behind her. Actually however, her mother went to her mortally-wounded husband’s aid and was then shot in the head.
As a survivor of the Luby’s massacre, Hupp testified across the country in support of concealed-handgun laws. She said that if there had been a second chance to prevent the slaughter, she would have violated the Texas law and carried the handgun inside her purse into the restaurant. She testified across the country in support of concealed handgun laws, and was elected to the Texas House of Representatives in 1996. The law was signed by then-Governor George W. Bush.
The Truth About Gun Control
Breaking News: Gov. Abbott sign Texas Open Carry Law June 2015
Texas ‘Open Carry’ Law Passes, Allowing Guns in Holsters on the Street
Charleston shooting Suspect, Dylann Storm Roof, in police custody
Dylann Storm Roof, the 21-year-old white male allegedly behind the shooting of nine African-Americans at the Emanuel African Methodist Episcopal Church Wednesday night in Charleston, SC, was arrested by law enforcement on Thursday morning. Manila Chan has more on the details and what the authorities know at this time.
Dylann Storm Roof Captured by NC Police, Charleston Shooting Suspect Escorting VIDEO
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John Lott: More Guns, Less Crime
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John Lott: More Guns, Less Crime book interview on CSPAN
Nine killed in South Carolina Charleston ‘hate crime’ shooting
Dylann Storm Roof Was ‘Wild,’ Not Violent, Took Drugs, Classmate of Charleston Shooting Suspect Says
President Obama makes statement on Charleston mass shooting
President Barack Obama expressed his sorrow about a mass shooting in Charleston, South Carolina that killed nine people during a news conference on Thursday. Speaking about the tragedy, the president also spoke about the need to take another look at gun violence in the nation.
Carolina Church Shooting: Obama gets it wrong–Guns SAVE Lives!
PJTV: Wake Up Obama. Drugs Are the Problem, Not Guns
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Donald Trump rails against immigrants in presidential campaign launch
Hillary Clinton ATTACKS Donald Trump Connects Negative Remarks on Mexico to MURDERS in Charleston
Hillary Clinton Takes a Veiled Shot at Donald Trump
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Donald Trump Presidential speech announcement 2016 – Donald Trump Bashes Mexico Obamacare
Charleston Shooting: What They’re Not Telling You
The Alex Jones Show (1st HOUR-VIDEO Commercial Free) Thursday June 18 2015: #CharlestonShooting
News Behind the News: John Lott on America’s Gun Laws
Top 10 Infamous Mass Shootings in the U.S.
Top 10 Infamous Mass Shootings Outside the U.S.
CHARLESTON SHOOTER WAS ON DRUG LINKED TO VIOLENT OUTBURSTS
Dylann Storm Roof was taking habit-forming drug suboxone
by PAUL JOSEPH WATSON | JUNE 18, 2015
Charleston shooter Dylann Storm Roof was reportedly taking a drug that has been linked with sudden outbursts of violence, fitting the pattern of innumerable other mass shooters who were on or had recently come off pharmaceutical drugs linked to aggression.
According to aCBS News report, earlier this year when cops searched Roof after he was acting suspiciously inside a Bath and Body Works store, they found “orange strips” that Roof told officers was suboxone, a narcotic that is used to treat opiate addiction.
Suboxone is a habit-forming drug that has been connected with sudden outbursts of aggression.
Another poster on the Drugs.com website tells the story of how his personality completely changed as a result of taking suboxone.A user on theMD Junction websiterelates how her husband “became violent, smashing things and threatening me,” after just a few days of coming off suboxone.
The individual relates how he became “nasty” and “violent” just weeks into taking the drug, adding that he would “snap” and be mean to people for no reason.
Another poster reveals how his son-in-law “completely changed on suboxone,” and that the drug sent him into “self-destruct mode.”
A user named ‘Jhalloway’ also tells the story of how her husband’s addiction to suboxone was “ruining our life.”
Aposter on a separate forumwrites about how he became “horribly aggressive” towards his partner after taking 8mg of suboxone.
A website devoted to horror stories about the drug called SubSux.com also features a post by a woman whose husband obtained a gun and began violently beating his 15-year-old son after taking suboxone.
According to aCourier-Journal report, suboxone “is increasingly being abused, sold on the streets and inappropriately prescribed” by doctors. For some users, it is even more addictive than the drugs it’s supposed to help them quit.
As we previously highlighted, virtually every major mass shooter was taking some form of SSRI or other pharmaceutical drug at the time of their attack, including Columbine killer Eric Harris, ‘Batman’ shooter James Holmes and Sandy Hook gunman Adam Lanza.
As the websiteSSRI Stories profusely documents, there are literally hundreds of examples of mass shootings, murders and other violent episodes that have been committed by individuals on psychiatric drugs over the past three decades.
Pharmaceutical giants who produce drugs like Zoloft, Prozac and Paxilspend around $2.4 billion dollars a yearon direct-to-consumer television advertising every year. By running negative stories about prescription drugs, networks risk losing tens of millions of dollars in ad revenue, which is undoubtedly one of the primary reasons why the connection is habitually downplayed or ignored entirely.
White suspect in massacre at black South Carolina church charged, held in jail
CHARLESTON, S.C
Relatives of some of the nine black parishioners gunned down at a historic South Carolina church addressed on Friday the 21-year-old white man charged with murdering their loved ones, before a judge ordered him held without bail.
Dylann Roof, appearing in a video feed from the jail where he was brought after the end of a 14-hour manhunt on Thursday, stood quietly, looking down, as Judge James Gosnell ordered him held and victims’ family members spoke.
“May God have mercy on your soul,” said the mother of the youngest victim, 26-year-old Tywanza Sanders, while Roof looked on, expressionless.
The attack on Wednesday at Charleston’s nearly-200-year-old Emanuel African Methodist Episcopal Church came in a year that has seen waves of protest across the United States over police killings of unarmed black men in cities including New York, Baltimore and Ferguson, Missouri, which have sparked some of the largest race riots since the civil rights movement of the 1960s.
Roof spoke little during the hearing, providing brief answers to the judge’s questions, confirming his name and address and saying he was unemployed.
Judge Gosnell, who had no authority to release Roof on the nine murder charges he faces, set a bond of $1 million for the one gun charge he faces. Roof remains in custody.
From U.S. President Barack Obama, who has said the attack stirred memories of “a dark past,” to residents on the streets of Charleston, Americans have expressed outrage at an act intended to provoke a “race war” in the United States.
This latest in a series of mass shootings that have rocked the United States also illustrated some of the risks posed by the nation’s liberal gun laws, which gun-rights supporters say are protected by the Second Amendment of the U.S. Constitution.
Alana Simmons, whose grandfather Reverend Daniel Simmons, 74, died in the attack, also expressed forgiveness.
“Although my grandfather and the other victims died at the hands of hate, this is proof, everyone’s plea for your soul is proof, that they lived in love,” Simmons said. “Their legacies will live in love so hate won’t win. I just want to thank the court for making sure that hate doesn’t win.”
In addition to church leader and Democratic state Senator Clementa Pinckney, 41, other victims included pastors DePayne Middleton Doctor, 49, and Sharonda Coleman Singleton, 45.
Also killed were Cynthia Hurd, 54, a public library employee; Susie Jackson, 87; Ethel Lance, 70, and Myra Thompson 59, an associate pastor at the church, according to the county coroner.
(Additional reporting by Luciana Lopez and Brian Snyder in Charleston, South Carolina, and Suzannah Gonzales in Chicago; Writing by Scott Malone; Editing by James Dalgleish)
Dylann Storm Roof appears by closed-circuit televison at his bond hearing in Charleston, South Carolina June 19, 2015 in a still image from video.
Hours after delivering a statement on the shooting massacre of nine people at an historic church in Charleston, S.C., President Obama and a group of entertainment industry donors had a lengthy discussion about the roots of gun violence in the first of two Hollywood-centric fundraisers in Los Angeles on Thursday, according to an attendee who was present.
About 30 people attended the event at the Pacific Palisades home of Chuck Lorre, executive producerof “Two and a Half Men.” Tickets for what was billed as an intimate discussion with the president sold for up to $33,400 each, with proceeds going to the Democratic National Committee.
Among those attending were Kiefer Sutherland, Matthew Perry, Conan O’Brien, UTA’s Jay Sures, Bob Broder, Tennis Channel CEO Ken Solomon and writer-producer James Burrows.
The attendee described the meeting, which lasted an hour and 15 minutes, as different from other events in that it offered an opportunity for Obama to have a “long, thoughtful” and serious discussion about issues, including gun violence and his presidency, in a much more “macro” sense than in other forums. The discussion about gun violence touched on gun laws, mental health and race, among other factors, the attendee said. Obama talked about being an optimist, especially about the country’s place in history.
Next on Obama’s agenda was a larger, $2,500-per-person event at the home of Tyler Perry. Perry is a longtime supporter who also held a fundraiser for Obama’s re-election campaign in Atlanta.
He also addressed the Charleston shootings at the Perry event, before a crowd of about 250 people.
“To see such a horrific event unfold like that is particularly shocking and it’s a reminder that we’ve got a lot of work to do,” Obama said, according to a pool report.
Perry introduced Obama, saying that he was “one of the most incredible people I have ever met.” He joked that Obama volunteered to take over the Titanic after it had already struck the iceberg, according to the pool report.
Perry also told about going to the White House for dinner. On the Truman Balcony afterwards, Obama winked at Michelle who “turned into a 15 year old girl,” Perry said, per the pool report.
Among those also at the event were January Jones, Ted Sarandos, Jason Collins and Matthew Weiner.
The Lorre event was closed to the press, while the Perry event, held at his Tuscan-style home off of Mulholland Drive, was open to pool reporters.
“There is something particularly heartbreaking about a death happening in a place in which we seek solace and we seek peace,” Obama said at the White House earlier on Thursday. He said that he and first lady Michelle Obama knew Rev. Clementa Pinckney, pastor of Emanuel AME Church, who was one of the victims.
“We don’t have all the facts, but we do know that, once again, innocent people were killed in part because someone who wanted to inflict harm had no trouble getting their hands on a gun,” Obama said, adding that “at some point, we as a country have to reckon with the fact that this type of mass violence does not happen in other advanced countries.”
A White House spokesman told reporters that there had not been discussion of calling off the fundraisers in the wake of the shootings. While there was speculation earlier on Thursday as to whether the trips would proceed, in the past the administration has held to the president’s schedule in the face of major events. Obama also has fundraisers scheduled in San Francisco on Friday.
Obama’s trip will be followed on Friday by Hillary Clinton’s trek to Los Angeles to raise money for her presidential campaign. She is scheduled to fundraise at the home of Peter Lowy, co-CEO of Westfield Corp., at a lunchtime gathering. That will be followed by an early evening reception at the home of Michael Lombardo, president of programming at HBO, and his husband Sonny Ward, and then another event the home of actor Tobey Maguire and wife Jennifer Meyer.
“I’m not a gun owner and, as I think as is the case for the more than half the people in the country who also aren’t gun owners, that means that for me guns are alien. In the current rhetorical climate people seem not to want to say: I think guns are kind of scary and don’t want to be around them.” — Josh Marshall
“A fear of weapons is a sign of retarded sexual and emotional maturity.”
~ Sigmund Freud
Sorry, but your Second Amendment rights no longer apply because liberals like Josh Marshall tinkle on themselves every time they come within fifty feet of a gun. This is really what the debate on gun control in America comes down to in the end: people who lose nothing if guns are banned because they don’t use them demanding that everyone else be disarmed. Meanwhile, trying to reason with gun control advocates is like arguing with a four year old about whether her imaginary friend is real or not. It doesn’t matter how clearly you prove your case; she’ll be pouring her pal tea two minutes after you’ve left the room. Speaking of imaginary…
1) A “gun free zone” won’t keep bad people with guns away: The basic problem with a “gun free zone” is that anyone you can’t trust with a gun will bring it in anyway while it will cause the people you’d want armed in a dangerous situation to leave their weapons behind. If this concept actually worked, we’d just train all of our soldiers in Jiu-jitsu and then we’d declare everywhere we sent them to be a “gun free zone.” Admittedly, Mortal Kombat: Afghanistan sounds like it would be an amazing movie, but someone needs to inform Democrats that the world doesn’t really work this way.
2) Criminals and lunatics don’t obey gun laws: The belief that someone who’s planning to go on a killing spree is going to turn in a gun because it’s made illegal is almost as nuts as going on the killing spree. Yet, the gun grabbers in the Democrat Party operate on the assumption that nut jobs like Adam Lanza or a gangbanger who sells crack for a living is going to get rid of a high-capacity magazine if Congress says he can’t have it. That’s like a prohibitionist who gets upset about alcoholism and deals with the problem by demanding that all the people without drinking problems have to be kept away from booze.
3) We already have somewhere between 200-300 million guns in this country: Adding to the last point, ever heard this old joke?
A drunk loses the keys to his house and is looking for them under a lamppost. A policeman comes over and asks what he’s doing.“I’m looking for my keys” he says. “I lost them over there”.
The policeman looks puzzled. “Then why are you looking for them all the way over here?”
“Because the light is so much better”.
If there were no already existing guns in America, gun control could conceivably help keep weaponry out of the hands of criminals and mass murderers. However, in a nation that’s already armed to the teeth, the next Adam Lanza, Jared Loughner, Tookie Williams or Mumia Abu-Jamal has already got his gun and new laws will only disarm law abiding Americans.
4) Gun owners aren’t required to explain a “need” for our Second Amendment rights: Why do gun owners “need” their guns? The same reason that Rosa Parks “needed” her seat at the front of the bus. In other words, it’s our constitutional right; so kiss off! If you need more of an explanation than that, why does California “need” to have its votes counted in the next presidential election? Why do we “need” so many liberal newspapers? Why not close a few? Why do movie stars “need” to make so much money for their films? Why don’t we confiscate it? What was it that Ann Coulter said?
“Free people are not in the habit of providing reasons why they ‘need’ something simply because the government wants to ban it. That’s true of anything — but especially something the government is constitutionally prohibited from banning, like guns.”
5) You’re not fooling us: Liberals like to think they’re smarter than everyone else, but they’re as transparent as glass to anyone who’s paying attention. That’s why gun sales have blown up like a can of shaving cream in a microwave. If Barack Obama, Diane Feinstein, Nancy Pelosi, Joe Biden and the rest of the Democrat gun grabbers in Congress could get away with it, they would ban and confiscate every gun in America tomorrow — and people know it. Anything short of, “Nobody is allowed to own a firearm except the government,” is unacceptable to them and that’s why they always seem so ghoulishly pleased after tragedies like the Gabrielle Giffords shooting or the Newtown massacre. Everybody else is thinking of the victims, while they’re twirling their mustaches Snidely-Whiplash-style and repeating, “Never let a serious crisis go to waste,” to each other.
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Supreme Court Chief Justice John Roberts has rewritten the law to save Obamacare—again.
Planned Parenthood’s Evil of Killing, Butchering and Selling Baby Parts Regrets Their Tone Not Their Actions– Reminds Me of The Nazis (National Socialist German Workers’ Party) Discussing The Final Solution for The Jewish Question — The Killing of Babies Supported By Barack Obama, Democratic Party, Progressives and Ruling Political Elites — Stop Killing Babies And Lying To The American People — Videos
Posted on July 18, 2015. Filed under: American History, Articles, Babies, Biology, Blogroll, Books, British History, Business, Catholic Church, Chemistry, College, Communications, Congress, Constitution, Corruption, Crime, Crisis, Cult, Culture, Demographics, Diasters, Documentary, Economics, Education, Employment, European History, Faith, Family, Federal Government Budget, Fiscal Policy, Friends, Genocide, government, government spending, Health Care, history, Homicide, Illegal, Immigration, Investments, IRS, Language, Law, Legal, liberty, Life, Links, media, Medical, Money, Music, Non-Fiction, Obamacare, People, Philosophy, Photos, Political Correctness, Politics, Press, Programming, Psychology, Quotations, Radio, Radio, Rants, Regulations, Religion, Science, Security, Strategy, Supreme Court, Talk Radio, Tax Policy, Taxation, Taxes, Television, Terrorism, Torture, Video, War, Wealth, Weapons, Welfare, Wisdom, Writing | Tags: 17 July 2015, Abby Johnson, Abortion Statistics, Abortions, America, articles, Audio, Auschwitz The Nazis and the Final Solution, Breaking News, Brenda Lee, Broadcasting, Butchering Babies, capitalism, Cartoons, Cecile Richards, Charity, Citizenship, Clarity, Classical Liberalism, Collectivism, Commentary, Commitment, Communicate, Communication, Concise, Convincing, Courage, Culture, Current Affairs, Current Events, Die Wannseekonferenz (1984), Discussing The Final Solution for The Jewish Question, economic growth, economic policy, Economics, Edmund Burke, Education, eugenics, Eugenics Movement, Evil, Evils of Agenda 21, Experience, Faith, Family, First, fiscal policy, Fit vs. UnFit, free enterprise, freedom, freedom of speech, Friends, Give It A Listen, God, Good, Goodwill, Growth, Hanna Arendt, Harvesting Babies Organs, Henry David Thoreau, Hope, I'm Sorry, Individualism, Jr, Justice Antonin Scalia, Killing Babies, Knowledge, liberty, Life, Love, Lovers of Liberty, MAAFA 21 THE BLACK HOLOCAUST, Margaret Sanger, Martin Luther King, monetary policy, MPEG3, Music, Nazis (National Socialist German Workers' Party), News, Number One Killer of Blacks -- Abortions, Opinions, Partial-Birth Abortions, Peace, Photos, Planned Parenthood, Podcasts, Political Philosophy, Politics, Progressives, Promoting Black Genocide in US, prosperity, Racism, Radio, Raymond Thomas Pronk, Representative Republic, Republic, Resources, Respect, rule of law, Rule of Men, Saint Augustine, Selling Baby Parts, Senator Lankford, Show Notes, Songs, Stephen Ambrose, Sterilizing Undesirables, Talk Radio, Targeting Blacks, The Final Solution, The Pronk Pops Show, The Pronk Pops Show 507, The Silent Scream, Thomas Hardy, Tone, Truth, Tyranny, U.S. Constitution, Undercover Video Exposes Planned Parenthood, United States of America, Videos, Virtue, War, Wisdom |
The Pronk Pops Show Podcasts
Pronk Pops Show 507: July 17, 2015
Pronk Pops Show 506: July 16, 2015
Pronk Pops Show 505: July 15, 2015
Pronk Pops Show 504: July 14, 2015
Pronk Pops Show 503: July 13, 2015
Pronk Pops Show 502: July 10, 2015
Pronk Pops Show 501: July 9, 2015
Pronk Pops Show 500: July 8, 2015
Pronk Pops Show 499: July 6, 2015
Pronk Pops Show 498: July 2, 2015
Pronk Pops Show 497: July 1, 2015
Pronk Pops Show 496: June 30, 2015
Pronk Pops Show 495: June 29, 2015
Pronk Pops Show 494: June 26, 2015
Pronk Pops Show 493: June 25, 2015
Pronk Pops Show 492: June 24, 2015
Pronk Pops Show 491: June 23, 2015
Pronk Pops Show 490: June 22, 2015
Pronk Pops Show 489: June 19, 2015
Pronk Pops Show 488: June 18, 2015
Pronk Pops Show 487: June 17, 2015
Pronk Pops Show 486; June 16, 2015
Pronk Pops Show 485: June 15, 2015
Pronk Pops Show 484: June 12, 2015
Pronk Pops Show 483: June 11, 2015
Pronk Pops Show 482; June 10, 2015
Pronk Pops Show 481: June 9, 2015
Pronk Pops Show 480: June 8, 2015
Pronk Pops Show 479: June 5, 2015
Pronk Pops Show 478: June 4, 2015
Pronk Pops Show 477: June 3, 2015
Pronk Pops Show 476: June 2, 2015
Pronk Pops Show 475: June 1, 2015
Pronk Pops Show 474; May 29, 2015
Pronk Pops Show 473: May 28, 2015
Pronk Pops Show 472: May 27, 2015
Pronk Pops Show 471: May 26, 2015
Pronk Pops Show 470: May 22, 2015
Pronk Pops Show 469: May 21, 2015
Pronk Pops Show 468: May 20, 2015
Pronk Pops Show 467: May 19, 2015
Pronk Pops Show 466: May 18, 2015
Pronk Pops Show 465: May 15, 2015
Pronk Pops Show 464; May 14, 2015
Pronk Pops Show 463; May 13, 2015
Pronk Pops Show 462: May 8, 2015
Pronk Pops Show 461: May 7, 2015
Pronk Pops Show 460; May 6, 2015
Pronk Pops Show 459: May 4, 2015
Pronk Pops Show 458: May 1, 2015
Pronk Pops Show 457: April 30, 2015
Pronk Pops Show 456: April 29, 2015
Pronk Pops Show 455: April 28, 2015
Pronk Pops Show 454: April 27, 2015
Pronk Pops Show 453: April 24, 2015
Pronk Pops Show 452: April 23, 2015
Pronk Pops Show 451: April 22, 2015
Pronk Pops Show 450: April 21, 2015
Pronk Pops Show 449: April 20, 2015
Pronk Pops Show 448: April 17, 2015
Pronk Pops Show 447: April 16, 2015
Pronk Pops Show 446: April 15, 2015
Pronk Pops Show 445: April 14, 2015
Pronk Pops Show 444: April 13, 2015
Pronk Pops Show 443: April 9, 2015
Pronk Pops Show 442: April 8, 2015
Pronk Pops Show 441: April 6, 2015
Pronk Pops Show 440: April 2, 2015
Pronk Pops Show 439: April 1, 2015
Story 1: Planned Parenthood’s Evil of Killing, Butchering and Selling Baby Parts Regrets Their Tone Not Their Actions– Reminds Me of The Nazis (National Socialist German Workers’ Party) Discussing The Final Solution for The Jewish Question — The Killing of Babies Supported By Barack Obama, Democratic Party, Progressives and Ruling Political Elites — Stop Killing Babies And Lying To The American People — Videos
He that is kind is free, though he is a slave; he that is evil is a slave, though he be a king.
The only thing necessary for the triumph of evil is for good men to do nothing.
There are a thousand hacking at the branches of evil to one who is striking at the root.
The resolution to avoid an evil is seldom framed till the evil is so far advanced as to make avoidance impossible.
The sad truth is that most evil is done by people who never make up their minds to be good or evil.”
~Hannah Arendt
Planned Parenthood: Cecile Richards’ Official Video Response
Brenda Lee – I’m Sorry
Senator Lankford Speaks about the Planned Parenthood Video on the Senate Floor
Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
What So-Called Pro-Choicers Cannot Watch From Start To Finish
The Silent Scream (Full Length)
FULL FOOTAGE: Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
Abby Johnson Exposes The Lie of Planned Parenthood
Planned Parenthood CEO Cecile Richards’ Attempt To Dismiss Viral Video Backfires!
Caught on Camera: Planned Parenthood Harvesting Babies Organs
Die Wannseekonferenz (1984)
A real time recreation of the 1942 Wannsee Conference, in which leading SS and Nazi Party officials led by SS-General Reinhard Heydrich gathered to discuss the “Final Solution to the Jewish Question”.
MAAFA 21 THE BLACK HOLOCAUST
Abortion Inc: Promoting Black Genocide in US?
Planned Parenthood Banks on Fraud
Planned Parenthood’s New Image
Fit vs. UnFit, Eugenics, Planned Parenthood & Psychology, Mind Control Report
Sex Control Police State, Eugenics, Galton, Kantsaywhere, Mind Control Report
Mind Control Hate Propaganda, Hate Speech & Crime, Black PR
Mind Control, Psychology of Brainwashing, Sex & Hypnosis
Margaret Sanger: Eugenicist (1/3)
Margaret Sanger: Eugenicist (2/3)
Margaret Sanger: Eugenicist (3/3)
Eugenics Glenn Beck w/ Edwin Black author of “War Against the Weak” talk Al Gore & Margaret Sanger
Margaret Sanger, Planned Parenthood’s Racist Founder
Justice Antonin Scalia talks about Roe v. Wade
Auschwitz The Nazis and the Final Solution complete
Auschwitz: The Nazi and the Final Solution (1/5)
AUSHWITZ:THE FINAL SOLUTION CLIP 2/5
Auschwitz: The Nazi and the Final Solution (3/5)
Auschwitz: The Nazi and the Final Solution (4/5)
Auschwitz: The Nazi and the Final Solution (5/5)
Science and the Swastika: The Deadly Experiment
Sterilizing Undesirables: Did The USA Inspire The Nazis?
Keeping Dems Honest: CNN’s Anderson Cooper Puts Truth First and Challenges DNC Abortion Lies
Glenn Beck : Agenda 21 is not a fiction, it’s implemented right now in US and all over the World !
Glenn Beck – Ted Cruz Discusses the Evils of Agenda 21
Bill Whittle What We Believe Full Version
Brenda Lee – I’m Sorry (Live from Canada 1980)
Planned Parenthood head apologizes for ‘tone’ of doctor in covert video
The president of Planned Parenthood Federation of America on Thursday apologized for remarks captured on video that show Deborah Nucatola, an executive of the organization, casually discussing abortion techniques aimed at preserving the internal organs of fetuses for use in research.
In a video posted on Planned Parenthood’s Web site, Cecile Richards called the tenor of the remarks “unacceptable,” and said the organization strives as its top priority to provide compassionate care.
“In the video, one of our staff members speaks in a way that does not reflect that compassion,” she said. “This is unacceptable, and I personally apologize for the staff member’s tone and statements.”
[Undercover video shows Planned Parenthood official discussing fetal organs used for research]
But Richards also emphatically defended the organization’s tissue donation program, which she said is purely voluntary for the women and does not yield a profit for Planned Parenthood. And she condemned the group that covertly recorded Nucatola’s remarks, which she said heavily edited the video to make “outrageous claims.”
“We know the real agenda of organizations behind videos like this, and they have never been concerned with protecting the health and safety of women,” she said. “Their mission is to ban abortion completely and cut women off from care at Planned Parenthood and other health centers.”
Richards’s apology came a day after a little-known anti-abortion group called the Center for Medical Progress unveiled the video as part of what its leader said was a 30-month investigation into Planned Parenthood’s tissue donation program. The group alleges Planned Parenthood illegally sells fetal body parts to companies that use the tissue for research.
While the video did not prove this claim, it still painted Planned Parenthood in an unflattering light that reignited controversy over the women’s health organization, the nation’s largest abortion provider and a longtime target of anti-abortion activism. It showed Nucatola, the organization’s senior director of medical services, discussing graphically the ways in which abortions can be completed to preserve a fetus’s liver, lungs, heart and other materials for research.
“I’d say a lot of people want liver,” she says in the video, drinking wine and eating salad with anti-abortion activists posing as medical company representatives.
Later in the video, she continues: “We’ve been very good at getting heart, lung, liver, because we know that, so I’m not gonna crush that part, I’m gonna basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact.”
The Center for Medical Research distilled the video into a nine-minute clip, but also posted a longer cut lasting more than two-and-a-half hours showing a fuller context of the discussion. It also posted some supporting documents on its site, and the group’s leader has promised more evidence in the coming weeks.
http://www.washingtonpost.com/news/post-nation/wp/2015/07/16/planned-parenthood-head-apologizes-for-tone-of-doctor-in-covert-video/
Planned Parenthood chief apologizes after video
By Eugene Scott, CNN
Planned Parenthood’s president apologized Thursday for a top official’s tone in a controversial video, but she also denied the clip’s allegation that her organization profits from tissue donation.
“Our top priority is the compassionate care that we provide. In the video, one of our staff members speaks in a way that does not reflect that compassion. This is unacceptable, and I personally apologize for the staff member’s tone and statements,” said Cecile Richards, the group’s president, in a video out Thursday. “As always, if there is any aspect of our work that can be strengthened, we want to know about it, and we take swift action to address it.”
Since the video’s release on Breitbart earlier this week, conservative elected officials have slammed its contents and called for congressional hearings on the incident, including House Speaker John Boehner and House Majority Leader Kevin McCarthy.
“I hope that everyone in the country watches it,” said Rep. Ann Wagner, R-Missouri, who called the video “the most horrifying and heartbreaking undercover video I have ever seen” during a Capitol Hill news conference on Wednesday.
But allegations that Planned Parenthood sells baby body organs and tissue are unfounded, she said.
“I want to be really clear: The allegation that Planned Parenthood profits in any way from tissue donation is not true. Our donation programs — like any other high-quality health care providers — follow all laws and ethical guidelines.”
On Wednesday, Richards used Twitter to criticize lawmakers and presidential candidates
“GOP leaders, including most of the ’16 field, are tripping over themselves to attack PP because they think that’s how to win elections,” organization president Cecile Richards said in a series of related tweets Wednesday. Her comments were her first addressing a video showing one of the organization’s top officials discussing the organs and tissue or aborted fetuses.
Congressional leaders and Republican presidential hopefuls slammed Planned Parenthood on Wednesday and called for congressional hearings on the incident.
RELATED: Lawmakers call for Hill hearings on Planned Parenthood
Richards said political attacks are nothing new for her organization, the country’s largest abortion provider.
“Spreading false information is an age-old strategy of people hell-bent on denying women care & shaming them for exercising their rights,” she tweeted.
Several Republican candidates have promised to defund federal dollars to Planned Parenthood if elected. Richards argued that would keep millions from breast exams, sexually transmitted infection exams and sex education.
“Reminder: 1 out of every 5 women has been to PP in her life. Threatening our patients’ care & rights will get politicians nowhere real fast,” she tweeted. “We’ve fought for our patients before, and we’ll fight for them again and again.”
http://www.cnn.com/2015/07/16/politics/planned-parenthood-president-criticizes-gop-candidates/
Planned Parenthood exec, fetal body parts subject of controversial video
By Steve Almasy and Eliott C. McLaughlin, CNN
An anti-abortion group has released an online video that it says documents how Planned Parenthood is selling fetal organs for a profit, a felony, while violating medical ethics by altering normal abortion procedures so as to preserve the organs.
Planned Parenthood has countered that it donates the tissue for scientific research and receives only reimbursement for its expenses, which is legal. The group also says it helps people donate tissue “with full, appropriate consent from patients and under the highest ethical and legal standards,” according to a statement from spokesman Eric Ferrero.
Later, Ferrero issued another statement saying, “These outrageous claims are flat-out untrue, but that doesn’t matter to politicians with a longstanding political agenda to ban abortion and defund Planned Parenthood. Women and families who make the decision to donate fetal tissue for lifesaving scientific research should be honored, not attacked and demeaned.”
The group leveling the accusation, the Irvine, California-based Center for Medical Progress, says it shot the video a year ago at a California restaurant. On it, two people purporting to be with a human biologics company speak with a Planned Parenthood doctor over what appears to be a lunch meeting. The Center for Medical Progress says the pair, who are off-camera and never seen, are paid actors.
The video, which is almost three hours long, was released Tuesday along with a heavily edited eight-minute version, which has drawn more than 1 million views on YouTube, as opposed to about 40,000 for the the full-length footage. The group has also released a transcript of the longer video.
“Planned Parenthood’s criminal conspiracy to make money off of aborted baby parts reaches to the very highest levels of their organization,” said statement from David Daleiden, who led the undercover project.
The video has drawn the ire of GOP lawmakers in Washington, with House Speaker John Boehner calling for hearings on Planned Parenthood’s abortion practices.
“When anyone diminishes an unborn child, we are all hurt, irreversibly so. When an organization monetizes an unborn child — and with the cavalier attitude portrayed in this horrific video — we must all act,” he said.
On the video, Dr. Deborah Nucatola, the senior director of medical services at Planned Parenthood Federation of America, is seen talking matter-of-factly about the organization’s participation in tissue-donation programs.
Though Planned Parenthood has described the Center for Medical Progress footage as a hit piece by “a well-funded group established for the purpose of damaging Planned Parenthood’s mission and services,” Nucatola acknowledges in the video that Planned Parenthood’s national office sees the potential for controversy.
“So, we tried to do this, and at the national office we have a Litigation and Law Department that just really doesn’t want us to be the middle people for this issue right now,” she said. “And so we had a conversation, and we said, ‘What if we go out and find everyone who is doing this and present everybody with a menu?’ And at the end of the day they just decided that right now, it’s just too touchy an issue for us to be an official middleman.”
In another part of the video, the doctor tells the undercover actors that “behind closed doors,” Planned Parenthood’s affiliates are discussing how to handle the matter.
“Every provider has had patients who want to donate their tissue, and they absolutely want to accommodate them. They just want to do it in a way that is not perceived as ‘This clinic is selling tissue. This clinic is making money off of this,’ ” she said.
The edited version of the video appears to be missing important context that’s provided in the longer video. For instance, one of the actors asks Nucatola about prices for the organs.
“OK, so when you are, or the (Planned Parenthood) affiliate is determining what that monetary … so that it doesn’t raise any question of ‘This is what it’s about; this is the main,’ what price range would you …” the woman asks, her question trailing off.
Nucatola responds that the price would be between $30 and $100 per specimen, with consideration for what facility is used and “what’s involved.” It’s not clear if a specimen constitutes the entire organ or only samples of it.
Nucatola doesn’t specifically say that the price is for the purchase of the tissue, but the comment troubled bioethicist Art Caplan of New York University, who said after watching the edited version of the video it sounds like Planned Parenthood might be trying to make a profit.
But in the longer version of the video, Nucatola elaborates and appears to say the price is related to the cost of performing the procedure and shipping.
“It just has to do with space issues. Are you sending someone there who is going to be doing everything or is their staff going to be doing it? What exactly are they going to be doing? Is there shipping involved or is someone coming to pick it up?”
Selling fetal body parts — or any body parts — is against federal law, but Planned Parenthood said it makes no profit.
“In some instances, actual costs, such as the cost to transport tissue to leading research centers, are reimbursed, which is standard across the medical field,” the group said.
Another part of the video also raised concerns for Caplan. Nucatola talks about doctors performing abortions in which ultrasound is used to ascertain the best location to grab the fetus with forceps.
“We’ve been very good at getting heart, lung, liver because we know that, I’m not going to crush that part,” she says.
Altering procedures in order to get tissue in the best condition would be a “big no-no,” the bioethicist said, because the patient’s health is paramount and that should be the only concern for doctors. Caplan did not comment specifically on whether the ultrasound procedure would endanger the mother, but he made it clear that any deviation from normal procedures is unacceptable.
“In abortion the primary goal is to give the safest abortion possible,” Caplan said. “Your sole concern has to be the mother and her health.”
There’s a parallel in patient care, he said. When someone is dying, doctors shouldn’t change how they treat the patient in order to harvest good tissue for donation after death.
Doctors should treat the patient as they normally would, and then use whatever is available after death. If a provider is considering how to get the tissue that’s in the best shape, “that’s a huge conflict of interest. … If you modify how someone dies, that’s unethical.”
The Center for Medical Progress also alleges that Nucatola describes a method — using ultrasound to manipulate the fetus so it comes out feet first, or breech presentation, instead of head first, or vertex presentation — that “is the hallmark of the illegal partial-birth abortion procedure.”
Partial birth abortions are illegal, according to U.S. law, which defines them as procedures “in which the person performing the abortion deliberately and intentionally vaginally delivers a living fetus until, in the case of a head-first presentation, the entire fetal head is outside the body of the mother, or, in the case of breech presentation, any part of the fetal trunk past the navel is outside the body of the mother, for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus.”
On the video, Nucatola describes the best strategy to extract calavarium, or skulls, intact, but it is not clear if she is speaking in general terms or if she is describing Planned Parenthood’s methods. And then, she says nothing about whether the fetus is still alive when it’s delivered.
“And with the calvarium, in general, some people will actually try to change the presentation so that it’s not vertex, because when it’s vertex presentation, you never have enough dilation at the beginning of the case, unless you have real, huge amount of dilation to deliver an intact calvarium. So if you do it starting from the breech presentation, there’s dilation that happens as the case goes on, and often, the last, you can evacuate an intact calvarium at the end.”
The Center for Medical Progress responded to Planned Parenthood’s written statement about the video and accused Planned Parenthood of lying about obtaining consent from patients and not making a profit on the tissue transactions. It did not offer any further evidence of either claim.
GOP calls for Hill hearings on Planned Parenthood video
Planned Parenthood, meanwhile, said the anti-abortion group was the one that was lying.
“A well-funded group established for the purpose of damaging Planned Parenthood’s mission and services has promoted a heavily edited, secretly recorded videotape that falsely portrays Planned Parenthood’s participation in tissue donation programs that support lifesaving scientific research,” it said.
The statement continued, “Similar false accusations have been put forth by opponents of abortion services for decades. These groups have been widely discredited and their claims fall apart on closer examination, just as they do in this case.”
http://www.cnn.com/2015/07/15/health/planned-parenthood-undercover-video/
Cecile Richards
Austin, Texas, U.S.
Cecile Richards (born 1958)[1] is an American activist and has been the president of the Planned Parenthood Federation of America since 2006.[2] She is a member of the Democratic Party.[3] In 2010, Richards was elected to the Ford Foundation board of trustees.
Contents
Political involvement
Richards previously founded and served as president of America Votes, a coalition of national Democratic Party-affiliated organizations.[4] Before that, she was deputy chief of staff to the U.S. Rep. Nancy Pelosi, the Democratic Leader in the U.S. House of Representatives.[5] She has also worked at the Turner Foundation.[6] In 1996, she founded the Texas Freedom Network, a Texas organization formed to counter the Christian right.[7]
Personal life
Richards is the daughter of former Texas governor Ann Richards (née Dorothy Ann Willis) and David Richards.[3] She attended St. Stephen’s Episcopal School for high school, and graduated from Brown University in 1980.[8] She is married to Kirk Adams, a labor organizer with the Service Employees International Union, and has three children.[9] She currently lives in New York City.[10]
Awards and honors
References
External links
Gloria Feldt
2006–present
https://en.wikipedia.org/wiki/Cecile_Richards
Planned Parenthood
Planned Parenthood Federation of America (PPFA), commonly shortened to Planned Parenthood, is the U.S. affiliate of the International Planned Parenthood Federation (IPPF) and one of its larger members. PPFA is a non-profit organization providing reproductive health and maternal and child health services. The Planned Parenthood Action Fund, Inc. (PPAF) is a related organization which lobbies for pro-choice legislation, comprehensive sex education, and access to affordable health care in the United States. In recent years, Planned Parenthood has begun to move away from the pro-choice label to words and phrases that more accurately reflect the entire range of women’s health and economic issues.[3]
Planned Parenthood is the largest U.S. provider of reproductive health services, including cancer screening, HIV screening and counseling, contraception, and abortion.[4][5][6] Contraception accounts for 34% of PPFA’s total services and abortions account for 3%; PPFA conducts roughly 300,000 abortions each year, among 3 million people served.[7][8][9]
The organization has its roots in Brooklyn, New York, where Margaret Sanger opened the country’s first birth-control clinic. Sanger founded the American Birth Control League in 1921, which in 1942 became part of the Planned Parenthood Federation of America. Since then, Planned Parenthood has grown to have over 820 clinic locations in the U.S., with a total budget of US $1 billion. PPFA provides an array of services to over three million people in the United States, and supports services for over one million clients outside the United States.
History
Early history
Margaret Sanger (1922), the first president and founder of Planned Parenthood
The origins of Planned Parenthood date to October 16, 1916 when Margaret Sanger, her sister Ethel Byrne, and Fania Mindell opened the first birth control clinic in the U.S. in the Brownsville section of Brooklyn, New York.[10] All three women were immediately arrested and jailed for violating provisions of the Comstock Act– for distributing “obscene materials” at the clinic. The “Brownsville trials” brought national attention and support to their cause, and although Sanger and her co-defendants were convicted, their convictions were eventually overturned. Their campaign led to major changes in the laws governing birth control and sex education in the United States.[11]
In 1938, the clinic was organized into the American Birth Control League, which became part of the only national birth control organization in the US until the 1960s, but the title was found too offensive and “against families” so the League began discussions for a new name.[12] By 1941, the organization was operating 222 centers and had served 49,000 clients.[13] By 1942 the League had become part of what became the Planned Parenthood Federation of America.[12]
By 1960, the Federation’s grassroots volunteers had provided family planning counseling in hundreds of communities across the country.[13] Planned Parenthood was one of the founding members of the International Planned Parenthood Federation when it was launched at a conference in Bombay, India in 1952.[13][14]
After Sanger
Following Margaret Sanger, Alan Frank Guttmacher became president of Planned Parenthood and served from 1962 till 1974.[15] During his tenure, the Food and Drug Administration approved the sale of the original birth control pill, giving rise to new attitudes towards women’s reproductive freedom.[13] Also during his presidency, Planned Parenthood lobbied the federal government to support reproductive health, culminating with President Richard Nixon‘s signing of Title X to provide governmental subsidies for low-income women to access family planning services.[16] The Center for Family Planning Program Development was also founded as a semi-autonomous division during this time.[17] The center became an independent organization and was renamed the Guttmacher Institute in 1977.[17]
Faye Wattleton was the first woman named president of the Planned Parenthood Federation of America in 1978 and served till 1992.[18] She was the first African-American to serve as president, and the youngest president in Planned Parenthood’s history.[19] During her term, Planned Parenthood grew to become the seventh largest charity in the country, providing services to four million clients each year through its 170 affiliates whose activities were spread across 50 states.[20]
A Planned Parenthood supporter participates in a demonstration in support of the organization.
From 1996 to 2006, Planned Parenthood was led by Gloria Feldt.[21][22] Feldt activated the Planned Parenthood Action Fund, the organization’s political action committee, launching what was the most far reaching electoral advocacy effort in its history.[23] She also launched the Responsible Choices Action Agenda, a nationwide campaign to increase services to prevent unwanted pregnancies, improve quality of reproductive care and ensure access to safe and legal abortions.[13] Another initiative was the commencement of a “Global Partnership Program” with the aim of building a vibrant activist constituency in support of family planning.[13]
On February 15, 2006, Cecile Richards became president of the organization.[24]
Margaret Sanger Awards
In 1966, PPFA began awarding the Margaret Sanger Award annually to honor, in their words, “individuals of distinction in recognition of excellence and leadership in furthering reproductive health and reproductive rights.” In the first year, it was awarded to four men, Carl G. Hartman, William H. Draper, Lyndon Baines Johnson, and Martin Luther King.[25][26][27][28] Later recipients have included John D. Rockefeller III, Katharine Hepburn, Jane Fonda, Hillary Rodham Clinton, and Ted Turner.[29][30][31]
Services and facilities
Location in Houston, Texas
PPFA is a federation of 85 independent Planned Parenthood affiliates around the U.S.[1] These affiliates together operate more than 820 health centers in all 50 states and the District of Columbia.[1][32] The largest of these facilities, a $26 million, 78,000-square-foot (7,200 m2) structure was completed in Houston, Texas in May 2010.[33] This serves as a headquarters for 12 clinics in Texas and Louisiana.[33] Together, they are the largest family planning services provider in the U.S. with over four million activists, supporters and donors.[34][35][36] Planned Parenthood is staffed by 27,000 staff members and volunteers.[37]
They serve over five million clients a year, 26% of which are teenagers under the age of 19.[38] According to Planned Parenthood, 75% of their clients have incomes at or below 150 percent of the federal poverty level.[37]
Services provided at locations include contraceptives (birth control); emergency contraception; screening for breast, cervical and testicular cancers; pregnancy testing and pregnancy options counseling; testing and treatment for sexually transmitted diseases; comprehensive sexuality education, menopause treatments; vasectomies, tubal ligations, and abortion.
In 2009, Planned Parenthood provided 4,009,549 contraceptive services (35% of total), 3,955,926 sexually transmitted disease services (35% of total), 1,830,811 cancer related services (16% of total), 1,178,369 pregnancy/prenatal/midlife services (10% of total), 332,278 abortion services (3% of total), and 76,977 other services (1% of total), for a total of 11,383,900 services.[9][37][39][40][41][42] The organization also said its doctors and nurses annually conduct 1 million screenings for cervical cancer and 830,000 breast exams.
Funding
Planned Parenthood headquarters on Massachusetts Avenue in Washington, D.C.
Planned Parenthood has received federal funding since 1970, when President Richard Nixon signed into law the Family Planning Services and Population Research Act, amending the Public Health Service Act. Title X of that law provides funding for family planning services, including contraception and family planning information. The law enjoyed bipartisan support from liberals who saw contraception access as increasing families’ control over their lives, and conservatives who saw it as a way to keep people off welfare. Nixon described Title X funding as based on the premise that “no American woman should be denied access to family planning assistance because of her economic condition.”[43]
In the fiscal year ending June 30, 2011, total (consolidated) revenue was $201 million: clinic revenue totaling $2 million, grants and donations of $190 million, investment income of $2 million, and $7 million other income.[44] Approximately two-thirds of the revenue is put towards the provision of health services, while non-medical services such as sex education and public policy work make up another 16%; management expenses, fundraising, and international family planning programs account for most of the rest.
Planned Parenthood receives about a third of its money in government grants and contracts (about $360 million in 2009).[45] By law, federal funding cannot be allocated for abortions,[46] but some opponents of abortion have argued that allocating money to Planned Parenthood for the provision of other medical services “frees up” funds to be re-allocated for abortion.[4][47]
A coalition of national and local pro-life groups have lobbied federal and state government to stop funding Planned Parenthood, and as a result, Republican federal and state legislators have proposed legislation to reduce the funding levels.[46][48] Some six states have gone ahead with such proposals.[4][49][50][51] In some cases, the courts have overturned such actions, citing conflict with federal or other state laws, and in others, the federal executive branch has provided funding in lieu of the states.[50][51][52] In other cases, complete or partial defunding of Planned Parenthood has gone through successfully.[53][54]
Planned Parenthood is also funded by private donors, with a membership base of over 700,000 active donors whose contributions account for approximately one quarter of the organization’s revenue.[55] Large donors also contribute a substantial portion of the organization’s budget; past donors have included the Bill & Melinda Gates Foundation, Buffett Foundation, Ford Foundation, Turner Foundation, the Cullmans and others.[56][57][58][59] The Bill & Melinda Gates Foundation’s contributions to the organization have been specifically marked to avoid funding abortions.[56] Some, such as the Buffett Foundation, have supported reproductive health that can include abortion services.[56] Pro-life groups have advocated the boycott of donors to Planned Parenthood.[60]
Stand on political and legal issues
Planned Parenthood and its predecessor organizations have provided and advocated for access to birth control. The modern organization of Planned Parenthood America is also an advocate for reproductive rights.[61] This advocacy includes contributing to sponsorship of abortion rights and women’s rights events[62] and assisting in the testing of new contraceptives.[63] The Federation opposes restrictions on women’s reproductive health services, including parental consent laws. Planned Parenthood has cited the case of Becky Bell, who died following a septic abortion after failing to seek parental consent, to justify their opposition.[64][65] Planned Parenthood also takes the position that laws requiring parental notification before an abortion is performed on a minor are unconstitutional on privacy grounds.[66] The organization also opposes laws requiring ultrasounds before abortions, stating that their only purpose is to make abortions more difficult to obtain.[67] Planned Parenthood has also opposed initiatives that require waiting periods before abortions,[68] and bans on late-term abortions including intact dilation and extraction, which has been illegal in the U.S. since 2003.[69]
Planned Parenthood argues for the wide availability of emergency contraception (EC) measures.[70] It opposes conscience clauses, which allow pharmacists to refuse to dispense drugs against their beliefs. In support of their position, they have cited cases where pharmacists have refused to fill life saving drugs under the laws.[71] Planned Parenthood has also been critical of hospitals that do not provide access to EC for rape victims.[72] Planned Parenthood supports and provides FDA-approved abortifacients such as mifepristone.[73]
Citing the need for medically accurate information in sex education, Planned Parenthood opposes abstinence-only education in public schools. Instead, Planned Parenthood is a provider of, and endorses, comprehensive sex education, which includes discussion of both abstinence and birth control.[74]
Political Action Committee
Planned Parenthood also has a political action committee called Planned Parenthood Action Fund. The committee was founded in 1996 by then new president Gloria Feldt for the purpose of maintaining reproductive health rights and supporting political candidates of the same mindset. In 2012 election cycle the committee gained prominence based on its effectiveness of spending on candidates.[75]
Before the U.S. Supreme Court
Former Planned Parenthood President Gloria Feldt with Congressman Albert Wynn in front of the U.S. Supreme Court
Planned Parenthood regional chapters have been active in the American courts. A number of cases in which Planned Parenthood has been a party have reached the U.S. Supreme Court. Notable among these cases is the 1992 case Planned Parenthood v. Casey, the case that sets forth the current constitutional abortion standard. In this case, “Planned Parenthood” was the Southeast Pennsylvania Chapter, and “Casey” was Robert Casey, the governor of Pennsylvania. The ultimate ruling was split, and Roe v. Wade was narrowed but upheld in an opinion written by Sandra Day O’Connor, Anthony Kennedy, and David Souter. Harry Blackmun and John Paul Stevens concurred with the main decision in separately written opinions. The Supreme Court struck down spousal consent requirements for married women to obtain abortions, but found no “undue burden”—an alternative to strict scrutiny which tests the allowable limitations on rights protected under the Constitution—from the other statutory requirements. Dissenting were William Rehnquist, Antonin Scalia, Clarence Thomas, and Byron White. Blackmun, Rehnquist, and White were the only justices who voted on the original Roe v. Wade decision in 1973 who were still on the Supreme Court to rule on this case, and their votes on this case were consistent with their votes on the original decision that legalized abortion.[76] Only Blackmun voted to maintain Roe v. Wade in its entirety.
Other related cases include:
Controversy and criticism
Abortion
Planned Parenthood has occupied a central position in the abortion debate in the U.S., and has been among the most prominent targets of U.S. pro-life activists for decades. Congressional Republicans have attempted since the 1980s to defund the organization,[45] nearly leading to a government shutdown over the issue in 2011.[86] The federal money received by Planned Parenthood is not used to fund abortion services, but pro-life activists have argued that the funding frees up other resources which are, in turn, used to provide abortions.[45]
Planned Parenthood is the largest single provider of abortions in the U.S.[7] In 2009, Planned Parenthood performed 332,278 abortions (for comparison, 1.21 million abortions were performed in the US in 2008[87]), from which it derives about $164,154,000, or 15% of its annual revenue as of their 2008–2009 calculations.[88] According to PPFA’s own estimates, its contraceptive services prevent approximately 612,000 unintended pregnancies and 291,000 abortions annually.[37][89] Planned Parenthood president Cecile Richards has argued that the organization’s family planning services reduce the need for abortions.[90] Megan Crepeau of the Chicago Tribune said that, because of its birth control and family planning services, PPFA could be “characterized as America’s largest abortion preventer.”[91] Anti-abortion activists dispute the evidence that greater access to contraceptives reduces abortions.[92]
Margaret Sanger and eugenics
In the 1920s various theories of eugenics were popular among intellectuals in the United States. For example, 75% of colleges offered courses on eugenics.[93] Sanger, in her campaign to promote birth control, teamed with eugenics organizations such as the American Eugenics Society, although she argued against many of their positions.[94][95][96] Scholars describe Sanger as believing that birth control, sterilization and abortion should be voluntary and not based on race.[97] She advocated for “voluntary motherhood”—the right to choose when to be pregnant—for all women, as an important element of women’s rights.[98][99] Opponents of Planned Parenthood often refer to Sanger’s connection with supporters of eugenics to discredit the organization by associating it, and birth control, with the more negative modern view of eugenics.[100][101] Planned Parenthood has responded to this effort directly in a leaflet acknowledging that Sanger agreed with some of her contemporaries who advocated the voluntary hospitalization or sterilization of people with untreatable, disabling, hereditary conditions, and limits on the immigration of the diseased. The leaflet also states that Planned Parenthood “finds these views objectionable and outmoded” but says that it was compelled to discuss the topic because “anti-family planning activists continue to attack Sanger . . . because she is an easier target” than Planned Parenthood.[102]
Recorded stings by pro-life activists
Planned Parenthood supporters in Columbus, OH
Periodically pro-life activists have tried to demonstrate that Planned Parenthood does not follow applicable state or federal laws. The groups called or visited a Planned Parenthood health center posing as victims of statutory rape,[103] minors who would need parental notification for abortion,[104][105] racists seeking to earmark donations for abortions for black women to abort black babies,[106] or pimps who want abortions for child prostitutes.[107] Edited video and audio productions of these dialogues seem to capture employees being sympathetic to potentially criminal acts, leading to allegations that the health centers in question are violating the law. An official federal inspection in 2005 by the Bush administration‘s Department of Health and Human Services “yielded no evidence of clinics around the nation failing to comply with laws on reporting child abuse, child molestation, sexual abuse, rape or incest.”[104]
In 2011, the organization Live Action released a series of videos that they said showed Planned Parenthood employees at multiple affiliates actively assisting or being complicit in aiding the underage prostitution ring of actors posing as a pimp and a prostitute. Planned Parenthood conducted a frame-by-frame analysis of the recordings, and said they found instances of “editing that dramatically alter[ed] the meaning of the recorded conversations.”[108]
None of these stings have led to criminal conviction.[109] However, a small number of Planned Parenthood employees and volunteers were fired for not following procedure, and the organization committed to retraining its staff.[106][110]
State and local court cases against Planned Parenthood
In some states, anti-abortion Attorneys General have subpoenaed medical records of patients treated by Planned Parenthood. Planned Parenthood has gone to court to keep from turning over these records, citing medical privacy and concerns about the motivation for seeking the records.[111]
In 2006, Kansas Attorney General Phill Kline, a strongly anti-abortion Republican, released some sealed patient records obtained from Planned Parenthood to the public. His actions were described as “troubling” by the state Supreme Court, but ultimately Planned Parenthood was compelled to turn over the medical records, albeit with more stringent court-mandated privacy safeguards for the patients involved.[111] In 2007, Kline’s successor, Paul J. Morrison, notified the clinic that no criminal charges would be filed after a three-year investigation, as “an objective, unbiased and thorough examination” showed no wrongdoing. Morrison stated that he believed Kline had politicized the attorney general’s office.[112] In 2012, a Kansas district attorney dropped all of the remaining criminal charges against the Kansas City-area Planned Parenthood clinic accused of performing illegal abortions, citing a lack of evidence of wrongdoing.[113] In all, the Planned Parenthood clinic had faced 107 criminal charges from Kline and other Kansas prosecutors, all of which were ultimately dropped for lack of evidence.[113]
In Indiana, Planned Parenthood was not required to turn over its medical records in an investigation of possible child abuse.[114] In October 2005, Planned Parenthood Minnesota/North Dakota/South Dakota was fined $50,000 for violating a Minnesota state parental consent law.[115]
On December 31, 2012, Judge Gary Harger ruled Texas may exclude otherwise qualified doctors and clinics from receiving state funding if they advocate for abortion rights.[116]
Anti-abortion violence
Planned Parenthood clinics have been the target of many instances of anti-abortion violence, including (but not limited to) bombing, arson, and attacks with chemical weaponry.[117][118][119][120][121][122][123][124][125][126][127]
1994 Brookline shootings
In 1994, John Salvi entered a Brookline, Massachusetts Planned Parenthood clinic and opened fire, murdering receptionist Shannon Elizabeth Lowney and wounding three others. He fled to another Planned Parenthood clinic where he murdered Leane Nichols and wounded two others.[128]
See also
Notes
https://en.wikipedia.org/wiki/Planned_Parenthood
Margaret Sanger
September 14, 1879
Corning, New York,
United States
Tucson, Arizona,
United States
James Noah H. Slee (1922–1943).
Margaret Higgins Sanger (September 14, 1879 – September 6, 1966) was an American birth control activist, sex educator, and nurse. Sanger popularized the term birth control, opened the first birth control clinic in the United States, and established organizations that evolved into the Planned Parenthood Federation of America. Sanger was also a writer. She used this method to help promote her way of thinking. She was prosecuted for her book Family Limitation under the Comstock Act in 1914. She was afraid of what would happen, so she fled to Britain until she knew it was safe to return to the US.[citation needed] Sanger’s efforts contributed to several judicial cases that helped legalize contraception in the United States. Sanger is a frequent target of criticism by opponents of abortion and has also been criticized for supporting eugenics, but remains an iconic figure in the American reproductive rights movement.[2]
In 1916, Sanger opened the first birth control clinic in the United States, which led to her arrest for distributing information on contraception. Her subsequent trial and appeal generated controversy. Sanger felt that in order for women to have a more equal footing in society and to lead healthier lives, they needed to be able to determine when to bear children. She also wanted to prevent unsafe abortions, so-called back-alley abortions, which were common at the time because abortions were usually illegal. She believed that while abortion was sometimes justified it should generally be avoided, and she considered contraception the only practical way to avoid the use of abortions.[citation needed]
In 1921, Sanger founded the American Birth Control League, which later became the Planned Parenthood Federation of America. In New York City, she organized the first birth control clinic staffed by all-female doctors, as well as a clinic in Harlem with an entirely African-American staff. In 1929, she formed the National Committee on Federal Legislation for Birth Control, which served as the focal point of her lobbying efforts to legalize contraception in the United States. From 1952 to 1959, Sanger served as president of the International Planned Parenthood Federation. She died in 1966, and is widely regarded as a founder of the modern birth control movement.
Life
Early life
Sanger was born Margaret Louise Higgins in 1879 in Corning, New York,[3] to Michael Hennessey Higgins, an Irish-born stonemason and free-thinker, and Anne Purcell Higgins, a Catholic Irish-American. Michael Hennessey Higgins had emigrated to the USA at age 14 and joined the U.S. Army as a drummer at age 15, during the Civil War. After leaving the army, Michael studied medicine and phrenology, but ultimately became a stonecutter, making stone angels, saints, and tombstones.[4] Michael H. Higgins was a Catholic who became an atheist and an activist for women’s suffrage and free public education.[5] Anne Higgins went through 18 pregnancies (with 11 live births) in 22 years before dying at the age of 49. Sanger was the sixth of eleven surviving children,[6] and spent much of her youth assisting with household chores and caring for her younger siblings. Anne’s parents took their children and emigrated to Canada when she was a child, due to the Potato Famine.
Supported by her two older sisters, Margaret Higgins attended Claverack College and Hudson River Institute, before enrolling in 1900 at White Plains Hospital as a nurse probationer. In 1902, she married the dashing architect William Sanger and gave up her education.[7] Though she was plagued by a recurring active tubercular condition, Margaret Sanger bore three children, and the couple settled down to a quiet life in Westchester, New York.
Sanger with sons Grant and Stuart, c. 1919
Social activism
In 1911, after a fire destroyed their home in Hastings-on-Hudson, the Sangers abandoned the suburbs for a new life in New York City. Margaret Sanger worked as a visiting nurse in the slums of the East Side, while her husband worked as an architect and a house painter. Already imbued with her husband’s leftist politics, Margaret Sanger also threw herself into the radical politics and modernist values of pre-World War I Greenwich Village bohemia. She joined the Women’s Committee of the New York Socialist party, took part in the labor actions of the Industrial Workers of the World (including the notable 1912 Lawrence Textile Strike and the 1913 Paterson Silk Strike) and became involved with local intellectuals, left-wing artists, socialists and social activists, including John Reed, Upton Sinclair, Mabel Dodge and Emma Goldman.[8]
Sanger’s political interests, emerging feminism and nursing experience led her to write two series of columns on sex education entitled “What Every Mother Should Know” (1911–12) and “What Every Girl Should Know” (1912-13) for the socialist magazine New York Call. By the standards of the day, Sanger’s articles were extremely frank in their discussion of sexuality, and many New York Call readers were outraged by them. Other readers, however, praised the series for its candor, one stated that the series contained “a purer morality than whole libraries full of hypocritical cant about modesty.[9] Both were later published in book form in 1916.[10]
During her work among working class immigrant women, Sanger was exposed to graphic examples of women going through frequent childbirth, miscarriage and self-induced abortion for lack of information on how to avoid unwanted pregnancy. Access to contraceptive information was prohibited on grounds of obscenity by the 1873 federal Comstock law and a host of state laws. Searching for something that would help these women, Sanger visited public libraries, but was unable to find information on contraception.[11] These problems were epitomized in a (possibly fictional) story that Sanger would later recount in her speeches: while Sanger was working as a nurse, she was called to the apartment of a woman, “Sadie Sachs,” who had become extremely ill due to a self-induced abortion. Afterward, “Sadie” (whose marital status Sanger never mentioned) begged the attending doctor to tell her how she could prevent this from happening again, to which the doctor simply advised her to remain abstinent. A few months later, Sanger was called back to “Sadie’s” apartment — only this time, “Sadie” died shortly after Sanger arrived. She had attempted yet another self-induced abortion.[12][13] Sanger would sometimes end the story by saying, “I threw my nursing bag in the corner and announced … that I would never take another case until I had made it possible for working women in America to have the knowledge to control birth.” Although “Sadie Sachs” was possibly a fictional composite of several women Sanger had known, this story marks the time when Sanger began to devote her life to help desperate women before they were driven to pursue dangerous and illegal abortions.[13][14]
Accepting the connection proposed between contraception and working-class empowerment by radicals such as Emma Goldman, Sanger came to believe that only by liberating women from the risk of unwanted pregnancy would fundamental social change take place. She proceeded to launch a campaign to challenge governmental censorship of contraceptive information. She would set up a series of confrontational actions designed to challenge the law and force birth control to become a topic of public debate. Sanger’s trip to France in 1913 exposed her to what Goldman had been saying. Sanger’s experience during her trip to France directly influence The Women Rebel newsletter. The trip to France was also the beginning of the end of her marriage with William Sanger.[15]
In 1914, Sanger launched The Woman Rebel, an eight-page monthly newsletter which promoted contraception using the slogan “No Gods, No Masters“.[16][note 2][17] Sanger, collaborating with anarchist friends, popularized the term “birth control” as a more candid alternative to euphemisms such as “family limitation”[18] and proclaimed that each woman should be “the absolute mistress of her own body.”[19] In these early years of Sanger’s activism, she viewed birth control as a free-speech issue, and when she started publishing The Woman Rebel, one of her goals was to provoke a legal challenge to the federal anti-obscenity laws which banned dissemination of information about contraception.[20][21] Though postal authorities suppressed five of its seven issues, Sanger continuing publication, all the while preparing, Family Limitation, an even more blatant challenge to anti-birth control laws. This 16-page pamphlet contained detailed and precise information and graphic descriptions of various contraceptive methods. In August 1914 Margaret Sanger was indicted for violating postal obscenity laws by sending the The Woman Rebel through the postal system. Instead of standing trial, she jumped bail and fled to Canada. Then, under the alias “Bertha Watson”, sailed for England. En route she ordered her labor associates to release copies of the Family Limitation.[22]
Margaret Sanger spent much of her 1914 exile in England, where contact with British neo-Malthusianists helped refine her socioeconomic justifications for birth control. She was also profoundly influenced by the liberation theories of British sexual theorist Havelock Ellis. Under his tutelage she formulated a new rationale that would liberate women not just by making sexual intercourse safe, but also pleasurable. It would, in effect, free women from the inequality of sexual experience. Early in 1915, Margaret Sanger’s estranged husband, William Sanger, was entrapped into giving a copy of Family Limitation to a representative of anti-vice crusader Anthony Comstock. William Sanger was tried and convicted, he spent thirty days in jail, while also escalating interest in birth control as a civil liberties issue.[23][24][25]
Birth control movement
This page from Sanger’s Family Limitation, 1917 edition, describes a cervical cap.
Some countries in northwestern Europe had more liberal policies towards contraception than the United States at the time, and when Sanger visited a Dutch birth control clinic in 1915, she learned about diaphragms and became convinced that they were a more effective means of contraception than the suppositories and douches that she had been distributing back in the United States. Diaphragms were generally unavailable in the United States, so Sanger and others began importing them from Europe, in defiance of United States law.[8]
In 1917, she started publishing the monthly periodical Birth Control Review.[note 3]
On October 16, 1916, Sanger opened a family planning and birth control clinic at 46 Amboy St. in the Brownsville neighborhood of Brooklyn, the first of its kind in the United States.[26] Nine days after the clinic opened, Sanger was arrested. Sanger’s bail was set at $500 and she went back home. Sanger continued seeing some women in the clinic until the police came a second time. This time Sanger and her sister, Ethel Byrne, were arrested for breaking a New York state law that prohibited distribution of contraceptives, Sanger was also charged with running a public nuisance.[27] Sanger and Ethel went to trial in January 1917.[28] Byrne was convicted and sentenced to 30 days in a workhouse but went on hunger strike. She was the first woman in the US to be force fed.[29] Only when Sanger pledged that Byrne would never break the law, she was pardoned after ten days.[30] Sanger was convicted; the trial judge held that women did not have “the right to copulate with a feeling of security that there will be no resulting conception.”[31] Sanger was offered a more lenient sentence if she promised to not break the law again, but she replied: “I cannot respect the law as it exists today.”[32] For this, she was sentenced to 30 days in a workhouse.[32] An initial appeal was rejected, but in a subsequent court proceeding in 1918, the birth control movement won a victory when Judge Frederick E. Crane of the New York Court of Appeals issued a ruling which allowed doctors to prescribe contraception.[33] The publicity surrounding Sanger’s arrest, trial, and appeal sparked birth control activism across the United States, and earned the support of numerous donors, who would provide her with funding and support for future endeavors.[34]
Sanger became estranged from her husband in 1913, and the couple’s divorce was finalized in 1921.[35] Sanger’s second husband was Noah Slee. He followed Sanger around the world and provided much of Sanger’s financial assistance. The couple got married in September 1922, but the public did not know about it until February 1924. They supported each other with their pre-commitments.[36]
American Birth Control League
Sanger published the Birth Control Review from 1917 to 1929.[note 4]
After World War I, Sanger shifted away from radical politics, and she founded the American Birth Control League (ABCL) in 1921 to enlarge her base of supporters to include the middle class.[37] The founding principles of the ABCL were as follows:[38]
Sanger’s appeal of her conviction for the Brownsville clinic secured a 1918 court ruling that exempted physicians from the law that prohibited the distribution of contraceptive information to women—provided it was prescribed for medical reasons—she established the Clinical Research Bureau (CRB) in 1923 to exploit this loophole.[8][39] The CRB was the first legal birth control clinic in the United States, and it was staffed entirely by female doctors and social workers.[40] The clinic received a large amount of funding from John D. Rockefeller Jr. and his family, which continued to make donations to Sanger’s causes in future decades, but generally made them anonymously to avoid public exposure of the family name,[41] and to protect family member Nelson Rockefeller‘s political career since openly advocating birth control could have led to the Catholic Church opposing him politically.[42] John D. Rockefeller Jr. donated five thousand dollars to her American Birth Control League in 1924 and a second time in 1925.[43] In 1922, she traveled to China, Korea, and Japan. In China she observed that the primary method of family planning was female infanticide, and she later worked with Pearl Buck to establish a family planning clinic in Shanghai.[44] Sanger visited Japan six times, working with Japanese feminist Kato Shidzue to promote birth control.[45] This was ironic since ten years earlier Sanger had accused Katō of murder and praised an attempt to kill her.[46]
In 1926, Sanger gave a lecture on birth control to the women’s auxiliary of the Ku Klux Klan in Silver Lake, New Jersey.[47] She described it as “one of the weirdest experiences I had in lecturing,” and added that she had to use only “the most elementary terms, as though I were trying to make children understand.”[47] Sanger’s talk was well received by the group, and as a result, “a dozen invitations to similar groups were proffered.”[47]
In 1928, conflict within the birth control movement leadership led Sanger to resign as the president of the ABCL and take full control of the CRB, renaming it the Birth Control Clinical Research Bureau (BCCRB), marking the beginning of a schism in the movement that would last until 1938.[48]
Sanger invested a great deal of effort communicating with the general public. From 1916 onward, she frequently lectured—in churches, women’s clubs, homes, and theaters—to workers, churchmen, liberals, socialists, scientists, and upper-class women.[49] She wrote several books in the 1920s which had a nationwide impact in promoting the cause of birth control. Between 1920 and 1926, 567,000 copies of Woman and the New Race and The Pivot of Civilization were sold.[50] She also wrote two autobiographies designed to promote the cause. The first, My Fight for Birth Control, was published in 1931 and the second, more promotional version, Margaret Sanger: An Autobiography, was published in 1938.
During the 1920s, Sanger received hundreds of thousands of letters, many of them written in desperation by women begging for information on how to prevent unwanted pregnancies.[51][52] Five hundred of these letters were compiled into the 1928 book, Motherhood in Bondage.[53][54]
Planned Parenthood era
Sanger’s Birth Control Clinical Research Bureau operated from this New York building from 1930 to 1973.
In 1929, Sanger formed the National Committee on Federal Legislation for Birth Control in order to lobby for legislation to overturn restrictions on contraception.[55] That effort failed to achieve success, so Sanger ordered a diaphragm from Japan in 1932, in order to provoke a decisive battle in the courts. The diaphragm was confiscated by the United States government, and Sanger’s subsequent legal challenge led to a 1936 court decision which overturned an important provision of the Comstock laws which prohibited physicians from obtaining contraceptives.[56] This court victory motivated the American Medical Association in 1937 to adopt contraception as a normal medical service and a key component of medical school curriculums.[57]
This 1936 contraception court victory was the culmination of Sanger’s birth control efforts, and she took the opportunity, now in her late 50s, to move to Tucson, Arizona, intending to play a less critical role in the birth control movement. In spite of her original intentions, she remained active in the movement through the 1950s.[57]
In 1937, Sanger became chairman of the newly formed Birth Control Council of America, and attempted to resolve the schism between the ABCL and the BCCRB.[58] Her efforts were successful, and the two organizations merged in 1939 as the Birth Control Federation of America.[59][note 5] Although Sanger continued in the role of president, she no longer wielded the same power as she had in the early years of the movement, and in 1942, more conservative forces within the organization changed the name to Planned Parenthood Federation of America, a name Sanger objected to because she considered it too euphemistic.[60]
In 1946, Sanger helped found the International Committee on Planned Parenthood, which evolved into the International Planned Parenthood Federation in 1952, and soon became the world’s largest non-governmental international family planning organization. Sanger was the organization’s first president and served in that role until she was 80 years old.[61] In the early 1950s, Sanger encouraged philanthropist Katharine McCormick to provide funding for biologist Gregory Pincus to develop the birth control pill which was eventually sold under the name Enovid.[62]
Death
Margaret Sanger Square, at the intersection of Mott Street and Bleecker Street in Manhattan
Sanger died of congestive heart failure in 1966 in Tucson, Arizona, aged 86, about a year after the event that marked the climax of her 50-year career: the landmark U.S. Supreme Court case Griswold v. Connecticut, which legalized birth control in the United States.[note 6] Sanger is buried in Fishkill, New York, next to her sister, Nan Higgins, and her second husband, Noah Slee.[63] One of her surviving brothers was College Football Hall of Fame player and coach Bob Higgins.[64]
Legacy
Long after her death, Sanger has continued to be regarded as a leading figure in the battle for American women’s rights. Sanger’s story has been the subject of several biographies, including an award-winning biography published in 1970 by David Kennedy, and is also the subject of several films, including Choices of the Heart: The Margaret Sanger Story.[65] Sanger’s writings are curated by two universities: New York University‘s history department maintains the Margaret Sanger Papers Project,[66] and Smith College‘s Sophia Smith Collection maintains the Margaret Sanger Papers collection.[67]
Sanger has been recognized with many important honors. In 1957, the American Humanist Association named her Humanist of the Year. Government authorities and other institutions have memorialized Sanger by dedicating several landmarks in her name, including a residential building on the Stony Brook University campus, a room in Wellesley College’s library,[68] and Margaret Sanger Square in New York City’s Greenwich Village.[69] In 1993, the Margaret Sanger Clinic—where she provided birth control services in New York in the mid twentieth century—was designated as a National Historic Landmark by the National Park Service.[70] In 1966, Planned Parenthood began issuing its Margaret Sanger Awards annually to honor “individuals of distinction in recognition of excellence and leadership in furthering reproductive health and reproductive rights.”[71]
Due to her connection with Planned Parenthood, many who are opposed to abortion frequently condemn Sanger by criticizing her views on racial supremacy, birth control, and eugenics.[72][73][note 7] In spite of such controversies, Sanger continues to be regarded as an icon for the American reproductive rights movement and woman’s rights movement.
Controversies
Sexuality
While researching information on contraception Sanger read various treatises on sexuality in order to find information about birth control. She read The Psychology of Sex by the English psychologist Havelock Ellis and was heavily influenced by it.[74] While traveling in Europe in 1914, Sanger met Ellis.[75] Influenced by Ellis, Sanger adopted his view of sexuality as a powerful, liberating force.[76] This view provided another argument in favor of birth control, as it would enable women to fully enjoy sexual relations without the fear of an unwanted pregnancy.[77] Sanger also believed that sexuality, along with birth control, should be discussed with more candor.[76]
However, Sanger was opposed to excessive sexual indulgence. She stated “every normal man and woman has the power to control and direct his sexual impulse. Men and women who have it in control and constantly use their brain cells thinking deeply, are never sensual.”[78][79] Sanger said that birth control would elevate women away from a position of being an object of lust and elevate sex away from purely being for satisfying lust, saying that birth control “denies that sex should be reduced to the position of sensual lust, or that woman should permit herself to be the instrument of its satisfaction.”[80] Sanger wrote that masturbation was dangerous. She stated: “In my personal experience as a trained nurse while attending persons afflicted with various and often revolting diseases, no matter what their ailments, I never found any one so repulsive as the chronic masturbator. It would not be difficult to fill page upon page of heart-rending confessions made by young girls, whose lives were blighted by this pernicious habit, always begun so innocently.”[81] She believed that women had the ability to control their sexual impulses, and should utilize that control to avoid sex outside of relationships marked by “confidence and respect.” She believed that exercising such control would lead to the “strongest and most sacred passion.”[82] However, Sanger was not opposed to homosexuality and praised Ellis for clarifying “the question of homosexuals… making the thing a—not exactly a perverted thing, but a thing that a person is born with different kinds of eyes, different kinds of structures and so forth… that he didn’t make all homosexuals perverts—and I thought he helped clarify that to the medical profession and to the scientists of the world as perhaps one of the first ones to do that.”[83] Sanger believed sex should be discussed with more candor, and praised Ellis for his efforts in this direction. She also blamed the suppression of discussion about it on Christianity.[83]
Eugenics
Sanger’s 1920 book endorsed eugenics.
As part of her efforts to promote birth control, Sanger found common cause with proponents of eugenics, believing that they both sought to “assist the race toward the elimination of the unfit.”[84] Sanger was a proponent of negative eugenics, which aims to improve human hereditary traits through social intervention by reducing the reproduction of those who were considered unfit. In “The Morality of Birth Control,” a 1921 speech, she divided society into three groups: the educated and informed class that regulated the size of their families, the intelligent and responsible who desired to control their families however did not have the means or the knowledge and the irresponsible and reckless people whose religious scruples “prevent their exercising control over their numbers.” Sanger concludes “there is no doubt in the minds of all thinking people that the procreation of this group should be stopped.”[85] Sanger’s eugenic policies included an exclusionary immigration policy, free access to birth control methods and full family planning autonomy for the able-minded, and compulsory segregation or sterilization for the “profoundly retarded”.[86][87] In her book The Pivot of Civilization, she advocated coercion to prevent the “undeniably feeble-minded” from procreating.[88] Although Sanger supported negative eugenics, she asserted that eugenics alone was not sufficient, and that birth control was essential to achieve her goals.[89][90][91]
In contrast with eugenicist William Robinson, who advocated euthanasia for the unfit,[note 8] Sanger wrote, “we [do not] believe that the community could or should send to the lethal chamber the defective progeny resulting from irresponsible and unintelligent breeding.”[92] Similarly, Sanger denounced the aggressive and lethal Nazi eugenics program.[87] In addition, Sanger believed the responsibility for birth control should remain in the hands of able-minded individual parents rather than the state, and that self-determining motherhood was the only unshakable foundation for racial betterment.[89][93]
Sanger also supported restrictive immigration policies. In “A Plan for Peace”, a 1932 essay, she proposed a congressional department to address population problems. She also recommended that immigration exclude those “whose condition is known to be detrimental to the stamina of the race,” and that sterilization and segregation be applied to those with incurable, hereditary disabilities.[86][87][94]
Race
W. E. B. Du Bois served on the board of Sanger’s Harlem clinic.[95]
Sanger’s writings echoed her ideas about inferiority and loose morals of particular races. In one “What Every Girl Should Know” commentary, she references popular opinion that Aboriginal Australians were “just a step higher than the chimpanzee” with “little sexual control,” as compared to the “normal man and Woman.”[78] Elsewhere she bemoaned that traditional sexual ethics “… have in the past revealed their woeful inability to prevent the sexual and racial chaos into which the world has today drifted.”[93]
Such attitudes did not keep her from collaborating with African-American leaders and professionals who saw a need for birth control in their communities. In 1929, James H. Hubert, a black social worker and leader of New York’s Urban League, asked Sanger to open a clinic in Harlem.[96] Sanger secured funding from the Julius Rosenwald Fund and opened the clinic, staffed with black doctors, in 1930. The clinic was directed by a 15-member advisory board consisting of black doctors, nurses, clergy, journalists, and social workers. The clinic was publicized in the African-American press and in black churches, and it received the approval of W. E. B. Du Bois, founder of the NAACP.[97] In 1939 Sanger wrote, “We should hire three or four colored ministers, preferably with social-service backgrounds, and with engaging personalities. The most successful educational approach to the Negro is through a religious appeal. We don’t want the word to go out that we want to exterminate the Negro population, and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.” She did not tolerate bigotry among her staff, nor would she tolerate any refusal to work within interracial projects.[98] Sanger’s work with minorities earned praise from Martin Luther King, Jr., in his 1966 acceptance speech for the Margaret Sanger award.[99]
From 1939 to 1942 Sanger was an honorary delegate of the Birth Control Federation of America, which included a supervisory role—alongside Mary Lasker and Clarence Gamble—in the Negro Project, an effort to deliver birth control to poor black people.[100] Sanger wanted the Negro Project to include black ministers in leadership roles, but other supervisors did not. To emphasize the benefits of involving black community leaders, she wrote to Gamble “we do not want word to go out that we want to exterminate the Negro population and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.” This quote has been cited by Angela Davis to support her claims that Sanger wanted to exterminate black people.[101] However, New York University’s Margaret Sanger Papers Project, argues that in writing that letter, “Sanger recognized that elements within the black community might mistakenly associate the Negro Project with racist sterilization campaigns in the Jim Crow South, unless clergy and other community leaders spread the word that the Project had a humanitarian aim.”[102]
Freedom of speech
Sanger opposed censorship throughout her career, with a zeal comparable to her support for birth control. Sanger grew up in a home where iconoclastic orator Robert Ingersoll was admired.[103] During the early years of her activism, Sanger viewed birth control primarily as a free-speech issue, rather than as a feminist issue, and when she started publishing The Woman Rebel in 1914, she did so with the express goal of provoking a legal challenge to the Comstock laws banning dissemination of information about contraception.[21] In New York, Emma Goldman introduced Sanger to members of the Free Speech League, such as Edward Bliss Foote and Theodore Schroeder, and subsequently the League provided funding and advice to help Sanger with legal battles.[104]
Over the course of her career, Sanger was arrested at least eight times for expressing her views during an era in which speaking publicly about contraception was illegal.[105] Numerous times in her career, local government officials prevented Sanger from speaking by shuttering a facility or threatening her hosts.[106] In Boston in 1929, city officials under the leadership of James Curley threatened to arrest her if she spoke—so she turned the threat to her advantage and stood on stage, silent, with a gag over her mouth, while her speech was read by Arthur M. Schlesinger, Sr.[107]
Abortion
Sanger’s family planning advocacy always focused on contraception, rather than abortion.[108][note 9] It was not until the mid-1960s, after Sanger’s death, that the reproductive rights movement expanded its scope to include abortion rights as well as contraception.[note 10] Sanger was opposed to abortions, both because she believed that life should not be terminated after conception, and because they were dangerous for the mother in the early 20th century. In her book Woman and the New Race, she wrote: “while there are cases where even the law recognizes an abortion as justifiable if recommended by a physician, I assert that the hundreds of thousands of abortions performed in America each year are a disgrace to civilization.”[111]
Historian Rodger Streitmatter concluded that Sanger’s opposition to abortion stemmed from concerns for the dangers to the mother, rather than moral concerns.[112] However, in her 1938 autobiography, Sanger noted that her opposition to abortion was based on the taking of life: “[In 1916] we explained what contraception was; that abortion was the wrong way no matter how early it was performed it was taking life; that contraception was the better way, the safer way—it took a little time, a little trouble, but was well worth while in the long run, because life had not yet begun.”[113] And in her book Family Limitation, Sanger wrote that “no one can doubt that there are times when an abortion is justifiable but they will become unnecessary when care is taken to prevent conception. This is the only cure for abortions.”[114]
Works
See also
https://en.wikipedia.org/wiki/Margaret_Sanger
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