General Bert’s Communiqué
Bringing Push Back Home
State by State Victory!
Soldiers fighting on their home territory are filled with vigor and determination which invaders lack. In our struggle for Health Freedom we need to take the push back battle to your state, your job, your home territory.
The next battlefield waiting for a push back victory is where you live. And Natural Solutions Founation is here to help you win that battle.
We are winning the war against our bodies. The forces that believe they can compel us to submit to their idea of medical “care” are retreating.
Twice so far, as we came to the brink of a Federal Law Suit against the vaccine mandates they retreated, claiming illogically that there were insufficient doses of vaccine to carry out their mandate.
Absurd, but telling.
Twice now, once in New York and then in New Jersey, we have seen their tails between the legs of the mandating forces as they take off in disarray. They will regroup, but right now, we hold the high ground. What that means is that we need to take back our health freedom state by state. Every school mandate, every worker’s mandate, every daycare mandate must be pushed back.
And together we can do that. We want you to succeed in Bringing Push Back Home!
We’ll work with you to (1) create a web page, (2) send Action Items that will go to your supporters only and (3) make a free conference bridge line available to you for local conference call participation.
Natural Solutions Foundation will advise you on strategy, legal possibilities, etc., all without charge to your group. Our Organizer’s eBook is being updated to include the latest techniques and tactics.
Why? Because community organization around health freedom issues is near and dear to our heart. We KNOW, we don’t just believe, we KNOW that it is the voice of the People, demanding our rights, that will protect our rights. That is what Dr. Paul G. King’s wonderful essay says and that is what Natural Solutions Foundation says, over and over and over and over.
And you know what? That repetition, the enlarging drum-beat of power, personal power, is turning the tide.
Of course, we have come to the most dangerous part of the game: we are becoming SO powerful that the other side, call them what, or whom you will, could, at a moment’s notice, change the rules of the game and come down on free men and women (and children, remember that part) like a ton of bricks IF they feel both threatened and IF they can get a way with it.
You know they feel threatened: hence the threats to shut down the internet, declare Martial Law, criminalize vaccine refusal, etc. But you also know that our collective power has an immobilizing effect on them: without that immobilizing effect, consider what would already have happened. Why has it not? Why is only the Ukraine under effective Medical Martial Law? Why has the WHO not exercised its treaty-granted powers to take over the governance of every country in the world under the 2005 agreement which went into effect in 2007 now that they have what they have been working toward: a declared “Level Six Pandemic” of their own defining and making?
The answer to all of these questions is the same: because of the People. Because we are alert, active and pushing back with the might of millions – and because evil is always weaker than good, because the entropy of the Universe, its disintegrative force, is balanced by the enthalpy, the constructive force. So knowledge, wisdom, caring accumulates while destruction destroys itself.
Our trick now is to make sure that the integrative forces are equal to, and, indeed, stronger in our time frame, than the disintegrative ones.
That is your job – nourishing the forces of freedom. The Three Vitamin D’s for Activists are –
Vitamin D1: Do – take Action, spread the Action eAlerts as widely as you can. The issues are getting hotter, more dangerous and more absurd with every passing day – people are more and more ready to hear our side now. This is a moment of ripeness for awareness.
Vitamin D2: Disseminate – This is a variant of Vitamin D1: there is no such thing as an overdose of dissemination! It is safe, effective, and stops a multitude of ills in the body politic.
Vitamin D3: Donate – Where do we get the money to assign people to do research? From you. Where do we get the resources to attend meetings you need to know about? From you. Where to we get the ability to create a model for the production of food which has a good chance of giving industrial agriculture the most serious run of its life? From you. And where do we get the resources necessary to tell you and everyone we need to reach about it? From YOU!
As our thank you for your support (besides the sheer joy of what we firmly believe will be the finest coffee you have ever sipped and sighed over, we’ll give you an 80% tax deduction for every bag of our GMO-free, pesticide-free, herbicide-free coffee straight from our educational Valley of the Moon™ Coffee Finca.
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Looking for a good read? How about a book that can help you reverse the most frightening of diseases, cancer, in weeks.
Dr. Leonard Coldwell’s The Only Answer to Cancer, available from www.Instinctbasedmedicinestore.com, is a magnificent breakthrough that you MUST read either now or later.
Looking for more? Well, there’s plenty to choose from.
Visit www.NaturalSolutionsMarketPlace.org and Organics4U.org for outstanding products which you need, the people you care about need and will appreciate and which support YOUR health freedom organization, Natural Solutions Foundation, the Voice of Global Health Freedom™.
Oh, yes, plain vanilla donation now comes in two flavors: Make your recurring donation, large or small, ending in the number 6 and we’ll earmark your donation for our vitally important legal support fund. Not only our Stop the Shot legal case against the FDA, but a host of other cases need attention and support to stop the recurring, and potentially lethal incursion of government agencies into your health, your medicine chest and your life.
You can also make a donation ending in any other number and that donation will be used for everything else we are doing.
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Whew! So much to do, so much that’s true and so much that’s new! Natural Solutions is there for you. Are you there for us, too?
Yours in health and freedom,
MONEY BOMB! MONEY BOMB! MONEY BOMB!
Natural Solutions Foundation
The Voice of Global Health Freedom™
IT’S MONEY BOMB TIME!
To Fund Health Freedom’s Next Victory!
Health Freedom Money Bomb – Round Three!
December Annual Giving Season
TOGETHER We’ve held off the uninsurable, un-safety tested, martial law-friendly “Swine Flu” H1N1 vaccine panic… and the Senate delayed voting on the (sic) “Food Safety” bill, S.510 after nearly a hundred fifty thousand emails to the committee and Senate…
Congratulations to US! We won a couple rounds! Our Push Back and Stop the Shot law suit forced the US to effectively “cancel” the H1N1 Pandemic. Oh, there are the usual “talking head” announcements about how dangerous H1N1 still is and a bizarre National Emergency Declaration from the President that seems to contradict his own Secretary of Health, but the juice is gone: there is no serious threat either from the disease (there never was) nor, with insufficient supplies, from the vaccine (which is where all the danger really lay). Both New York and New Jersey, the only two states with flu vax mandates, suspended theirs after we went to court on one and threatened to do so on the other. But we have a long way to go before we are finished with these threats.
This Money Bomb’s continued success can be our most powerful Push Back to the President’s “National Emergency Declaration” of October 23, 2009 regarding the alleged “swine flu pandemic”. See: http://drrimatruthreports.com/?p=3763
The depopulationists / globalists / pharma-terrorists and their government/WHO/UN henchmen and henchwomen (such as Napolitano, Sebelius and Hamburg) will be back again. By the time they mount their next terror tactic, we will be stronger, even better organized and ready to beat them back on that one, and the next, and the next, all because of your help.
Round Three… [But that’s a secret; we have cooperating plaintiffs and are preparing to file.]
Oh, by they way, did you forget about Codex? We didn’t. In fact, now that Gen. Bert and Dr. Rima can safely travel without fear of deadly injections, they went to the most recent Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU), whose Chairman is the notorious Dr. Rolf Grossklaus.
They attended this meeting in Dusseldorf from Nov 2-6, and all workshops and associated meetings – for you. As usual, they did daily video updates, radio specials and so on. You know you can count on them to tell you what is happening and make contacts with delegates from around the world that can change history – just as we did with the H1N1 scam-for-death-and-money.
We need you to help us generate the funds needed to move our seminal legal challenge to the entire vaccine approval travesty forward, fighting any appeal that the FDA and other defendants may initiate and we need the funds to make sure that we can continue our Codex work. We need funds to update our Codex book and make sure that every Head of State, every Minister of Health and Agriculture and every Codex delegate gets that publication along with a clear explanation of how to use this information. Despite the (ill-informed) Nay-Sayers, when Austria, Hungary and the Netherlands used our Codex Two Step Process, they won their cases in the WTO, escaping both trade sanctions AND Codex in those instances!
We need money to help reclaim the production of food here at the Valley of the Moon(TM) Eco Demonstration Project. Right now the government of Panama is asking us to help them turn ALL cattle farming in the breadbasket province of Chiriqui into BeyondOrganic/Biodynamic farming. They are asking us to help them do the same with their agricultural production, as well. We need money to support volunteers who provide hands, heads and hearts to make this project work so that we can teach farmers and non farmers alike how to grow clean, abundant food for life and health here and elsewhere.
What does that have to do with you and your health? A lot. First, we can create products which, because of their excellence, will violate Codex guidelines and standards and can then be shipped internationally, helping to further crack Codex apart. Second, we are creating a teaching center to help farmers from the developing world, where more and more of your food comes from, to grow their food in a way that is healthy for them AND for you. That means, of course, that their countries, too, will need to follow our Two Step Process to ship and sell their products.
AND we need serious funding to complete the Health Freedom Documentary which we began, but did not have enough funding to complete.
So much to do. So much to do for you. How can we do it all? Simple: we need the resources and then we can do it all – you know that you can trust the Natural Solutions Foundation to be on top of issues before they arise and find the solutions. You know you can trust us to use every single penny for the Foundation’s work since none of the Trustees takes a penny for our much-more-than-full-time work. You know that we are 100% supporter supported so that our only focus is what is good for health, and for freedom. We are there for you.
Now it is time for you to be there for Health Freedom with a powerful, decisive Money Bomb!
Lay it on us so we can keep health freedom free. Just think! Today you are free of the threat that was looming over our heads: the voluntary-but-really-mandatory adjuvanted vaccine for a made-up, make-believe disease. And we, you and the Natural Solutions Foundation, did that together. What else can we do? Let’s find out. It’s Money Bomb Time!
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Donate to Support Court Case Seeking to Bar FDA from Releasing Untested Swine Flu Vaccines with Squalene: http://drrimatruthreports.com/?page_id=189 Tax deductible donations ending in numeral “6” are earmarked for legal case. Don’t forget to make a second recurring donation to support Natural Solutions Foundation. We are 100% supporter supported and your help makes our work possible.
The police power of the state is a well established principle in the US Constitution. What happens when it is used to decide how to make the population healthier, or better, or smarter, or more desirable?
Fascism, both medical and non medical, is the inevitable result.
Many people do not know that the formal concept of Eugenics originated in the US with Stanford University professor Frances Galton, PhD and that it was enthusiastically championed by the select, unelected “masters” like John D. Rockefeller and the Harriman family. So successful were they in selling their loathsome idea that the perfection and purification of the human species could – and should – be accomplished at the discretion of the rulers of humanity, starting, of course, with themselves, that they sold the idea to numerous US State legislatures. The concept was upheld in the Supreme Court of the United States and then, once firmly established through legislation and practice, the idea was exported to Germany preceding the National Socialists. From there, it was enthusiastically embraced by the Nazis who modeled their eugenics laws and programs on the US ones, as the article below details.
Rockefeller set up and funded the Kaiser Wilhelm Institute (clearly long before the Nazis seized power) which was the “scientific” font of this burgeoning atrocity.
The results are history. Or are they?
Perhaps they are part of the current world view of the ruling elite.
The article which follows is of great importance and, although lengthy, is well work a careful read. The information about deadly and abortion-inducing vaccines is especially timely. Please share it with full attribution.
Equally important, please visit www.HealthFreedomUSA.org and take the important action steps related to making sure that you have the right to say NO to a squalene laced vaccine containing one million times more squalene than the devastating Vaccine A given to Gulf War Vets which made at least 25% of them devastatingly ill for the rest of their foreshortened lives.
You read that right. One Million Time More Squalene.
Please visit http://drrimatruthreports.com/?page_id=189 to make two tax deductible recurring donations: one, ending in the numeral “6” which will identify it as earmarked for the legal fund to bring a Court Case demanding a Stay to the FDA’s intended release of weaponized Swine Flu Pandemic Vaccines which have not had any safety testing on them completed. There are significant expenses with a Federal Court Case and we need your help in bringing this urgent request for an Emergency Temporary Restraining Order before the appropriate Court THIS WEEK. The second donation is to keep the Natural Solutions Foundation operating and serving you. We are 100% supporter supported and your donations are our lifeblood.
Here is the article. Read, enjoy, share, take action, donate.
The history of public health efforts in the United States in many ways is a story of great accomplishment. In the 19th century, public health officials constructed urban water and sanitation systems to protect the public against filth. With the discovery of germs, they turned their attention to transmissible diseases and instituted measures to inspect and quarantine ships. The original name of the U. S. Public Health Service, in fact, was the “Marine Hospital Service.” (It became the Public Health Service in 1912.) In the late 19th century and early 20th century, public health authorities began mass inoculation programs. This culminated in the spectacular success of polio vaccination in the early 1950s.
Vaccinations were not universally applauded in the early 20th century, however, and one resident of Cambridge, Massachusetts, Henning Jacobson, sued the state public health department after he was fined $5 for refusing to be vaccinated against smallpox, and then jailed when he refused to pay the fine. The case, Jacobson v. Massachusetts,1 went all the way to the United States Supreme Court. Not only was this the first Supreme Court decision regarding the government’s public health powers but it still stands as the leading case acknowledging the scope of these powers.
The Court’s opinion, written by Justice Harlan, analogizes the public health power of the state to the power to defend itself against foreign attack, including requiring citizens to take up arms and risk “the chance of being shot down.” Harlan emphasizes that the common good takes precedence over the “wishes or convenience of the few.” The only constraints on the exercise of this broad public health power are that it may not be either “arbitrary or unreasonable” or “cruel and inhuman.” Accordingly, the opinion states that a person can refuse to be vaccinated if doing so “would seriously impair his health, or probably cause his death.” In the Court’s judgment, Henning Jacobson’s objection that he had had an adverse reaction to vaccination as a child did not meet that test. (Note that the grant of an exception to immunization would not mean that a potentially infected individual would be allowed to circulate freely among the population, since the public health authorities could quarantine the person indefinitely.)
The AIDS Crisis
The AIDS epidemic posed some difficult challenges for public health officials. This was not the first time that they had confronted a sexually transmitted disease (STD). In the early 20th century, the STD of concern was syphilis and the government’s actions were vigorous. During World War I, for example, 20,000 women believed to be at risk for spreading the disease (hence, the reason they were called “spreaders”) were incarcerated in government camps. In the mid-1930s, Surgeon General Thomas Parran developed the techniques of mandatory reporting of infected persons, partner notification and contact tracing that became staples of the public health armamentarium. By the end of World War II, all states required syphilis testing before a couple could obtain a marriage license. Most states repealed these laws in the 1980s but not before many people suffered severe anguish as a result of the 25% false positive rate of the test then in use.
In the early stages of the AIDS epidemic, even more draconian public health measures were proposed. In 1985, the legislatures of Colorado, Florida and Texas considered bills to ban HIV positive individuals from working as food handlers. Rev. Jerry Falwell called for all prostitutes to be placed in quarantine and a bill to that effect was introduced in the Colorado legislature. William F. Buckley called for universal HIV screening. In 1987, Illinois began requiring HIV testing for marriage licenses. (By the end of 1988, 159,000 people had been tested at a cost of $5.6 million. A total of 23 cases were detected.) Also in 1987, then-Vice President George Bush urged the nation to mandate universal HIV screening.
These calls for mandatory action were resisted by AIDS activists and some physicians. Quarantining individuals who engaged in high risk activities was deemed imprudent because it was known that a person could be infected with the HIV virus yet yield a negative test result because of a delay in seroconversion (the ability to detect antibodies to the virus in the blood). Thus, a person who was quarantined would have no way of proving that he or she was uninfected; quarantine, in effect, would have to be for life. The same seroconversion phenomenon bedeviled calls for mandatory testing of patients and prisoners after health care workers, law enforcement personnel or firefighters suffered accidental exposures. This led to an emphasis instead on universal precautions. Furthermore, the stigma attached to AIDS and the discrimination faced by those infected or at risk persuaded health policymakers that, in contrast to the use of mandatory reporting, partner notification and contact tracing that had been employed in the fight against syphilis in the 1930s, more people would obtain HIV testing if the tests were available on a voluntary, anonymous basis.
Yet many in the public health community chafed at anonymous testing, believing that it placed the public at unnecessary risk by tying the hands of public health officials when it came to tracking and preventing the spread of the disease. There were repeated calls to return to the old mandatory public health style of intervention. Gradually, this viewpoint gained support. In 1992, North Carolina public health officials called a halt to anonymous HIV testing, an action that was upheld by the Supreme Court of North Carolina in a case called ACT-UP Triangle v. Commissioner for Health Services.2 As of now, anonymous testing is banned in Alabama, Idaho, Iowa, Mississippi, Nevada, North Carolina, North Dakota, South Carolina, South Dakota and Tennessee.
What tipped the balance against voluntary, anonymous testing was the development of drug treatment. The FDA approved AZT in 1987, followed by protease inhibitors in 1995. Once these drugs became available, the chilling effect of the stigma or discrimination associated with identifiable reporting of positive HIV test results was deemed to be negated by an individual’s desire to be tested so that treatment could commence.
An indication of how far the nation has gone toward a mandatory public health model in its response to AIDS is the September, 2006, recommendation by Centers for Disease Control and Prevention (CDC) that identifiable, reportable HIV tests be made a part of “routine” medical testing. The CDC states that patients should be notified that they were about to be tested for HIV and given an opportunity to decline, but the CDC also states that physicians should not have to obtain specific informed consent for the testing. At the same time, the CDC did not specific what would count as adequate notice. Conceivably, it might be sufficient if HIV testing were merely listed among the series of other tests on a laboratory order form.
Still, the nation seems to have weathered the AIDS epidemic relatively successfully, without seriously weakening the public health system. The question is whether we will be as fortunate in responding to new challenges, especially the challenges posed by our growing knowledge of genetics and by the War on Terror. In order to understand exactly what is at stake, we need to revisit some less successful public health campaigns of the past.
Sickle Cell Screening
After a rapid, accurate genetic test for the sickle cell mutation was developed, a number of states mandated population screening. In some states, the screening was limited to African-Americans, who comprise about 8 to 10% of those who carry the mutation for the disease. In other states, testing was a prerequisite for public schooling. There was inadequate public education about the significance of a positive test ? result. Many who were merely carriers of the autosomal recessive gene thought that they actually had the disease. People who were homozygous for the mutation did not understand that the severity of the disease varied substantially from one individual to another. Eventually, most of the mandatory screening laws were repealed but not before many people suffered emotional distress and discrimination by insurers and employers.
And in case you thought that winning a Nobel prize for science equips you to make good public health policy, Linus Pauling, who did pioneering work in the late 1940s on the molecular basis for sickle cell disease, not only fully supported the screening laws but, in 1968, urged that every person who was revealed to be a carrier of the sickle cell trait should have an “S” tattooed on their foreheads so that they could avoid reproducing with another carrier.
The U.S. Public Health Service Experiment at Tuskegee
In 1932, the U.S. Public Health Service began a study of 410 African-American syphilitic men in rural Alabama. The purpose of the study was to follow the course of the untreated disease. Subjects were not informed what was wrong with them, and they were not treated, even in the 1950s after penicillin was recognized as standard, effective therapy. In fact, U.S. public health officials actively discouraged treatment by local physicians, the state health department and the army. Subjects were offered a $50 burial subsidy to stay in the study and in 1958 each survivor was given $25 and a certificate of appreciation.
The first paper describing the study appeared in the medical literature in 1936 and reports continued to be published through the 1960s. In 1969, a committee of the CDC reviewed the experiment and authorized it to continue. By the time the press exposed the study in 1972 and it was halted, only 74 men remained alive.
The year 2007 marks the 100th anniversary of the enactment of the first eugenic involuntary sterilization law in history. It may come as a surprise that this law was not passed by the Nazis but by the State of Indiana.
The term “eugenics” was coined in 1883 by Francis Galton, a cousin of Charles Darwin. In 1904, he defined it as “[t]he science which deals with all influences that improve the inborn qualities of a race; also with those that develop them to the utmost advantage.” Upon receiving a large gift from the wife of railroad magnate E. H. Harriman, a biology professor named Charles Davenport in 1905 established an organization called the Eugenics Record Office at Cold Spring Harbor, Long Island. (Ironically, this is now a center for genetic research and the home of Dr. James Watson, one of the discoverers of the structure of DNA.) In 1907, as mentioned above, the Indiana legislature authorized the compulsory sterilization of “confirmed criminals, idiots, imbeciles, and rapists” residing in a state institution, provided that a panel of one physician and two surgeons agreed that there was “no probability of improvement” and that it was “inadvisable” for the inmate to procreate.
Eugenics legislation really took off after Davenport hired an Iowa high school teacher by the name of Harry Loughlin to direct the Eugenics Record Office. Loughlin was a tireless advocate of eugenics and, by 1913, 14 states operated active compulsory sterilization programs. Supporters of these programs included many prominent progressives and social reformers. Between 1913 and 1918, a number of the state laws were held unconstitutional on various grounds (including lack of equal protection because they only applied to institutionalized persons; lack of adequate procedural safeguards; and cruel and unusual punishment). In response, Loughlin drafted a new model sterilization law.
One of the states that adopted the new language was Virginia. Under the provisions of the Virginia law, the state sterilized a woman named Carry Buck, who was institutionalized in the Virginia State Colony for Epileptics and Feeble Minded, and she then filed a lawsuit ostensibly to challenge the constitutionality of the statute. As legal historian Paul Lombardo discovered, the suit was a sham. Buck was given virtually no effective legal representation; her lawyer, as well as her supporting witnesses, had gotten together with the state officials to concoct the suit in order to convince the courts to uphold the new model law.
Like the earlier Jacobson case, the case of Buck v. Bell also made it all the way to the U.S. Supreme Court and, in 1927, Oliver Wendell Holmes, one of the most respected jurists in American history, upheld the law with the now infamous words:
We have seen more than once that the public welfare may call upon the best citizens for their lives. It would be strange if it could not call upon those who already sap the strength of the State for these lesser sacrifices, often not felt to be such by those concerned, in order to prevent our being swamped with incompetence. It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes. Jacobson v. Massachusetts, 197 U.S. 11. Three generations of imbeciles are enough.
Decades later, Lombardo’s research showed that Buck had been institutionalized when she got pregnant after she had been raped by the nephew of the foster family she had been living with. Neither she, nor her mother or child, were “feeble-minded.”
With the constitutional door held open by the Court in Buck, 28 states enacted compulsory sterilization laws by 1931. Georgia passed the last sterilization law in the U.S. in 1937. The number of reported sterilizations in California rose from 322 in 1925 to 2,362 over the course of 1928 and 1929. Nationally, approximately 3,000 operations were reported annually prior to World War II. Many sterilizations that occurred were not reported.
Eugenic sterilization is a form of “negative” eugenics, in that it seeks to prevent the birth of genetically undesirable individuals. The eugenics movement also fostered positive eugenics. During the 1920s, state fairs awarded prizes to “fitter families” and “better babies” alongside champion farm animals. An organization called the Pioneer Fund offered military pilots and crews with three children the equivalent of $45,000 if they fathered a fourth.
The allure of eugenics was apparent to a former German army corporal who read about Loughlin’s model law in 1924 while he was in jail writing a book called Mein Kampf. When the Nazis came to power, the first piece of legislation they enacted was a sterilization law modeled on the Virginia statute. (Loughlin was so revered by the Nazis that the Nazi-controlled University of Heidelberg gave him an honorary degree in 1934.) By 1935, over 150,000 people had been sterilized under the German law, including a number of deaf persons who volunteered as a show of support for the Fatherland. Gradually the scope of the law was broadened into a tool of genocide. The Germans also vigorously pursued positive eugenics, as illustrated by the Lebensborn program, in which selected Aryan women were bred with members of the SS and the resulting offspring raised in state-approved foster families.
Although the revelations of Nazi atrocities chilled involuntary sterilization in the U.S. after the war, the practice did not completely disappear. In 1958, 574 operations were performed in Georgia, North Carolina and Virginia. By the time its law was finally repealed in 1974, Virginia had sterilized over 8,000. In April 2007, a woman who was sterilized for eugenic purposes in Indiana in 1972 participated in a ceremony commemorating the victims of that state’s program.
Current Public Health Initiatives
Are dark episodes like the eugenics movement a thing of the past? Maybe not. There are many current public initiatives that could be considered eugenic in the sense that they discourage the birth of children in certain populations, such as the poor. According to the Alan Guttmacher Institute, for instance, the government in 2001 spent $1.26 billion on reversible contraceptive services and $95 million on sterilization services, virtually all of which were earmarked for the poor. The welfare programs in 24 states stop increasing benefits once a woman has had more than a certain number of children. In Dandridge v. Williams, the Supreme Court upheld this approach in the face of constitutional challenge. The Court found that the state of Maryland did not violate the Equal Protection Clause of the Fourteenth Amendment because it had a reasonable basis for the program, namely, “the state’s legitimate interest in encouraging employment and in avoiding discrimination between welfare families and the families of the working poor.” Interestingly, the state itself had articulated an additional goal–“providing incentives for family planning” — which the Court did not mention.
Some commentators object to calling these programs eugenic because, in contrast to compulsory sterilization or screening, they are in a sense voluntary. A woman does not have to get pregnant or accept welfare. Yet there is one mandatory public health program that is becoming increasingly eugenic: newborn screening. This program began in the 1960s after physician Robert Guthrie developed a screening test for phenylketonuria (PKU), an autosomal recessive metabolic disorder that can be treated effectively if detected soon after birth. Guthrie also pioneered a method for collecting and transporting the blood samples used for screening on special filter paper, known as “Guthrie cards.” Massachusetts adopted newborn screening on a voluntary basis in 1962 but after President Kennedy’s Advisory Committee on Mental Retardation recommended mandatory screening, states began to enact newborn screening as a legal requirement. By 1973, newborn screening was compulsory in 43 states. Now it is universal.
Pressure from public health officials and groups like the March of Dimes, combined with faster and cheaper technologies such as tandem mass spectrometry and microchip arrays, are causing programs to screen for greater numbers of disorders. The American College of Medical Genetics currently advocates screening for 29 disorders and California now screens for over 70.
Only Maryland, Wyoming and the District of Columbia currently seek parental consent for newborn screening. (Massachusetts recently has begun doing so in a pilot program.) In Maryland, the consent is for the total screening package; parents are not asked to consent to specific tests. Thirty-three states provide an exemption from screening if contrary to parents’ religious beliefs but it is up to the parents to assert the objection without being asked.
In 2005, the Nebraska Supreme Court rejected a parental challenge to newborn screening on religious grounds in a case called Douglas County v. Anaya.3 After a home birth, the Anayas refused to allow a blood sample to be taken and sued the public health department to block enforcement of the law, which contained no exceptions. The court refused to recognize a religious exemption, noting that “[t]he health and safety of the child are of particular concern…”
By focusing on the health and safety of the child, the court makes the case seem no different from the numerous decisions in which the courts refuse to allow parents such as Jehovah’s witnesses to withhold treatment from children for religious reasons. But courts override a parental treatment decision for religious reasons only when the denial of treatment would be fatal or would seriously impair the child’s health. Routine newborn screening does not have such a direct connection to the child’s welfare. The prevalence of PKU in newborns is only about 1 in 16,000. Of the 29 disorders for which the American College of Medical Genetics recommends screening, 12 have a prevalence of less than 1 in 100,000.
Recently, a federal district court upheld the right of a mother to refuse to allow her child to undergo a spinal tap for suspected meningitis.4 The mother did not assert a religious objection but instead felt that the risks of a spinal tap exceeded the benefit in her daughter’s situation. The court held that “[t]he tipping point–the point at which parents lose their substantive due process right to decline medical treatment for their minor child and the State is allowed to exercise its parens patriae interest to compel the child to undergo the treatment–exists when, considering all the circumstances in a particular case, no reasonable parent would decline treatment.” Based on this principle, the question for the Anaya court should have been: Would any reasonable parent refuse newborn screening? Only if the answer is “no” would the court be justified in overriding the parents’ wishes.
In any event, the Supreme Court of Nebraska did not rest its decision in the Anaya case on the need for screening to protect the newborn’s health alone. In addition, the court observed that mandatory screening was necessary in order to address “the potential social burdens created by children who are not identified and treated.”
The eugenics implications of this statement are all the more striking in view of the changing nature of newborn screening programs. Originally, states only screened for disorders such as PKU for which effective treatment must begin soon after birth. However, some of the tests being added to screening panels detect disorders that do not have to be treated at such an early age or, in some cases, are not readily treatable at all. Moreover, some public health advocates are now calling for abandoning the connection between newborn screening and treatment altogether. Screening for untreatable disorders, they argue, could spare the family years of uncertainty once symptoms emerge, provide the child with adjunctive if not curative interventions and permit the child to participate in research on the disorder. In addition, however, they point to the value of screening as a tool in family planning. As one recent article explains, “[a]rguments for considering broader benefits from the early diagnosis that only newborn screening can provide include…knowledge on which to base reproductive decision-making years before a disease would be diagnosed for the affected child…”5 In other words, screening should be expanded so that parents can avoid giving birth to another child with the same disability.
It is one thing for parents to make reproductive decisions in order to prevent the birth of children with disabilities. It is another thing altogether for the government to establish a compulsory genetic screening program to facilitate this objective. This is not to say that public health programs designed to give parents more information about the health status of newborns are a bad idea or that they are on a par with the atrocities of Nazi Germany. But we shouldn’t kid ourselves that they are not eugenic practices.
One of the more vigorous efforts now underway to expand the power of public health authorities is being waged as part of the War on Terror. Beginning immediately after 9/11, and spurred on by the subsequent mail-borne anthrax attacks, inspection of our public health infrastructure showed that it was woefully inadequate and incapable of responding effectively to a major bioterrorism incident. This prompted intense efforts to increase public health spending on equipment and training.
In addition, however, some public health zealots believed that the nation’s public health laws needed to be revamped to give public health officials adequate power and discretion to take whatever steps might be necessary to combat bioterrorism. They proposed language for a model state law and, with funding from the Robert Wood Johnson Foundation and the W.K. Kellogg Foundation, enlisted the aid of a “who’s who” of public health officials and advocates to draft a Model State Public Health Act.
An indication of the scope of the powers that would be conferred on public health officials under this law can be seen by considering its provisions for mandatory screening and testing. Under the act, a state or local public health agency may establish a compulsory screening program for any “conditions of public health importance that pose a significant risk or seriously threaten the public’s health” (section 5-106(d)(1)). The terms “significant risk” and “seriously threaten” are not defined in the act but the term “condition of public health importance” is defined to mean “a disease, syndrome, symptom, injury, or other threat to health that is identifiable on an individual or community level and can reasonably be expected to lead to adverse health effects in the community” (section 1-102(6).
Under the model act, could a public health agency therefore make prenatal screening for genetic diseases and conditions mandatory for all pregnant women? The answer is yes, so long as the agency believes that the diseases and conditions, if not detected in utero, pose a significant threat to health that can reasonably be expected to lead to adverse health effects in the community. Is such a belief far fetched? Not necessarily: the American College of Obstetrics and Gynecology recently called for “routine” prenatal screening for Down’s syndrome”.
Another provision of the model act states that a public health agency may make participation in such a screening program a condition “of participating in or receiving a service or privilege” (section 5-106(d)(2)). Accordingly, women who refused to be screened could be denied health and welfare benefits.
The dark side of public health is most vividly reflected in the eugenics movement, which it championed. It is noteworthy that only three cases involving public health law have reached the U.S. Supreme Court. One, Skinner v. Oklahoma, decided in the middle of World War II, invalidated a state law requiring certain habitual criminals to be sterilized but not others.6 This is the only Supreme Court case in which the justices curbed the public health power of the state. But the Court’s opinion left open the possibility that a law that sterilized all habitual criminals would be constitutional. The other two cases were Jacobson, the vaccination case, and the eugenics case, Buck v. Bell, both discussed above.
What is striking about the Buck, case is that Justice Holmes’s opinion sustaining the constitutionality of Virginia’s eugenic sterilization law cited only one previous case as legal precedent: Jacobson. Holmes felt that the broad public health powers upheld in Jacobson extended so far that the state could sterilize people whose genes were deemed defective. Even more striking, the Buck case has never been overruled.
As Justice Holmes made clear in Buck, public health officials may sacrifice the welfare of individuals in order to promote the welfare of the public. One enduring question is who gets to decide what constitutes the public welfare. Under the Model State Public Health Act, it is the public health authorities and the act places few constraints on their discretion. A second question is how far the authorities may go in achieving a public health objective. Under the model act, their power is virtually unlimited.
A recent news story described a patient with drug-resistant TB who, believing himself to have been treated successfully, refused to wear a face mask. Public health officials accordingly quarantined him in a hospital jail cell, where the jailers refused to allow him to have access to a clock radio, television or cellphone. After news reports pointed out that the man was only under quarantine, not arrest, his cellphone was restored and the authorities promised to return his TV.
Public health practices must strike the right balance between individual and community welfare. The TB patient’s plight may seem trivial. After all, TB is a scourge and drug-resistant TB is on the increase. But the nation was founded on the principle that the power of the state must be exercised within constitutional limits and overly zealous measures in the past have left an indelible stain on the history of public health.
1. Jacobson v. Massachusetts, 197 U.S. 11 (1905). return
2. ACT-UP Triangle v. Commissioner for Health Services, 483 S.E.2d 388 (NC 1997).
3. Douglas County v. Anaya, 694 N.W.2d 601 (Neb. 2005).
4. Mueller v. Auker, 2007 U.S. Dist. LEXIS 13172 (D. Id. 2007).
5. Duane Alexander (NIH) and Peter C. van Dyck (HRSA) 2006: “A Vision of the Future of Newborn Screening” 117 PEDIATRICS 350, 352.
6. Skinner v. Oklahoma, 316 U.S. 535 (1942). June 2007