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From the Los Angeles Times

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Not targeted but not safe, young illegal immigrants push for a new policy

Young activists had pinned their hopes on the Dream Act. When it was put to bed, they started a new strategy: 'Coming out' as illegal immigrants and protesting their uncertain fates in this country.

by Richard Fausset, Los Angeles Times

April 10, 2011

Reporting from Atlanta

Seven college-age Latinos gathered in downtown Atlanta and passed around a microphone, announcing to the world that they were coming out of the shadows as illegal immigrants.

Then, in an act of civil disobedience, they sat down in the middle of a busy street and announced it again to a large and chanting crowd. When they were hauled off to jail, they even declared their status to a pair of Immigration and Customs Enforcement officers — who proceeded to do nothing.

Wednesday, after a night in jail, the seven were free again, clutching misdemeanor tickets issued by the city for blocking traffic.

So what, one might ask, does it take for an illegal immigrant to get deported in the United States of 2011?

That turns out to be a good question, particularly for immigrants who, like the Georgia youths, call themselves "the Dreamers" — that is, immigrants who might have achieved legal status through the federal Dream Act.

The legislation would have offered a path to citizenship for illegal immigrants who were brought to the United States at a young age, had lived here for at least five years, had stayed out of trouble and enrolled in college or served in the military.

The bill passed the House of Representatives in December, but was scuttled in the Senate by Republican-led opposition.

With the bill dead for the foreseeable future — especially given the new GOP majority in the House — the Obama administration appears to be operating in a kind of workaround mode.

At an April 1 public forum in Washington, Homeland Security Secretary Janet Napolitano said that immigrants who would have benefitted from the Dream Act were "not the priority" when it came to enforcing immigration law.

Well before her comments, administration officials had said they would focus deportation efforts on those who commit serious crimes. But some immigrant rights groups have complained that the administration has been too aggressive in deportations. The Obama administration deported 392,862 people in the last fiscal year, up from 369,221 people deported in the last full year of the Bush administration.

When an Immigration and Customs Enforcement spokesman was asked to comment on the agency's inaction after the Atlanta protests, he simply referred to Napolitano's April 1 comments.

As policy statements go, it is a rather ambiguous one. Does it mean that no Dreamers will be deported? Or that some of them will? Gillian M. Christensen, an agency spokeswoman in Washington, declined to elaborate.

Anti-illegal-immigration groups are predictably perturbed. The New American, a John Birch Society newsmagazine, declared in a recent headline that the "Unpassed" Dream Act was "Now the Law."

"Obama has apparently passed his own de facto Dream Act, and disregarded the will of Congress," said D.A. King, head of the Dustin Inman Society, a Georgia-based anti-illegal-immigration group. "I'd like to know which federal laws I can ignore without punishment."

But the Dreamers are frustrated as well. Mohammad Abdollahi, 25, a co-founder of thedreamiscoming.com and one of the organizers of the Atlanta protest, said he believed that many young people were still subject to detention and deportation.

"Just because they stayed away from [the Atlanta] case because it was a more public case doesn't show that they're staying away from undocumented youth," said Abdollahi, who was brought to the U.S. illegally at age 3 from Iran. "The whole notion of not deporting Dreamers is just a lie on the Obama administration's part."

Even so, Abdollahi said his group was urging immigrant youth to publicly declare their illegal status, in part because it appeared that the Obama administration was handling the more public cases with kid gloves.

"The more out there you are, the more public you are, the safer you really are," he said.

Some of the young Latinos who spoke out in Atlanta said they were aware that the strategy may be risky. A less sympathetic person could win the presidency in 2012.

Still, they said they had to implore other illegal youths to come out; they could not build a political movement with a population in hiding.

Their own public declarations Tuesday were directed at Georgia education officials' decision to bar illegal immigrants from being admitted to the state's five most selective public colleges beginning in the fall.

The coming-out also served as a catharsis. "I am undocumented and I am unafraid!" said Viridiana Martinez, 24, of North Carolina, who came to the United States from Mexico at age 7. "We're people. We want to go to school, and we want to be doctors and lawyers and nurses."

To similarly situated youth, she said, "Come out — the courage is in you!"

The group's Atlanta protest was the first in which participants were arrested since the bill's defeat in December. Abdollahi said it would not be the last.

http://www.latimes.com/news/nationworld/nation/la-na-illegal-immigrants-20110410,0,4947496,print.story

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The 9/11 trials at Guantanamo will create a distressing legacy

Once the military commission apparatus becomes established, every future administration will have a ready instrument to arrest, judge and sentence wholly within the executive branch, evading the separation of powers carefully calibrated in the Constitution.

by David K. Shipler

April 10, 2011

The system of military commissions that will try Khalid Shaikh Mohammed and four other alleged 9/11 plotters contains a dirty little secret. Hardly anybody talks about it, but it's a key reason for concern as the apparatus becomes established.

It is this: The commissions can operate inside the United States, and they have jurisdiction over a broad range of crimes. Nothing in the Military Commissions Act limits the military trials to Guantanamo detainees, or to people captured and held abroad, or even to terrorism suspects. Nothing prevents the commissions from trying noncitizens, arrested inside the country, whom the president unilaterally designates as "unprivileged enemy belligerents." In other words, the law permits military officers to try non-Americans from Alabama and Arkansas as well as Afghanistan.

The Obama administration's decision last week to shift the high-profile 9/11 case from federal court is bound to move the military system toward legitimacy. The commissions lack the seasoned body of precedent that guides civilian courts, so their procedures will have to survive litigation by defense lawyers. But once the commissions gain stature and become the "new normal," every future administration will have a ready instrument to arrest, judge and sentence wholly within the executive branch, evading the separation of powers carefully calibrated in the Constitution. The judicial branch has no role except on appeal, where only the federal court for the D.C. circuit may review a verdict and sentence after the trial.

It seems far-fetched to imagine tribunals in San Francisco as well as Guantanamo, yet the law allows the spread of such a system, impeded only by officials' restraint. Atty. Gen. Eric H. Holder Jr. pledged Monday to restrict the use of commissions, but one official's good intentions cannot shield civil liberties from government intrusion. Restraint usually dies during spasms of fear over national security.

The framers saw that rights depend on structural bulwarks, not on particular officeholders. "All men having power ought to be distrusted to a certain degree," James Madison declared at the Constitutional Convention as he noted "the political depravity of men and the necessity of checking one vice and interest by opposing to them another vice and interest." The checks are being eroded here.

Because terrorism has fostered a concept of war as boundless and timeless, many crimes normally tried in civilian courts can be brought under the shifting rubric of war, granting military commissions broad jurisdiction. Provided the offense is committed in the context of "hostilities," defined as "any conflict subject to the laws of war," commissions may try a noncitizen on charges that include spying, seizing property for private use, taking hostages, rape, sexual assault, hijacking, mistreating a dead body or improperly using a truce flag or distinctive emblem, as well as murder, torture or material support for terrorism.

A trial has a truth-finding mission. Its accuracy is determined by a panoply of rights: to effective counsel, to summon and confront witnesses, to exculpatory evidence. These rights are weaker before military commissions than in courts-martial or criminal courts; although enhanced by 2009 amendments to the 2006 Military Commissions Act, they still allow certain hearsay and statements coerced during combat or capture. So the military commissions' findings may be less reliable.

But the truth may already be known in the 9/11 case. The accused are reportedly ready to confirm their roles in the attacks, not in a spirit of guilt but of pride. Their trial will be a pageant and a precedent, a rendering of the expected judgment and sentence — and then a legal legacy.

It is the symbolism, not the legal impact, that has been most vigorously debated. Yet it's the legal damage that is likely to remain long after the five are tried. Symbolically, a strange symmetry unites both the defendants and those in Congress who see a military trial reflecting the 9/11 attack as an act of war, larger than a common crime. Supporters of a civilian trial did not favor a different outcome but rather a different message — the display of a crown jewel in our constitutional democracy: the criminal justice system with its full array of individual rights.

Long after the verdicts and sentences, the plotters will continue to wound the country, now with American cooperation. If ultimately upheld by the Supreme Court, the elements of the military commissions will pass into the precedent of case law, creating a permanent apparatus, parallel to the criminal justice system, to prosecute and try foreign civilians. It could become a lasting injury of Sept. 11.

http://www.latimes.com/news/opinion/commentary/la-oe-shipler-military-commissions-20110410,0,7178927,print.story

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From the New York Times

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Newly Born, and Withdrawing From Painkillers

BANGOR, Me. — The mother got the call in the middle of the night: her 3-day-old baby was going through opiate withdrawal in a hospital here and had to start taking methadone, a drug best known for treating heroin addiction, to ease his suffering.

The mother had abused prescription painkillers like OxyContin for the first 12 weeks of her pregnancy, buying them on the street in rural northern Maine, and then tried to quit cold turkey — a dangerous course, doctors say, that could have ended in miscarriage. The baby had seizures in utero as a result, and his mother, Tonya, turned to methadone treatment, with daily doses to keep her cravings and withdrawal symptoms at bay.

As prescription drug abuse ravages communities across the country, doctors are confronting an emerging challenge: newborns dependent on painkillers. While methadone may have saved Tonya's pregnancy, her son, Matthew, needed to be painstakingly weaned from it.

Infants like him may cry excessively and have stiff limbs, tremors, diarrhea and other problems that make their first days of life excruciating. Many have to stay in the hospital for weeks while they are weaned off the drugs, taxing neonatal units and driving the cost of their medical care into the tens of thousands of dollars.

Like the cocaine-exposed babies of the 1980s, those born dependent on prescription opiates — narcotics that contain opium or its derivatives — are entering a world in which little is known about the long-term effects on their development. Few doctors are even willing to treat pregnant opiate addicts, and there is no universally accepted standard of care for their babies, partly because of the difficulty of conducting research on pregnant women and newborns.

Those who do treat pregnant addicts face a jarring ethical quandary: they must weigh whether the harm inflicted by exposing a fetus to powerful drugs, albeit under medical supervision, is justifiable.

“I've had pharmacies that have just called back and said: ‘This lady's pregnant. Why do you want me to fill this scrip? I can't do that,' ” said Dr. Craig Smith, a family practitioner in Bridgton, Me. “But when you stop and think about what actually happens during withdrawal and how violent it can be, that would certainly be not in the baby's best interest.”

Still, even doctors who advocate treating pregnant addicts have had moments of doubt.

“At first I was going, ‘Gosh, what am I doing?' ” said Dr. Thomas Meek, a primary care physician in Auburn, Me. “ ‘Am I really helping these people?' ”

There are no national figures that document the extent of the problem, but interviews with doctors, researchers, social workers and women who abused painkillers while pregnant suggest that it has grown rapidly, especially in rural regions, where officials say such abuse is most common.

In Maine, which has been especially plagued by prescription drug abuse, the number of newborns treated or watched for opiate withdrawal, known as neonatal abstinence syndrome, at the state's two largest hospitals climbed to 276 in 2010 from about 70 in 2005. Hospitals in states including Florida and Ohio reported similar increases, and experts said the numbers were probably higher since pregnant women are rarely tested for drug use and many mothers do not admit to abusing opiates.

Tonya, 24, said she was introduced to painkillers like OxyContin, Percocet and Vicodin while working the overnight shift at an industrial bakery an hour from her home. Everyone — including co-workers, the boyfriend she met on the job and their manager — was taking pills, she said.

“It was a lot easier to get through life and have energy,” Tonya said at Eastern Maine Medical Center here in January, holding Matthew a month after his birth. He was still being weaned off methadone.

Before she was pregnant, Tonya said, she quickly became addicted, spending all of her money on pills bought on the street. She and her boyfriend, Josh, needed to stave off withdrawal and get through the day, she said.

Now that she is in treatment, Tonya, who like most mothers interviewed for this article did not want her last name used, said her focus was on Matthew. “We put him in this situation,” she said, “and we have to help him out of it.”

‘How Little We Know'

Rigorous studies on treating infant withdrawal are scarce, and the American Academy of Pediatrics has not published guidelines since 1998.

“It's really remarkable how little we know about the effect of prescription drugs and even nonprescription drugs on the fetus,” said Dr. Nora D. Volkow, director of the National Institute for Drug Abuse. “There are real roadblocks in terms of helping us advance the field.”

Dr. Mark L. Hudak, a neonatologist in Jacksonville, Fla., is helping to revise the pediatrics academy's guidelines. “There are commonalities, but it's not like you can go to a Web site that says, ‘This is what should be used by everyone,' ” Dr. Hudak said. “No one knows what the best approach is.”

Within states, every hospital that delivers babies exposed to painkillers may have its own approach. Eastern Maine treats affected newborns with tiny doses of methadone, while Maine Medical Center in Portland uses morphine combined with phenobarbital, a barbiturate that prevents seizures. Some hospitals are also experimenting with clonidine, a mild sedative that can relieve withdrawal symptoms.

There is growing debate over treatment for pregnant women addicted to prescription drugs, in light of concerns over the effects on their babies. Many are slowly weaned from their dependence with methadone, the standard of care for decades. Methadone, when taken in prescribed doses, keeps a steady amount of opiate in the body, preventing withdrawal and drug cravings that occur when levels dip. But it, too, can be addictive and cause nagging side effects like drowsiness . And for addiction treatment, it can be obtained only at federally licensed clinics where most users have to report for a daily dose.

A growing number of addicts are instead taking buprenorphine, another drug used to treat addiction that some studies suggest staves off drug cravings as effectively as methadone but is less likely to cause withdrawal in newborns. In rural areas of the nation, where methadone clinics are few, buprenorphine is considered a promising alternative because it can be prescribed by primary care doctors and taken at home.

But buprenorphine also appears not to work for some addicts.

Still, a study published in December in The New England Journal of Medicine showed that babies whose mothers had taken buprenorphine required significantly less medication after birth and less time in the hospital than did babies whose mothers were treated with methadone. But researchers cautioned that exposure to buprenorphine in utero can still cause withdrawal symptoms and that further study was needed.

“We don't want it misconstrued that buprenorphine is a miracle drug,” said Hendrée E. Jones, a Johns Hopkins University researcher and the study's lead author.

Even less is known about longer-term effects on babies exposed to painkillers, though in a second leg of their study, Dr. Jones and her fellow researchers plan to follow the 131 babies in the cohort until they turn 3.

A recent study by the Centers for Disease Control and Prevention found that babies exposed to opiates in utero, in this case legally prescribed painkillers, had slightly higher rates of birth defects, including congenital heart defects, glaucoma and spina bifida.

Experts say that since many drug users also smoke and abuse alcohol, not to mention that they face extenuating circumstances like poverty, it is difficult to tease out the effects of each substance on their offspring.

“Most of the literature suggests consistently that the drug exposure itself is not the primary concern,” said Karol Kaltenbach, a professor at Jefferson Medical College in Philadelphia who studies addiction in pregnant women. “It's the cumulative effect of the drug-using lifestyle — poverty, chaos in the home, domestic violence. All those things affect development.”

Not all newborns exposed to opiates have severe enough withdrawal to need medicine; at Maine Medical Center since 2003, about 55 percent of babies exposed to buprenorphine and 80 percent of those exposed to methadone have needed treatment. But it is hard to predict which ones will need it: a newborn whose mother was on a high dose of either drug might need none, while a baby whose mother took a low dose might experience acute withdrawal.

Babies known to have been exposed to drugs are often kept in the hospital for at least five days because withdrawal symptoms usually do not set in immediately. Nurses examine them for a checklist of symptoms every few hours, assigning each baby a score that, if high enough, calls for treatment.

“They don't stop crying, they can't settle down, they don't relax,” said Geraldine Tamborelli, nursing director of the birthing unit at Maine Medical Center, which in 2010 diagnosed opiate withdrawal in 121 newborns. “They're struggling in your arms instead of snuggling into you like a baby that is totally fine.”

In the neonatal intensive care unit at Eastern Maine, Kendra, 3 days old, was sleeping in a dark, silent room one morning, away from the bustle and bright lights that can be especially irritating to babies going through withdrawal. Nurses frequently crept in to observe her, though, and by the afternoon her limbs had stiffened and she was crying excessively and having tremors; it was enough to begin treatment.

“This seems to be ramping up fairly quickly for her,” said Dr. Mark Brown, the hospital's chief of pediatrics, “so the decision was to start treatment more quickly.”

On the pediatric ward, Matthew started fussing while his mother, Tonya, talked to reporters that afternoon in January; his cry had a strange, reedy pitch that nurses say is common to babies with his condition. The small dose of methadone he had received gave him gas and heartburn, for which he was given two stomach medications. He also was on clonazepam, a muscle relaxant and anti-anxiety drug that helped him metabolize the methadone more slowly.

Tonya said that at first she “didn't believe in” methadone treatment during pregnancy and that doctors had to persuade her that it would not hurt her fetus. She had experienced wrenching withdrawal when she stopped using painkillers after learning she was pregnant, she said, and the doctors had warned her that “when I was feeling that bad, he was feeling 1,000 times worse.”

Tonya said that in a previous pregnancy, she quit using drugs altogether and miscarried a month later.

“That was the last thing I wanted to happen this time,” she said.

Avoiding Addicts, and Liability

Treating drug-dependent mothers and babies is often lonely work, with little communication among the doctors who take it on. As Dr. Brown said, “My network for people who do this is really very small.”

Dr. Mark R. Publicker, an addiction medicine specialist at Mercy Recovery Center in Westbrook, Me., is on a mission to get more of the state's doctors to treat pregnant prescription drug abusers and more hospitals to deliver their babies. Only a handful of doctors here treat pregnant women with buprenorphine, Dr. Publicker said, partly because they fear liability and do not want to deal with addicts.

The fact that most hospitals will not deliver the babies makes doctors even less likely to treat the women.

“It's mostly ignorance,” Dr. Publicker said. “It's a concern that it's a risky proposition and that they're going to wind up with an ill baby.”

In February, Dr. Smith persuaded Bridgton Hospital, which has only 25 beds, to deliver the babies of women on buprenorphine — a major victory, he said, because until then women in rural southwestern Maine had to drive an hour or more to Maine Medical to deliver.

Courtney, a patient of Dr. Smith's who discovered she was pregnant while in jail for stealing OxyContin from her landlord, said buprenorphine treatment seemed the best of her bleak options.

“I just don't want to mess up,” she said.

Tonya, too, said she was determined to make things right for Matthew, who was five weeks old when she took him home to a trailer outside Bangor. He is off the methadone now and appears healthy, but Tonya still has to go to a methadone clinic in Bangor every day for her dose and resist the pressures to return to illicit drug use. Her boyfriend began using opiates as a young teenager, she said, and his father and grandmother abused OxyContin along with him.

“I'm proud that I changed my life,” Tonya said. “But at the same time, when you see your child in pain and you know your child is in pain because of a life decision you made, it's the hardest thing in the world.”

http://www.nytimes.com/2011/04/10/us/10babies.html?pagewanted=print

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What's in a Lethal Injection ‘Cocktail'?

THE latest controversy over the always controversial subject of capital punishment: the drugs used to execute people on death row.

Lawyers for death row inmates in Texas and Arizona have filed challenges to the executions questioning the use of specific drugs in the lethal injection of their clients. (Last week, the Supreme Court stayed the executions for other reasons.)

These challenges have been prompted by a shortage of one of the drugs, sodium thiopental, an anesthetic. The American manufacturer of sodium thiopental, Hospira, recently announced that it would no longer produce the drug, and manufacturers in Europe do not want to supply the drug if it will be used in executions. Some executions have been postponed while states try to sort out the drug situation.

In Texas, which carries out more executions than any other state, the controversy is focused on the proposed switch from sodium thiopental to pentobarbital in a three-drug cocktail.

What is the difference?

The two drugs come from the same family: barbiturates, drugs that depress the central nervous system. So, in general, said Dr. John Dombrowski, director of the Washington Pain Center and a board member of the American Society of Anesthesiologists, “it's like if you ask me what's the difference between Johnnie Walker Blue, Black and Red — they're all scotch.”

But sodium thiopental has been commonly used as an anesthetic in hospitals. Pentobarbital has a few medical uses in humans, but is often used by veterinarians to anesthetize or euthanize animals. It has also been used in physician-assisted suicide in Oregon and in Europe.

When injected into the bloodstream, both drugs “cross the blood-brain barrier very efficiently,” said Dr. Scott Segal, chairman of the department of anesthesiology at Tufts Medical Center in Boston. “They get into brain tissue itself.”

Within the brain tissue, on the surface of the neurons, he said, are receptors that respond to a neurotransmitter called gamma-aminobutyric acid, or GABA.

“GABA is an inhibitory receptor, meaning that stimulation of the GABA receptor reduces firing of neurons,” Dr. Segal said, depressing the brain's electrical activity.

Both drugs stimulate these GABA receptors.

“All barbiturates put the brain to sleep by slowing down brain function,” said Dr. Mark A. Warner, president of the American Society of Anesthesiologists. “The brain cells that drive the desire to breathe are also suppressed. So any barbiturate, if you give enough of it, somebody quits breathing. Also, if you give enough of it the heart quits pumping as hard and that can cause decreased blood pressure.”

But while the way the drugs work might be similar, the effects are different.

Sodium thiopental is used in hospitals because it “has a relatively fast onset and it doesn't last long,” Dr. Warner said. “You want a patient to go sleep and wake up pretty quickly.”

Pentobarbital is a long-acting drug.

“If veterinarians are using this, they don't really care if an animal wakes up faster or not,” Dr. Dombrowski said. “If the dog or cat is still a little sleepy it doesn't make a difference.”

In euthanizing animals, higher doses are used, and “the lethal effect is a cardiovascular effect,” Dr. Segal said, meaning that it stops the heart.

Pentobarbitol is used in hospitals in certain circumstances, like inducing a coma in brain-damaged patients because “that allows the brain to use more energy and oxygen to repair itself,” Dr. Warner said. He said it can also be used to stop seizures in patients for whom other drugs are ineffective.

Opponents of the death penalty object to either drug. Some say thiopental can wear off too quickly, allowing inmates to feel pain. Others object to using pentobarbital, because it is so infrequently used in humans.

In the three-step cocktail common in executions, a barbiturate is given with pancuronium bromide, a paralyzing drug, and potassium chloride, which induces cardiac arrest. Dr. Segal said all three drugs can have lethal effects.

“I'm not sure anyone knows which drug actually kills someone,” he said.

In fact, one can do the job. Ohio has used both barbiturates by themselves in executions.

http://www.nytimes.com/2011/04/10/weekinreview/10injection.html?pagewanted=print

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From Google News

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Principal Apologizes For Mock Auction of Black Students in Virginia

April 09, 2011 | FoxNews.com

Apparently, during a fourth grade teacher's lesson on the Civil War, students were separated by race. White students on one side and African American and mixed-race students on the other, who were then offered up for auction, Virginia's Fox 43 news reports.

In an April 6 letter to the students' parents and guardians, Principal Mary B. Wrushen wrote, "I recently became aware of a history lesson that was presented to the students in Ms. Jessica Boyle's fourth grade class. Although her actions were well intended to meet the instructional objectives, the activity presented was inappropriate for the students."

Wrushen added that she intends to follow up with the teacher to make sure this never happens again.

"The lesson could have been thought through more carefully, as to not offend her students or put them in an uncomfortable situation," Wrushen said in the letter.

The letter also said a guidance counselor is available to discuss any concerns with students concerning the classroom lesson.

Superintendent Dr. Richard Bentley said the school district does not condone this type of lesson.

"It was wrong. It was outside the boundaries of the curriculum and appropriate instructional practices," Bentley said.

http://www.foxnews.com/us/2011/04/09/principal-apologizes-mock-auction-black-students-virginia/

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