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Our Unfounded Medical Optimism – Slate Magazine

Posted: July 26, 2017 at 12:50 am

Chris Gard and Connie Yates, the parents of terminally ill baby Charlie Gard, speak to the media on Monday in London.

Carl Court/Getty Images

The parents of Charlie Gard announced on Monday that theyd given up on treating their 11-month-old child, who suffers from a rare and deadly gene mutation affecting his mitochondrial DNA. The roller-coaster case began in February when physicians at the London hospital treating the infant said it was time to remove Charlies life support. They refused to let the British couple fly him to New York City for a last-ditch, experimental treatment that, according to its inventor, had a small but significant chance of reversing his brain damage. Over the past five months of legal battles, the hospital never wavered from its claims that every reasonable means of saving Charlie had been tried already and that he should be spared any further suffering that might come with a form of therapy that has never been tested on a patient with exactly his condition, and which isnt part of any clinical trial.

Daniel Engberis a columnist for Slate.

Charlies parents now say that its too late for any intervention and that its time to let him go. But for several months now, the #CharlieGard saga has served as the focus for a broader push for patients rights in Washington. Conservative politicians were quick to champion Charlies parents causePresident Trump tweeted his support and the House tried to grant the couple permanent residencyin keeping with the GOPs strong endorsement of so-called right-to-try laws. These measureslately passed in 33 statesare meant to guarantee very sick people access to experimental or nonconventional medical treatments that havent yet passed muster with the Food and Drug Administration. In practice, that means the parents of a dying patient such as Charlie wouldnt need to ask permission from the FDA to move ahead with therapy; they could just request it directly from the manufacturer.

Its hard to argue with vocal patient-advocates who say their lives were saved by gaining access to experimental treatments. The right to try sounds like common sense: It should be up to patients to decide whether the potential upside of a treatment (surviving a terminal illness) seems worth any risk of painful side effects. Why not let them give it hell and go down swinging? But stepping back from anecdotes, the spread of experimental access laws (like the calls for Charlies puddle-jumping medevac) suggests that critical decisions about the final months of peoples lives are often based on biased judgments of reality. Patients seem to overvalue innovation, as a rule, and assume that newer drugs have a better chance of working than any other treatment, just because theyre new. Not only does this sanguine view of scientific progress fail to fit the facts; it also leads patients to the converse, false impression that nonconventional treatments arent likely to be harmful in themselves. A more sober view suggests that the hope that often moves people to seek out these types of treatmentsand the ever-present pressure to fight until the endis not as useful as we think.

The spread of experimental access laws suggests that critical decisions about the final months of peoples lives are often based on biased judgments of reality.

Unfounded optimism tends to be the rule in medicine. A 2015 review of several dozen studies of peoples expectations from treatment, comprising data from more than 27,000 subjects, found systematic evidence of a Pollyanna Patient problem: We overestimate the value of the care that we receive and underestimate its harm. That work is cited in an excellent article by Liz Szabo of Kaiser Health News, on the surprising ineffectiveness of cancer drugs that have been FDA approved. Its not just that these treatments do little to prolong survival, Szabo says; according to one study, many patients never grasp this fact. In a sample of several thousand adults, 39 percent said they believe the FDA only approves prescription drugs that are extremely effective; 1 in 6 asserted that drugs that have serious side effects cannot be advertised to consumers. Neither statement is even close to being true. According to Vinay Prasad, an oncologist and expert in evidence-based medicine at Oregon Health and Sciences University, we dont have any hard evidence of benefitin terms of patients living longer livesfor the majority of cancer drugs approved in recent years.

If FDA-approved drugs often fail to offer substantive benefits, then experimental onesthose that havent even passed the suspect bar for agency signoffare even less likely to be helpful. In fact, about 90 percent of experimental treatments flunk out during clinical trials, either because they arent shown to be any more effective than the standard treatment or because their side effects are too severe. In some cases, experimental treatments once thought to be miraculouslike the use of bone-marrow transplants as a cure for breast cancer, which started in the 1980shave turned out to be worse than ineffective in clinical trials. In the bone marrow case, the procedure could be deadly on its own. This abysmal failure rate persists in spite of the enormous cost of running trials and researchers clear incentive (read: bias) to produce positive results.

Such dire stats have done little to discourage eager patients, though. When it comes to clinical trials, we seem to harbor a version of the favoritelong shot biasthe tendency of horse-track gamblers to overvalue the underdog at the expense of the odds-on favorite. In medicine, this translates to fixation on the value of experimental treatmentsand the remote possibility that they might turn out to be wonder cures. Indeed, for those who are faced with imminent death, the desire to bet ones health on long-shot drugs (and the right to do so, when all other options have been tried) is so insistent that patients even deride clinical trials as another structure blocking access to potentially life-saving treatments. The trials randomized treatment groups and stringent inclusion criteria mean the majority of patients never get the chance to serve as guinea pigs at all.

In certain casesthink of early AIDS drugs or Ebola vaccinesthis rigidity can indeed have tragic consequences. But how much rigor should be sacrificed, and how many rules should be suspended, on behalf of patients whose expectations may be substantially inflated? In late June, that question served as the backdrop for a two-day symposium of doctors, bioethicists, patient-advocates, and public-health officials on the future of randomized controlled trials. The problems with RCTs are legion, speakers said: Theyre not well-suited to emerging threats; theyre too expensive; theyre too slow.

But it seemed just as clear from the proceedings that patients should think twice before they clamor for inclusion in these trials and for greater flexibility in their administration. The randomized trial is the single greatest medical innovation of the 20th century, said Prasad, who was in New York City for the meeting. But he warned against the use of massive studies of experimental treatments that may have only very tiny benefits in the end. Its unethical, he said, to put so many desperate patients on a drug unless you have good reason to believe in its effectiveness.

Even in this era of informed consent, patients may not understand exactly what they stand to gain (or lose) by entering a trial. Research going back to 1982 has found that many suffer from a therapeutic misconception: They assume theyll benefit personally from being in a clinical trial, though in fact they may not get the tested treatmentand even if they did, chances are it wouldnt help. (In fairness, some researchers now say this problem has been overstated.) My advice is, youre better off in the control group, warned former FDA chief Robert Califf in his keynote lecture at the symposium, speaking to prospective patients in the audience who had been arguing for greater access to experimental drugs. Most things dont work or theyre dangerous.

This creates an intoxicating atmosphere of progressa sense that new and better treatments are always on the verge of coming out.

The fact that an experimental drug is usually a bad bet isnt likely to dull our instinct to gamble on untested treatments, though. The idolatry of experimentation has even spawned a sinister, for-profit industry, lurking in the shadows of the FDA approval process. In a disturbing paper published last week, bioethicist Leigh Turner describes how the government website ClinicalTrials.gova registry established in 1997 to improve the reliability of formal research on potential treatmentsis being used to market sketchy medical practices. Patients who are looking for a way to break into a clinical trial may scan the registry for opportunities to volunteer; now, instead of finding only legitimate, government-sanctioned research trials, they could land on so-called patient-funded or patient-sponsored ones. In these, they have to pay for access to a therapy that isnt necessarily based on any peer-reviewed, preclinical data, and which may lack any evidence of safety or effectiveness. (Already there have been reports of patients suffering severe complications from their participation in these ersatz trials.)

What makes us so gung-ho for things that arent fully tested? It may in part be human nature, but aspects of the bias seem to be conditioned, too. Even honest science coverage tends to focus on putative medical breakthroughs that have either just occurred or may be coming soon; less scrupulous media figures hawk salves or potions with little basis whatsoever. Taken altogether this creates an intoxicating atmosphere of progressa sense that new and better treatments are always on the verge of coming out.

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We're also too quick to pretend that a dead child isn't dead; Charlie Gard died months ago. Nothing that was offered would have changed that. I mention this because the other prob with have is an infantile faith in miracles. More...

Yet the excitement in the air rarely matches up to reality: Actual medical advancement tends to be incremental and excruciatingly slow. The discord this createsbetween the feeling of innovation inspired by the media and the real options that were offered in the clinicmay distort our view of experimental treatments. It could make us think there must be some reason why our cancers havent yet been cured; there must be some external factors preventing us from getting access to the new and better drugs weve heard so much about. If only regulators werent so overcautious and uptight, we end up thinking, it would be possible to tap this cache of innovation.

Right-to-try laws indulge the fear that unbending bureaucrats in Washington have kept patients from medical cures with an excess of red tape. In fact, these laws have little real effect. Thats because the FDA already offers access to experimental treatments with very modest oversightand in recent years the agency has done away with a few unnecessary rules that slowed the process down. The problem isnt that patients (or their parents) have insufficient freedom to decide how theyd like to balance out potential risks and benefits from experimental treatments. Its that our bias often makes them victims of false hope.

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Microdystrophin restores muscle strength in Duchenne muscular dystrophy – Medical Xpress

Posted: at 12:50 am

July 25, 2017

Researchers from Genethon, the AFM-Telethon laboratory, Inserm (UMR) and the Royal Holloway University of London demonstrated the efficacy of an innovative gene therapy in the treatment of Duchenne muscular dystrophy. Indeed, after injecting microdystrophin (a "shortened" version of the dystrophin gene) via a drug vector, the researchers managed to restore muscle strength and stabilise the clinical symptoms in dogs naturally affected by Duchenne muscular dystrophy. A first. This work, published today in Nature Communications, has been achieved thanks to donations from the French Telethon.

Duchenne muscular dystrophy is a rare progressive genetic disorder involving all the muscles of the body, and affects 1 in 5,000 boys. It is the most common neuromuscular disorder in children. It is associated with abnormalities in the DMD gene, which encodes dystrophin, a protein that is essential for proper muscle function. This gene is one of the largest in our genome (2.3 million base pairs, of which over 11,000 are coding). Because of this size, it is technically impossible to insert the entire DNA for dystrophin into a viral vector (or even the 11,000 coding base pairs alone), as is usually done for gene therapy.

To meet this challenge, teams at Genethon developed, in collaboration with a team at Royal Holloway University of London led by Pr. Dickson, and produced, a gene therapy drug combining an AAV-type viral vector with a shortened version of the dystrophin gene (approximately 4,000 base pairs), allowing the production of a functional protein. Dr Le Guiner's team tested this innovative treatment in 12 dogs naturally affected by Duchenne muscular dystrophy. By injecting this microdystrophin intravenously, and hence into the whole body of the dogs, the researchers observed that dystrophin expression returned to a high level, and muscle function was significantly restored, with stabilisation of the clinical symptoms observed for over 2 years following injection of the drug (see video). No immunosuppressive treatment was administered beforehand, and no side-effects were observed.

Some Golden Retrievers develop Duchenne muscular dystrophy naturally. The successful treatment of these dogs, which show the same clinical symptoms as children with this disease, and are of a similar weight, is a decisive step toward developing the same treatment in children."This preclinical study demonstrates the safety and efficacy of microdystrophin, and makes it possible to consider developing a clinical trial in patients. Indeed, this is the first time that it has been possible to treat the whole body of a large-sized animal with this protein. Moreover, this innovative approach allows treatment of all patients with Duchenne muscular dystrophy, regardless of the genetic mutation responsible," says Caroline Le Guiner, the main author of this study.

"This is tremendously exciting progress towards a gene therapy for DMD. The studies in GRMD dogs have been spectacular and exceeded our expectations. My team has worked for many years to optimise a gene therapy medicine for DMD, and now the quite outstanding work of colleagues in France, in Genethon, in Nantes and in Paris has taken us close to clinical trials in DMD patients. I pay thanks also to the amazing and steadfast support of this research by AFM-Telethon and MDUK (Muscular Dystrophy UK) which has been essential to this achievement." commented George Dickson.

For Frederic Revah, Chief Executive Officer of Genethon: "For the first time, researchers obtained a systemic therapeutic effect on a neuromuscular disease in dogs using microdystrophin, and without immunosuppressive treatment. This highly complex cutting edge technology has been developed as part of an exceptional collaborative effort between Genethon and academic teams from Britain and France. Now our bioproduction experts have the task of producing a sufficient quantity of these new drug vectors, under GMP conditions, for the clinical trial."

"This new evidence of the efficacy of gene therapy in Duchenne muscular dystrophy strengthens the therapeutic arsenal developed (exon skipping, CRISPR Cas-9, pharmacogenetics, etc.), and the first results are there. We need to forge ahead to complete the final phase and transform these scientific advances into drugs for children," emphasises Serge Braun, Scientific Director of AFM-Telethon.

Explore further: Gene therapy treats all muscles in the body in muscular dystrophy dogs

More information: Caroline Le Guiner et al, Long-term microdystrophin gene therapy is effective in a canine model of Duchenne muscular dystrophy, Nature Communications (2017). DOI: 10.1038/ncomms16105

Journal reference: Nature Communications

Provided by: AFM-Telethon laboratory

(HealthDay) Emflaza (deflazacort) has been approved by the U.S. Food and Drug Administration to treat Duchenne muscular dystrophy in people five years and older, the agency said Thursday in a news release.

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Senior Australians say political correctness is ruining society – NEWS.com.au

Posted: at 12:50 am

Best of the Web Columnist James Taranto on new evidence that Donald Trump benefited from his plain talk and rejection of politically correct rhetoric. Photo: AP

Older man reprimands young man. Photo from Thinkstock

ATTENTION, Gen Y: Baby Boomers have had it with your political correctness.

New Australian research suggests over 50s are fed up with being told what they can and cant say, and believe young people are the worst offenders.

The survey of 1000 Australians over 50 saw nine in 10 agree political correctness is ruining society, and thought younger generations were too worried about offending people.

According to the CoreData research commissioned by Australian Seniors Insurance Agency, 86 per cent of seniors believed having to be politically correct all the time was ruining society, and 86.6 per cent said it was inauthentic.

Bathurst teacher Vicki Evans is not afraid to admit she loathes political correctness.

The 55-year-old says shes constantly being told off by her three children, all in their 20s, for opinions they say she shouldnt be allowed to express.

Vicki Evans, 55, is done with political correctness. Picture: Vicki Evans/SuppliedSource:Supplied

The number of times I saw something and my kids say oh Mum, you cant say that, she says.

They say you cant make assumptions about things, but I think you can make observations.

You cant say anything thats offensive and that could be deemed to label anyone. You have to be always aware of perceptions, apparently.

Ms Evans says that her childrens sensitivities are clearly not a product of her parenting, but blames universities and television for encouraging political correctness.

I do get really cross with the whole idea that children arent allowed to talk about anything religious in relation to Christmas or Easter because it might offend someone, she said. I think if we cant discuss any of these things we run the risk of losing our cultural identity.

Seniors were asked, how much do you agree with the following statements about political correctness? Picture: CoreData Social Etiquette and Pet Peeves Survey (June 2017)Source:Supplied

The data also indicated that Aussies grew less concerned about social norms and pleasing others as they grew older.

Almost a third (31 per cent) said they no longer cared about social norms or pleasing others.

Two in five (42.7 per cent) admitted to having shared politically incorrect jokes, and a quarter (24.3 per cent) said they used humour even it they knew it might make some people uncomfortable. One in five admitted they had used politically incorrect humour among inappropriate company.

Most respondents said they thought social etiquette had got worse in Australia. Picture: CoreData Social Etiquette and Pet Peeves Survey (June 2017)Source:Supplied

Australian Seniors Computer Club Association president Nan Bosler said seniors were resisting societal pressure to be politically correct.

Seniors are not letting this pressure deter them from staying true to themselves and their beliefs and they should be respected for that attitude, she said.

Australias older generation have been through a momentous amount of change and challenges, and this has made them a resilient bunch who value good humour and are not easily offended by lighthearted teasing.

Therefore, it is easy to understand why this generation can be frustrated with certain political correct filters that are assumed in modern-day living.

Political correctness was among the top answers to the question: What really bothers you the most these days that didn't seemed to bother you so much when you were younger? Picture: CoreData Social Etiquette and Pet Peeves Survey (June 2017)Source:Supplied

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The MMIW is stuck in a politically correct limbo – Toronto Sun

Posted: at 12:49 am


Toronto Sun
The MMIW is stuck in a politically correct limbo
Toronto Sun
But since the commission was designed not to blame First Nations culture or indigenous men, it is stuck in a politically correct limbo. It is tasked with finding the truth, unless the truth it finds is politically incorrect, at which point the MMIW's ...

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Grand Junction’s Scott continues to stir the pot on tax for bicycle road use – Colorado Springs Gazette

Posted: at 12:49 am

Caption + Janet Winterhalder, left, and Zach Russell with COS Racing ride eastbound on Research Parkway Tuesday, November 1, 2016, in the buffered bike lane that has been in service since the end of September. Photo by Mark Reis, The Gazette

Last week Colorado Politics was the first to tell you about Sen. Ray Scott's talk on social media about taxing bicycles.

In an interview with us, the Republican pragmatist from Grand Junction said cyclists use the roads just like other forms of transportation, but unlike owners of those other forms of transportation, cyclists pay no taxes to help support the roads or services. Other vehicles, including motorcycles and ATVs, pay gas taxes and vehicle taxes and fees. As expected, the idea is getting pushback from cyclists.

A bike tax passed the Oregon legislature this year, but it was Democrats pushing it and Republicans opposing it.

Scott has a double purpose: to raise some much-needed money for transportation while exposing what he sees as a double-standard. And, thirdly, Scott loves to stir the pot of conversation and debate. He has a wicked sense of humor.

Can a bicycle outrun the tax man forever?

Here's what Scott said Monday night on Facebook:

"I'm a little shocked by the raw nerve I struck with my comments about leveling the playing field between cyclists, ATVs, snowmobiles and watercraft, when it comes to how we treat, and tax, these machines. But maybe I shouldn't be, given how defensive bicyclists get when anyone raises the apparently politically-incorrect question of whether they benefit from a double standard and ought to pay a fairer share of the cost for the roadways they use with increased frequency. My attempt to start a conversation has been met with hysteria by some and reasonable ideas by others, reflecting a diversity of opinions on the subject that didn't cut neatly along party or ideological lines.

"The Denver Post, for instance, voiced support for bike taxes, while the Grand Junction Sentinel, came out hard against any discussion of the topic. The need to take swipes at me was the only thing both papers apparently agreed on. I've heard from normally-tax-averse Republicans supporting some type of tax, fee or assessment on bicyclists, and from Democrats who show zero support, even though their peers in liberal-leaning Oregon already have embraced the idea.

"My tracking is showing a 50-50 split on both sides.

"The 2018 legislation is still many months away, giving me plenty of time to weigh the wide variety of responses I've received and consider next steps. But I'm more convinced than ever, based on the live wire nerve I inadvertently struck when I raised the issue, that this is a debate worth continuing in the down time between legislative sessions, so that any concrete proposals that result can be refined and improved before the General Assembly meets again.

"I sincerely appreciate the feedback and responses I've received, from all sides, and will be continuing to discuss the issue with colleagues and various stakeholder groups in the time between now and the next session. So keep those cards and letters, those tweets and emails and nasty-grams, coming, folks. This clearly is an issue the Coloradans feel passionately about, and something lawmakers might want to take up when we next meet."

Scott is planting seeds to yield food for thought, but he'll have a hard time on this one. Cyclists have good friends in the legislature, including passionate riders in both chambers. But he also will have a hard time nailing down all 18 members of the Republican caucus in the Senate. The GOP has only a one-seat majority, but then again Democrats do like a tax for bike lanes and the great outdoors, so don't count Scott out yet.

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A Better Deal Isn’t Going to Cut It – HuffPost

Posted: at 12:49 am

Its a little ironic that the Democratic Party that in 2016 nominated a losing presidential candidate who was heavily identified with the partys shift away from working-class politics and toward corporate neoliberalism would now seek belatedly to counter its failure with new messaging.

With great fanfare in a tiny white and rustic Republican town, Berryville, Virginia, Democratic leaders unveiled what their pollsters and consultants tell them is a winning slogan to try to encapsulate what they stand for: A Better Deal.

A Better Deal contains a lot of vague promises, such as raising the minimum wage and providing health care for all, designed to ring in the ears of Berniecrats and progressives while not putting off the corporate pro-business wing of the party that remains wedded as ever to the same neoliberalism voters rejected.

I suppose the pollsters who came up with this new brand read about TRs Square Deal or FDRs New Deal to concoct a prepackaged catchphrase going forward that might make the Democrats appear to have ideas again and to stand for something now that theyve lost he whole enchilada.

But the new zippy slogan raises the obvious question: A Better Deal compared to what? Are Democratic leaders finally copping to their three-decade failure (despite controlling the government from 1993 to 1995 and from 2009 to 2011) to do anything meaningful to make the lives of most working Americans better in any way? For thirty years theyve been too busy to worry about giving working people A Better Deal.

Theyve been too busy deregulating Wall Street banks and then bailing them out; facilitating corporate mergers and global trade deals that batter workers and the environment; supporting military build-ups and trillion dollar wars; and beating up on teachers unions and welfare recipients. A Better Deal would seem to conflict directly with the Democratic Establishments loving embrace of everything neoliberal.

Democratic power brokers including Hillary Clinton and Debbie Wasserman Shultz were so busy transforming their party into Republican-lite and serving largely the same billionaire and corporate donor class that bankrolls the GOP to notice that the American working class was being chewed up and spit out by the neoliberal policies and transactional politics to which they are beholden (and are now attempting to re-brand).

While Democratic leaders party in the Hamptons with Trump officials and supporters theyve failed to notice that we face a crisis of values as a nation and as a people and no change in simple messaging will be adequate to address this crisis. Some big questions keep being ignored in our era of transactional politics and plutocracy despite the nice sounding rhetoric we hear to the contrary every election season.

Are we going to be a nation where people take care of and support one another as fellow citizens in a republic? Or are we going to fragment into a set of mini-states where most Americans are forced to go it alone while a ruling elite uses governmental power to serve its narrow class interests condemning the rest of us to fight against each other in a race to the bottom? And what does the term A Better Deal even mean at a time when we are facing so many social injustices and grotesque inequality?

Donald Trump, Mitch McConnell, and Paul Ryan represent a pathology in American society with roots deeper than we wish to acknowledge. Self-reflection has never been a strong suit in exceptional Merica. We seem incapable of understanding the meaning and ramifications of the United States deadly actions in Afghanistan and Iraq (and elsewhere), the economic injustices exposed by the Wall Street rip-off of 2007-2008, and the racial injustices symbolized by events in Ferguson Missouri and Flint Michigan.

To get beyond this pathology we must first begin to recognize and reinforce the values that created Social Security, Medicare, and Medicaid and build on these with a national health system where everybody has a human right to health care; a society that understands and celebrates our interconnectedness despite our racial, ethnic, and sexual differences.

An empty slogan concocted by Democratic pollsters cannot even begin to provide an alternative to the real struggles involved in acknowledging and ultimately overcoming this crisis in values. Talking about A Better Deal in a little white Republican town in Virginia isnt going to begin to chip away at the Far Right juggernaut we now face.

The Republican Party of Trump, McConnell, and Ryan doesnt so much govern as it does twist every institution within its icy grasp to serve the power and class interests of a ruling corporate and banking oligarchy. The people who run the GOP as it stands today in the Trump era are in favor of further impoverishing those who are not already rich and stripping health care away from millions of working and low-income people. They dont value the arts or humanities, or science, or anything with the word public attached to it. Theyre against basic privacy rights and net neutrality. They promote a 19th Century capitalism that preys on its own people and destroys the planet with abandon. Trump Republican values are best symbolized by some of the worst scenes of poverty in a Dickens novel combined with the self-congratulatory claptrap of Ayn Rand.

All of their values are subordinated to one overarching value: the use of state power to throw as much money as possible to the already rich while ensuring that working people lead harder, grubbier, less secure and increasingly impoverished lives. The end result of all of this deconstruction of the administrative state can be nothing more than a nation with larger and more desperate pockets of extreme poverty, where working people breathe dirtier air, drink dirtier water, send their kids to crappier for-profit schools, work longer hours for lower pay, and get ripped off by every corporation or bank they come into contact with.

Its All an Ego Trip for Them

The Republican donors and Trump Administration officials are already so wealthy they could choose to do anything they want. But for their own ego-driven weirdo reasons they choose to finance campaigns and candidates and propaganda forums like Breitbart or head off to Washington themselves to carve up those parts of the government that serve to protect people and the environment from craven exploitation to make it easier for corporations to plunder nature, oppress workers, prey on sick people, and profit from war.

Their contempt for democracy is clear. Theyve created a voter suppression commission filled with characters out of a parody headline from The Onion. Kris Kobach played a pivotal role in disfranchising as many as two million voters prior to the 2016 election and he heads the commission. Another member is Kenneth Blackwell who is notorious for suppressing the Democratic vote as Ohio Secretary of State (and Bush-Cheney campaign state chair) that threw the election and gave us four more miserable years of President George W. Bush.

So what is A Better Deal when compared to this onslaught of greed, social pathology and death? The Trump Republicans are behaving exactly like the rapacious capitalist ruling class that leaps from the most lurid descriptions by Karl Marx or Vladimir Lenin. The billionaire donor class is filled with aging baby boomers who view their fellow citizens with contempt and see them as little more than another resource to be plundered. After deconstructing the welfare state theyll turn their attention to shredding Social Security and workers pensions, suppressing voters they cant bamboozle, and privatizing everything from schools to prisons to citizenship itself.

Trump Re-centers the White Male

On a superficial level, after eight years of the Obama presidency there appeared to have been accomplished what academics tucked away in English and Cultural Studies departments had been theorizing about for decades: the decentering of the white male. Remember the hours of breathless commentary on MSNBC and other so-called liberal media outlets about what a big mistake Trump was making by alienating non-white voters?

With Trump weve seen what might be called the re-centering of the cis white male (with a vengeance). And Trump accomplished this feat with the support of 53 percent of white women voters who preferred a pussy-grabbing misogynist over the first real chance in American history to elect a woman president. According to the two journalists who wrote the book Shattered about the Hillary Clinton campaign, on election night Democratic consultants and strategists were stunned when the results came pouring in from counties in Florida and elsewhere long considered bellwethers of the white vote with Trump driving the white vote up nearly ten times the tally of votes Mitt Romney received in 2012. (Shattered, 2017, p. 375)

With Trump and Pence, Bannon and Priebus, Price and Pruitt, Ross and Mnuchin the rich cis white guys are in control now and they along with their ultra-wealthy backers like the Mercers and the Kochs are aggressively doing everything in their power to cement their current institutional advantage well beyond the next eight years.

And squaring off against this rich white male, politically incorrect corporate juggernaut the Left (whatever that means in 2017) will soon have no choice but to organize in workplaces, in neighborhoods, in districts and in counties, and seek to unify those Americans who are NOT rich or male. We will need to weaponize the intersectionality weve heard so much about in recent years, turn it into an electoral force and a form or resistance. We must band together in unapologetic and fierce resistance to counter the resurgence and dominance of the rich white male Christian political order we now live under or else were sunk.

Partying at the Hamptons with Trump supporters and then flying off to Virginia to launch the new A Better Deal brand isnt going to work for an anemic and defeated political party mostly run by hacks and overpaid consultants. Were in an existential battle to save American democracy, not searching for A Better Deal.

We are now ruled by people who have nothing but contempt for democracy, for working people, for the rule of law, and even for common decency. The tone of the President of the United States tweets is that of a spoiled pre-adolescent boy and an embarrassment to the world.

Meanwhile, the inflammatory rhetoric that comes from Trumps supporters on right-wing talk radio, Fox News, Drudge, Breitbart, Reddit, and 4chan has the tone of eliminationism: liberals arent only seen as the enemy, but as a cancer in society that must be totally obliterated. And with control of the House, the Senate, the White House and the Supreme Court, this new brand of immature authoritarianism, Trump Republicans can very well succeed in vanquishing the opposition through means that a few short years ago would seem outside the bounds of whats possible in the United States.

Despite it all, people who consider themselves part of the Resistance or the opposition or whatever we want to call ourselves have no alternative but to choose optimism over despair. But that doesnt mean we have to sugarcoat the dystopian moment in which we find ourselves. The new Democratic party slogan, A Better Deal, despite its best intentions, is simply not up to the task to counter the rising authoritarianism in the Trump era.

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From killing the enemy to KILLING IT in business – Florida Weekly

Posted: at 12:49 am

Editions:

July 26, 2017 July 19, 2017 July 12, 2017 July 5, 2017 June 28, 2017 June 21, 2017 June 14, 2017 June 7, 2017 May 31, 2017 May 24, 2017 May 17, 2017 May 10, 2017 May 3, 2017 April 26, 2017 April 19, 2017 April 12, 2017 April 5, 2017 March 29, 2017 March 22, 2017 March 15, 2017 March 8, 2017 March 1, 2017 February 22, 2017 February 15, 2017 February 8, 2017 February 1, 2017 January 25, 2017 January 18, 2017 January 11, 2017 January 4, 2017 December 28, 2016 December 21, 2016 December 14, 2016 December 7, 2016 November 30, 2016 November 23, 2016 November 16, 2016 November 9, 2016 November 2, 2016 October 26, 2016 October 19, 2016 October 12, 2016 October 5, 2016 September 28, 2016 September 21, 2016 September 14, 2016 September 7, 2016 August 31, 2016 August 24, 2016 August 17, 2016 August 10, 2016 August 3, 2016 July 27, 2016 July 20, 2016 July 13, 2016 July 6, 2016 June 29, 2016 June 22, 2016 June 15, 2016 June 8, 2016 June 1, 2016 May 25, 2016 May 18, 2016 May 11, 2016 May 4, 2016 April 27, 2016 April 20, 2016 April 13, 2016 April 6, 2016 March 30, 2016 March 23, 2016 March 16, 2016 March 9, 2016 March 2, 2016 February 24, 2016 February 17, 2016 February 10, 2016 February 3, 2016 January 27, 2016 January 20, 2016 January 13, 2016 January 6, 2016 December 30, 2015 December 23, 2015 December 16, 2015 December 9, 2015 December 2, 2015 November 25, 2015 November 18, 2015 November 11, 2015 November 4, 2015 October 28, 2015 October 21, 2015 October 14, 2015 October 7, 2015 September 30, 2015 September 23, 2015 September 16, 2015 September 9, 2015 September 2, 2015 August 26, 2015 August 19, 2015 August 12, 2015 August 5, 2015 July 29, 2015 July 22, 2015 July 15, 2015 July 8, 2015 July 1, 2015 June 24, 2015 June 17, 2015 June 10, 2015 June 3, 2015 May 27, 2015 May 20, 2015 May 13, 2015 May 6, 2015 April 29, 2015 April 22, 2015 April 15, 2015 April 8, 2015 April 1, 2015 March 25, 2015 March 18, 2015 March 11, 2015 March 4, 2015 February 25, 2015 February 18, 2015 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December 4, 2013 November 27, 2013 November 20, 2013 November 13, 2013 November 6, 2013 October 30, 2013 October 23, 2013 October 16, 2013 October 9, 2013 October 2, 2013 September 25, 2013 September 18, 2013 September 11, 2013 September 4, 2013 August 28, 2013 August 21, 2013 August 14, 2013 August 7, 2013 July 31, 2013 July 24, 2013 July 17, 2013 July 10, 2013 July 3, 2013 June 26, 2013 June 19, 2013 June 12, 2013 June 5, 2013 May 29, 2013 May 22, 2013 May 15, 2013 May 8, 2013 May 1, 2013 April 24, 2013 April 17, 2013 April 10, 2013 April 3, 2013 March 27, 2013 March 20, 2013 March 13, 2013 March 6, 2013 February 27, 2013 February 20, 2013 February 13, 2013 February 6, 2013 January 30, 2013 January 23, 2013 January 16, 2013 January 9, 2013 January 2, 2013 December 26, 2012 December 19, 2012 December 12, 2012 December 5, 2012 November 28, 2012 November 21, 2012 November 14, 2012 November 7, 2012 October 31, 2012 October 24, 2012 October 17, 2012 October 10, 2012 October 3, 2012 September 26, 2012 September 19, 2012 September 12, 2012 September 5, 2012 August 29, 2012 August 22, 2012 August 15, 2012 August 8, 2012 August 1, 2012 July 25, 2012 July 18, 2012 July 11, 2012 July 4, 2012 June 27, 2012 June 20, 2012 June 13, 2012 June 6, 2012 May 30, 2012 May 23, 2012 May 16, 2012 May 9, 2012 May 2, 2012 April 25, 2012 April 18, 2012 April 11, 2012 April 4, 2012 March 28, 2012 March 21, 2012 March 14, 2012 March 7, 2012 February 29, 2012 February 22, 2012 February 15, 2012 February 8, 2012 February 1, 2012 January 25, 2012 January 18, 2012 January 11, 2012 January 4, 2012 December 28, 2011 December 21, 2011 December 14, 2011 December 7, 2011 November 30, 2011 November 23, 2011 November 16, 2011 November 9, 2011 November 2, 2011 October 26, 2011 October 19, 2011 October 12, 2011 October 5, 2011 September 28, 2011 September 21, 2011 September 14, 2011 September 7, 2011 August 31, 2011 August 24, 2011 August 17, 2011 August 10, 2011 August 3, 2011 July 27, 2011 July 20, 2011 July 13, 2011 July 6, 2011 June 29, 2011 June 22, 2011 June 15, 2011 June 8, 2011 June 1, 2011 May 25, 2011 May 18, 2011 May 11, 2011 May 4, 2011 April 27, 2011 April 20, 2011 April 13, 2011 April 6, 2011 March 30, 2011 March 23, 2011 March 16, 2011 March 9, 2011 March 2, 2011 February 23, 2011 February 16, 2011 February 9, 2011 February 2, 2011 January 26, 2011 January 19, 2011 January 12, 2011 January 5, 2011 December 29, 2010 December 22, 2010 December 15, 2010 December 8, 2010 December 1, 2010 November 24, 2010 November 17, 2010 November 10, 2010 November 3, 2010 October 27, 2010 October 20, 2010 October 13, 2010 October 6, 2010 September 29, 2010 September 22, 2010 September 15, 2010 September 8, 2010 September 1, 2010 August 25, 2010 August 18, 2010 August 11, 2010 August 4, 2010 July 28, 2010 July 21, 2010 July 14, 2010 July 7, 2010 June 30, 2010 June 23, 2010 June 16, 2010 June 9, 2010 June 2, 2010 May 26, 2010 May 19, 2010 May 12, 2010 May 5, 2010 April 28, 2010 April 21, 2010 April 14, 2010 April 7, 2010 March 31, 2010 March 24, 2010 March 17, 2010 March 10, 2010 March 3, 2010 February 24, 2010 February 17, 2010 February 10, 2010 February 3, 2010 January 27, 2010 January 20, 2010 January 13, 2010 January 6, 2010 December 30, 2009 December 23, 2009 December 16, 2009 December 9, 2009 December 2, 2009 November 25, 2009 November 18, 2009 November 11, 2009 November 4, 2009 October 28, 2009 October 21, 2009 October 14, 2009 October 7, 2009 September 30, 2009 September 23, 2009 September 16, 2009 September 9, 2009 September 2, 2009 August 26, 2009 August 19, 2009 August 12, 2009 August 5, 2009 July 29, 2009 July 22, 2009 July 15, 2009 July 8, 2009 July 1, 2009 June 24, 2009 June 17, 2009 June 10, 2009 June 3, 2009 May 27, 2009 May 20, 2009 May 13, 2009 May 6, 2009 April 29, 2009 April 22, 2009 April 15, 2009 April 8, 2009 April 1, 2009 March 25, 2009 March 18, 2009 March 11, 2009 March 4, 2009 February 25, 2009 February 18, 2009 February 11, 2009 February 4, 2009 January 28, 2009 January 21, 2009 January 14, 2009 January 7, 2009 December 31, 2008 December 24, 2008 December 17, 2008 December 10, 2008 December 3, 2008 November 26, 2008 November 19, 2008 November 12, 2008 November 5, 2008 October 29, 2008 October 22, 2008 October 15, 2008 October 8, 2008 October 1, 2008 September 24, 2008 September 17, 2008 September 10, 2008 September 3, 2008 August 27, 2008 August 20, 2008 August 13, 2008 August 6, 2008 July 30, 2008 July 23, 2008 July 16, 2008 July 9, 2008 July 2, 2008 June 25, 2008 June 18, 2008 June 11, 2008 June 4, 2008 May 28, 2008 May 21, 2008 May 14, 2008 May 7, 2008 April 30, 2008 April 23, 2008 April 16, 2008 April 9, 2008 April 2, 2008 March 27, 2008 March 20, 2008 March 13, 2008 March 6, 2008 February 28, 2008 February 21, 2008 February 14, 2008 February 7, 2008 January 31, 2008 January 24, 2008 January 17, 2008 January 10, 2008 January 3, 2008 December 27, 2007 December 20, 2007 December 13, 2007 December 6, 2007 November 29, 2007 November 22, 2007 November 15, 2007 November 8, 2007 November 1, 2007 October 25, 2007 October 18, 2007 October 11, 2007 October 4, 2007 September 27, 2007 September 20, 2007 September 13, 2007 September 6, 2007 August 30, 2007 August 23, 2007 August 16, 2007 August 9, 2007 August 2, 2007 July 26, 2007 July 19, 2007 July 12, 2007 July 5, 2007 June 28, 2007 June 21, 2007 June 14, 2007 June 7, 2007 May 31, 2007 May 24, 2007 May 17, 2007 May 10, 2007 May 3, 2007 April 26, 2007 April 19, 2007 April 12, 2007 April 5, 2007

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Pinkwashing Censorship: How the Chicago Dyke March Won its War on the Media – American Spectator

Posted: at 12:48 am

July 25, 2017, 10:04 pm

Gretchen R. Hammond, a transgender reporter, was personally threatened, subject to sexist and anti-Semitic abuse and Neo-Nazi slurs as retribution against an article she wrote, losing her job as a result and the National Review is the only major American publication reporting on it. How did this happen? Hammond was the first reporter to write about the Chicago Dyke March removing three Jewish women from the march for having Jewish symbolism on their flags. While the Dyke March holds that there is nothing anti-Semitic about forbidding Jewish symbols while allowing other religious imagery, they were evidently unhappy with anyone reporting on their totally not anti-Semitic actions and letting the public draw its own conclusions. Shortly after the article was published, Hammond and her employer, the LGBT newspaper Windy City Times, began receiving insults and threats, which included anti-Jewish and sexist slurs. Shortly after, Hammond was forced off of reporting and placed into sales, which she blames on harassment from the Dyke March.

Instead of condemning this harassment, the Chicago Dyke March bragged about it, tweeting Zio tears replenish my electrolytes. Zio is an anti-Jewish slur popularized by the KKK, and the Dyke March initially defended the comment before deleting and replacing the original tweet.

If other organizations used derogatory slurs towards or celebrated the abuse of an individual by people angry at her reporting, the outrage would be deafening. After all, when CNNs Andrew Kaczynski faced harassment from redditors after publishing an article perceived as threatening to dox the private individual responsible for a gif that president Trump tweeted, Vox and the New York Times were quick to document the harassment that he faced. When a bunch of angry videogame fans harassed feminist journalist Anita Sarkeesian and game developer Zoe Quinn for criticizing sexism in videogames, it kicked off a 3+ year cycle of story after story on what became known as Gamergate. Surely, harassment that cost someone their job and that has the support not just of fringe internet users, but a large mainstream institution is the sort of bullying and intimidation that people would be up in arms against. And yet, the same organizations that have long campaigned against what they see as harassment and intimidation of progressive writers are suddenly silent, or even supportive of this bullying when its done by supporters of the Chicago Dyke March. Are journalists falling for the disingenuous invocation of LGBT rights by the March to distract from the racism, sexism, harassment, and courting of fascism that their movement is engaging in? Or have journalists seen what happened to the last left-wing writer who tried to expose intolerance and hypocrisy in the Chicago Dyke March and decided that is safer to turn a blind eye? Whatever the answer, the Chicago Dyke Marchs successful war on the media should be deeply disturbing for those interested in a free and honest press.

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Google Wants Federal Judge To Nix Canadian Censorship Order – MediaPost Communications

Posted: at 12:48 am

Canada's highest court recently upheld a controversial order requiring Google to remove certain results from its worldwide search listings. Now, Google is asking a federal judge to rule that that the Canadian order is unenforceable in the U.S.

"Without a declaration from a United States court that enforcement of the Canadian order in the U.S. is unlawful, Google believes that Equustek will continue to pursue enforcement of the Canadian order," the company writes in a complaint filed Monday in San Jose, California. "Google now seeks a declaration from this court that will protect its rights."

The battle over the search results dates to 2012, when technology company Equustek asked a judge in British Columbia to order Google to remove search results for Datalink Technologies -- which allegedly stole trade secrets from Equustek and engaged in counterfeiting.

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The Canadian issued a worldwide injunction prohibiting Google from displaying search results for Datalink. That order was upheld last month by Canada's Supreme Court.

The digital rights groups Electronic Frontier Foundation, which weighed in on Google's side, criticized the Canadian court's ruling.

"The courts decision will likely embolden other countries to try to enforce their own speech-restricting laws on the Internet, to the detriment of all users," the EFF wrote. "Its not difficult to see repressive regimes such as China or Iran use the ruling to order Google to de-index sites they object to, creating a worldwide hecklers veto."

Google argues in its new court papers that enforcing the Canadian court's order in the U.S. would violate free speech principles. Among other arguments, Google says that the First Amendment prohibits injunctions that are not "narrowly tailored" to achieve a substantial interest.

"The existence of the Datalink websites is, and remains, a matter of public record," Google writes. "Equustek cannot show that it has no alternatives available other than enjoining Googles search results outside of Canada."

Google adds that Equustek has not sought injunctions against other search engines and social media sites and has not stopped Amazon from selling Datalink products.

Google also argues that the order shouldn't be enforced because it's "repugnant" to public policy in the U.S. "The ... standard applied by the Supreme Court of Canada did not come close to satisfying well-settled United States law for imposing injunctions," Google writes.

"The Canadian court placed the burden on Google, a non-party, to disprove Equusteks rights in every country outside of Canada, rather on Equustek, the plaintiff in the action, to prove its entitlement to removal of search results in each country in which it sought removal," Google writes. "Moreover, the Canadian standard took no account of the 'public interest' at all."

While Google says it's trying to protect the company's rights, it's uncertain how this lawsuit will do so, according to Santa Clara University law professor Eric Goldman. That's because even if Google prevails, it's not clear that a victory in the U.S. would prevent a Canadian court from holding the company in contempt, Goldman says.

"There could still be Canadian enforcement actions that would not be governed by U.S. law," he says.

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SIMPLE CREATURE Review – Film Pulse

Posted: at 12:47 am

2.5

Release Date: July 25, 2017 (DVD and VOD platforms)Director:Andrew FinniganMPAA Rating: NR Runtime: 92 mins

The very concept of transhumanism, the belief that the human body can be pushed past its physical and mental limitations through an incorporation of technology, seems like a narrative concept that is almost impossible to make mundane and stale. The implications, possibilities and risks of the wavering status of humanity transhumanism challenges would supply even the most basic science fiction writer with a wealth of existential questions.

Simple Creature, however, never bothers to ask any of these questions in its Bionic Woman-like fable because, beyond skimming the surface of the possibilities of mechanical augmentation, director Andrew Finnigan shows he hasnt the drive or perhaps the budget to delve any further.

Bearing its catchpenny budget on its shoulders with sets of laughably barren mise-en-scne, the film unfolds uneasily as if confused to what particular issue related to the transhuman debate it wants to address. Millennial college student Em (Carollani Sandberg), whose supposed mastery of modern technology is marked by her dependence on a smartphone, is involved in a near-fatal bus accident that prompts her father to rebuild her because of course we have the technology.

Mind you, we never actually see any of this technology due to budgetary constraints, but the script poorly fills us in with its bizarre, layman techno jargon, making one doubt that Finnigan, who along with directing and writing this dreck is also responsible for the screenplay, hasnt the slightest clue about medical technology. Hes more comfortable with employing buzzwords like nanotechnology as insipid catchalls to the process to ensure no one could be intellectually stimulated by his story.

As Em recovers from her condition, Finnigan demonstrates how uninterested he was in transhumanism to begin with by diverting the films attention to her boyfriend, Seth (DAngelo Midili), and his struggle to keep his family farm operational after his fathers passing. For some unknown reason, Finnigan thought it was prescient to draw parallels between human augmentation and corporate farms infringing on the family-owned business under Simple Creatures blanket thesis: technology does not equal humanity. These scenes before Ems reintegration into the films narrative are only useful to highlight its atrocious sense of pacing.

Half of the film is presented in flowing montage, which dances around things like character building and story through excessive cutting, while the other half is comprised of monotonous dialogue exchanges that played more like the actors building a demo reel, seeing how much personality they could cram into their blank characters.

It is as if the film is permanently stuck its own Kickstarter promotional video, trying to secure enough budget to have makeup effects beyond Em sticking an iPhone cord into her arm to check her vitals. Filming, as he does, from natural light obstructing long shots of utter apathy, Finnigans inconsistent aesthetic practically broadcasts the fresh-out-of-film-school pretensions that one harbors when they earnestly think they can be the next Shane Carruth. As the film goes on, it spirals into a lackluster conspiracy thriller involving the facility in which Em was transformed and the farmers plotting to expose them before limply petering out. Simple Creature is a surprising film in that it somehow made transhumanism boring. Not sure where it wants to place its mistrust of technological advancement that stems from its own ignorance of the topic, Simple Creature spins its wheels futilely without a solid point to make or the means to do so.

Simple Creature review

Written by: Chris Luciantonio

Date Published: 07/25/2017

2.5 / 10 stars

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