Day: October 30, 2020

health

Hartford judge hears testimony on safety of masks in schools as parents seek to block face coverings rule

A Hartford judge heard hours of testimony on the safety and efficacy of masks to help prevent the spread of the coronavirus Friday as he decides whether to grant an emergency injunction blocking a state requirement that students wear face coverings in schools.

In a daylong hearing on the injunction, Judge Thomas G. Moukawsher heard from both those downplaying the effectiveness of masks as well as those who said face coverings do not negatively impact children and slow the spread of the virus.

The hearing came several weeks after a group of parents and the CT Freedom Alliance sued the state’s education department and top officials to lift the requirement that children wear masks in schools out of fear of the harms they pose to children both mentally and physically.

The assertions in the lawsuit are in direct conflict with scientific evidence that shows that mask-wearing slows the spread of COVID-19. Lawyers for the state have argued there is no evidence to support the claim that masks are dangerous and that in fact masks are protecting students as they attend in-person classes.

Quick to send students home for virtual learning in the spring, Connecticut education officials outlined extensive measures to safely return students to school this fall. Key among those measures was a requirement that students and staff wear masks in school.

Moukawsher set Friday’s hearing to get testimony from two expert witnesses called by the plaintiffs, as well as the state’s witnesses, before ruling on the request for an injunction. The state has filed a motion to dismiss the case, which Moukawsher will address after the injunction.

Lawyers for the parents and CT Freedom Alliance first called on a Los Angeles-based psychiatrist, who said that masks can inhibit development, cause stress and led to other complications for children.

“I am greatly concerned by what I am seeing … children who are forced to wear masks in a school settings as well as outside the school settings are in imminent harm,” said Dr. Mark McDonald. McDonald also noted that the risk of oxygen deprivation can led to “permanent neurological damage in children, which we will not be able to address because the window will have passed.”

The state questioned McDonald’s beliefs in masks and the government response to the pandemic. McDonald said he believes that a healthy person confers no benefits to others when wearing a mask.

The plaintiff’s second witness, Knut Whittkowski, a New York-based epidemiologist with 35 years in the field, said he reviewed scores of studies and could not find evidence that masks were effective outside a health care setting.

“I went through all the literature I could find, and all the literature I was presented and I could not find convincing evidence on the effectiveness of surgery masks or bandannas or other masks worn in non-health care settings in general,” Whittkowski said. “And in particular, I couldn’t find evidence for the effectiveness of mask wearing by children.”

The U.S. Centers for Disease Control and

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health

‘Cardio-obstetrics’ Tied to Better Outcome in Pregnancy With CVD

A multidisciplinary cardio-obstetrics team-based care model may help improve cardiovascular care for pregnant women with cardiovascular disease (CVD), according to a recent study.

“We sought to describe clinical characteristics, maternal and fetal outcomes, and cardiovascular readmissions in a cohort of pregnant women with underlying CVD followed by a cardio-obstetrics team,” wrote Ella Magun, MD, of Columbia University, New York, and coauthors. Their report is in the Journal of the American College of Cardiology.

The researchers reported the outcomes of a retrospective cohort analysis involving 306 pregnant women with CVD, who were treated at a quaternary care hospital in New York City.

They defined cardio-obstetrics as a team-based collaborative approach to maternal care that includes maternal fetal medicine, cardiology, anesthesiology, neonatology, nursing, social work, and pharmacy.

More than half of the women in the cohort (53%) were Hispanic and Latino, and 74% were receiving Medicaid, suggesting low socioeconomic status. Key outcomes of interest were cardiovascular readmissions at 30 days, 90 days, and 1 year. Secondary endpoints included maternal death, need for a left ventricular assist device or heart transplantation, and fetal demise.

The most frequently observed forms of CVD were arrhythmias (29%), cardiomyopathy (24%), congenital heart disease (24%), valvular disease (16%), and coronary artery disease (4%). The median Cardiac Disease in Pregnancy (CARPREG II) score was 3, and 43% of women had a CARPREG II score of 4 or higher.

After a median follow-up of 2.6 years, the 30-day and 90-day cardiovascular readmission rates were 1.9% and 4.6%, which was lower than the national 30-day postpartum rate of readmission (3.6%). One maternal death (0.3%) occurred within a year of delivery (woman with Eisenmenger syndrome).

“Despite high CARPREG II scores in this patient population, we found low rates of maternal and fetal complications with a low rate of 30- and 90-day readmissions following delivery,” the researchers wrote.

Experts Weigh In

“We’re seeing widely increasing interest in the implementation of cardio-obstetrics models for multidisciplinary collaborative care and initial studies suggest these team-based models improve pregnancy and postpartum outcomes for women with cardiac disease,” said Lisa M. Hollier, MD, past president of the American College of Obstetricians and Gynecologists and professor at Baylor College of Medicine in Houston.

Magun and colleagues acknowledged that a key limitation of the present study was the retrospective, single-center design.

“With program expansions over the next 2-3 years, I expect to see an increasing number of prospective studies with larger sample sizes evaluating the impact of cardio-obstetrics teams on maternal morbidity and mortality,” Hollier said.

“These findings suggest that our cardio-obstetrics program may help provide improved cardiovascular care to an otherwise underserved population,” the authors concluded.

In an editorial accompanying the reports, Pamela Ouyang, MBBS, and Garima Sharma, MD, wrote that, although this study wasn’t designed to assess the benefit of cardio-obstetric teams relative to standard of care, its implementation of a multidisciplinary team-based care model showed excellent long-term outcomes.

The importance of coordinated postpartum follow-up with both cardiologists and obstetricians is becoming increasingly recognized, especially for women with

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health

Javaid Perwaiz, ob/gyn accused of unnecessary procedures, testifies

“Yes, I knew the 30-day requirement. I just couldn’t say no,” he said from the witness stand Thursday. “I’m an advocate for my patients.”

He said he performed the sterilizations in contradiction to the requirement to benefit his patients. Often, they had discussed sterilization with doctors who referred them. They told him, he testified, that their insurance would run out if he waited or that they could not get a ride or a babysitter on other dates. Asked during cross examination if he could name which of the patients in the indictments told him that their insurance was running out, Perwaiz could not.

Backdating forms is part of three broad categories of charges against Perwaiz. Prosecutors say he altered medical records to justify unnecessary surgery, often scaring women by mentioning the threat of cancer. They allege he changed due dates so he could induce women into labor on the Saturdays he was operating on other patients at Chesapeake Regional Medical Center. And they contend he billed insurers for office medical procedures done with broken equipment.

He is also charged with falsifying his application to health-care providers by omitting a felony conviction for tax fraud in 1996, which resulted in a brief suspension of his license, and failing to admit his loss of privileges at Maryview Hospital in 1983. Perwaiz, 70, has been jailed since his November arrest.

In a full day of testimony, Perwaiz, led by defense lawyer Emily Munn, defended the care he gave to the two dozen patients named in the 61 counts against him. In case after case, she broadcast his medical charts and the form he filed with Chesapeake Regional Medical Center before surgery. The charts were identified by the initials of the women prosecutors charge he operated on unnecessarily — D.B., D.P., A.G., T.D.C., A.F., A.N. S.N., D.B.D — and by their age and the complaints they wrote down, which several women who testified previously said were false.

In case after case, Perwaiz explained that the complaints by the women — often pelvic pain, bleeding and cramping — justified his procedures. Often, he said, women asked him to be sterilized. In none of the cases of women named in the indictments, Perwaiz said, did he refer them to other doctors after finding evidence of cancer.

During cross examination by Elizabeth Yusi, an assistant U.S. attorney, Perwaiz said due dates for patients were changed not for his convenience so he would be paid for the deliveries, but because he relied on a “range” of possible dates from several ultrasound examinations. The American College of Obstetricians and Gynecologists and Chesapeake hospital guidelines advise against inducing labor before 39 weeks without a medical reason, saying it leads to health problems for the baby. Chesapeake Regional Medical Center prohibited inducing labor before 39 weeks without a medical reason.

Perwaiz said his own research indicated no reason for that policy. “There is no difference in immediate morbidity and mortality” he told Yusi. “I find it not understandable that we enforce

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health

Disney World to lay off 11,000 amid pandemic

ORLANDO, Fla. — Walt Disney World says it plans to lay off more than 11,000 unionized workers because of the new coronavirus, bringing the total number of pandemic-related job casualties at the Florida resort to almost 18,000 positions.

Disney World said in a letter to state and local leaders Thursday that the 11,350 union workers — mostly part-timers — will be laid off at the end of the year. Company officials previously had said that another 6,400 nonunion Disney employees in Florida would lose their jobs.

Earlier this week, 720 Disney World actors and singers were laid off since many of the live entertainment shows at the Florida resort have gone dark, according Actors’ Equity Association, the labor union representing the performers.

The layoffs are part of a decision by The Walt Disney Co. last month to eliminate 28,000 positions in its parks division in California and Florida because of the pandemic.


Disney’s parks closed last spring as the coronavirus began spreading in the U.S. The Florida parks reopened this summer with restrictions on how many people could be in the parks at any given time and new requirements for social distancing and mask-wearing. The California parks have yet to reopen because of restrictions by the state of California.

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HERE’S WHAT YOU NEED TO KNOW ABOUT THE VIRUS OUTBREAK:

— U.S. now has 9 million confirmed cases of the coronavirus

— Georgia Gov. Kemp in quarantine after coronavirus exposure

— Virus antibody drug trial paused for safety issue by Regeneron Pharmaceuticals

— Kenya joins trial of AstraZeneca coronavirus vaccine

— European countries want WHO given greater powers to independently investigate outbreaks and compel countries to provide more data,

— For many Latinos, coronavirus deaths loom over Day of the Dead. Some are mourning more than one relative, which underscores the pandemic’s disproportionate impact on communities of color.

— Curious about going to a movie theater in U.S.? A few things to know.

Follow AP’s coronavirus pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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HERE’S WHAT ELSE IS HAPPENING:

TOPEKA, Kan. — Kansas counties that require masks have seen about half as many new coronavirus infections as counties that don’t mandate face coverings, a study has found, as cases statewide surged again to record levels.

“Do Masks Matter in Kansas” produced by the Institute for Policy and Social Research at the University of Kansas found that counties that require masks saw a decrease in their seven-day rolling average of daily cases per 100,000 population starting 14 days after the mandate was issued.

“Masks, it is important to note, do not eliminate COVID, but they significantly slow the spread of the disease — at least here in Kansas,” said Donna K. Ginther, the institute’s director, in a video presenting the study’s findings. The Institute for Policy and Social Research at the University of Kansas has been tracking the impact of COVID-19 on the state, The Kansas City Star reported.

Kansas Gov. Laura Kelly tried over the summer to issue a statewide mask

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Kentucky reports near-record number of new coronavirus cases

FRANKFORT, Ky. (AP) — Kentucky reported a near-record number of new coronavirus cases Friday as the surging outbreak continued sending more people to hospitals, Gov. Andy Beshear said.

“This is a dangerous time. We’re moving the wrong way,” the Democratic governor said as he urged Kentuckians to wear masks in public to protect themselves and those around them.

Beshear reported 1,941 new COVID-19 cases — the second-highest statewide daily total since the pandemic began — and 15 more virus-related deaths.

The state’s positivity rate reached 6.19% — the highest level since May 6, he said.


The recent surge has led to rising hospitalizations. On Friday, there were 974 patients hospitalized in Kentucky due to the virus, the governor said, noting the number of COVID-19 patients in intensive care rose to 241.

“Remember, the more cases, the more people in the hospital, the more people in the ICU and the more people who die,” Beshear said.

Total statewide COVID-19 cases surpassed 105,000, and the virus-related death toll reached at least 1,476. The latest deaths announced included people ranging in ages from 39 to 91.

More than half of Kentucky’s counties are listed in the most serious category for COVID-19 incidence rates. Schools in red-zone counties are urged to hold only virtual classes because of high virus transmission rates in their communities.

Beshear has recommended those counties take stricter steps to contain the virus’s spread.

People in those counties are urged to avoid hosting or attending gatherings of any size. Employers should allow employees to work from home when possible, and noncritical government offices should operate virtually. In-person shopping should be reduced, with people opting to order online for pickup. And people are urged to avoid nonessential activities outside their home.

“As a community, we’ve got to be following those red-zone reductions, because if we don’t it costs lives of our neighbors around us,” the governor said Friday. “It’s time for a coordinated community effort with everybody on board. … Now is the time for leadership, not for excuses.”

For most people, the coronavirus causes mild or moderate symptoms that clear up within weeks. But for others, especially older adults and people with existing health problems, the virus can cause severe symptoms and be fatal. The vast majority of people recover.

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Follow AP’s pandemic coverage at https://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak.

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Utah sent every phone in the state an emergency alert warning about rapidly rising Covid-19 cases

“State of Utah: COVID-19 is spreading rapidly. Record cases. Almost every county is a high transmission area. Hospitals are nearly overwhelmed,” read the alert. “By public health order, masks are required in high transmission areas. Social gatherings are limited to 10 or fewer.”

“Be careful!” it warned, alongside a link containing more information about the ever-worsening coronavirus surge.

The messages were sent beginning at 2 p.m. on Friday and remained active for 15 minutes.

Typically used for severe weather and AMBER Alerts, state and local officials are increasingly deploying these Wireless Emergency Alerts (WEA) to warn of Covid-19 spikes as well. Through late September, according to the Federal Emergency Management Agency (FEMA), local officials had sent the public than 400 such alerts.

Typically they are targeted to a city; New Yorkers have gotten a few. But Utah’s appears to be the first time a WEA was sent to an entire state. Officials explained in a news statement that the “dire situation” there drove them to try the stark approach.

“Despite the ongoing pandemic, there are a number of people who are not aware of the dire situation we find ourselves in,” state officials said. “As a result, the emergency alert was an effort to “make sure nearly everyone is aware of the serious nature of the pandemic.”

The alert came as the state hit a grim milestone, as Utah hits record highs in several Covid-19 measures, including number of new cases, 7-day case average, and test positivity percentage, the state data dashboard shows.

In a press conference on Thursday, Utah Gov. Gary Herbert called the state’s situation “one of the worst outbreaks in the country.”

The state reported a record 2,281 new Covid-19 cases Friday, according to state data. Previously, its record high was 1,989 cases on October 22. Furthermore, its 7-day case average now sits at a record of 1,621.7 cases, and its percentage of positive tests is at a record 18.17% as of Friday. All of these barometers are steadily climbing.

Meanwhile, 72.5% of Utah’s ICU beds are occupied, along with 54% of its traditional beds, according to the state dashboard, meaning that hospitals are quickly running out of space for new patients.

All this comes as the US hits a record of 9 million Covid-19 cases, a number that experts are warning will continue to surge.

CNN’s Jenn Selva contributed to this report.

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Covid cases in the U.S. are ‘extremely high and quite unacceptable’ ahead of the winter, Fauci says

  • The U.S. is reporting an “extremely high and quite unacceptable” daily number of new coronavirus cases ahead of the winter season, Dr. Anthony Fauci said in an interview that aired Friday.
  • The country is still facing its original wave of coronavirus infections that “just resurges up, comes down a little, and resurges up again,” he said.
  • Unlike previous outbreaks the nation has faced so far, the most recent surge appears to be spreading in nearly every corner of the country.



a man wearing a suit and tie: Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases.


© Provided by CNBC
Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases.

The U.S. is reporting an “extremely high and quite unacceptable” daily number of Covid-19 cases ahead of the winter season when people will be spending more time indoors and threatening to spread the virus even more, White House coronavirus advisor Dr. Anthony Fauci said.

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The U.S. reported a record-breaking 88,521 new Covid-19 cases on Thursday, continuing its upward climb on what’s now the pandemic’s third peak. Although some have referred to the latest surge in cases as a “third wave,” Fauci said the country is still grappling with its original wave of coronavirus infections.

As the outbreak that originally ripped through New York and the Northeast began to decline in the spring, America’s Sun Belt states began reporting swelling outbreaks and infections rose again over the summer, Fauci told SiriusXM’s “Doctor Radio Reports” in an interview that aired Friday. The country was never able to report below 20,000 daily Covid-19 cases on average like other parts of the globe, Fauci said.

“We never got out of the real wave. We kind of went up and down within a wave,” Fauci said. “When I hear people talk about second and third waves, it really is the original wave that just resurges up, comes down a little, and resurges up again.”



chart, histogram


© Provided by CNBC


Unlike previous outbreaks the nation has faced so far, the most recent surge appears to be spreading in nearly every corner of the country. Covid-19 cases were growing by 5% or more in 45 states over the week as of Thursday, according to a CNBC analysis of data compiled by Johns Hopkins University.

The positivity rate, or the percentage of tests that are positive, is increasing in over 30 states, and roughly 13 states are in the “red zone,” which means they have a positivity rate above 10%, Fauci said. A high positivity rate is a sign that “there’s more infection out there that we’re not turning over,” Dr. Scott Gottlieb, a former Food and Drug Administration commissioner, told CNBC on Friday.

“That’s something that you wish you did not have as you enter into the colder months because out of necessity, a lot more things are going to have to be done indoors because of the weather,” Fauci said.

On Friday, the U.S. surpassed 9 million total Covid-19 cases reported since the beginning of the pandemic, adding an additional 1 million cases since mid-October alone, according to

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Bethel, Now A Coronavirus Orange Zone, Treads Carefully

BETHEL, CT — The state Department of Public Health has named Bethel a coronavirus orange zone community.

The color code means that 10-14 cases of COVID-19 per 100,000 population per day, over a two-week average, have been reported in the town. The town’s current case rate is 13.8.

First Selectman Matt Knickerbocker said that health officials had identified the main sources of the infection spread in Bethel as sporting events, within families, and gatherings where people have become less diligent about distancing and mask-wearing.

On Thursday, Gov. Ned Lamont announced that towns in the orange zone can opt to revert to Phase 2 reopening restrictions in an effort to mitigate the spread of the virus. Red zone towns (15-plus cases per 100,000) had that option since the color coding program’s inception.

More than two-thirds of the towns in the state are now classified as either red or orange, and the state hit its highest COVID-19 positivity rate since the beginning of June this week.

“If the rate of infections continues to rise, the result may be that some restrictions that had recently been relaxed will need to be put back in place,” Knickerbocker posted to the town website.

Bethel has had a total of 392 confirmed cases of the coronavirus since the pandemic began. There was a spike of 16 cases reported Wednesday, and 26 cases over the past seven days.

The town is urging residents to follow these guidelines:

  • Limit social gatherings, practice distancing and always wear a mask when around other people, even if they are members of your family if they have been places where they could have been exposed.

This article originally appeared on the Bethel Patch

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New Technologies Aim to Improve Ovarian Cancer Detection

Encouraging trends abound in the management of ovarian cancer. As rates of ovarian disease continue to decline, there has also been a notable increase in tools for detecting it earlier in its course.



Dr Rebecca Stone

To better understand these developments, Medscape recently reached out to Rebecca Stone, MD, an ovarian cancer expert and associate professor of gynecologic oncology at Johns Hopkins University School of Medicine, in Baltimore, Maryland. This interview has been edited for length and clarity.

Medscape: There has been a decline in the rates of ovarian cancer in recent years. What are the possible causes of this?

Dr Stone: The number of new cases in the United States has actually been declining over the past two decades. This is thought to be attributable to the increased prescribing of oral contraceptive pills in the late 1990s and the uptake of preventive measures, such as risk-reducing gynecologic surgery for women with genetic predisposition to ovarian cancer, as well as opportunistic salpingectomy in the general population. Opportunistic salpingectomy was introduced about 10 years ago. It is a surgical means for primary prevention of tubo-ovarian cancer by removing both fallopian tubes at the time of elective surgery for women who have completed childbearing or in lieu of “tying the tubes” for women who desire permanent surgical sterility.

What can you tell us about a recent study suggesting that high-grade serous epithelial ovarian cancer may be detected earlier in the course of the disease by testing for TP53 clonal variants in DNA from Papanicolaou (Pap) tests performed during cervical cancer screening?

The idea here is that early mutational events that ultimately result in the development of epithelial ovarian cancer can be detected by performing gene sequencing on genetic material collected at the time of routine Pap smear screening done for cervical cancer. Pap tests are known to contain cells and genetic material shed from the fallopian tubes, where the precancerous lesions thought to give rise to epithelial ovarian cancer, predominantly serous epithelial ovarian cancers, start.

p53 gene mutations are thought to occur early in the evolution of ovarian cancer. There are data indicating that these mutations actually occur in cells lining the fallopian tubes. Polymerase chain reaction–based DNA/gene sequencing performed on cervical fluid collected by Pap smears could detect these p53-mutated cells shed from the fallopian tubes.

A strength of this study is that it included healthy controls. None of their Pap smears screened positive for the p53 mutations, unlike the Pap smears of women predating their diagnosis of ovarian cancer.

Limitations of the study include the fact that it had a small sample size. Findings will need to be confirmed in a larger patient population.

Also, the study only looked for p53 gene mutations. Ovarian cancers, like other cancers, are largely thought to occur when there is a buildup of mutations in critical genes that result in uncontrolled cell growth and division. These genetic changes/mutations are acquired during a person’s lifetime. Thus, there are likely early genetic changes/mutations that occur

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Poland’s Constitutional Court Has Effectively Banned Abortion, But We Will Not Stop Fighting For Our Fundamental Rights

Polish Abortion Protests Continue - Day Seven
Polish Abortion Protests Continue – Day Seven

A Pro-Choice activist holds a smoke flare during a protest in Krakow’s Market Square. Women’s rights activists and their supporters staged their seventh day of protests in Krakow and all over Poland, opposing pandemic restraint, to express their anger at the ruling of Polish Supreme Court, which tightened the already strict abortion laws. Credit – Artur Widak—NurPhoto via Getty Images

Poland’s anti-abortion laws have always been among the most restrictive in Europe. Until this week the procedure was only permitted when the pregnancy posed a threat to the woman’s life; if there was a fatal fetal abnormality or in cases rape or incest.

However on Oct. 22 the country’s constitutional court ruled that a fatal fetal abnormality was not justification for terminating a pregnancy and violates the constitution. For the over 10 million women of reproductive age in Poland, this ruling effectively puts in place a complete ban on abortion.

According to official data, just over 1,100 legal abortions are performed annually in Poland–98% of which are in cases of fatal fetal abnormalities. The procedure prevented further pain and suffering for both the woman and the fetus.

While the court’s ruling has not yet come into force, many Polish hospitals have already stopped carrying out terminations. Women with scheduled procedures are having their appointments canceled. Women with a diagnosis of fatal fetal abnormality are not being provided with information and don’t know where to find help, left alone with their tragic news. At the Federation for Women and Family Planning we are getting calls from men asking for help for their wives or partners. The women are often so devastated they are unable to speak.

We try to support them as much as possible and there are some doctors who support them too. After our campaigning some hospitals have again begun to perform abortions but it is only a drop in the ocean of what is needed.

The ruling is an outrageous violation of women’s human rights. Women are being treated like living incubators. We do not have any rights, not even the fundamental human rights guaranteed by the Polish Constitution: the right to health, the right to private life, the right to equal treatment.

Not one word was said in defense of women during the debate. The fetus, called the “conceived child,” has the rights of an already existing life. During the Tribunal’s debate the most cruel statement was that we cannot “kill a conceived child” just because its birth would “reduce the comfort of a woman’s life.”

Forcing a woman to give birth to a child with severe, irreversible conditions is cruelty. Whether or not to keep the pregnancy should be the decision of the woman, or the woman and her partner. They will be the only ones to bear the traumatic consequences of this decision.

The politicians of the ruling party in Poland allowed the politicized Tribunal to issue what is a cruel and shameful decision. They hoped

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