Epic Battle Begins Over Scalia's Vacant Supreme Court Seat
Though first stopping to offer family and friends condolences after news broke on Saturday that U.S. Supreme Court Justice Antonin Scalia had unexpectedly passed away, the political world in the U.S. wasted no time in drawing the battle lines over the key who and when questions regarding the successor to the empty seat.
Antonin Scalia (1936-2016) died unexpectedly on Saturday turning the political world upside down.
Within hours of the news of Scalia's death, high-profile Republicans—including Senate Majority Leader Mitch McConnell and leading contenders for the GOP presidential nomination—all issued statements arguing that it should be the next president, not President Obama, who should appoint the next Justice.
"The American people should have a voice in the selection of their next Supreme Court Justice," said Sen. McConnell in a statement on Saturday. "Therefore, this vacancy should not be filled until we have a new President."
As the Huffington Post reports, it was just "mere minutes after the Scalia news broke" when "Conn Carroll, a spokesman for Sen. Mike Lee (R-Utah), who sits on the Judiciary Committee—through which any Supreme Court nominee must go—placed the chances of a replacement at nil."
According to a tweet sent by Carroll: "What is less than zero? The chances of Obama successfully appointing a Supreme Court Justice to replace Scalia?"
When he heard to the news, presidential canidate Sen. Ted Cruz tweeted: "Justice Scalia was an American hero. We owe it to him, & the Nation, for the Senate to ensure that the next President names his replacement."
Leading Senate Democrats, of course, also weighed in. Sen. Patrick Leahy (D-Vt.), ranking member of the judiciary committee, rejected Republican arguments by stating, "I hope that no one will use this sad news to suggest that the President or the Senate should not perform its constitutional duty."
During Saturday night's Republican presidential debate in South Carolina, hosted by ABC News, Scalia's death and what it means for the future makeup of the court dominated the early rounds. Most agreed with the idea that Republicans in the Senate should do everything possible to make sure Obama not be able to push through his chosen nominee.
Obama himself, however, also appeared live from the White House on Saturday. He expressed his condolences to Scalia's family but also let it be known that he had no intention of abdicating his responsibility to make the appointment, saying he would make one "in due time" and that he expects Congress to give his ultimate nominee a "fair hearing and a timely vote."
The responsibility to make such appointments, he said, was "something I take seriously, as should everyone. They’re bigger than any one party. They’re about our democracy."
Given the contentious and high-stakes implications of appointing a Supreme Court Justice during his last year in office—especially against the backdrop of a highly energized and polarized electorate focused more on the issue than usual—legal experts, historians of the court, and political observers argue that Obama's decision to appoint an appropriate successor, and his ability to get that nominee through the Senate, will be both difficult and enormously consequential.
As William Blum, political historian and author, wrote in this analysis on Saturday evening:
Politically, Scalia’s passing will unleash a pitched battle on two fronts: first, in the fight to name his successor, and second, as an issue in the upcoming presidential elections.
In the coming weeks and months, we can expect to hear a rising and increasingly hysterical chorus of Republicans demanding that President Obama refrain from nominating Scalia’s successor. Indeed, if initial press reports are any indication, the trench warfare has already begun.
But with roughly 11 months remaining in his term, Obama undoubtedly will move forward. Anyone he names will surely be more liberal than Scalia, and anyone he names will tip the balance of the court.
Republicans are basically arguing that the existence of the presidential campaign season should strip Obama of his right to appoint a new Justice, calling instead to make the election a kindof referendum on the empty seat. But according to Amy Howe, a legal scholar and write for the SCOTUS, there is no convincingly sound or historical precedent for making such claims.
"The historical record does not reveal any instances since at least 1900 of the president failing to nominate and/or the Senate failing to confirm a nominee in a presidential election year because of the impending election," writes Howe. Since at least 1900, she continues, "there were several nominations and confirmations of Justices during presidential election years."
Howe later explains that even though there were two times in the twentieth century when "presidents were not able to nominate and confirm a successor during an election year" neither of these examples reflect "a practice of leaving a seat open on the Supreme Court until after the election."
Meanwhile, New Yorker staff writer John Cassidy said he would leave it to constitutional experts to parse some of the history and judicial arguments, but said that in "political terms" there is no way that operatives in both parties are not scheming to take advantage of the situation:
It is well known, and accepted on both sides, that the Democrats’ hopes of holding on to the White House hinge on getting a high voter turnout on November 8th. If you were a Democratic strategist trying to maximize turnout, what would you most like to see? One possibility, surely, is the prospect of the election being transformed into a referendum on the President versus the do-nothing Republican Congress. [...]
If the Republicans block the nomination without properly considering it, which also seems likely, a huge political row will ensue, enveloping the Presidential race. (In fact, it has already done that, as the Republican debate proved.) Come summer and fall, the Democratic candidate, be it Hillary Clinton or Bernie Sanders, will be able to go the country and appeal for support in preventing the Republicans from humiliating President Obama and making a mockery of democracy.
In remarks on Saturday night given at a fundraiser for the Colorado Democratic Party in Denver, both Democratic presidential candidates rejected the idea of Republican obstructionism.
"It appears that some of my Republican colleagues in the Senate have a very interesting view of our Constitution of the United States," said Bernie Sanders. "Apparently, they believe that the Constitution does not allow a Democratic president to bring forth a nominee to replace Justice Scalia. I strongly disagree with that."
Sanders continued, "I very much hope that President Obama will bring forth a strong nominee and that we can get that nominee confirmed as soon as possible. The Supreme Court of the United States has nine members, not eight. We need that ninth member."
Hillary Clinton offered similar sentiments. "It is outrageous that Republicans in the Senate and on the campaign trail have already pledged to block any replacement that President Obama nominates," Clinton declared. "Barack Obama is the president of the United States until Jan. 20, 2017. That is a fact, my friends, whether Republicans like it or not."
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By Sherry H-Y. Chou, Aarti Sarwal and Neha S. Dangayach
The patient in the case report (let's call him Tom) was 54 and in good health. For two days in May, he felt unwell and was too weak to get out of bed. When his family finally brought him to the hospital, doctors found that he had a fever and signs of a severe infection, or sepsis. He tested positive for SARS-CoV-2, the virus that causes COVID-19 infection. In addition to symptoms of COVID-19, he was also too weak to move his legs.
When a neurologist examined him, Tom was diagnosed with Guillain-Barre Syndrome, an autoimmune disease that causes abnormal sensation and weakness due to delays in sending signals through the nerves. Usually reversible, in severe cases it can cause prolonged paralysis involving breathing muscles, require ventilator support and sometimes leave permanent neurological deficits. Early recognition by expert neurologists is key to proper treatment.
We are neurologists specializing in intensive care and leading studies related to neurological complications from COVID-19. Given the occurrence of Guillain-Barre Syndrome in prior pandemics with other corona viruses like SARS and MERS, we are investigating a possible link between Guillain-Barre Syndrome and COVID-19 and tracking published reports to see if there is any link between Guillain-Barre Syndrome and COVID-19.
Some patients may not seek timely medical care for neurological symptoms like prolonged headache, vision loss and new muscle weakness due to fear of getting exposed to virus in the emergency setting. People need to know that medical facilities have taken full precautions to protect patients. Seeking timely medical evaluation for neurological symptoms can help treat many of these diseases.
What Is Guillain-Barre Syndrome?
Guillain-Barre syndrome occurs when the body's own immune system attacks and injures the nerves outside of the spinal cord or brain – the peripheral nervous system. Most commonly, the injury involves the protective sheath, or myelin, that wraps nerves and is essential to nerve function.
Without the myelin sheath, signals that go through a nerve are slowed or lost, which causes the nerve to malfunction.
To diagnose Guillain-Barre Syndrome, neurologists perform a detailed neurological exam. Due to the nerve injury, patients often may have loss of reflexes on examination. Doctors often need to perform a lumbar puncture, otherwise known as spinal tap, to sample spinal fluid and look for signs of inflammation and abnormal antibodies.
Studies have shown that giving patients an infusion of antibodies derived from donated blood or plasma exchange – a process that cleans patients' blood of harmful antibodies - can speed up recovery. A very small subset of patients may need these therapies long-term.
The majority of Guillain-Barre Syndrome patients improve within a few weeks and eventually can make a full recovery. However, some patients with Guillain-Barre Syndrome have lingering symptoms including weakness and abnormal sensations in arms and/or legs; rarely patients may be bedridden or disabled long-term.
Guillain-Barre Syndrome and Pandemics
As the COVID-19 pandemic sweeps across the globe, many neurologic specialists have been on the lookout for potentially serious nervous system complications such as Guillain-Barre Syndrome.
Though Guillain-Barre Syndrome is rare, it is well known to emerge following bacterial infections, such as Campylobacter jejuni, a common cause of food poisoning, and a multitude of viral infections including the flu virus, Zika virus and other coronaviruses.
Studies showed an increase in Guillain-Barre Syndrome cases following the 2009 H1N1 flu pandemic, suggesting a possible connection. The presumed cause for this link is that the body's own immune response to fight the infection turns on itself and attacks the peripheral nerves. This is called an "autoimmune" condition. When a pandemic affects as many people as our current COVID-19 crisis, even a rare complication can become a significant public health problem. That is especially true for one that causes neurological dysfunction where the recovery takes a long time and may be incomplete.
Though there is clear clinical suspicion that COVID-19 can lead to Guillain-Barre Syndrome, many important questions remain. What are the chances that someone gets Guillain-Barre Syndrome during or following a COVID-19 infection? Does Guillain-Barre Syndrome happen more often in those who have been infected with COVID-19 compared to other types of infections, such as the flu?
The only way to get answers is through a prospective study where doctors perform systematic surveillance and collect data on a large group of patients. There are ongoing large research consortia hard at work to figure out answers to these questions.
Understanding the Association Between COVID-19 and Guillain-Barre Syndrome
While large research studies are underway, overall it appears that Guillain-Barre Syndrome is a rare but serious phenomenon possibly linked to COVID-19. Given that more than 10.7 million cases have been reported for COVID-19, there have been 10 reported cases of COVID-19 patients with Guillain-Barre Syndrome so far – only two reported cases in the U.S., five in Italy, two cases in Iran and one from Wuhan, China.
It is certainly possible that there are other cases that have not been reported. The Global Consortium Study of Neurological Dysfunctions in COVID-19 is actively underway to find out how often neurological problems like Guillain-Barre Syndrome is seen in hospitalized COVID-19 patients. Also, just because Guillain-Barre Syndrome occurs in a patient diagnosed with COVID-19, that does not imply that it was caused by the virus; this still may be a coincident occurrence. More research is needed to understand how the two events are related.
Due to the pandemic and infection-containment considerations, diagnostic tests, such as a nerve conduction study that used to be routine for patients with suspected Guillain-Barre Syndrome, are more difficult to do. In both U.S. cases, the initial diagnosis and treatment were all based on clinical examination by a neurological experts rather than any tests. Both patients survived but with significant residual weakness at the time these case reports came out, but that is not uncommon for Guillain-Barre Syndrome patients. The road to recovery may sometimes be long, but many patients can make a full recovery with time.
Though the reported cases of Guillain-Barre Syndrome so far all have severe symptoms, this is not uncommon in a pandemic situation where the less sick patients may stay home and not present for medical care for fear of being exposed to the virus. This, plus the limited COVID-19 testing capability across the U.S., may skew our current detection of Guillain-Barre Syndrome cases toward the sicker patients who have to go to a hospital. In general, the majority of Guillain-Barre Syndrome patients do recover, given enough time. We do not yet know whether this is true for COVID-19-related cases at this stage of the pandemic. We and colleagues around the world are working around the clock to find answers to these critical questions.
Sherry H-Y. Chou is an Associate Professor of Critical Care Medicine, Neurology, and Neurosurgery, University of Pittsburgh.
Aarti Sarwal is an Associate Professor, Neurology, Wake Forest University.
Neha S. Dangayach is an Assistant Professor of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai.
Disclosure statement: Sherry H-Y. Chou receives funding from The University of Pittsburgh Clinical Translational Science Institute (CTSI), the National Institute of Health, and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. Sherry H-Y. Chou is a member of Board of Directors for the Neurocritical Care Society. Neha S. Dangayach receives funding from the Bee Foundation, the Friedman Brain Institute, the Neurocritical Care Society, InCHIP-UConn Center for mHealth and Social Media Seed Grant. She is faculty for emcrit.org and for AiSinai. Aarti Sarwal does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Reposted with permission from The Conversation.
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Unity Task Forces formed by presumptive Democratic presidential nominee Joe Biden and Sen. Bernie Sanders unveiled sweeping party platform recommendations Wednesday that—while falling short of progressive ambitions in a number of areas, from climate to healthcare—were applauded as important steps toward a bold and just policy agenda that matches the severity of the moment.
"We've moved the needle a lot, especially on environmental justice and upping Biden's ambition," said Sunrise Movement co-founder and executive director Varshini Prakash, a member of the Biden-Sanders Climate Task Force. "But there's still more work to do to push Democrats to act at the scale of the climate crisis."
The climate panel—co-chaired by Rep. Alexandria Ocasio-Cortez (D-N.Y.) and former Secretary of State John Kerry—recommended that the Democratic Party commit to "eliminating carbon pollution from power plants by 2035," massively expanding investments in clean energy sources, and "achieving net-zero greenhouse gas emissions for all new buildings by 2030."
In a series of tweets Wednesday night, Ocasio-Cortez—the lead sponsor of the House Green New Deal resolution—noted that the Climate Task Force "shaved 15 years off Biden's previous target for 100% clean energy."
"Of course, like in any collaborative effort, there are areas of negotiation and compromise," said the New York Democrat. "But I do believe that the Climate Task Force effort meaningfully and substantively improved Biden's positions."
Today the 6 Biden-Sanders Unity Task Forces are unveiling final language. The Climate Task Force accomplished a gr… https://t.co/gz3broq2qe— Alexandria Ocasio-Cortez (@Alexandria Ocasio-Cortez)1594240617.0
The 110 pages of policy recommendations from the six eight-person Unity Task Forces on education, the economy, criminal justice, immigration, climate change, and healthcare are aimed at shaping negotiations over the 2020 Democratic platform at the party's convention next month.
Sanders said that while the "end result isn't what I or my supporters would've written alone, the task forces have created a good policy blueprint that will move this country in a much-needed progressive direction and substantially improve the lives of working families throughout our country."
"I look forward to working with Vice President Biden to help him win this campaign," the Vermont senator added, "and to move this country forward toward economic, racial, social, and environmental justice."
Biden, for his part, applauded the task forces "for helping build a bold, transformative platform for our party and for our country."
"I am deeply grateful to Bernie Sanders for working with us to unite our party and deliver real, lasting change for generations to come," said the former vice president.
On the life-or-death matter of reforming America's dysfunctional private health insurance system—a subject on which Sanders and Biden clashed repeatedly throughout the Democratic primary process—the Unity Task Force affirmed healthcare as "a right" but did not embrace Medicare for All, the signature policy plank of the Vermont senator's presidential bid.
Instead, the panel recommended building on the Affordable Care Act by establishing a public option, investing in community health centers, and lowering prescription drug costs by allowing the federal government to negotiate prices. The task force also endorsed making all Covid-19 testing, treatments, and potential vaccines free and expanding Medicaid for the duration of the pandemic.
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Dr. Abdul El-Sayed, a former Michigan gubernatorial candidate and Sanders-appointed member of the Healthcare Task Force, said that despite major disagreements, the panel "came to recommendations that will yield one of the most progressive Democratic campaign platforms in history—though we have further yet to go."
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Observers and advocacy groups also applauded the Unity Task Forces for recommending the creation of a postal banking system, endorsing a ban on for-profit charter schools, ending the use of private prisons, and imposing a 100-day moratorium on deportations "while conducting a full-scale study on current practices to develop recommendations for transforming enforcement policies and practices at ICE and CBP."
Marisa Franco, director of immigrant rights group Mijente, said in a statement that "going into these task force negotiations, we knew we were going to have to push Biden past his comfort zone, both to reconcile with past offenses and to carve a new path forward."
"That is exactly what we did, unapologetically," said Franco, a member of the Immigration Task Force. "For years, Mijente, along with the broader immigrant rights movement, has fought to reshape the narrative around immigration towards racial justice and to focus these very demands. We expect Biden and the Democratic Party to implement them in their entirety."
"There is no going back," Franco added. "Not an inch, not a step. We must only move forward from here."
Reposted with permission from Common Dreams.
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