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The hidden players putting independent pharmacies out of business
Liz Tung
How pharmacy benefit managers impacted one independent pharmacist. (Fand Std. / Big Stock Photo)
This story is from The Pulse, a weekly health and science podcast.
Subscribe on Apple Podcasts, Spotify or wherever you get your podcasts.
Editor's note: Many independent pharmacies say their business model is threatened by pharmacy benefit managers. To see the impact on one business, reporter Liz Tung interviewed a pharmacist over the course of many months to better understand the issues facing him. In the end, he said he wanted to share what happened to him, but only under the condition of anonymity — he was afraid of backlash from PBMs. We have verified and fact-checked his story, and decided to tell it without using his real name. We're calling him Bill.
The story of how Bill opened his own pharmacy is about as small-town wholesome as it gets. He first got interested while working at one in high school. And from the beginning, it just felt like a good fit.
"I felt like I wanted to go into health care, and wanted to be able to help patients," he said. "But I didn't want to go through a medical school or be a nurse, and I thought that pharmacy would be a good choice for me. The chemistry interested me, and of course the patient interaction was always a good thing as well."
So Bill went to pharmacy school, and spent the next decade or so working for someone else. Finally, around 15 years ago, he worked up the nerve to open his own business.
"It's something I've always wanted to do — I just never had the gumption," Bill said. "It's probably the best decision I made."
It seemed like a good move. Shortly after opening his own pharmacy, the shop he'd worked at previously shut down, and Bill inherited many of his old customers. "The money wasn't great, but it was decent."
Like a lot of community pharmacies, Bill's business offered personal service — they knew their patients by name, would call them on their birthdays, and even deliver prescriptions right to their doors.
Trouble begins — enter PBMs
It's hard to pinpoint when exactly things started going south. Bill estimates it was around 2013 when business earnings began to fall.
"There was a drastic decline," Bill said. After a slight recovery, the pharmacy's income continued into steady decline.
Bill said the majority of the pharmacy's earnings come from reimbursements — the money it gets for dispensing prescriptions.
Reimbursements are a lot of pharmacies' bread and butter, which has become a problem in recent years because pharmacy benefit managers, or PBMs, play a major role in how they work.
PBMs arose in the late 1960s to help insurance companies process prescription claims. Before that, patients had to mail their own prescription claims to their insurance companies and wait to get reimbursed.
With PBMs, the process was streamlined and digitized, easing the burden on insurance companies, and becoming an important link between pharmacies and health plans.
Over the coming years, PBMs' responsibilities expanded to include reimbursements — the money health plans pay pharmacies to reimburse them for the cost of the medications they dispense. Insurance companies empowered PBMs not only to pay pharmacies, but to decide how much money they should receive.
The problem, pharmacies say, is that over the years, reimbursements have been shrinking, to the point that some aren't even receiving enough to cover the original cost of the drugs they buy.
What PBMs bring to the table
Pharmacy benefit managers can do this for a few reasons. For one thing, there's a huge amount of secrecy that surrounds how they operate. The details of the contracts they write, of the formulas they use to calculate reimbursements, are often insanely complicated — or hidden, or both. And that leads to situations such as pharmacies actually losing money on prescriptions they dispense.
Another reason PBMs can get away with lowering reimbursements is that pharmacies need them. Three PBMs control around 75% of the market, so if pharmacies want access to all those customers, they have to accept the PBMs' terms.
PBMs, however, say they're justified by their role in the health care world — lowing costs.
"There's sometimes a lack of understanding as to just how much value and savings PBMs provide in our health care system," said Greg Lopes, spokesman for the Pharmaceutical Care Management Association, the PBMs' trade association.
"Over the next 10 years, PBMs are going to save health plan sponsors and consumers more than $1 trillion on prescription drug costs. PBMs are hired by employers, unions, and government programs to negotiate with drug manufacturers on their behalf because of their expertise in lowering drug costs. There's no requirement to hire a PBM, but health care plan sponsors and employers choose to work with PBMs because we lower drug costs and increase quality of care."
Pharmacists dispute that characterization, among them Mel Brodsky, executive director of the Philadelphia Association of Retail Druggists, a group that represents about 200 stores in Southeastern Pennsylvania.
"The only thing that I've seen them be able to do is increase health care costs [and] put independent pharmacies out of business," Brodsky said. "And [they] have become so powerful now that they don't listen to politicians or regulations or laws that they don't like. And they find ways to take them to court and put injunctions on laws and on regulations that they don't like. They have become so powerful, it's just ridiculous."
Falling reimbursements and growing fees
Bill noticed the decrease in reimbursements starting around 2013. But it wasn't until fall of 2019 that they fell off a cliff.
"They started deducting about $4,500 a week from my current checks that I was getting," Bill said.
Bill's weekly reimbursement checks usually ranged from $5,000 to $15,000, which meant the deductions were eating up anywhere from 30% to 90% of his income.
So Bill checked with his pharmacy services administrative organization — basically, a middleman group that represents independent pharmacies' interests in contract negotiations with PBMs. Bill found out that the deductions were because of a debt — a debt no one had bothered to tell him about, totaling $79,000.
"I was extremely, extremely shocked," Bill said.
This nightmare scenario is something that's been happening to more and more pharmacies over the past few years. It's part of a widely reviled practice called "clawbacks" — fees, often totally unpredictable, that PBMs charge pharmacies to "claw back" some of the money they've already paid them in reimbursements.
Stories about the people and places at the heart of health and science.
For instance, imagine if you started a job under the agreement that you'd get paid $4,000 a month. But after six months, you get a notification that your account is overdrawn. When you check your account history, you see that a couple months ago, your job decreased your salary from $4,000 a month to $3,000 a month without telling you. When you confront your boss, he tells you, "Yeah, we decided that $4,000 was just too much. So we changed your salary to $3,000 a month … And by the way, that's retroactive, which means you owe us $6,000 — $1,000 for every month we 'overpaid' you. So we'll just deduct that from your current paychecks."
Sound unfair? That's what a lot of pharmacists think too. How can PBMs be allowed to take back payments they've already made, for services already rendered?
In part, it relates, ironically enough, to what was supposed to be an incentive program. The Centers for Medicare and Medicaid came up with quality measures to make sure pharmacists were taking good care of their Medicare patients.
"Adherence to your drugs, making sure that if you're diabetic, you're checking your sugar levels — all these things that their Medicare would like you to do," said health care consultant Susan Lang, who's spent years working with pharmacies and PBMs. "If you do those things, then we will pay you extra because you're a high-performing pharmacy."
In other words, pharmacies were supposed to get financial rewards for good performance.
But instead, experts and pharmacists said, PBMs have largely used these standards against pharmacies, punishing them financially for "underperforming" without ever fully explaining how they're making those judgments.
"That's not really pay-for-performance," Lang said. "That's just price-gouging."
For the pharmacists, it's like playing a high-stakes game without knowing the rules — or worse, a game in which there are no rules.
"They have no line of sight on the calculations of how the PBM calculated what they get back," Lang said. "So it's completely nontransparent. They're at the mercy of the PBM. And they have to just trust that the PBM is doing the right thing for them. Which, why would you?"
What the PBMs have to say
PBMs, however, say the rules of their incentive programs are totally transparent — even those related to the most reviled clawbacks of all, called direct and indirect remuneration fees, or DIR for short.
"Pharmacy DIR is a performance-based system with rewards and penalties," said Lopes, from the Pharmaceutical Care Management Association, which represents the 11 largest PBMs in the country. "And the penalties, yes, are paid at retroactively, but they are transparent. They are well known to the independent pharmacy. That information is available to them in real time."
So does that mean that if independent pharmacists just looked closely at their contracts, then they'd be able to predict how much they need to pay in clawbacks?
"That is correct," Lopes said. "We think if independent — all pharmacies, I should say, retail and independent — looked at their contracts closely and worked with their PSAO, they would understand where these incentives lie and where they are at with meeting them."
The pharmacy services administrative organizations, the PSAOs, — the groups that represent independent pharmacies at the table with PBMs — and their own lack of transparency are the real problem, Lopes said.
Bill, however, doesn't agree. While he admits that PSAOs are partially responsible, he puts the majority of the blame on PBMs.
Bill also disputes Lopes' characterization of DIR fees as an "incentive program."
"Even if you're perfect, you did everything you possibly could, you are 100%," Bill said, "they still take money back."
Susan Lang said that these clawback fees, combined with shrinking reimbursements, are putting more and more pharmacies in an untenable position.
"I talked to a pharmacist a few months ago who went out of business, and he told me initially his DIR fees were running about $20,000 a month, say four years ago," Lang said. "And then they were running $50,000 a month and then $60,000 a month. And finally, they were not sustainable, and, he said, `I had to close shop.'"
The long road to closing
That was Bill's fear when he was first interviewed last spring. He'd just received back-to-back clawback fees totaling nearly $200,000, and had been struggling to make ends meet.
"Obviously, I've cut my salary," Bill said. "I've had to cut staff, And that doesn't feel great either, on a personal level."
Five months later, Bill said things had gone from bad to worse. Business was down because of the pandemic, and he'd taken out a loan to stay afloat.
He was stressed and exhausted, frustrated and angry.
"Tremendous amount of stress," Bill said. "Sleep sometimes is an issue. I think it's more of your mind racing, and you're trying to go to sleep, but you'll get up and then start thinking again, and then can't go back to sleep."
Bill couldn't stop thinking about the worst-case scenario — losing his business. What would he do if that happened?
"Pray that I could find a job," Bill said with a little laugh, citing his family with three kids. "I just turned 50, so I still have at least 15 to 20 years to work. So I would definitely have to figure out something."
But it wasn't just the financial pressures stressing Bill out — it was the fact that he felt so helpless.
"You're sitting there, and you're powerless. No one wants to help you," Bill said. "Your wholesaler can't give you a better price on your cost of goods. The PSAO who you thought was helping you are signing bad contracts on your behalf. And the PBM, you know, they don't care. They're just making money hand over fist. So here we are all by ourselves on this little island."
Bill finally decided to sell his pharmacy in the fall
"It was one of the toughest decisions I had to make," he said. "I went back and forth multiple, multiple times — multiple discussions with my wife, with my business partners. And we could not see a light at the end of the tunnel."
It was the end of an era for Bill, who said some of his customers he's been helping for nearly 30 years.
"I watched kids grow up, I've watched grandchildren be born," Bill said. "So yeah, the patients and my staff is what I'm going to miss the most."
For now, Bill is dusting off his resume, trying to make contacts, and figuring out what he's going to do next. As for whether he'll ever own a pharmacy again?
"The only possible way I think I would ever do that again at this point is if I knew for sure that PBMs were gone no longer in the equation," Bill said. "Or had some serious oversight and nowhere near the power that they have over independent pharmacy."
Brought to you by The Pulse
Go on an adventure into unexpected corners of the health and science world each week with award-winning host Maiken Scott.
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About Liz Tung
@lizxtung ltung@whyy.org


- WCCW Parade of Champions (June 24, '72) = Mascaras won over the Alaskan.
- Tokyo Sports All-Star Dream Card (August 26, '78) = Mascaras, Jumbo Tsuruta, & Tatsumi Fujinami beat Masa Saito, Akihisa Takachiho, & Tiger Toguchi.
- AJPW Real World Tag League '79 (November/December) = Mascaras & Dos Caras competed in the league, which was won by Terry & Dory Funk Jr.
- AJPW Sumo Hall (December 13, '79) = Mascaras & Dos Caras fell to Giant Baba & Jumbo Tsuruta.
- AJPW Sumo Hall (October 9, '81) = Mascaras defeated Mighty Inoue.
- Mid-South Superdome Extravaganza (November 25, '82) = Mascaras & Chavo Guerrero Sr beat Tully Blanchard & Gino Hernandez.
- AJPW Heavyweight Battle Royal '83 (January 2) = Mascaras won the Battle Royal.
- Mid-South Superdome Extravaganza (July 16, '83) = Mascaras & Tim Horner won over Boris Zuhkov & Mr. Olympia.
- WWC 10th Anniversary Show (September 17, '83) = Mascaras & Dos Caras defeated the Infernos.
- AJPW Real World Tag League '83 (November/December) = Mascaras & Dos Caras competed in the league, which was won by Bruiser Brody & Stan Hansen.
- AJPW Sumo Hall (December 12, '83) = Mascaras & Dos Caras beat Ron Fuller & Barry Windham.
- AWA SuperClash (September 28, '85) = Mascaras retained the IWA Heavyweight Title, taking down Buddy Roberts.
- AJPW 13th Anniversary Show (October 21, '85) = Mascaras & Art Cruz fell to Riki Choshu & Yoshiaki Yatsu.
- AJPW Budokan Hall (June 12, '86) = Mascaras, Harley Race, & Shunji Takano defeated Tiger Mask, Mighty Inoue, & Hata.
- WCCW 4th Von Erich Memorial Parade of Champions (May 3, '87) = Mascaras pinned Al Madril.
- WWF Paul Boesch Retirement Show (August 28, '87) = Mascaras & Tito Santana won, via DQ, over Demolition.
- WCW Clash of the Champions X (February 6, '90) = Mascaras pinned Cactus Jack.
- UWA 16th Anniversary Show (January 27, '91) = Mascaras, Dos Caras, & El Canek took down Kokina, Fatu, & Samu.
- WAR Sumo Hall (December 15, '93) = Mascaras beat Gran Markus Jr.
- WAR 3rd Anniversary Show (July 7, '95) = Mascaras, Bob Backlund, & Jimmy Snuka defeated Hector Garza & the Eliminators.
- Michinoku Pro 3rd Anniversary Show (October 10, '96) = Mascaras Tiger Mask, & the Great Sasuke were beaten by Dos Caras, Kuniaki Kobayashi, & the Dynamite Kid.
- WWF Royal Rumble '97 (January 21) = Mascaras competed in the Royal Rumble, which was won by Steve Austin.
- WWC 25th Anniversary Show (August 1, '98) = Mascaras fought to a Double Disqualification with the WWO Intercontinental Champion, Pierroth Jr.
- AJPW Tokyo Dome (January 28, '01) = Mascaras & El Hijo del Santo beat Arkangel de la Muerte & Blue Panther.
- AJPW Prefectural Gym (July 17, '02) = Mascaras & Dos Caras won over Yoji Anjoh & Abdullah the Butcher.
- AJPW Budokan Hall (July 20, '02) = Mascaras, Dos Caras, & Keiji Mutoh beat Gran Hamada, Gran Naniwa, & Abdullah the Butcher.
- Hustle 1 (January 4, '04) = Mascaras, Dos Caras Sr, & Sicodelico Jr defeated Steve Corino, Tom Howard, & Dusty Rhodes.
- Wrestle-1 Sumo Hall (August 4, '05) = Mascaras & Terry Funk took down Tomoaki Honma & Katsuhiko Nakajima.
- Toryumon Mexico Dragon Mania II (May 13, '07) = Mascaras, Marco Corleone, Kazuchida Okada, & Ultimo Dragon defeated Ultimo Guerrero, Minoru Suzuki, Yoshihiro Takayama, & Suwa.
- Todo x el Todo (December 8, '07) = Mascaras & El Fantasma beat Dos Caras Sr & Tinieblas Sr.
- WWE WrestleMania XXVIII (April 1, '12) = Mascaras was inducted into the WWE Hall of Fame.


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Digital games: interesting!
> Elkorda
A-GAMES-Part-II_Case-Studies.pdf. Designing Learning Games, Part 1: Evaluate Games. The best apps, games, websites, and digital curricula rated for learning. DisableMyCable - Media Services. Free and Cheap TV on the Internet These are many online sources or free and cheap TV and movies.
You can watch most of these on your computer, and some of them on game boxes and set-top boxes like Roku, Chromecast, Amazon Fire TV, or Apple TV. Some are pay-per-view, while some like Netflix and Hulu Plus have a subscription model. If you are looking for a particular check out my Internet TV Remote control! Netflix: good for movies Netflix has a large subscriber base and good content. Hulu/Hulu Plus: good for TV shows Hulu is a great site known for offering old TV programs, but they offer lots of new ones as well. For set-top boxes (Roku and Apple TV), they offer Hulu Plus at $7.99 per month.
Amazon Instant Video Amazon Instant Video offers tons movies and TV shows - a great selection. Amazon Prime subscription Amazon Prime is a service that is well worth mentioning. Note that these services don't work on Apple TV. iTunes If you own an Apple device, you know about iTunes. The network websites. Playing Games in the Classroom. Gamifying Education: Do We Know How to Gamify the Classroom? Gamification in many parts of education is a sham.
Listening to the researchers and experts in this area has convinced me of that. If you're interested in making your classroom more intriguing and powerful, read on. We can do better. Who Is Shaping The Gamifying Education Conversation? In this week's conversation with Australian Gamer and researcher Lauren Ferro we all went on a bit of a rant about the ridiculous state of badges in education.Teacher Alice Keeler uses games all the time (and doesn't give grades).Sixth grade teacher Michael Matera reinvented his whole sixth grade classroom as a Games Based classroom and shares how he did it.A Higher Ed Panel had a powerful conversation for why we need games in highered.
All of these are YouTube videos that have been recorded over the past week and a half as part of the Open Online Community (called an OOC) focusing on games in education. I have 3 take aways from the learning so far: Education. For information about the institutes that children and teens attend, see School.
The Education career track is available in The Sims: Unleashed, The Sims 2: Seasons and The Sims 3: Ambitions. The Sims Edit The Minister of Education will eventually change careers and become a President in the Business career track. The Sims 2 The Career reward is Books First for Learning: A Bookshelf of Education that allows Sims to study all skills. Adult Promotion Levels Edit Teen/Elder Promotion Levels. Home - Interact Simulations. Software Library: MS-DOS Games : Free Software : Download & Streaming.
Published by MECC Developed by MECC Released 1990 Also For Apple II, Atari 8-bit, Macintosh, Windows, Windows 3.x Genre Adventure, Educational, Simulation Perspective 3rd-Person Perspective, Side-Scrolling Sport Hunting Theme Managerial, Real-Time Educational Geography, History Description As a covered wagon party of pioneers, you head out west from Independence, Missouri to the Willamette River and valley in Oregon.
You first must stock up on provisions, and then, while traveling, make... favoritefavoritefavoritefavorite ( 198 reviews ) Click here for the manual. Published by Bro/derbund Software, Inc. Developed by Bro/derbund Software, Inc. Published by Apogee Software, Ltd. MS-DOS: Oregon Trail Deluxe, The by (1992) favoritefavoritefavoritefavorite ( 89 reviews ) Published by Capcom U.S.A., Inc. Published by Bro/derbund Software, Inc. Published by Virgin Interactive Entertainment, Inc. Published by Bro/derbund Software, Inc. Published by Capcom U.S.A., Inc. Software eye favorite 133. Video Games For Grown-ups. The office of Funomena, a small video-game company based in San Francisco's SOMA district, has all the creativity-enhancing knickknacks you expect in a Bay Area startup: clumps of clay, hydrophilic sand, a Lego mermaid, and what cofounder Robin Hunicke describes as other "stupid things we fiddle with.
" The idea is to set an atmosphere that's "more like a Montessori school than a game development studio," she says. That makes sense: Funomena isn't like most other game companies. Past Presentations. Carol Dweck: The power of believing that you can improve. Flowlab Game Creator - Make games online. Physics Puzzle Game Maker - Make your own Games Online for Free. Learning and teaching through Minecraft. Learning and teaching through Minecraft Kids will always learn in their own world, where they are comfortable, where they know the rules, and where they can experiment.
Computing Brains: Neuroscience, Machine Intelligence and Big Data in the Cognitive Classroom. The human brain has become a major topic in education.
The field of educational neuroscience, or neuroeducation, is flourishing. At the same time, a number of initiatives based in computer science departments and major technology companies are also taking the brain seriously. Computer scientists talk of developing new brain-inspired cognitive learning systems, or of developing new theoretical and computational understandings of the brain in order to then build new and more effective forms of machine intelligence. The important aspect of these synchronous developments in neuroscience and brain-based systems is that they are beginning to come together in particular technological developments and products targeted specifically at schools.
Neuropedagogies. Here's How Gamer-Teachers Use Video Games In The Classroom. Study Shows Video Games' Impact On Face-to-face Teaching. Video Games in the Brain: Study Shows How Gaming Impacts Brain Function to Inspire Healthy Behavior. "Identifying a direct connection between the stimulation of neural circuits and game play is a key step in unlocking the potential for game-based tools to inspire positive behavior and improve health," said Brian Knutson, Ph.D., Stanford University.
Translational Psychiatry - The neural basis of video gaming. A Third Grader's Plea For More Game-Based Learning. Game Building Resources. The best FREE resources of game building for teachers and children: Building games for teaching Teach with Portal – Today, innovative educators are finding ways to incorporate Portal™ and Portal 2 into their classrooms—helping teach physics and critical-thinking skills.
It's eye-opening to see how video games can be used in amazing and unexpected ways to help educate our next generation. You'll find the beginnings of an engaging set of lesson plans, created by teachers, using the Portal 2 Puzzle Maker. Science. Vallett, D., Annetta, L., Lamb, R., & Bowling, B. (2014).
Diffusing innovations: Adoption of serious educational games by K-12 science teachers. Contemporary Issues in Technology and Teacher Education, 14(3). STEAM Games, Apps, and Sites. MindShift's Guide to Game-Based Learning. MindShift Guide to Digital Games and Learning How can games unlock a rich world of learning? This is the big question at the heart of the growing games and learning movement that's gaining momentum in education.
The MindShift Guide to Digital Games and Learning [PDF] explains key ideas in game-based learning, pedagogy, implementation, and assessment. This guide makes sense of the available research and provides suggestions for practical use. The MindShift Guide to Digital Games and Learning started as a series of blog posts written by Jordan Shapiro with support from the Joan Ganz Cooney Center at Sesame Workshop and the Games and Learning Publishing Council.
Here's a preview of the table of contents: Introduction: Getting in the Game (Page 4) An overview of games in the classroom from Katie Salen Tekinbaş, executive director of the Institute of Play. What the Research Says About Gaming and Screen Time (Page 6) Much of the research around digital games and screen time is evolving.
Related: Other Cool Stuff :) - Gamificación - lessons - Gamificación 1 - Gamification in Education - Online Resources - Pc and Mobile - gamificacion física - E learning blogs - Interessantes - Scholar - SEN Science support - learning.2 - Teaching Resources - Designing Learning Games, Part 1: Evaluate Games - The best apps, games, websites, and digital curricula rated for learning - Gamifying Education: Do We Know How to Gamify the Classroom? - Software Library: MS-DOS Games : Free Software : Download & Streaming - Carol Dweck: The power of believing that you can improve - Flowlab Game Creator - Make games online - Game Building Resources - MindShift's Guide to Game-Based Learning - Education - Enterprise

redpajama_set_name: RedPajamaCommonCrawl


Karachi, (IANS) A rickshaw driver in Pakistan's port city of Karachi who shot to fame through his singing video on Facebook, says he has quit driving after being praised by Indian legendary singer Lata Mangeshkar.
Aslam has now again started his singing training at home on a harmonium and always begins the session with the same 'thumri' that he sang in the famed video clip, Dunya News reported on Wednesday.
"I was amazed when Lata Mangeshkar praised my voice and skills and from that moment I have quit driving rickshaw," he said.
The 55-year-old rickshaw driver got recognition when his clip was uploaded on social media in which he was singing acclaimed Pakistani maestro Ghulam Ali's thumri 'Yaad Piya Ki Aaye'.
As the 'thumri' sung by Aslam went viral, many were surprised to know that the singer drove an auto-rickshaw in Karachi.
A few hours after the clip was uploaded, Lata Mangeshkar in Mumbai shared it on her Facebook page.
She also wrote that she was stunned to hear this talented singer and wished for him to stand in front of the microphone and not drive a rickshaw.
However, Aslam is not new to being in the limelight. In 1993, he took part in a TV programme and reached the grand finale of the talent show.
He had also lent his vocals in some Pakistani films and movies but then the process was hindered after he fell ill.


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Posts Tagged 'adoption'
When Judge's get it wrong when endeavoring to make it right. Second-parent adoption proceedings in New York after U.S. v. Windsor and In the Matter of Seb C-M.
January 31, 2014 | By: Liz
Disclaimer: The following blog post is of a rather technical nature insofar as it is an analysis of recent legal decisions impacting second-parent adoptions and the rights of same-sex parents in New York State. While I will strive to make legal quotes as easy to read as possible (I will not be following strict legal citation formatting) it has occurred to me that some people might like me to translate this blog into plain English. Accordingly, once this post is up I will create a second post which strips this blog down into simpler, more understandable terms for those people who didn't make the mistake of going to law school and having their brains completely and utterly corrupted. So, if you understand the following blog, more power to you but if you don't (I'm not sure I do and I wrote it), fear not, I will post a follow-up written from that part of my brain that speaks to human beings and not lawyers. 😉 I also apologize for the length of this blog. This wasn't an easy argument to lay out and perhaps a blog isn't the best means of getting my thoughts "out there" . . . but I needed to reason through this new case and I needed to do it in a public forum because I am concerned about the ramifications of this decision.
By now most people are aware of the groundbreaking, landmark decision in the case of United States v. Windsor, a case which determined that same-sex marriages must be recognized under federal law, thereby overturning part of DOMA, and leading to the passage of many state laws embracing same sex marriage or otherwise altering state's views on same-sex marriage. One important fact about Windsor that many people have overlooked — although lawyers took note — is that Windsor did not apply to section 2 of DOMA, which permits states to ignore or fail to recognize same-sex marriages performed in other states. Thus while the federal government must now recognize the marriage of two men or two women in the State of New York, Windsor did nothing to change the rights of other states to ignore same-sex marriages entered into in New York. Insofar as a state could ignore or choose not to recognize such a marriage, that state also could choose not to recognize the legitimacy of children born during the course of that marriage. Even in the tremendous wake of Windsor, as nothing changed on this point — recognition of same-sex marriages in states unfriendly to principles of marriage equality — lawyers did not alter the advice they offered to clients who are in same-sex marriages especially with respect to those issues related to recognition of their rights as parents. At least I didn't change my recommendations and last time I checked I still had that dubious distinction of being a lawyer and one who practices in the field of third-party assisted reproduction and adoption law.
Because Section 2 of DOMA remains good law, attorneys typically recommend to their clients who are same-sex families that the non-genetic or non-gestational parent should enter into a second-parent adoption in order to ensure that his/her parental rights are recognized in hostile states (states that don't like same-sex marriages). The hypothetical I typically provide to my clients upon discussing whether and to what extent they might deem it appropriate to take the additional step of entering into a second-parent adoption to secure their parental rights in other states, is one involving a medical crisis. And because I used to be a drama major (and perhaps still am in many respects), I have created a lovely little soap-opera-like legal hypothetical to help make my point: Let's say that Jane and Jan, who are married under the laws of the State of New York, have a child, Jack, who is genetically related to Jane. Jane also is Jack's birth or gestational mother, but Jan has no genetic or gestational connection to Jack. Jan is Jack's mother because –like all couples who have a child together — she intended to conceive him with Jane, and was married to Jane when Jack was born. Because NY law is so favorable to same-sex couples, both Jane and Jan are listed on baby Jack's birth certificate. New York basically says that it doesn't matter what your sexual orientation is, if you are married at the time a child is born, both married partners have equal rights to the child born during the marriage, and both parents names shall be placed on that child's birth certificate. This is wonderful law and I am proud to be a New Yorker because of its stance with respect to marriage equality. However, just because NY lets Jane and Jan put Jan's, the non-genetic parent's, name on baby Jack's birth certificate, doesn't necessarily protect Jan if they get into a car accident in a state which doesn't respect marriage equality. In my horrific hypothetical soap opera-like drama, I ask Jane and Jan to consider what happens to them if they get into a car accident in a state that is unfriendly to same-sex marriage. Imagine that Jane is on life support and unable to communicate, and little Jack is critically injured and needs surgery (hey I said I am the queen of drama). The hospital however, refuses to recognize Jan as Jack's parent, refuses to recognize Jane's and Jan's marriage, and Jan is in a time-sensitive situation in which she needs to make a medical decision to save her son's life but is being precluded from so doing because the state in which this accident took place doesn't recognize any aspect of Jan's relationship to Jack or Jane. This sadly isn't me being melodramatic, this is a reality that Jane and Jan could be facing. But let's let this little soap opera sit for a moment and get back to my discussion of DOMA, Windsor, and a recent case decided in Surrogate's Court located in King's County (Brooklyn), New York, which case on the one hand reinforces the beauty of the laws of the State of New York but simultaneously sets legal precedent protecting same-sex marriages on its head. And many attorneys are deeply concerned about the ramifications of this case should it not be overturned on appeal or otherwise reversed.
As noted, notwithstanding Windsor, a decision which has marked a rapid and wonderful shift toward recognition of marriage equality, Section 2 of DOMA is still valid law (and likely to remain so due to issues related to federalism, a concept which far exceeds the scope of this blog), and permits states to refuse to recognize same-sex parental rights even where a parent's name is listed on a child's birth certificate. This is true in our little soap opera, and a state could rely on this provision of DOMA to refuse to recognize Jan's parental rights. Thus, up until this new case from the Brooklyn Surrogate's Court, in light of Section 2 of DOMA and the variety of state laws as they apply to same-sex marriages, most attorneys (including yours truly) would have advised Jan to enter into a second-parent adoption and obtain a court order or other judgment establishing her to be Jack's legal parent. Under the Full Faith and Credit provision of the United State's Constitution, that "Order of Adoption" must be recognized everywhere — even in the face of section 2 of DOMA — and Jan could use that Order to ensure she has the ability to make that medical decision for little Jack in our soap opera. The second-parent adoption proceeding and the recognition afforded to that Order of Adoption gives Jan and our little soap opera a happy ending (assuming everyone recovers from the horrific hypothetical car accident).
However, this recent decision from the court in Brooklyn, In the Matter of Seb C-M (NYLJ 1202640083455, Surr. Ct. King's County Jan. 6, 2014), recently held that a woman in Jan's position is precluded from entering into that second-parent adoption because her name already is on Jack's birth certificate and she was married to Jack's birth/biological mother at the time he was born. Under New York law, says this Judge, Jan is Jack's mom and there is no need for Jan to take any steps to ensure that her rights as Jack's mother are recognized in other jurisdictions, even those that don't recognize same-sex marriage. This opinion thus denies Jan, and women and men in Jan's position, the ability to obtain the one document that most legal practitioners feel would protect Jan's ability to exercise parental rights in our nightmare soap opera hypothetical.
Why did the Judge decide this? Well in part because she's right. Under New York law, Jan is Jack's parent and no further steps are needed in New York for her rights as a parent to be recognized. Marriage decrees and birth certificates are enough under the eyes and laws of the State of New York that nothing more need be done to enforce the rights of this family. They are a family. Period. Nothing more need be said. Valid marriage + valid birth certificate = family regardless of your sexual orientation. That is, in and of itself, a wonderful statement and recognition of how far New York has come in recognizing marriage equality and the rights of same-sex parents. However, as well-intended as this Judge was, and while her legal argument is correct with respect to the laws of the State of New York, the decision totally ignores the impact of Section 2 of DOMA, and ignores well-settled case law regarding the Full Faith and Credit provision mentioned above. In holding that Jan cannot enter in a second-parent adoption because she already is legally a mother, the decision potentially eviscerates Jan's parental rights and those of other same-sex parents when they are outside the borders of New York. While I applaud this Judge for upholding the laws of the State of New York and recognizing that Jan is a parent from day-one regardless of the fact that she has no genetic connection to Jack, and regardless of the fact that she is in a same-sex marriage, it is somewhat arrogant to assume the laws of New York are so superior to the laws of other states that, in the face of a well-recognized danger presented by disparity in laws as they apply to marriage equality throughout the United States, and the enforceability of a federal statute that expressly permits states to reject Jane and Jan as a married couple, New York law is sufficient in all circumstances to protect this couple and their child. Simply said, the laws of the State of New York do not protect this family everywhere they may travel and second-parent adoptions have historically been identified as a means by which a parent in a same-sex marriage can protect and enforce their parent-child relationship outside of the State of New York.
For the Judge in Seb C-M, a compelling fact in denying the second-parent adoption was that Jan already was on Jack's birth certificate (keeping it simple by keeping the characters in our melodrama consistent, the people in the case of course have different names). The Judge seemed to feel the birth certificate and presumptions surrounding birth certificates as codified in New York statutes and set forth in case law, are sufficiently strong to carry Jan safely into other jurisdictions. This is a legal argument called "portability". Indeed, there is a relatively significant body of law that addresses the "portability" of birth certificates with respect to same-sex marriages. To quote another groundbreaking case from New York, In re Sebastian, a case which pre-dates Seb C-M, the Judge in Seb C-M, ironically like other judges before her, "apparently was not concerned with issues of portability." In re Sebastian, 25 Misc.3d 567, 572 (Surr. Ct. N.Y. County 2009)(citations omitted).
Sebastian is another case that explores in detail the rights of same-sex parents who are married, have a child, and wish to protect the non-genetic parent's rights in jurisdictions which do not recognize same-sex marriage. Indeed, Sebastian sets forth a detailed analysis of the "portability" of birth certificates and indeed, of Jane's and Jan's rights as parents. The Court in Sebastian ultimately concluded that in order to protect someone like Jan, she would need to enter into a second-parent adoption as that is the only type of legal/court document that would have to be recognized in states which don't recognize same-sex marriage. Sebastian provided the necessary protection to same-sex couples which the court in Seb C-M has just taken away. Here is what the Court said in Sebastian (in Sebastian, Mona stands in the same shoes as does Jan in our soap opera, and Ingrid is Jane):
"[A]s the child of a married couple, Sebastian already has a recognized and protected child/parent relationship with both Ingrid and Mona, arguably making adoption unnecessary and impermissibly duplicative. . . Unfortunately, while this is the case in New York, the same recognition and protection of Mona's parental rights does not currently exist in the rest of this country, or in most other nations in the world. For this reason, the parties argue that only an order of adoption would ensure the portability of Sebastian's parentage, and further ensure that the federal government and other states would recognize Mona as Sebastian's legal parent."
Sebastian at page 573.
Analyzing DOMA and presumptions of parenthood afforded by birth certificates and thus their portability among states, the Court in Sebastian further noted that:
"[A] marriage validly contracted in another state need not be accorded recognition if that marriage runs afoul of the forum state's public policy. Currently there are explicit prohibitions against same-sex marriages in [many] states . . . these clear legislative statements of public policy would appear to permit courts of those states to deny recognition of same-sex marriages contracted elsewhere, and, arguably, also to legal rights flowing from those marriages, including presumptive parenthood. . . . Such a position is supported by DOMA, a 1996 Congressional enactment that . . . appears to allow the states to deny recognition of same-sex marriages validly contracted elsewhere. . . . A holding by this court that Mona is already a legal parent . . . in this state may therefore offer insufficient protection in other states . . . just as DOMA itself precludes [recognition] based on marital status to same sex couples. Thus . . . adoption is the sole means by which their parent/child relationship and the 'rights and obligations incident thereto' can be fully protected."
Sebastian at pages 575-76 (emphasis added).
Another of the arguments on which the Court in Seb C-M relied in denying the second parent adoption is the strong presumption of parenthood New York laws afford to a child born during a marriage as reflected on a birth certificate. The Court cited this as one of the "strongest and most persuasive [presumptions] known to the law." Seb C-M at page 2. However, just because New York recognizes this presumption in favor of same sex marriages, does not mandate that presumption also be recognized in other jurisdictions. Indeed, Sebastian is clear that the laws of other states do not need to recognize that presumption: According to Sebastian:
"[a] birth certificate is . . . only prima facie evidence of parentage . . . and does not, in and of itself, confer parental rights that must be recognized elsewhere. Accordingly, although the parties here may obtain a . . . birth certificate by virtue of their marriage, that birth certificate alone, without some judicial determination of Mona's parentage would provide insufficient protection of Mona's parental rights."
Sebastian at page 576 (emphasis added).
If the New York birth certificate potentially is insufficient to recognize or enforce Jan's parental rights, what is she to do in order to ensure her relationship to little Jack is protected in our soap opera, or in the event Jane and Jan were to move? Sebastian addressed this concern noting that:
"[t]he parties' argument for an adoption here is based on their desire to have a determination of parentage that will be recognized everywhere, as opposed to one that other jurisdictions may be free to disregard. Although there is no Supreme Court decision on point, federal courts that have considered the issue have held that a judicial order of adoption in one state must be afforded full faith and credit in every other state, and that there can be no "public policy" exception to that mandatory recognition . . ."
The Court in Sebastian concluded that although Sebastian's genetic mother had other potential legal avenues to establish her parental rights — avenues which are now firmly established in New York and form the foundation of the decision in Seb C-M, only an Order of Adoption would provide protection to a same-sex family outside of New York due to its entitlement to full faith and credit. Sebastian at page 587.
"And, although it is also true that an adoption should be unnecessary because Sebastian was born to parents whose marriage is legally recognized in [New York], the best interests of this child require a judgment that will ensure recognition of both Ingrid and Mona as his legal parents throughout the entire United States."
So we are now left with the decision in Seb C-M which has denied a parent the right to establish her relationship with her child in a manner that will be protected outside the borders of New York, that fails to make her child's birth certificate "portable" and her legal parent-child relationship firmly established in the eyes of the law throughout the United States. This decision is at odds with the well-reasoned opinion set forth in Sebastian, which decision remains consistent with the principles and issues still presented by Section 2 of DOMA. The Judge in Seb C-M was not unsympathetic to the plight of our friend Jan, and recognized that she left Jan at risk of facing a situation where her parental rights might not be recognized. The Judge felt, however, that those rights should be addressed in the jurisdiction that denies the rights (see footnote 2 of the opinion). Rather than upholding the protective approach as set forth in Sebastian, In the Matter of Seb C-M, leaves Jan to fight with a judge over Jan's constitutional rights and marriage equality in a jurisdiction which is inherently hostile to her and her family; and she has left Jan to do this in a potentially time-sensitive situation as that set forth in our soap opera drama of a hypothetical.
While New York has come a long way in recognition of same-sex relationships and In the Matter of Seb C-M is a recognition of those advancements, the decision leaves same-sex couples at risk in other jurisdictions. New York's laws are (unfortunately) not superior to those of other states, certainly not when there is a statute like DOMA which allows another state to deny the rights New York provides to the LGBT community. While I applaud this decision in its recognition of New York's stance on same-sex marriage and recognition of same-sex families, it presents a potentially disastrous outcome by denying protections currently recognized under New York law, which protections are recognized and enforceable in other jurisdictions. In the Matter of Seb C-M applies a misinterpretation of the decision in Windsor (or seemingly fails to acknowledge that Section 2 of Doma was not overturned), and fails to recognize the significant limitations that remain embodied in Section 2 of DOMA relative to the existing framework of the rights of same-sex parents. Even more, the Judge's statement in Seb C-M that any state which fails to recognize same-sex marriages and families is equally likely to deny full faith and credit to adoption decrees from New York, overlooks the detailed analysis of these issues as set forth in Sebastian and an existing body of enforceable case law regarding the application of Full Faith and Credit to Orders of Adoption.
The question is whether these misinterpretations and overlooked or misapplied body of case law will result in an appeal of the decision in Seb C-M? In endeavoring to recognize the advancements of the rights of same-sex parents in New York, this case has fallen short of protecting those rights, especially in light of the provisions of DOMA which remain intact even after the Windsor decision. While the Judge In the Matter of Seb C-M strives to make the rights of same-sex couples more enforceable, the ultimate outcome of the decision is to deny protections to same-sex families which ensure they are enforceable in places other than the State of New York. Is it not better to have a family that can be protected and recognized throughout the United States as provided by In re Sebastian, rather than one which can only be recognized within the State of New York as provided in In the Matter of Seb C-M? And more importantly, if Sebastian is authoritative case law, insofar as In the Matter of Seb C-M, contradicts Sebastian on so many points, is the decision In the Matter of Seb C-M not wrong as a matter of law?
This blog represents the opinions of the author and are not intended to provide legal advice.
Filed under: adoption, Current Affairs, In the News, Sam Sex Parenting and Reproductive Law, Same Sex Parenting and Reproductive Law, Third-Party Assisted Reproduction, Uncategorized
Tags: adoption
The painful silence of recurrent pregnancy loss and stillbirth. A first hand perspective and perhaps finally, a voice.
The shrowd of silence around stillbirth and pregnancy loss finally is being lifted. Someone is making a documentary about miscarriage, recurrent pregnancy loss, and stillbirth. This morning I watched the trailer of "Still" a documentary devoted to raising awareness of the pain of the loss of a pregnancy, a child born too soon, or a stillbirth. I think "Still" may focus more on stillbirth or pre-term delivery, but some of the articles I read as I researched its production indicated that the documentary intends to address recurrent pregnancy loss and/or miscarriage more than is touched upon in this trailer.
As I watched the trailer I was reminded of a long call I had with a new client this week. It is rare that I have a client who has a similar background to my own experience with infertility. Like me she has experienced 12 unexplained pregnancy losses (although I sort of stopped counting about a year ago when I went through it again . . . something about hitting the number 13 and I really decided it didn't matter how many I had, I have had enough, one is enough). Only in addition to experiencing a number of first term (non-chemical) pregnancy losses, my new client also lost pregnancies in the second trimester and near the beginning of the third trimester. We had a lengthy conversation about how isolating it is, how lonely it is, how there is no person other than your partner or spouse who "gets it" (and even then sometimes perhaps they don't totally get it because it isn't their body), and how the silence that surrounds pregnancy loss can engulf one's life, one's existence. Our call also reminded me of a blog I posted about a gravestone I once saw that marked the death of fetus. As I commented in that blog, it wasn't a pro-life stunt. It was a family who had been given permission not only to mark the death of their baby while in utero (or loss of their pregnancy) but to recognize all those other families that have suffered the same pain. In silence.
Reproductive medicine has provided so many advances to assist infertile couples in achieving their dreamed of family but recurrent pregnancy loss remains largely unexplained. While theories abound, there are far too many of us who don't know why this happens to us, repeatedly. Reproductive medicine and reproductive law now give us the option of having our biological child carried by someone who is likely to deliver that child when we can't. Indeed, the option to use a surrogate after experiencing pregnancy loss is perhaps the driving force behind at least half of my clients who come to me to assist them with legal agreements as they begin their journey using a surrogate. As is the case with the call and the client I just mentioned.
As many of you know, in the absence of an explanation of why my babies die, I was too frightened that a surrogate might lose my child. I couldn't ask another woman to risk experiencing the pain I have dealt with so many times. Adoption was always something my husband and I had wanted to pursue so when we were faced with the [dreaded] conversation where our doctor told us we were out of options other than surrogacy or adoption, it was a no-brainer for us. It was going to be adoption. And as one of the women in the trailer for "Still" points out, I wouldn't turn back the clock or make different decisions; because without those pregnancy losses I wouldn't be parenting the two beautiful children I have now. I cannot imagine a life without these particular little souls in it. It seems like a heartbreaking price to pay but as I told my new client, one day when this is all over and you are holding your baby in your arms, it will make sense and you will know that but for all that came before (all 12 of those horrendously difficult pregnancy losses) this little baby wouldn't be yours.
But as she journeys toward that day where she hopefully does feel that sense of peace and gratitude for the child in her arms, she is left with a huge void. She has no one to talk to. I had no one to talk to. Even my best IVF friends didn't understand how I felt. Excuse me: how I FEEL. I still feel pain on a day that one of my longtime friend's celebrates, the day she heard the heartbeat of each of the babies she was carrying. I don't begrudge her that joy. I celebrate with her. But for me, inside, it always is a reminder of the miscarriage that I experienced just a few days earlier. My client and I share a special bond, one of knowing what each carries inside her and the thoughts that creep into our mind throughout the day. Thoughts that largely go un-shared with anyone.
Will "Still" do justice to this topic, to this diagnosis, to the countless women and men who have endured the loss of a life growing inside them or one that came into the world far too early to survive? I think so. I hope so. Because I would like nothing more than for women like me who are going through what I went through, women like my new client, to have a voice in the reproductive community. To have doctors pay attention to our kind of infertility. To have better resources and support groups. To just plain have a voice to express their pain. Amazing options for family building notwithstanding, the pain associated with recurrent pregnancy loss, miscarriage, and stillbirth shouldn't continue to be shrouded in silence.
And so today I thank the people behind this documentary entitled "Still". THANK YOU for initiating a dialogue that is long overdue.
And one final note, to all those physicians who have dedicated their careers to exploring the mystery of recurrent pregnancy loss . . . THANK YOU.
If you would like to watch the trailer click here
Filed under: Current Affairs, Deadly Silence, Faith and Infertility, infertility in the media, Infertility In The Movies etc., Infertility on Television, IVF, Miscarriage, Peace to Parenthood, Personal Musings, Recurrent Pregnancy Loss, Stillbirth, The Journey to Parenthood, Thinking Out Loud, Third-Party Assisted Reproduction
Tags: adoption, gestational carrier, hope, infertility, miscarriage, movies, Peace to Parenthood, premature birth, recurrent pregnancy loss, stillbirth, The Infertility Survival Handbook, youtube
The Bizarre World of Embryo Banking. Where My Motherhood and Morality Meet.
December 7, 2012 | By: Liz
Every once in a while I have true conflicts between my self as a former infertility patient and my career as a reproductive lawyer and adoption attorney. A couple of years ago, I wrote a law review article on the disposition of frozen embryos, and whether or not talking about embryo adoption was legally correct whether the better, more appropriate terminology was/is embryo donation. There are hundreds of thousands of frozen embryos in cryopreservation in this country where the intended parents of those embryos no longer wish to use the embryos for their own family building. These embryos are often referred to as "leftovers" a term which somewhat disturbs me but is strictly speaking, accurate. These embryos are "leftover", after a family was created through IVF and now remain in a state of frozen suspension. Many of those embryos could be used to help build another family, and be donated to an infertile couple. There was some confusion as to whether these embryos should be placed for adoption or donated in a similar manner to egg and sperm donation and I wanted to resolve that confusion — at least for myself. I ultimately drew the legal conclusion that the term embryo adoption isn't really accurate because there isn't a human being to adopt. I could go into a lengthy analysis of how I came to that conclusion but your eyes would roll back in your head and you would probably start drooling from boredom. So let's just defer that analysis and argument for another day. If you are interested, you can get a copy of the article on the web (click here). I now happen to be a huge advocate for embryo donation. I think it is a fabulous way to build a family. However, these are musings for another blog. But my article did provide some clarity to those medical facilities which are banking those frozen "leftover" embryos.
So here I have been sitting happy as a woman with a barren uterus could ever be, contemplating my holiday shopping safe and secure in my belief in, and advocacy of embryo donation. And then I hear about this doctor in California who has a new kind of embryo bank.
Before I heard of this physician in California, I was aware of only one type of embryo bank; one where frozen "leftover" embryos are being made available for donation to infertile families. These frozen embryos were the subject of my law review article. This new embryo bank, however, does not contain any of these "leftover" frozen embryos. This bank is comprised of embryos which were recently created using carefully selected donor eggs and donor sperm. The donated eggs are fertilized with the donated sperm and the resulting embryos are frozen for future selection by hopeful intended parents. Let's stop briefly and note emphasis on the words "future selection". We will circle back to why this is relevant but I wanted to point out that these embryos are being created for future selection by wanna-be-moms and dads.
This physician has created his embryo bank in a manner to facilitate selection for all types of characteristics — everything from physical traits like blond hair and blue eyes to religious ethnicity. Jewish embryos, who knew? Actually, this could be fantastic for Jewish couples who need a single Jewish egg donor, and/or want to further ensure a connection with Judaism by having a genetic connection on the sperm side of life. You have no idea how hard it can be to find a specific ethnic donor and this is something I gather this doctor has identified as a plus to his business model. Speaking of business models, he also offers a money back guarantee. You choose a batch of embryos to use to try and get pregnant. If you don't get pregnant the first time, you get two more tries using different batches of embryos. If you don't get pregnant, you get 100% of your money back (approx. $12,000).
Upon hearing of this embryo bank a part of me was disgusted and a part of me . . . well I was excited. Super excited. Especially about the money back guarantee.
The infertility patient part of me sees this as a great opportunity to get pregnant. Frozen embryo transfers — while statistically less successful than fresh embryo transfers — can be lot easier to go through than an IVF cycle. For me having the embryos created using donor gametes isn't a big deal. But if it were, I would be able to select an embryo based on whatever I might deem important. So, yeah baby! Let's have another baby! Give me this doctor's number. I am in! Or perhaps it would be better to say the embryos are [going to be] in [me]!
But the legal scholar, academic, intellectual, lawyer part of my brain is sitting here vomiting and is pissed that I am putting these thoughts onto cyber-paper and making an argument in favor of this horrific new kind of embryo bank. Stork Lawyer Reality check: It is pretty much illegal to create embryos without first having identified intended parents as recipients for those embryos and from what I understand, there are no intended parents waiting for those embryos when this doctor is creating them. The intended parents don't enter the picture until the embryos are selected from the database and someone signs up with this program to undergo an embryo transfer procedure. This is where that whole "future selection" comes in.
The laws regarding assisted reproduction essentially come down to intent to parent before conception: in a third party assisted reproductive arrangement there is supposed to be a contract or other document signed before the embryos are created, whereby intended parent(s) agree to be legally and morally responsible for the embryos and children that may result from the ART process. In this case there is no such contract or preexisting intended parent. The embryos subject of my law review article all had intended parents before the egg and sperm came together to create the now frozen "leftover" embryo. But this new type of embryo banking lacks that component. There are no intended parents choosing the eggs and the sperm with the immediate intent to parent.
And speaking of all those "leftover" embryos shouldn't we first be dealing with and using all the existing cryopreserved embryos before we go about creating them? And what about the potential that this doctor may be creating even more "leftover" frozen embryos (what happens to those embryos that don't get selected)?
Let's not analyze whether this is baby selling. I can't, or won't go there, although many others have. Consanguinity, or the risk of an individual created through donor gametes marrying or having a child with a genetic sibling is another issue that has been raised. The number of families that are created using any individual egg or sperm donor's genetic material is a concern not to be overlooked or ignored. These donors presumably are also donating through egg donation agencies, fertility clinics or sperm or egg banks. We all have been astonished by stories of men who have discovered that they have fathered over a 100 children as a result of their donation to sperm banks — there is a significant risk that through this new type of embryo banking program not only will children have multiple full siblings running around but that egg and sperm donors have created half siblings through other programs.
Even more, if I understand this program correctly (and I am pretty sure I do) batches of embryos are being created which contain embryos which are full siblings to embryos which are contained in other or separate batches of embryos. It sounds like it is possible that three separate donations could take place using these three batches of embryos. Okay, follow-me slowly here for a minute because this is a little bit like playing Twister. In other words, three batches of embryos each of which contain embryos which are full genetic siblings to embryos in other batches, could be donated to three different families thereby creating three separate families whose children are all full genetic siblings to each other!
Do the recipients of these embryos know how many full genetic siblings their child may have? Are the donors aware?
It is supposedly almost impossible from a statistical standpoint for one of these children to marry its full sibling. But when you add in the half siblings that could be created through other donation programs, and/or smaller ethnic groups for whom donation can be a challenge because of the limited number of donors available matching their ethnicity, doesn't the risk become somewhat more than insignificant? And even if it doesn't, I worry that people don't have enough information about how many genetic siblings are out there whether they are full or half siblings.
But I get it, I get why he did it. Especially for someone with an ethnic background this type of program would be hugely popular and let's not forget the money back guarantee. We're all broke after trying IVF multiple times, why the heck not take out a second mortgage if you know you will be able to pay it back if you don't get pregnant? Sounds pretty good doesn't it?
I am at war with myself. I want to go running to that clinic and pick out an embryo tomorrow. And then my lawyer (self) tells me to stop and think about whether I want to participate in, and thereby endorse a practice which I believe, in my own legal opinion, is legally impermissible, and legally and medically unethical. Is my desire to be a gestational mother stronger than my moral center? Good question.
The views expressed in this blog are the views and opinions of this author and are not intended to provide or constitute legal advice or a statement of the laws as they may pertain third-party assisted reproduction within the United States.
Filed under: adoption, Check This Out, Current Affairs, Egg Donation, Financing Fertility Treament or Adoption, In the News, IVF, known sperm donation, Personal Musings, The Journey to Parenthood, Third-Party Assisted Reproduction, Thoughts on Choosing an Egg Donor, Uncategorized
Tags: adoption, Economy, Egg Donation, egg donor, Finances, financing, infertility, intent, IVF, success, The Stork Lawyer


text:
GordonsOnTheGo
We Travel Not to Escape Life, but For Life Not to Escape Us
On the Road 2022
Family, Baseball and Repairs (September 20 – October 4, 2016)
October 7, 2016 October 7, 2016 ~ Phil and Jan Gordon
After saying goodbye to our campsite in Marengo, IL, we headed to Lagrange, IN for some warranty work on our rig. We had originally planned to have the work done at the DRV factory but, when Phil called in early June to schedule an appointment, they were booked all the way out until late October. Since our manufacturer warranty expired on October 11th, we needed to find another alternative. The warranty manager at DRV suggested we try Cross RV for the work. Phil had heard good things about Cross RV on various RV forums so he scheduled an appointment for Sept. 21st. We were very happy with the decision. Paul and Kay Cross took very good care of us and were able to address our list of issues. We spent two nights camped on the side of their facility, nothing fancy but it's hard to argue with free. While our rig was being worked on, we killed the day by visiting Phil's 96-year-old mother and exploring a number of Amish stores in Shipshewana, IN.
The following day, we headed about an hour northwest to Lake Spaulding Campground in Niles, MI. This family-run campground is small but well maintained. They have three small lakes and a stream on the property but, once again, we didn't find time for any fishing. Our site was surrounded by mature trees which, unfortunately, kept us from using our satellite dish. Fortunately, we were only a few miles from South Bend, IN and were able to get quite a few TV channels over the air. A bigger annoyance was an invasion of stinkbugs. We spent the next couple of weeks capturing these bugs and releasing them outdoors. We had only planned to stay in Niles for three nights but ended up staying there for a week.
Niles is only about 25 miles from Elkhart, IN so we were able to visit Phil's mother at the Hubbard Hill nursing home almost every day, as well as his sister and her family. We spent some time feeding the ducks in the Angel Garden at Hubbard Hill.
We also found time to do some exploring in southern Michigan. We drove about an hour north to Holland, MI. Although the wrong season for tulips, Holland was still quite scenic. We walked along the Lake Michigan beach and tipped our toes in the water. Later we climbed the 237 steps to the top of Mount Pisgah and, after catching our breath, enjoyed the view of the beach and the Lake Macatawa harbor.
On the drive home, we stopped for lunch at The Butler, a historic restaurant in Saugatuck, MI. Saugatuck is a cute little harbor town that clearly caters to tourism. After lunch, we strolled the two blocks of shops. Jan had read that having fudge was a "must do" when visiting Saugatuck and we had to oblige.
Phil spent much of the week trying to line up campsite reservations for the coming weeks. Despite our desire to be free to travel at will, he soon discovered that the demand for campsites in the fall outweighs the supply. Despite numerous rejections, Phil was finally able to fill our calendar with campsites through early November.
On Sept. 29th we left Michigan and began our trip to the Cincinnati area. We overnighted at Hidden Paradise Campground in St. Paul, IN. Getting to the campground was our initial challenge. It required driving through a small residential neighborhood. Phil didn't have time to read the sign for the campground before he turned down a smaller street than he should have. It made the journey a little more of a challenge but we managed to get to the campground without incident. Being mid-week, the campground had many available sites, although we were fortunate to get one of the few 50 amp pull-through sites. After getting set up, we explored the campground. They have a small petting zoo and we were able to get up close with some very tame deer. They have a lake that was once a quarry where scuba diving is allowed year-round.
The following day we drove on to the Cincinnati South Campground in Dry Ridge, KY, about 30 miles south of Cincinnati. We had purchased tickets to two of the last three Chicago Cubs regular season games but had then discovered that campgrounds in the Cincinnati area were fully booked for that weekend. Although the drive from Dry Ridge to the ballpark was longer than we'd hoped, the campground was quite adequate for our needs. The only complaint was that a very active railroad track was directly across from the campground. The trains didn't keep us awake at night but, when we were awake, we were very aware of the trains that seemed to pass about every 10 minutes.
The Cincinnati Reds' ballpark, Great American Ball Park, overlooks the Ohio River and is a quite impressive venue for a baseball game. The Cubs led most of the way in the Friday night game and won 7-3. We enjoyed fireworks after the game.
On Saturday, we did some sightseeing in Kentucky near our campground. We visited Rabbit Hash, KY and spent time exploring the general store. In reality, it was just a temporary setting as the historic general store (in operation since 1831) burned down in February and is being rebuilt.
On Sunday, we arrived early for the Cubs' game and happened to be passing the Westin as some of the Cubs players were leaving the hotel and boarding their bus. Among others, we saw Dexter Fowler and Ben Zobrist. We spent the next hour exploring the Banks, between Paul Brown Stadium and the Great American Ball Park. We posed in front of the Queen City sign and walked by the Roebling Suspension Bridge and the National Underground Railroad Freedom Center.
The Sunday Cubs' game, the final game of the regular season, was very suspenseful. Kyle Hendricks, the likely NL Cy Young award winner, was the starting pitcher for the Cubs but did not have a good game, giving up four runs in the first inning. The Cubs were still losing 4-3 with two out and two strikes in the ninth inning before rallying to win 7-4. It was the Cubs' 103rd win.
On Monday, October 3rd, we began our drive to Knoxville where Phil had scheduled some routine annual maintenance at RVs for Less, the dealer where we bought our rig. We had not made campground reservations since we hoped to be able to spend the night on the dealer's lot as we had when we bought our rig. One hour from Knoxville Phil called the dealer to see if they had room on the lot and learned that they didn't have any record of our service appointment. Although Phil had scheduled the appointment for October 4th about six weeks earlier, he had sent an email in late September that mistakenly referenced our service appointment as being on November 4th. It's amazing how easy it is to lose track of time now that we're retired! Anyway, the dealer was able to fit us in on October 4th but didn't have room for us to camp out on their lot. Instead, we stayed at the Escapees' Raccoon Valley RV Park for two nights. The pull-through site was relatively short and close to our neighbors but we were just happy to get a site on short notice.
On October 4th we dropped off our rig at the dealer and killed the day in Knoxville. We returned at 5 pm and learned that our service appointment had been very fortuitous. The Sales Manager told us that they had found that three of the brake calipers were not operating properly and that one of the brake lines was wearing badly. The defects were so serious that the dealer fixed the brakes and did all the other maintenance Phil had requested as warranty work, resulting in no charge to us instead of over $500 we had expected to pay.
Posted in On the Road 2016
Published by Phil and Jan Gordon
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Old Treasures and Shipwrecks News - Galleon Jesus Maria de la Limpia Concepcion
The Wreck of Jesus Maria de la Limpia Concepcion
from The Liverpool Daily Post
A Spanish galleon that sank with treasure of plundered gold 343 years ago has been found by divers off the coast of Ecuador, it was revealed on March 11th. The Spanish naval flagship La Capitana Jesus Maria went down in 1645 with a cargo of gold, silver and jewels stolen from Peru's Indians.
The treasure is believed to be worth up to £5bn, according to Norwegian reports.
'It's completely unbelievable. I can hardly believe that I found the ship.' said Norwegian diver Anton Smith about the discovery.
An international consortium has been searching for the vessel for three years. As the finders they can keep half the treasure, with the rest going to the government of Ecuador.
'It is like walking right into a fairy tale,' said a spokesman for the Norwegian consortium which has helped fund the treasure hunt, 'People have been searching for this ship for 300 years without success.
La Capitana Jesus Maria was sailing from Peru to Panama when it sank in shallow waters. Even though the captain survived and was able to note the ship's approximate position, it remained hidden for centuries.
'It's not very deep there, only about 50 feet, but part of the problem is that the waters are very turbulent and the last ten feet are very silty. So it has been very difficult to get orientated.' said Norwegian investor Morten Moe.
From the registers of the Archivo General de Indias in Sevilla, the passengers on board declared that the contraband was more than 10 million pesos in treasure and the Plaza de Armas of the city of Los Reyes would be too small for it...!
Historical facts by Wendy Adeler Hall
The story of this "Unlucky Treasure" begins aboard the ship know as 'La Capitana' which was the largest vessel of her time built in South America.
She weighed 1,150 tons with a length of 122 feet and a beam of 40 feet. Carrying 60 guns, 44 of which were bronze, the ship was the flagship of the Viceroyalty of Peru and the South Sea Armada (an area which covered the countries of Peru, Bolivia, Chile, and Ecuador).
On October 26, 1654, the pilot, Miguel Benitez, was confident that they would clear Punta Santa Elena safely and make port at Isla de Plata. At 11:00 p.m. that night, however, a passenger spotted breakers ahead.
What follows is a quote from Captain Sosa: 'The danger was very near and dead ahead. In turning, we found ourselves in the midst of reefs. After hitting three times, our rudder fell off. The pumps were started because the shock of each impact was splitting our seams.
Water was pouring through the caulking. In addition to the three pumps being manned, everyone on board was bailing with jars, bowls and buckets. We worked all night. At daylight we had about eight feet of water in the hold. Everyone was exhausted.' In the testimony of another crew member it was also noted that 'there was difficulty getting the anchors down because there were mountains of unregistered goods stored on the foredeck and on top of the anchor cables.'
La Capitana was so overloaded that she drew water up to the second deck. It was stated that if the ship had not been so heavily loaded it would have been able to free itself from the bottom beneath 22 feet of water.
The morning of October 27th was total havoc; everyone was exhausted and near panic. Some people tried loading their pockets with gold and silver and swimming to shore; at least twenty people drowned in their attempts to reach safety.
By high tide Captain Sosa managed to move La Capitana closer to shore and permanently grounded her in shallow water. Here he and his silver master worked feverishly and salvaged much of the treasure, cargo and 4 of the 44 bronze cannons.
For greater access to the treasure and other valuables below deck, they burned the ship to the water line. Many of the compartments there were not yet filled with water. At the peak of salvage operations, up to 52 divers worked the wreck with only one fatality; a diver bitten by a sea snake. Captain Sosa was able to salvage 1,500,000 pesos from the wreck and salvagers sent later from Spain recovered another 2,000,000 pesos; it was known that more treasure remained.
This started a major scandal as only 3,000,000 pesos is silver was supposed to be the cargo; later estimates placed the total aboard closer to 10,000,000. During the trials that followed, several people were jailed and condemned to death for neglect of duty.
Fate was not done with the treasure of La Capitana. The salvaged treasure was moved to Cuba where it was loaded onto another galleon, 'Nuestra Senora de la Maravilla', which sank on January 4, 1656 and was subsequently the subject of salvage operations. A salvage vessel sent from Cuba to convey the salvaged treasure from the 'Maravilla' also sank.
In 1996 this story continued when this shipwreck was discovered by Herman Moro and his crew. After reaching an agreement with the country of Ecuador, he was granted full ownership of half the salvaged treasure. This amazing treasure now, remarkably, rests in our own Great Falls.
1. Brendan Burns On 24/08/2010
Deb, would you be interested in selling it?
If so, please contact me directly.
2. Deb Raulerson On 01/02/2010
I have a concepcion piece with a certificate of authenticity. How do I find out how much it is worth?
3. john d On 23/04/2009
we have a silver coin at the pawnshop i work at, i just thought it was cool that it made it to texas..


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Home » TIMag.com news » Tournaments/Events » World TeamTennis to Make Australian Open Debut
World TeamTennis to Make Australian Open Debut
New York, N.Y. — World TeamTennis will make its Australian debut in the second week of Australian Open 2010. The American-based concept co-founded by tennis legend Billie Jean King in the 1970s has been thrilling United States tennis crowds for more than three decades. A special Australia versus Internationals match will be played on Margaret Court Arena on January 27.
WTT co-founder Billie Jean King is confident Australian crowds will love the concept. "For more than three decades World TeamTennis has been one of the leading innovators in tennis and we are so excited to bring our unique brand of tennis to the worldwide stage at this year's Australian Open," said King. "This year marks our 35th season and some of my favorite moments in WTT were playing alongside and against some of the Australian greats. To have the opportunity to introduce WTT to an entirely new generation of Australian fans is both an honor and a privilege." Some of the greats of the sport have been included in the two teams.
An Australian team of Pat Rafter, Pat Cash, Nicole Bradtke and Alicia Molik will take to the court under the guidance of team coach John Fitzgerald. The International team comprises Tracy Austin, Goran Ivanisevic, Todd Martin and Mary Joe Fernandez who will also coach the team.
The WTT match consists of five sets, with one set each of men's singles, women's singles, men's doubles, women's doubles and mixed doubles. The first team to reach five games wins each set and team scoring is cumulative over the five sets. "It is good fun, interactive and high quality tennis," Australian Open Tournament Director Craig Tiley explained. "It is fiercely competitive and the team spirit is strong and adds another dimension to the tennis."
Australian tennis champions have been very much a part of the WTT history with Rod Laver, Margaret Court, Evonne Cawley, Roy Emerson, Pat Rafter, John Newcombe, Tony Roche, Ken Rosewall, Wendy Turnbull and Mark Philippoussis all playing at some point in their careers. Current day players Casey Dellacqua, Rennae Stubbs, Ashley Fisher and Joe Sirianni are also among the 74 Australians who have collectively played 203 seasons and won 22 titles in World TeamTennis in its rich three decade history. For more information on the 2010 Australian Open, visit australianopen.com.


Gaurav Goyal remains stalwarts of Wind Horse Tours, India since its inception in 2005. Along with company he gained salience. His friend says " He aged once he started to work ". Like any other works, it was hardly a stroll in park at the start. In initial days, where every little aspects was overwhelming to learn but he weathered the storm tenaciously and befitting he is in the stage where a rave review from the guests is just like another day in the office.
He grew up in old Delhi locality and did his college from there itself. He is familiar with every nook and corner around Delhi and surrounding regions. This assist in untying knots of intricate history of Delhi and its monuments it harbours in its fold when taking guests on tours.
When not guiding, you can find him in cricket ground with a Kookaburra cricket ball in hand all geared up to disturb the three timbers that batman passionately guard.
Dear Anand; On the whole we had a positive experience. The guides who came through Indian Archaeology (or some govt certifying agency) were good, notably in Khajuraho. The reception by the local agent (Amritsar, Jhansi, Kahjuraho) was excellent. The hotel in Orcha (Bundekhand) was located nicely but needed renovation. Radisson- blue was the best in Khajuraho. Hotel services at all places were good. I would not hesitate to recommend you as a travel agent to my friends.
Overall, the trip was fantastic and I am truly grateful that you suggested India before Bhutan. However, the hotel in Delhi was superb. They upgraded us to a fabulous room the the 2nd and 3rd times that we were there which was lovely. Our guides in India were fine. I do have a couple of suggestions....I think we could have done with 1 night in Rathombore. We saw 1 tiger on all our safaris, although others saw many more...just lucky. We really liked Jaipur and maybe should have had 2 nights there instead. Darjeeling. Bhutan was really spectacular...we loved it.


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Is the VTX 1800 Fast?
How many owners have a Honda VTX1800?
What kind of suspension does a Honda VTX1300 have?
What kind of engine does a Honda VTX have?
How many miles does a Honda VTX 1800 have?
What's the price of a 2002 Honda VTX?
What kind of engine does a Honda VTX1300 have?
Despite its considerable heft (727 lb. dry), the VTX clocked a very respectable 12.12-second quarter-mile time at 108.6 mph and hit a measured top speed of 125 mph. Useful resources: You will find practically anything about the VTX1800 you could imagine on the Internet.
7 owners have reviewed their HONDA VTX1800 (2001 – 2006) and rated it in a number of areas. Read what they have to say and what they like and dislike about the bike below.
The big 1800 has decent suspension on it, although the USD front forks are non-adjustable. The VTX handles well for something so heavy, but it lacks real ground clearance, so cornering has to be slow and steady. The VTX1300 has conventional forks and slightly softer suspension, but the same low-to-the-ground chassis layout.
The engine is typically Honda smooth, with just enough vibes to remind you it is in fact a V-twin. Slicker gearbox than most big cruisers, plus shaft drive. It's hard to fault the build quality of Honda's American made cruisers and the VTX range are no exception.
Nice VTX1800 with only 30,962 miles!Get it before it's gone! The VTX1800 is a liquid-cooled, fuel-injected V-Twin. With a 1,795cc engine, this bike puts out 107 hp and 120 ft-lbs of torque. In addition to havin… The VTX1800 is a liquid-cooled, fuel-injected V-Twin. With a 1,795cc engine, this bike puts out 107 hp and 120 ft-lbs of torque.
Loading your results… 2002 Honda VTX 1800 – $3,900 Low mileage (~ 26K miles compared to a more typical 40K odometer reading), one-owner 107hp sport/cruiser bike with 120 ft… 1800 cc VTX Very solid crusier, fast and strong for local or very long disance crusing.
But if power is your thing, then the VTX1800 has got plenty of it, a certain classy elegance about its lines and the mandatory V-twin shaped engine. Also has Honda's linked braking system. The big 1800 has decent suspension on it, although the USD front forks are non-adjustable.
Although the VTX1300 lacks a bit of punch, you cannot say that of the 1800, which makes a meaty 115 ft/lbs of torque at 3000rpm. That's grunt baby. The engine is typically Honda smooth, with just enough vibes to remind you it is in fact a V-twin. Slicker gearbox than most big cruisers, plus shaft drive.
What did tobacco cards come in?
What kind of brake pads do Hondas use?


Michigan State lost a talented wide receiver from its 2019 recruiting class over the weekend.
On Saturday, three-star wide receiver Alante Brown announced his decommitment from Michigan State. He gave the Spartans his verbal pledge in June, but had a change of heart as National Signing Day approaches.
Brown made his announcement via Twitter.
Brown, a 5-foot-10, 180-pound receiver out of Chicago, has 19 offers from the FBS and FCS levels. In addition to Michigan State, he's received interest from Florida State, Minnesota, Missouri, Cincinnati and Texas Tech, among others.
Per 247Sports, Brown is a top 15 prospect from the state of Illinois and is a top 80 receiver in the 2019 class.
Michigan State's 2019 class now has 19 commitments, 18 of which have already signed their National Letter of Intent. The Spartans currently have the B1G's seventh-ranked recruiting class and stand No. 27 nationally.
Cassius Winston says his NBA dreams can wait another year.


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Home Hot right now 2021 Emmy Awards: Facts & Feats
2021 Emmy Awards: Facts & Feats
September 20, 2021 , , Comments Off on 2021 Emmy Awards: Facts & Feats
The 73rd annual Emmy Awards, which were held at Microsoft Theater in Los Angeles on Sunday (Sept. 19), got off to a surprisingly hip start. Emmy host Cedric the Entertainer opened the telecast with a parody of Biz Markie's 1990 hip-hop classic, "Just a Friend." He was joined by LL Cool J, Lil Dickie and actress/singer Rita Wilson on the fondly remembered hit by the rapper, who died in July.
The Emmys also made a hip choice over the In Memoriam spot. Jon Batiste, who won an Oscar in April, joined Leon Bridges for a two-guitar version of "River," a song from Bridges' 2015 debut album.
Beyond some hip musical choices, history was made during the three-hour show. Here are 10 of this year's most notable Emmy facts and feats.
RuPaul became the person of color with the most career Emmys. He won his 11th Emmy for outstanding competition program as an executive producer of RuPaul's Drag Race (VH1). RuPaul pulled ahead of Donald A. Morgan, a cinematographer and lighting director, who has won 10 Emmys. This is the fourth consecutive win for outstanding competition program for RuPaul's Drag Race, which puts it in a tie with The Voice (NBC) for second place on the all-time winners list in this category, behind only The Amazing Race (CBS), which won 10 times.
'Hamilton' won outstanding variety special (pre-recorded), five years after it swept the Tonys. The show won one other Emmy — outstanding technical direction, camerawork, video control for a special, at last weekend's Creative Arts Emmys. Hamilton won a near-record 11 Tony Awards five years ago. The cast album won a Grammy in early 2016 for best music theater album. The original cast album climbed as high as No. 2 on the Billboard 200, the highest ranking for a cast album since 1969, when Hair logged 13 weeks at No. 1.
'Saturday Night Live' won outstanding variety sketch series for the fifth straight year. Prior to this streak, the show won twice—in 1976 and 1993—for outstanding variety series. SNL won eight Emmys this year, bringing its lifetime total to 85, more than any other series in TV history. In accepting the award, executive producer Lorne Michaels said that Weekend Update has been one of the show's signature features since the show's launch in 1975 and that Norm McDonald, who hosted the segment from 1994 to 1997, "was one of the best we ever had." McDonald died on Sept. 14.
'Stephen Colbert's Election Night 2020′ won outstanding variety special (live). It beat The Grammys (which has yet to win a top variety program Emmy), The Oscars, and the Super Bowl halftime show starring The Weeknd, all of which were co-produced by Jesse Collins, as well as Celebrating America – An Inauguration Night Special.
'Last Week Tonight with John Oliver' won outstanding variety (talk) series for the sixth year. That puts the HBO series in a tie with Late Show with David Letterman (CBS) for second place on the all-time winners list in this category, behind only The Daily Show with Jon Stewart (Comedy Central), which won an astonishing 11 times. In accepting the award, Oliver paid tribute to fellow nominee Conan O'Brien, who wrapped up a 30-year run in late night in June.
'The Crown' and 'The Queen's Gambit' were the year's top winners, with 11 Emmys each. They won for outstanding drama series and outstanding limited or anthology series, respectively. This was The Crown's first win for outstanding drama series. The show lost in its first three seasons to The Handmaid's Tale, Game of Thrones and Succession, respectively.
'Ted Lasso' won outstanding comedy series in its first season. It's the fifth sitcom since 2000 to win this top award in its first season. It follows Arrested Development (2004), 30 Rock (2007), Modern Family 2010) and The Marvelous Mrs. Maisel (2018).
Jean Smart became the oldest winner ever for outstanding lead actress in a comedy series. In winning for Hacks, Smart, 69, set a new record as the oldest winner in the history of the category. The old record was set just last year by Catherine O'Hara of Schitt's Creek, who was 66 when she won.
As happened at the Oscars, an actor, widely expected to win posthumously, did not. Many expected the late Michael K. Williams, nominated for Lovecraft Country, to win for outstanding supporting actor in a drama series, but he lost to English actor Tobias Menzies, who played Price Philip in The Crown. Something similar happened at the Oscars in April, where many expected Chadwick Boseman to win best actor for Ma Rainey's Black Bottom, but he lost to Welsh actor Anthony Hopkins for The Father. In both cases, the winning actors were not on hand to accept their awards.
Debbie Allen has won as many Emmys in the past week as she had in her entire career prior to this year. Allen received the governor's award on Sunday, one week after winning two Creative Arts Emmys for her work as an executive producer and choreographer of Netflix's Dolly Parton's Christmas on the Square. These three Emmys in one year equal the number of Emmys Allen had received in her entire career prior to this year. She won two Emmys for her work on the series Fame in 1982-83 and one on the 1991 special, Motown 30: What's Going On!
Miley Cyrus Addresses Panic Attack During Summerfest Performance
Ed Sheeran Logs Record-Breaking Year Atop U.K. Chart
Mary J. Blige Shares New Song 'Rent Money' Featuring Dave East
Louis Vuitton Pulls Out All the Stops For Virgil Abloh Swansong in Paris


Number of Players: Each team has a maximum of 8 players. Teams play 4-v-4 games so that each player can be involved as much as possible and have more touches on the ball. Teams are encouraged to play down a player if their team is winning by 5 goals or more.
Goalkeeper: None, Players are not allowed to stand in their defensive goal mouth (or arch) and defend the goal.
Referees: Coaches are to referee the game. Each team is allowed to have one coach on the field to assist the players and be the official of the game.
Playing Time: There is a minimum of two quarters playing time for each player.
Game Length: Each game is divided into four quarters, 8 minutes in length. There is a 2 minute rest period between quarters and 5 minutes at halftime.
Throw-ins: Throw-ins are taken when the opposing team kicks the ball across one of the sidelines. The player taking the throw in must keep both feet on the ground when the ball is thrown and both hands must deliver the ball from behind and over his/her head in a continuous forward motion.
Corner Kicks: Corner kicks are taken when the ball crosses the end-line and is last touched by a member on the defending team.


Originally written in 1964, this report is the first ethnographic monograph ever written on the Semelai, an Orang Asli community who make Tasek Bera - now a renowned wetlands heritage site - their home.
The report is filled with keen observations on the way of life of the Semelai people a generation ago, at a time when they were resettled to Pos Iskandar to isolate them from the security threat caused by the Communist insurgents. The author was therefore observing the Semelai during a period when they were changing from a traditional to a more modernlife style. This makes his observations all the more memorable and significant.
Hoe Ban Seng carried out his fieldwork on the Semelai as part of his undergraduate studies. He was 19 years old at the time.
Today, Dr. Hoe is the Curator of Asian Studies at the Canadian Museum of Civilization in Quebec.


If you're searching for the ideal holidays cottages in England for you, look no further than Imagine UK Cottages.
We have an excellent selection of beautiful holiday cottages in the UK in a range of regions, from the beautiful peak district to the most scenic parts of Lancashire.
And here at Imagine UK Cottages we understand just how important choosing the right accommodation is to ensuring you have the best possible experience during your stay.
That's why we have holiday homes in England to suit all tastes and needs.
So, whether you're searching for a cottage your dog can stay in too or accommodation suitable for families with babies, you're bound for find something that's just perfect when you come to us. Why not browse our site today and start planning your getaway?
What can I expect from holiday cottages in the UK?
At Imagine UK Cottages, we pride ourselves on always going the extra mile to ensure you have the best break possible.
You'll find our properties are located in a range of fantastic destinations around England, so you can visit some of the most scenic areas the country has to offer.
For example, if you're a keen walker you could choose to stay in Northumberland, where you will be able to visit the vast, picturesque Northumberland National Park.
Alongside the stunning scenery, you can expect to see a vast array of wildlife.
Meanwhile, we also offer holiday homes catering for just about every need possible, from pet-friendly accommodation to those perfect for beach and fishing holidays.
Golfing cottages, luxury properties and homes designed with romance in mind are all among the vast selection we offer – so you can be sure of finding something that's just right for you, no matter what kind of break you are planning.
Finding and booking incredible holiday homes is easy when you come to Imagine UK Cottages.
Committed to offering an excellent service, we provide a wonderful selection of quality accommodation catering to a range of needs.
To start planning your dream getaway, simply search our site for properties that meet your requirements and you'll find yourself enjoying the break of a lifetime with us in next to no time.


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Q: Auto spawn rabbit mq listener I'm working on an application where-in I have a listener on a rabbit mq queue. Depending on the kind of message, the listener goes ahead and performs a task. My problem is I need a way to spawn a new listener if a single listener isn't able to cope up with the queue. As far as I can tell, I can use the rabbitmq json api to find the len of the queue and take actions based on that. So, I write a script that checks using curl the queue length and spawns a new listener process. Am I on the right path here? Is there a better way to achieve this? I'm looking for a solution that kinda scales with load to a certain limit atleast.

A: Checking the RabbitMQ API to see the length of the queue is one way, and it would definitely work.
You should try to predict when the load is spiking so that you slowly can increase the number of consumers if needed, so that you don't see a sudden spike of instances spawning. Having many instances spawning simultaneously could cause unnecessary load on your system.

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