Balkinization  

Friday, March 14, 2008

Spitzer v. United States (2010)

Michael Stokes Paulsen

SPITZER v. UNITED STATES, No. 09-102

JUSTICE KENNEDY delivered the opinion of the Court, joined by Justices Souter, Ginsburg, Breyer, and Clinton

Just seven years ago, this Court proclaimed: "Liberty protects the person from unwarranted government intrusions into a dwelling or other private places. In our tradition the State is not omnipresent in the home. And there are other spheres of our lives and existence, outside the home, where the State should not be a dominant presence. Freedom extends beyond spatial bounds. Liberty presumes an autonomy of self that includes freedom of thought, belief, expression, and certain intimate conduct. The instant case involves liberty of the person both in its spatial and more transcendent dimenstions."

Those words were, of course, the opening lines of our landmark decision in Lawrence v. Texas. Those words are as important today as they were in 2003. This case, too, presents an issue of liberty, this time time outside the home, involving thought, expression, and intimate conduct. In this case, too, the State should not be a dominant presence.

This case presents the issue we carefully reserved in Lawrence. See Slip Op. at 18 (noting that that case did "not involve . . . prostitution"). We now conclude that the liberty recognized in Lawrence applies equally to private, consensual sexual conduct by adults, in whatever form of intimacy those adults design. The fact that the arrangement might, in some sense, be thought commercial does not necessarily indicate that it is anything other than consensual.

The reasoning of Lawrence fully extends to the conduct at issue here. The government has attempted to criminalize consensual adult sexual relationships, merely because that consent involves a financial transaction. Though given the name "prostitution," that ancient pejorative, full of moral condemnation, cannot survive the realities of modern understandings of the right of individuals to make their own choices in matters "involving the most initimate and personal choices a person may make in a lifetime, choices central to personal dignitiy and autonomy." Slip op. at 13, quoting Planned Parenthood v. Casey, 505 U.S. 833, 851 (1992).

As we noted in Lawrence, and as is likewise true here, [t]he petitioners were adults at the time of the alleged offense. Their conduct was in private and consensual." We noted, in Lawrence, the long line of cases supporting the constitutional right to privacy with respect to consensual sexual conduct, from Griswold to Eisenstadt to Roe to Carey to Casey. We swept aside Bowers v. Hardwick as a deviant case, departing from our norms. As we said in Lawrence, "a person relationship that, whether or not entitled to formal recognition in the law, is within the liberty of persons to choose without being punished as criminals." Slip Op. at 6. "When sexuality finds overt expression in intimate conduct with another person, the conduct can be but one element in a personal bond that is more enduring." Id. One need not endorse the sexual conduct at issue here -- one may recognize its emotional harm to third parties, such as spounses and children -- yet still recognize that an intimate sexual relationship, "whether or not" entitled to the law's embrace, cannot incur the laws condemnation. The record here shows a long relationship. The petition certainly cannot be punished as a criminal for that relationship. To do so would be to deny him the "right to define [his] own concept of existence, of meaning, of the universe, and of the mystery of human life" -- matters "[a]t the heart of liberty." Lawrence, quoting Casey.

As in Lawrence, we acknowledge that "for centuries there have been powerful voices" to condemn prostitution "as immoral. The condumnation has been shaped by religious beliefs, conceptions of right and acceptable behavior, and respect for the traditional family. * * * These considerations do not answer the question before us, however. The issue is whether the majority may use the power of the State to enforce these views on the whole society through operation of the criminal law. 'Our obligation is to define the liberty of all, not to mandate our own moral code.'" Slip op. at 10 (quoting Casey). That liberty, as we demonstrated in Lawrence, evolves with our sense of evolutions in social understandings, reflected in changed perceptions both in the United States, and, especially, in enlightened nations of western Europe, like the Netherlands. See id. Slip op. at 11-12. As in Lawrence, so too here: "The right the petitioners seek in this cae has been accepted as an integral part of human freedom in many other countries. There has been no showing that in this country the governmental interest in circumscribing personal choice is somehow more legitimate or urgent." Slip Op. at 15.

There is no persuasive basis for distinguishing the Lawrence Liberty here. Moral condemnation is not, as we have shown, a persuasive or legitimate basis for laws interfering with intimate sexual liberty. Again, in Lawrence, we observed (following JUSTICE STEVENS's dissent in Bowers), that "'the fact that the governing majority in a State has traditionally viewed a particular practice as immoral is not a sufficient reason for upholding a law prohibiting the practice.'" , Slip Op. at 17. Nor is the fact that the arrangement may have a commercial element sufficient to distinguish this case. Abortion, which we have held to be an essential aspect of liberty, usually involves a commercial transaction. That does not lessen the liberty-refuge that we think should not be doubted.

This case, like Lawrence, involves "two adults who, with full and mutual consent from each other, engaged in sexual practices common to a [prostitution] lifestyle. The petitioners are entitled to respect for their private lives. The State cannot demean their existence or control their destiny by making their private sexual conduct a crime. The right to liberty under the Due Process Clause gives them the full right to engage in their conduct without intervention of the government." Slip Op. at 18. There is, as we have often said, "a realm of personal liberty which the government may not enter." Casey, supra at 847. The Mann Act furthers "no legitimate [government] interest which can justify its intrusion into the personal and private life of the individual."

We conclude where we began, with the stirring words of Lawrence, this time from its penultimate paragraph:

"Had those who drew and ratified the Due Process Clauses of the Fifth Amendment or the Fourteenth Amendment known the components of liberty in its manifold possibilities, they might have been more specific. They did not presume to have this insight. They knew times can blind us to certain truths and later generations can see that laws once thought necessary and proper in fact serve only to oppress. As the Constitution endures, persons in every generation can invoke its principles in their own search for greater freedom."

We uphold petitioner Spitzer's "search for greater freedom." We therefore reverse his conviction on constitutional grounds. We have no need to reach the question of the proper construction of the federal statute at issue here, for we rest our decision on the more fundamental ground that liberty protects consensual prostitution. The statute cannot constitutionally applied to the conduct for which petitioner was prosecuted.

It is so ordered.

Comments:

Assuming that Justice Clinton is Bill Clinton, is it not ironic that your theoretical Court Opinion that one of the Justices who overturn the previous decision (I'm assuming Spitzer was convicted on prostitution charges) was caught in a similar situation in office?
 

i'm sure that prof. paulsen is having a field day over the inclusion of "justice clinton"; however, i would submit that inasmuch as bill clinton has been disbarred, i would assume he is not eligible to sit as a member of the supreme court. on the other hand, i understand that hillary is still a member in good standing; therefore, she could be the justice referred to, which assumes an obama presidency inasmuch as i doubt hillary (or bill for that matter) would be nominated by mccain. on the other hand, it could be any other clinton who happens to be a member in good standing with any bar association.
 

Cf. Lawrence, 539 U.S. at 578: "The present case ... does not involve public conduct or prostitution."
 

One need not be an attorney to be a Supreme Court justice, so I see no reason why a disbarred attorney could not be one. On another subject, although, as a legal matter, I agree with the opinion in Spitzer v. United States because the case involved consenting adults, as a moral matter, I think that for a 48-year-old man to have sex with a 22-year-old prostitute is for him to take advantage of her and is repulsive.
 

Let's keep sight of what's really going on here -- this is an attack on Lawrence, not a real argument in favor of legalizing prostitution.
 

The use of Justice Clinton is cute if a bit snide. I second the fact that nearly anyone can be confirmed as a justice; one need not be a lawyer, for instance.

I personally think a serious case can be made (and know of a mock opinion voicing the point, one written before Lawrence) that prostitution is a liberty interest with constitutional dimensions.

And, the fact sale is involved is not a bar -- see, e.g., Carey, involving sale of contraceptives. One ruling involving sex toys wrongly suggested it did matter.

All the same, the economic component of prostitution along with the gender issues do raise some serious rational basis reasons for banning the practice. Lawrence specifically put it in another category and not arbitrarily so.

This includes (see Balkin's discussions) societal legitimacy. Those who want to criminalize homosexual relations are simply not on the level of those who think there is a rational basis for prostitution laws. Nor did states over the last two decades slowly legitimatize prostitution relations as it did homosexual couples (e.g., supporting same sex adoptions, domestic relationship rights, anti-bias laws, etc.).

Lawrence did not use the same level of scrutiny as Roe (or even Casey), so purchase of abortion services (which might have some problems, but is quite different from prostitution in various ways) is not quite on point either.

Finally, Spitzer might be guilty of some financial crime, like "structuring" which is a separate matter.

Again, honestly, I think prostitution should be legal, and various blogs over the last few days (some feminist leaning) agree. But, this mock opinion is a bit too cute.
 

Back in the fall of 1952, the late Prof. Thomas Reed Powell described in his ConLaw class whether the Mann Act was violated as follows: "It depends upon whether it [the alleged act] was for pure pleasure or purely for pleasure." Keep in mind that the sport of baseball was not considered to be commerce, even though money was involved, in addition to extensive interstate activities. (Justice Thomas' originalism might agree with this, especially since baseball was not a sport at the founding.) Spitzer's trip to D.C. appears primarily to have been to testify before Congress. Thus, the potential Mann Act act appears to have been incidental only to his trip from New York to D.C. Call this pure hypothesis on my part that his trip was not purely for pleasure (e.g., testifying before Congress), although he got a little on the side. Shouldn't the world's oldest profession be accorded the same courtesy and precedent as baseball? Can the Mann Act survive without interstate commerce?
 

Assuming that Justice Clinton is Hillary, this gives new meaning to being an enabler...

In any case, this hypo serves as an excellent backhanded critique of the Lawrence decision which Justice Scalia could have written.
 

I'm surprised the decision omits the important stepping-stone precedent of Dildo v. Texas (2009).

But of course, if it had, then the "satire" goal of your post would have imploded. So perhaps I'm not surprised after all.
 

Unless Texas wins en banc, it'll be the petitioner in the sex-toys case. (Plus it's a non-criminal case, so it'd be Earle v. PHE, Inc.--can't sue the state directly, 11A and all that.)
 

So if Justice Scalia had written the Lawrence decision focusing upon the slippery slope connection of two alleged strange bedfellows, which bedfellows among the other justices might have joined in his decision? Might such a Justice Scalia decision serve as a precedent against a solo non-public masturbater? It was George Carlin who pointed out that if such a solo act were illegal, people would take the law into their own hands. Justice Scalia's response to Carlin, off hand, might be that with two there's a conspiracy, and everybody knows how evil conspiracies can be.
 

Unfortunately, markets in real life don't operate the way they do in textbooks.

The law exists to do more than to facilitate 'mutually beneficial transactions'.
 

Justice Thomas' originalism might agree with this, especially since baseball was not a sport at the founding.

There's a least one reference to "base ball" from 1774. Doubtless it referred to something more like cricket or rounders, but if an originalist can go from muskets to Uzis, this shouldn't pose any problem.
 

beautiful....

Fox News would breathlessly report that the SC ruling would lead to church ceremonies for a man could marry his sister's male dog just as they warned us it would happen.

Bill O'Reilly's word of the day:

Liberal necrophilia


and henry;

I think that for a 48-year-old man to have sex with a 22-year-old prostitute is for him to take advantage of her and is repulsive.

hence the commercial aspect to the relationship ;)

and isn't that just so patriarchal and ageist of you... "take advantage"

i saw a picture of her on the front page of the SF Examiner today. she was pretty hot...

you'd think that would make spitzer more manly in the republican lexicon... like whoa dude! sure you paid for it, but, like, you're rich and she's hot!

isn't that what they said about Fred Thompson and his barbie doll, not to mention the endearing web of lies about age that McCain likes to tell about meeting his young, impressionable, and HOT heiress.

Ricki Lake: Cousin Lovin'
 

Unless Texas wins en banc

Which I'm kind of expecting, given where we are.

Appellants filed their responses opposing review March 10; the same day, a "revised" version came down, but I haven't correlated it w/ the original (such an annoying habit of the judiciary -- say up front in a footnote *what* is revised).

And of course it's Justice Hillary Clinton, silly people. Obama would happily do that to keep her from running for the nomination again in 2012.
 

At $1000+ per hour, it seems to me that she took advantage of him.
 

Shag from Brookline,

The statute is violated if the defendant knowingly induced someone to cross state lines to engage in an illegal sexual act. Whether Spitzer was crossing state lines to do so is irrelevant so long as "kristen" was.

Orin Kerr
volokh.com
 

The statute is violated if the defendant knowingly induced someone to cross state lines to engage in an illegal sexual act.

Right. Or as the old shaggy-dog joke has it, transporting gulls across state lions for immortal porpoises.
 

The point is he broke the existing law, and unlike you or me, he is the Governor and chief law enforcement officer of NY. What does a rant about prostitution have to do with anything, except to confuse what is at stake?
mike in Miami
 

Further with respect to Justice Thomas' originalism, especially regarding the commerce clause, I doubt that he buys into Chief Justice Marshall's Gibbons v. Ogden view that commerce includes intercourse. I say this tongue in cheek, of course - my tongue in my cheek, that is. Further, the Mann Act discriminates by gender unless equally applicable to all sexes. Isn't there a question as to who was the inducer and who was the inducee?

When was the last time a Mann Act allegation violation went to court? Is there a prosecutor or defense attorney out there who has been involved in such a case (but not as a party) in the past 20 years?

By the way, the late Prof. Powell had a much better sense of humor than most ConLaw professors today.
 

Griswald held hetero couples could use prophylactics if they so chose. Roe held women could terminate an unwanted pregnancy. Bowers sactioned police entering homes to arrest homophiles, and finally Lawrence decided the Bowers case was wrong.

Only Griswald, Bowers, and Lawrence involved no money. Yet, the Supreme Nines took until 2003 to acknowledge barely that their 1986 Bowers was an extreme intrusion into privacy and a double standard in light of Griswald, Roe, etc. I doubt the Supreme Nine today would vote the same. If money were added, well, no way the same.

Perhaps notions of "consistency," "coherency," "logic," and predication are too remote for our Supremes. They seem to reach for the stars, foreign ideas, and violate ordinary language with remarkable success. Perhaps, the problem is the lack of language and logic courses in law schools. Reading the justices' casuistry, they either know it, and commit every fallacy knowingly, or don't know it, and their decisions reflect it.
 

I don't think this satire really works, because there are obviously all sorts of rational basises (bases?) for banning prostitution besides moral condemnation. However, Lawrence does raise questions about bestiality, necrophilia, and statutory rape laws.
 

The condumnation has been shaped by religious beliefs, conceptions of right and acceptable behavior, and respect for the traditional family.

I'd expect a better typo in an article like this. Why not "condomnation"? Too subtle?
 

Actually the Lawrence majority is clear that money was NOT involved and that if it was, they might have ruled differently.
 

When was the last time a Mann Act allegation violation went to court?

At least 6 such cases have gone all the way to the Supremes. Wiki summarizes them here.
 

Let's not forget the bottom line here. Prof. Paulsen was offended that the Supreme Court ruled that the government couldn't throw gays in jail because of who they had sex with.

In other words, he is using condemnation of prostitution as a backhanded way to justify condemnation of gays and lesbians, i.e., bigoted homophobia.

It stinks, and he should be called on it.
 

Good satire should be a little more believable. The illegality of prostitution is justified by its secondary effects, not because of its immorality. Unless you think lewd conduct is protected by Lawrence, Lawrence is simply inapposite.
 

i am somewhat disappointed that this submission has been dismissed as satire and that no one had mounted a spirited defense of the fact that a great number of Americans would rejoice in a decision like this.

there have been a few references justifying the ban on prostitution on non-moral grounds. while they have been alluded to, they have not been mentioned.

i submit that it is only moral sensibilities that consign prostitution to illegality.

having sex with a hooker is analgous to a ride at six flags, sure there are some risks... that's why you have safety standards... many industries had them under democratic presidents.

i also gather from the tone of some of these posts that paulsen rather approved of bowers, in some sense... i could be wrong... but, either way... who cares....

who wants to point out what is substantively wrong with this opinion on grounds other than morality?

obviously for the right amount of money some women are willing to have sex with men, and vice versa i presume...

why should this not be treated as a fundamental right to treat your body like an amusement park if you want?

offended sensibilities?
 

I think the comments to Professor Paulsen's post well make (what I take to be) his point. One may argue that Spitzer is distinguishable from Lawrence or one may argue that the reasoning of Lawrence should govern Spitzer. But neither of these arguments has any connection to the Constitution because Lawrence has no connection to the Constitution, other than having been decreed by Justices appointed and confirmed according to its provisions.
 

"I think that for a 48-year-old man to have sex with a 22-year-old prostitute is for him to take advantage of her and is repulsive."

He paid her 4300 friggin dollars for crissake! Tell me again... WHO "took advantage" of WHO???
 

MLS,

You are blatantly wrong. This has everything to do with the fact that the Bill of Rights was intended to keep the government out of certain private, consensual activities.

It was.

That we are only now getting around to weeding sanctimonious morality out of the law is not argument that it shouldn't be done.
 

i can't remember who said it, but, i love this quote.

"Virtual reality? The rich have had it for years."

they've always had it. brothels are a rich part of american history often overlooked in the H.S. curriculum.

hypocripsy on this is as old as the profession.
 

He paid her 4300 friggin dollars for crissake! Tell me again... WHO "took advantage" of WHO[M]???

Well, she certainly didn't take advantage of him, as he was an intelligent and knowing purchaser of her services. But 22-year-olds are still children in some ways, and a girl (I use the word deliberately) who goes into prostitution -- high-priced or not -- is likely to have psychological problems. I think that we ought to have compassion for her, and that Spitzer was exploiting a vulnerable young woman.

Perhaps, however, Spitzer deserves compassion too, as his behavior doesn't seem particularly sane. His risk-taking resembles a symptom of the manic phase of bipolar illness. But I know next to nothing about Spitzer and have no idea whether he has exhibited such symptoms before.
 

As I read somewhere on another blog, why is it that:

Two people have sex, both are paid, it is taped, and later the tapes are marketed and sold as a commercial product and that transaction is legal;

As compared to

Only one person is paid for the sex, and that transaction is illegal.

Seems to me every escort service “John” should bring a video camera and claim he is volunteering his services.
 

Garth said:

MLS,

You are blatantly wrong. This has everything to do with the fact that the Bill of Rights was intended to keep the government out of certain private, consensual activities.

It was.

That we are only now getting around to weeding sanctimonious morality out of the law is not argument that it shouldn't be done.



I stand corrected. I have reviewed my constitutional history and now see that Hamilton clearly referred to the right of the Governor of New York to make appointments “closeted in a secret apartment with at most four, and frequently with only two persons.” I don’t know how I missed the obvious sexual innuendo, particularly since it is smack in the middle of Federalist 69.

Now that the scales of sanctimonious morality have fallen from my eyes, it is apparent that the Constitution protects the right to abortion, sodomy, gay marriage and prostitution. Also bigamy, pornography, drug use and smoking. Unless those are based on the non-sanctimonious type of morality. Sometimes it is so hard to tell.

I can hardly wait for Justice Clinton to enlighten me.
 

Per Mark Field and Dilan, let's be fair. His hatred (see his mock opinion in Balkin's book) of Roe also factors in here.

A search of The Federalist will lead to a couple references to "private" rights, John Adams honored the rights of private life in the development of a moral people, invasion of the privacies of life was a core concern (see, e.g., fear of general warrants and quartering), etc. Thus, it was an essential liberty, secured at least by the 1st, 3rd, 4th, 5th and 9th (and probably the 10th) amendments. And, toss in the 2A, since arms secures our rights from invasions.

As to the 14A, invasion of privacy in sexual relationships was a core evil of slavery. Equality also is sorta in the Constitution, and anti-homosexual laws harms that as well. Privacy and equality were both referenced in 19th century opinions.

Finally, a 22 year old is still a child in many ways?! I guess we have loads of child brides (a few in my family, natch), huh? Let's not forget those May/December marriages!
 

Joe, how adult were you at 22? Unless you're not much older than that now, an honest answer, unless you're exceptional, would probably be "not very." Remember, I'm not talking law right now; I'm thinking of the psychological implications of a 48-year-old man having sex with a 22-year-old woman.
 

Henry,

22 year olds are old enough to drink, vote, have consensual sex, sign up as a Halliburton contractor in Iraq...

They are deemed by the law to be fully their own purpose entitled to all of their constitutional rights to privacy.

For a local example of how legalized prostitution would work, one need look no further than the state of Nevada. Many an Entertainment Tonight story featured a visit to the legendary Mustang Ranch and surprisingly sympathetic interviews with some of the girls...

Prostitution and brothels have existed in every major american city since before they were cities.

It is squeemishness about human sexuality that is driving all of the purely moral objections to legalized prostitution.

The logic of Lawrence logically extends precisely as Prof. Paulsen proffers.

I have yet to see anyone offer a critique on the merits. Too cute by half.

Sure, sure, I know the busch hounds at the doj are tring to drum up financial "irregularities" but that is truly beside the point of what is clearly a political hit.

Perhaps Prof. Paulsen would be willing to honor us with a copy of this opinion written by the S.T.A.R. chamber justices.

*scalia, thomas, alito, roberts
 

Garth, I favor legalizing prostitution, at least for 21-year-olds, and believe that the Constitution demands it. I also agree with everything you say in your comment; as I said, I was not talking about law. I still think that Spitzer, unless he suffers from bipolar illness and was in the throes of a manic phase, exploited the young woman and engaged in morally reprehensible behavior.
 

Henry,

That's a curious diagnosis.

Isn't it just as likely that Spitzer merely enjoyed casual sex?

I am not denying that a penchant for prostitutes couldn't be masking some deeper personal problems, but, aside from this prostitution bust, they hadn't really affected his ability to become a rising star in the democratic party and poised to remove one of the last bastions of Republican support in New England, the NY State legislature.

Spitzer was a dangerous man and he has been neutralized, brought down by deliberate exposure of his private affairs.

Prior to this I don't recall hearing any whispers of a bi-polar elliot spitzer.
 

Henry,

i freely concede that many on Wall Street thought he was morally reprehensible...

good.

to paraphrase one of my favorite RW moonbats, every now and then it's good for democracy if our government picks some scummy corporation and throws'em against them wall.
 

Garth, I agree that it just as likely that Spitzer merely enjoyed casual sex. I have no evidence from before this episode that Spitzer is bipolar; I merely raised the possibility because symptoms of the manic phase can include reckless behavior, extra-marital sex, and overspending of money. But sane people, obviously, also engage in all those practices.
 

Consider the age difference in this context:

A wealthy 90 year old man marries a beautiful 30 year young trophy wife.

Question: How many times does 90 go into 30:

Answer: Fractionally.

But is age the issue here or the fact that Spitzer is a democrat? Let s/he who has never sinned, cast the first stone? Now how many of you critics voted for George W, twice?
 

politicians are complicated people. i think it comes from having so much power and money that they become uncentered.

it was truly reckless for spitzer to think he could get away with this and it's hard to feel too much sympathy for the guy.

but, as for forcing his resignation, i think that's just a bit much, and, frankly, moralistic. It's all right to feel moral outrage. I agree that many people find his actions unseemly at best, but, let's not blow things out of proportion.

This matter is rightly between him and his family.

The constitutionality of prostitution goes to the heart of why this should be a purely private matter.

I agree that the whole thing is embarrasing to witness because it is so private. Some things you just don't want to know. Upon learning about the whole sorry affair, my first reaction was, I did not need to know that. but i do want to know that it was leaked by a doj intent on bringing down another political enemy.

while i feel the press was obligated to report it, clearly the doj violated the law in leaking it.

This is embarrassing for Spitzer, his wife, his friends and family. It is the airing of dirty laundry, titillating gossip for some, wince inducing for most, and cheer inducing for his enemies.

Henry, I agree with you that there is a major imbalance in any relationship between an older, experienced person and a younger, compratively less experienced person. As in any imbalance in power, the possibility that advantage will be taken is present.

Unfortunately, it's part of growing up and finding one's way in the world on your own terms.
 

Garth, I agree that Spitzer should not have resigned. If this incident has involved a European politician, it would have been on the back pages, because people are more grown up in Europe; if Spitzer had not resigned, it might have started to make politicians' personal conduct less important here too. (Perhaps his resignation was part of a plea deal offered by Republican prosecutors who wanted to forced him out.) Of course, even though I did not want him to resign, I could understand not voting for him again because of his hypocrisy -- unless he learned something from the experience and ordered that the prosecution of prostitutes in New York cease.
 

Agreed :)
 

Now that the scales of sanctimonious morality have fallen from my eyes, it is apparent that the Constitution protects the right to abortion, sodomy, gay marriage and prostitution. Also bigamy, pornography, drug use and smoking. Unless those are based on the non-sanctimonious type of morality. - MLS


By George I think you've got it!
 

Harvey Silverglate's Op-Ed in today's Boston Globe titled "Spitzer's legal minefield" spells out the potential legal obstacle course Spitzer may face at the federal level. Here's the closing paragraph:

"In cases like Spitzer's, the pliability of federal law won't generate much outrage. Many look forward to seeing the arrogant governor get his comeuppance. But there is good reason to fear these weapons at the Department of Justice's disposal. Anyone in the daily commerce of professional life is vulnerable."

A word to the wise from a civil libertarian.
 

We don't live in Europe. Overall, it is quite pragmatic to think ES in particular had to resign. A different public figure who hired a prostitute very well could be different.

The guy prosecuted prostitutes. He had a rep as a sanctimonius prick who already had a rough beginning as governor, partially because of a controversial move by some underlinings involving the soon to be second in charge (the Republican head of the state Senate). He earned his chops as a law enforcer reformer. He already had a bad relationship with the legislature and fiscal community, so had little breathing room as is.

Moralistic concerns surely factor in here, but that is not the only problem. He had to resign because he was a reckless hypocrite who didn't have the room to ask for a pass here. This doesn't mean his targeting shouldn't get us nervous. It just means that yeah life is sometimes unfair, especially when we tempt fate a bit too much.

I'm mostly on the same page with Garth, however, on the age thing. At 22, you often have graduated college, might be on your own, have a job, and yeah, are probably sexually active. And, part of that is growing pains, and often some relationship with an older partner.

But, ES wasn't having sex with an intern or aide here. He bought the sex. Older employers exploit labor all the time, I guess, but to be morally offended about the age difference in this respect -- getting a young thing seems a key point of buying it -- seems a bit off.

Esp. for someone who speaks of consenting adults (are we talking 30 year olds?) and legalized prostitution.
 

to be morally offended about the age difference in this respect ... seems a bit off. Esp. for someone who speaks of consenting adults ... and legalized prostitution.

There is an inconsistency here only if one believes, as too many people do, that what is immoral or bad for you should necessarily be illegal. One can favor the legalization of prostitution, drugs, abortion, etc., without endorsing them.
 

Of course both tobacco and booze have been legal for a long, long time. Booze is a drug, in fact my personal drug of choice, but in moderation. I don't endorse either tobacco or booze for others, but I should have the right to choose for myself, even if smoking and drinking can be bad. (Full disclosure: I do not specialize in DUI defense.) I once asked (tongue in cheek) what was the difference between a libertarian and a libertine. A wiseguy responded: "The libertine gets laid."
 

I take that point about finding things that should be legal repulsive (still think prostitution is different than a different sort of relationship in this respect) though I do wonder what is "adult" enough for you.

25? She easily could have been 25. Or is it all twenty-somethings? These days, many still are at home etc. Sorry, that is just too far for me.

And, maturity often isn't an age thing ... if we really want to be fair here. Spitzer is 48, but was more reckless and immature than many twentysomethings.

Repulsion is a personal sentiment, so I can easily disagree respectfully with you on this issue. Anyway, a pretty lame piece led to interesting comments ... cheers!
 

Whether the hypothetical opinion was intended as satire or not, it represents a plausible extension of the reasoning of Lawrence v. Texas. The contours of the personal autonomy and privacy interests embaced within the Lawrence concept of personal liberty are indeed being litigated in state and lower federal courts.

The U.S. Eleventh Circuit and Fifth Circuit Courts of Appeals have reached different conclusions about the effect of Lawrence upon state statutes criminalizing the sale of sex toys. If the Fifth Circuit does not grant rehearing, that intercircuit split may reach the Supreme Court.

With regard to prostitution, a divided Supreme Court of Hawaii upheld that state's prostitution statute agaist a claim, based in part on Lawrence, that the statute as applied violated the constitutional right to privacy. The dissenting justice wrote:

"The uncontroverted evidence in the present matter demonstrates that Romano was held criminally accountable for wholly private, though admittedly sexual, behavior with another consenting adult. As its majority noted, Lawrence presupposed private sexual activity between two adults fully capable of giving valid consent. 539 U.S. at 578. Neither the present matter nor Lawrence concerned 'persons who might be injured or coerced or who are situated in relationships where consent might not be easily refused.' See id. And, as I have emphasized, this case does not implicate public solicitation, streetwalking, or salacious advertising, which are not private activities. Rather, the present record reflects that the charged transaction could not conceivably have hurt anybody other than Romano, which renders her conviction under [the Hawaii statute] -- absent a showing of a compelling interest from the prosecution -- a violation of her federal and state constitutional rights to privacy as articulated in Lawrence and by the drafters of article I, section 6[ of the Hawaii Constitution.]"

State v. Romano, 114 Haw. 1, 23, 155 P.3d 1102, 1124 (2007) (Levinson, J., dissenting).

I have challenged the constitutionality of Tennessee's
prostitution statutes, based in part on Lawrence. The Court of Criminal Appeals of Tennessee conspicuously declined to address the Lawrence issue, (despite a vigorous petition for rehearing,) thus leaving this issue open for future litigation. Indeed, the appellate court did not even mention Lawrence.
 

Here's a piece available via FindLaw on the Mann Act:

http://news.findlaw.com/ap/other/1110//03-16-2008/20080316095003_10.html

providing a history, including its application (or misapplication?).
 

I think that for a 48-year-old man to have sex with a 22-year-old prostitute is for him to take advantage of her and is repulsive.

Well, I agree someone's being taken advantaged of here, but last time I checked the 22 year old wasn't paying someone $5,000 an hour to satisfy some lusting carnal urge.
 

I don't give a hoot about having sex with a pro. that is not the real issue. there might be charges other than consorting with a prostitute...Mann Act and money laundering...that is not legal.
 

As I understand it the criminalization of prostitution is a relatively recent idea. Brought to you by the same people who thought alcohol prohibition was a swell idea.

We fool with long standing human institutions at our peril. Sometimes it works - slavery. Sometimes it backfires - alcohol prohibition.
 

Is lewd conduct a fixed standard like robbery?

Any one listen to hip-hop lately?

How can you have laws against things with no fixed definition?

Oh. Yeah. The socialist fig leaf. Community standards.

Magic word: xbbanlm

There is a message in there. Perhaps Wonkette can help.
 

My guess is that Hillary wanted him to resign. Too close to home. Too many reminders of Bill.
 

But 22-year-olds are still children in some ways, and a girl (I use the word deliberately) who goes into prostitution -- high-priced or not -- is likely to have psychological problems.

The government is my shrink. It will not only take care of me physically but mentally too.

Comforting.
 

Pseudo-trackback ping: Most frighteningly plausible fantasy I've read this month. And my bet is that the reference is to Madame Justice Clinton, as part of the Great Denver Compromise of 2008 in which the Clintons were guaranteed President Obama's first two SCOTUS appointments. (Bill's Arkansas license was only suspended for five years back in 2001, and he resigned his SCOTUS bar membership under threat of permanent disbarment, but that's no obstacle under Article III, which as others have pointed out doesn't even require that one be a lawyer.)
 

BTW, it's clear to me that this isn't a Mann Act case, nor an appeal from a conviction for structuring or another federal financial crime. Rather, this is an appeal from a straight-up solicitation of prostitution charge filed under District of Columbia Code § 22-2701, with that venue explaining why the United States is the respondent.

dilan (8:00 p.m.): It is entirely possible to agree with the result reached in Lawrence (reversing the sodomy conviction) without joining in the substantive due process malarky contained in Justice Kennedy's majority opinion. Read, for example, Justice O'Connor's concurring opinion, which was based on an equal protection analysis ("Sodomy between opposite-sex partners ... is not a crime in Texas. That is, Texas treats the same conduct differently based solely on the participants") that would have left Bowers intact. So perhaps you should back off from your accusations of bigotry on the part of Prof. Paulsen. Not everyone who questions, or even ridicules, Lawrence is homophobic, and indeed some of us (myself included) would describe ourselves as being pro-gay rights in general.
 

Wouldn't Lochner also apply?

CW
 

""I think that for a 48-year-old man to have sex with a 22-year-old prostitute is for him to take advantage of her and is repulsive."

He paid her 4300 friggin dollars for crissake! Tell me again... WHO "took advantage" of WHO???
# posted by Blogger Belchfire : 9:09 PM"

Actually, on reflection, Heather took advantage of Paul. $50M!!!
 

The reference to the case from Hawaii is interesting, but the dissent is pretty limited.

In part:

Adoption of my analysis by the majority, would not, therefore, compel the legalization of prostitution in its usual manifestations: streetwalking, escort services, or even hostess bars.

The service here was publicly advertised. It was an "escort service." Also, the dissent leaves something to be desired:

However, where two consenting adults swap money for sex in a transaction undertaken entirely in seclusion, the analysis of the Lawrence majority, despite the majority's attempt to avoid the notion, leads inexorably to the conclusion that the state may not exercise its police power to criminalize a private decision between two consenting adults to engage in sexual activity, whether for remuneration or not. See 539 U.S. at 590 (Scalia, J., dissenting)

Interpreting the majority in the way you but not they find consistent isn't quite the road to appellate success. The cite to Scalia's dissent is also a red flag. Opinions normally don't have the "slippery slope" quality, for better or worse, than dissents accuse them of having.

Anyway, by its own words, the dissent only would protect a limited range of prostitution. As to the late comment on this thread challenging Dilan, I question if Paulson supported O'Connor's concurrence.

Relatedly, Lawrence is quite reasonable application of earlier privacy rulings. Equal application, perhaps, one can say. You might find them "malarky" too, but that's another matter.
 

Finally. Thank you for having the sense and guts to take a stand by freeing up consensual sex between people. Neither Government nor Religion should involve themselves in that part of our personal lives. Especially if we want sex to happen. You have to understand. Everytime a woman says to her husband, "You didn't buy me anything for my birthday, so you're not getting any sex." She is asking selling herself. It happens all the time. There is nothing wrong with it. Men need sex more than most women, so men give us things. Little boys and girls behave the same way, without their parent's influence. Buying sex when you need it is a "service" like any other. Food is a necessity, yet we have to pay for it. Shelter is a necessity, but we pay for it. Same with sex. It is a necessity. I know religious people will never understand this, but that's only because they've been brain-washed since birth, to think they way their parents tell them. If they could truly think and feel for themselves, maybe religion would go away... and people would just be good to each other because it's the "right thing to do." I hope this bill actually passes. You know, everytime I hear news people and common Americans use this phrase: "Soldiers are fighting for our Freedoms". I always say to myself, WHAT FREEDOMS??? There are so many Christian Laws that we probably break 10 laws before we leave the house in the morning. Just be a good person, don't kill unless in self-defense, and believe what You want, and let others believe or not believe what they want. It won't hurt you, I guarantee it. I am an Atheist, and I help people, and give people freedom. It is the religious people who are taking everyone's freedoms. Trust me, it's true. I Look forward ot actually hearing that this consensual sex bill passes in 2010...Thanks for listening.
 

I apologize for the typos in my last comment. Shayan
 

mesothelioma Mesotheliomais a form of cancer that is almost always caused by exposure to Asbestos In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart the pericardium (a sac that surrounds the heart or tunica vaginalis.
Most people who develop
mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing Mesothelioma Unlike lung cancer, there is no association between mesothelioma and smoking but smoking greatly increases risk of other asbestos induced cancer.Compensation via
Asbestos funds or lawsuits is an important issue in
mesothelioma The symptoms of
mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis, which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural
mesotheliomaSymptoms of peritoneal
mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal
mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by
mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
chest wall pain
pleural effusion, or fluid surrounding the lung
shortness of breath
fatigue or anemia
wheezing, hoarseness, or cough
blood in the sputum (fluid) coughed up hemoptysis
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
abdominal pain
ascites, or an abnormal buildup of fluid in the abdomen
a mass in the abdomen
problems with bowel function
weight loss
In severe cases of the disease, the following signs and symptoms may be present:
blood clots in the veins, which may cause thrombophlebitis
disseminated intravascular coagulation a disorder causing severe bleeding in many body organs
jaundice, or yellowing of the eyes and skin
low blood sugar level
pleural effusion
pulmonary emboli, or blood clots in the arteries of the lungs
severe ascites
A
mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs
Diagnosing
mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for
mesothelioma A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of
mesothelioma A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude
mesothelioma it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of
mesothelioma A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
There is no universally agreed protocol for screening people who have been exposed to
asbestosScreening tests might diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients. The serum osteopontin level might be useful in screening asbestos-exposed people for
mesotheliomaThe level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening. Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells
Incidence
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate is approximately one per 1,000,000. The highest incidence is found in Britain, Australia and Belgium: 30 per 1,000,000 per year. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades. It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal.
Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States.[ Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite.
asbestos
is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven.
asbestos
has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
The combination of smoking and
asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer bronchial carcinoma). The Kent brand of cigarettes used
mesothelioma in its filters for the first few years of production in the 1950s and some cases of
mesothelioma have resulted. Smoking modern cigarettes does not appear to increase the risk of mesothelioma.
Some studies suggest that simian virus 40 may act as a cofactor in the development of mesothelioma.
Asbestos was known in antiquity, but it wasn't mined and widely used commercially until the late 1800s. Its use greatly increased during World War II Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with
asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of
asbestos exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, the British Government's Health and Safety Executive (HSE) states formally that any threshold for
mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with
asbestos wear personal protective equipment to lower their risk of exposure. Recent findings have shown that a mineral called erionite has been known to cause genetically pre-dispositioned individuals to have malignant mesothelioma rates much higher than those not pre-dispositioned genetically. A study in Cappadocia, Turkey has shown that 3 villiages in Turkey have death rates of 51% attributed to erionite related
mesotheliomaExposure to
asbestos fibres has been recognised as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum.
The documented presence of
asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres. Although many authorities consider brief or transient exposure to
asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct exposure.
Commercial
asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.
Family members and others living with
asbestos workers have an increased risk of developing
mesothelioma and possibly other asbestos related diseases. This risk may be the result of exposure to
asbestos dust brought home on the clothing and hair of
asbestos workers. To reduce the chance of exposing family members to asbestosMany building materials used in both public and domestic premises prior to the banning of
asbestos may contain
asbestos Those performing renovation works or activities may expose themselves to asbestos dust. In the UK use of Chrysotile asbestos was banned at the end of 1999. Brown and blue
asbestos was banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials.
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to
mesothelioma radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Although
mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel.
Radiation Therapy when given alone with curative intent has never been shown to improve survival from
mesothelioma The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
Chemotherapy is the only treatment for
mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy) in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery. This trial was the first to report a survival advantage from chemotherapy in malignant pleural
mesothelioma showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the combination pemetrexed group in patients who received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give.
Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin.
In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates.
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer.
mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by at the Washington Cancer Institute. The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.
This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.

What is the mesothelium?
The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs to glide easily against adjacent structures.
The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart. The
mesothelioma tissue surrounding the male internal reproductive organs is called the tunica vaginalis testis. The tunica serosa uteri covers the internal reproductive organs in women.
What is mesothelioma?
mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs.
cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.
How common is mesothelioma?
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age.
What are the risk factors for mesothelioma?
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in about 70 percent to 80 percent of all cases. However, mesothelioma has been reported in some individuals without any known exposure to
Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung.
Who is at increased risk for developing mesothelioma?
asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
The risk o f asbestosrelated disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma On the other hand, not all workers who are heavily exposed develop asbestos-related diseases.
There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to
asbestos dust brought home on the clothing and hair of
asbestos workers. To reduce the chance of exposing family members to
asbestos fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
What are the symptoms of mesothelioma?
Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to
asbestos Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by
mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis
How is
mesotheliomadiagnosed?
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.
A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the
cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the
cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
How is
mesotheliomatreated?
Treatment for mesothelioma depends on the location of the
cancerthe stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.
Surgery is a common treatment for
mesotheliomaThe doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural
mesotheliomaa lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.
Stereo Tactic Radiation Therapy also called radiotherapy, involves the use of high-energy rays to kill
cancercells and shrink tumors Radiation therapy affects the
cancercells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the
cancercells are found (internal radiation therapy).
Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat
mesotheliomaare given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy).
To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation Therapy and surgery may also be helpful in relieving symptoms.
 

HD kaliteli porno izle ve boşal.
Bayan porno izleme sitesi.
Bedava ve ücretsiz porno izle size gelsin.
Liseli kızların Bedava Porno ve Türbanlı ateşli hatunların sikiş filmlerini izle.
Siyah karanlık odada porno yapan evli çift.
harika Duvar Kağıtları bunlar
tamamen ithal duvar kağıdı olanlar var
2013 Beyaz Eşya modeller
Sizlere Güvenlik Sistemleri ayarliyoruz
Arayin Hırdavat bulun
Samsung Nokia İphone Cep telefonu alin.
Super Led Tv keyfi

Amatör Porno - Amcik Porno - Anal Porno - Asyali Porno - Bakire Porno - Erotik Porno - Esmer Porno - Fantazi Porno - Gay Porno - Götten Porno - Grup Porno - Hard Porno - HD Porno - Hemsire Porno - Latin Porno - Lezbiyen Porno - Liseli Porno - Olgun Porno - Oral Porno - Rokettube - Sarisin Porno - Sert Porno - Tecavüz Porno - Travesti Porno - Türbanli Porno - Türk Porno - Ünlü Porno - Yasli Porno - Zenci Porno - Kari Koca Porno - Hayvanli Porno

 

Post a Comment

Home