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Expert: Comatose woman may not have shown signs of pregnancy

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PHOENIX — A doctor examined an Arizona woman in a vegetative state nearly nine months before she gave birth but did not find that she was pregnant, and medical experts said Thursday that it’s possible she displayed no outward signs that workers who cared for her every day would have noticed either.

Police are looking for her rapist and say it appears none of the staff members at a Phoenix long-term care facility knew about the pregnancy until the baby was born Dec. 29, a notion that has drawn skepticism. But the 29-year-old woman, who is described in a medical report as having tubes to feed her and help her breathe, may not have had a swollen belly, according to a doctor of fetal medicine.

While factors remain unknown, such as how far along she was, someone who is fed the same amount from a tube every day might not show any dramatic changes that would be noticed, especially by staffers who don’t work with pregnant patients, said Dr. C. Kevin Huls, a clinical assistant professor and maternal-fetal medicine fellowship director at the University of Arizona College of Medicine-Phoenix.

The mother could actually lose weight in other places like her face or arms if a fetus is consuming nutrients, Huls added.

“A good way to understand it is that really, the baby’s going to continue to grow even at the expense of the mom’s nutrition,” Huls said. “So, her weight may not change because she’s not taking in additional calories. There may be changes to her body that are going to go undetected in a chronic care condition or at a facility like this.”

The revelation that an incapacitated woman was sexually assaulted inside a care facility has horrified advocates for people with disabilities and the community at large. The provider’s CEO resigned this week, and the state said the centre has made safety changes.

A doctor examined the woman on April 16 and found “no change” in her health, writing that the exam was external only, according to Maricopa County Superior Court documents. Her mother submitted the results of the physical as part of an annual report that state law requires of legal guardians.

Phoenix police learned of the situation when they received a call on Dec. 29 about a newborn in distress at the Hacienda HealthCare facility. Officers launched a sex crime investigation when it was determined the mother was in a vegetative state, police spokesman Tommy Thompson said.

“She was not in a position to give consent to any of this,” Thompson said.

The baby and the woman are recovering at an area hospital, and their conditions were not released.

It’s possible the woman won’t have any additional long-term complications from giving birth. Women in a vegetative state after accidents or strokes have successfully delivered babies, Huls said.

Her family, who are members of the San Carlos Apache tribe in southeastern Arizona, said in a statement through their attorney that they will care for the baby boy.

Phoenix police, meanwhile, have not ruled out any suspects in the sexual assault. They are gathering DNA samples from the facility’s male staffers and have appealed to the public for any information.

It remains unclear to investigators if the woman was raped more than once.

“I know at least once she was sexually assaulted, which is way too many times,” Thompson said.

The Hacienda intermediate care facility specializes in providing around-the-clock care for infants, children and young adults with developmental disabilities or who are “medically fragile.”

Since the birth came to light, Hacienda HealthCare has implemented increased safety measures, including more than one staff member being present during patient interactions and more scrutiny of visitors.

The company has said it welcomes DNA testing of its male staffers and is co-operating in the investigation.

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Follow Terry Tang on Twitter at www.twitter.com/ttangAP .

Terry Tang, The Associated Press

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After Trump, Biden aims to reshape the presidency itself

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WASHINGTON — When Joe Biden takes the oath of office Wednesday outside a wounded U.S. Capitol, he will begin reshaping the office of the presidency itself as he sets out to lead a bitterly divided nation struggling with a devastating pandemic and an insurrection meant to stop his ascension to power.

Biden had campaigned as a rebuke to President Donald Trump, a singular figure whose political power was fueled by discord and grievance. The Democrat framed his election as one to “heal the soul” of the nation and repair the presidency, restoring the White House image as a symbol of stability and credibility.

In ways big and small, Biden will look to change the office he will soon inhabit. Incendiary tweets are out, wonky policy briefings are in. Biden, as much an institutionalist as Trump has been a disruptor, will look to change the tone and priorities of the office.

“It really is about restoring some dignity to the office, about picking truth over lies, unity over division,” Biden said soon after he launched his campaign. “It’s about who we are.”

The White House is about 2 miles up Pennsylvania Avenue from the Capitol, where broken windows, heavy fortifications and hundreds of National Guard members provide a visible reminder of the power of a president’s words. Trump’s supporters left a Jan. 6 rally by the president near the White House to commit violence in his name at the Capitol, laying siege to the citadel of democracy and underscoring the herculean task Biden faces in trying to heal the nation’s searing divisions.

Few presidents have taken on the job having thought more about the mark he wants to make on it than Biden. He has spent more than 40 years in Washington and captured the White House after two previous failed attempts. He frequently praises his former boss, President Barack Obama, as an example of how to lead during crisis.

“Biden’s main task is going to be need to be to reestablish the symbol of the White House to the world as a place of integrity and good governance. Because right now everything is in disarray,” said Douglas Brinkley, a presidential historian and professor at Rice University. “But Biden is uniquely situated to do this, his whole life has been spent in Washington and he spent eight years watching the job up close.”

The changes will be sweeping, starting with the president’s approach to the COVID-19 pandemic that has claimed nearly 400,000 American lives. The sharp break from Trump won’t just come in federal policy, but in personal conduct.

Trump flouted the virus, his staff largely eschewing masks in the warren of cramped West Wing offices while the president hosted “superspreader” events at the White House and on the road. Biden’s team is considering having many staffers work from home; those who do enter the building will wear masks. Biden has already been vaccinated, something Trump, who got the virus last fall, has chosen not to do despite suggestions that it would set an example for the nation.

Biden’s approach to the day-to-day responsibilities of the office will also be a break from his predecessor. For one, Twitter won’t be a principal source of news.

Trump’s trail of tweets has roiled the capital for four years. Across Washington, phones would buzz with alerts anytime the president used his most potent political weapon to attack Democrats and keep Republicans in line.

Biden’s tweets tend to be bland news releases and policy details with the occasional “Here’s the deal, folks” thrown in for good measure. Allied lawmakers are unlikely to have to pretend not to have seen the latest posting in order to avoid commenting on it.

Biden has said he wants Americans to view the president as a role model again; no more coarse and demeaning language or racist, divisive rhetoric. His team has promised to restore daily news briefings and the president-elect does not refer to the press as “the enemy of the people.” But it remains to be seen whether he will be as accessible as Trump, who until his postelection hibernation, took more questions from reporters than any of his recent predecessors.

While Trump filled out much of his Cabinet and White House staff with relatives, political neophytes and newcomers to government, Biden has turned to seasoned hands, bringing in Obama administration veterans and career officials.

Policy papers will be back in vogue and governing by cable chyron likely out.

Trump was mostly indifferent to the machinations of Congress, at times appearing to be an observer of his own administration. Biden, a longtime senator who will have Democratic control of both houses, is positioned to use the weight of his office to push an ambitious legislative agenda.

His team will be tested, though, by the tumult at home: a virus that is killing more than 4,000 people a day, a sluggish vaccination distribution program, a worsening economy and contention over the upcoming second impeachment trial for Trump.

Biden also has as much work ahead repairing the image of the presidency overseas as he does on American shores.

Trump repositioned the United States in the world, pulling the U.S. out of a number of multilateral trade deals and climate agreements in favour of a more insular foreign policy. His ever-shifting beliefs and moods strained relations with some of the nation’s oldest allies, including much of Western Europe.

As the COVID-19 pandemic swept the globe, Trump fostered competition, not co-operation, on research and vaccine development. Trump also abandoned the tradition role the president plays in shining a light on human rights abuses around the world.

Biden, who spent years on the Senate Foreign Relations Committee and had a vast foreign policy portfolio as vice-president, has pledged a course correction. He has promised to repair alliances, rejoin the Paris climate treaty and the World Health Organization and said he would shore up U.S. national security by first addressing health, economic and political crises at home.

Offering the White House as a symbol of stability to global capitals won’t be easy for Biden as Trump’s shadow looms.

“He has a structural problem and needs to make the U.S. seem more reliable. We’re diminished in stature and less predictable,” said Richard Haass, president of the Council on Foreign Relations. He noted that even after Biden’s win, the European Union bolstered ties to China with a new investment treaty.

“Everyone around the world is hedging, they have no idea if Biden’s a one-term president or what could come after him,” Haass said. “There is a fear across the world that Trump or Trumpism could return in four years.”

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Follow Lemire on Twitter at http://twitter.com/@JonLemire

Jonathan Lemire, The Associated Press

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Biden fills out State Department team with Obama veterans

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WASHINGTON — President-elect Joe Biden is filling out his State Department team with a group of former career diplomats and veterans of the Obama administration, signalling his desire to return to a more traditional foreign policy after four years of uncertainty and unpredictability under President Donald Trump.

A transition official said Biden intends to nominate Wendy Sherman as deputy secretary of state and Victoria Nuland as undersecretary of state for political affairs — the second- and third-highest ranking posts, respectively.

They were expected to be the 11 department appointees that Biden was announcing Saturday to serve under his pick for secretary of state, Antony Blinken, the official said. The official was not authorized to publicly discuss the appointments before the announcements and spoke on condition of anonymity.

Among the others joining the Biden team are:

—longtime Biden Senate aide Brian McKeon, to be deputy secretary of state for management.

—former senior diplomats Bonnie Jenkins and Uzra Zeya, to be under secretary of state for arms control and undersecretary of state of democracy and human rights, respectively.

—Derek Chollet, a familiar Democratic foreign policy hand, to be State Department counsellor.

—former U.N. official Salman Ahmed, as director of policy planning.

—Suzy George, who was a senior aide to former Secretary of State Madeleine Albright, will be Blinken’s chief of staff.

—Ned Price, a former Obama administration National Security Council staffer and career CIA official who resigned in protest in the early days of the Trump administration, will serve as the public face of the department, taking on the role of spokesman.

—Jalina Porter, communications director for Rep. Cedric Richmond, D-La., who is leaving Congress to work in the White House, will be Price’s deputy.

Price and Porter intend to return to the practice of holding daily State Department press briefings, officials said. Those briefings had been eliminated under the Trump administration.

Jeffrey Prescott, a former national security aide when Biden was vice-president, is Biden’s pick to be deputy ambassador to the United Nations, He would serve under U.N. envoy-designate Linda Thomas-Greenfield.

Five of the 11 are either people of colour or LGBTQ. Although most are not household names, all are advocates of multilateralism and many are familiar in Washington and overseas foreign policy circles. Their selections are a reflection of Biden’s intent to turn away from Trump’s transactional and often unilateral “America First” approach to international relations.

“These leaders are trusted at home and respected around the world, and their nominations signal that America is back and ready to lead the world, not retreat from it,” Biden said in a statement. “They also reflect the idea that we cannot meet this new moment with unchanged thinking or habits, and that we need diverse officials who look like America at the table. They will not only repair but also reimagine American foreign policy and national security for the next generation.”

Sherman led the Obama administration’s negotiations leading to the 2015 nuclear deal with Iran, from which Trump withdrew, and had engaged in talks over ballistic missiles with North Korea during President Bill Clinton’s second term. Nuland served as assistant secretary of state for European Affairs during the Ukraine crisis..

Sherman, McKeon, Nuland, Jenkins and Zeya will require Senate confirmation to their posts while the others will not.

Matthew Lee, The Associated Press

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january, 2021

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