Paxton subpoenaed medical records from Seattle Children's Hospital in December seeking information about Texas youth that may have received gender affirming care in that facility. The hospital sued to block the release of patient records, citing Paxton's lack of jurisdiction.
Paxton sent a similar subpoena to a Georgia Telehealth clinic called QueerMed which provides gender affirming care to youth from all 50 states including Texas. The clinic's founder, Dr. Izzy Lowell, said she was speaking with her attorneys about the best course of action.
“I’m not breaking any laws,” Lowell said. “We are doing everything by the book according to state law.” It was also reported that Lambda Legal, a Texas law firm which represents families of transgender youth, had spoken to representatives from several other organizations who said they had received similar records requests from Paxton's office. Paxton's subpoena for records included patient diagnoses, medications, laboratory testing and treatment.
Paxton's motive is not known, but LGBTQ advocates say the subpoenas are designed to intimidate Texas youth who may be looking out-of-state for medical services due to Texas' ban on gender affirming care for minors. Attorneys for the families have stated Paxton has no legal authority to enforce Texas law outside of Texas, a pre-Civil War precedent that is being challenged for both gender affirming care and for travel to receive abortion services after the overturning of Roe v. Wade in 2022. The Texas law specifically allows the AG to sue healthcare providers only within the state of Texas.
The Privacy Rule standards address the use and disclosure of individuals’ health information (known as protected health information or PHI) by entities subject to the Privacy Rule. These individuals and organizations are called “covered entities.”
The Privacy Rule also contains standards for individuals’ rights to understand and control how their health information is used. A major goal of the Privacy Rule is to make sure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high-quality healthcare, and to protect the public’s health and well-being. The Privacy Rule permits important uses of information while protecting the privacy of people who seek care and healing.
Permitted Uses and Disclosures
The law permits, but does not require, a covered entity to use and disclose PHI, without an individual’s authorization, for the following purposes or situations:
- Disclosure to the individual (if the information is required for access or accounting of disclosures, the entity MUST disclose to the individual)
- Treatment, payment, and healthcare operations
- Opportunity to agree or object to the disclosure of PHI
- An entity can obtain informal permission by asking the individual outright, or by circumstances that clearly give the individual the opportunity to agree, acquiesce, or object
- Incident to an otherwise permitted use and disclosure
- Limited dataset for research, public health, or healthcare operations
- Public interest and benefit activities—The Privacy Rule permits use and disclosure of PHI, without an individual’s authorization or permission, for 12 national priority purposes:
- When required by law
- Public health activities
- Victims of abuse or neglect or domestic violence
- Health oversight activities
- Judicial and administrative proceedings
- Law enforcement
- Functions (such as identification) concerning deceased persons
- Cadaveric organ, eye, or tissue donation
- Research, under certain conditions
- To prevent or lessen a serious threat to health or safety
- Essential government functions
- Workers’ compensation
For the last several years, there has been a largely right-wing movement to ban books with “woke agendas” throughout certain states and communities. This includes banning books with “woke” themes, like violence, abuse, racism, race, and LGBTQ+ identities, from classrooms and library shelves.
However, this book ban movement is starting to negatively affect students looking to pursue higher education in the United States. Let’s get into it.
In a 2023 study from the free speech group PEN America, the organization found that 3,362 cases of book bans took place during the year. Book bans saw a surge compared to the 2021-2022 school year, when 2,532 were prohibited.
"We keep wondering if we've reached the peak yet," Meehan says to NPR. "And all signals suggest that there's still growing momentum, and it really is against public opinion."
A majority of the banned books came from Florida, which accounts for more than 40 percent of book bans (1,406 books). Texas came in second place with 625 books, followed by Missouri, Utah, and Pennsylvania.
PEN asserts that coordinated pressure campaigns at both local and national levels, along with punitive state laws, are turbocharging efforts to ban books. These actions are wreaking havoc on teachers, librarians, and students.
In a new study released by First Book Research & Insights, more than 1,500 educators serving students in under-resourced communities responded to the challenges they are facing as book bans continue to limit the reading material both in and outside of the classroom.
For teachers, the book bans are affecting morale, with 71 percent of educators saying that the bans make them feel distrusted, making it difficult to teach material in a classroom that relates to the subject material.
“Educators serving students in low-income, under-resourced communities remain unheard in the discussion–and they are a critical voice because of their role in supporting student academic growth while managing the negative effects of ongoing actions to ban books,” says Kyle Zimmer, president and CEO of First Book.
Here's C.I.'s "Iraq snapshot:"
Like many around the world, I'm laughing at her claim to have received feedback from her mythical Muslim friends. She slurred a people with her racist stereotyping and called for their deaths. Quit acting like a piece of correction tape is going to make things alright.
Countless lives have been shattered, ripped apart, and upended due to the crisis in Gaza, Israel and wider Occupied Palestinian Territories. In the face of such devastation and suffering, humanity must prevail.
Right now, civilian deaths in Gaza are rising at a staggering rate. The Israeli authorities' 16-year-long illegal and inhumane blockade has trapped 2.2 million people in Gaza, including children, the elderly, and disabled, under relentless bombardment by Israeli authorities. With nowhere to go, they face losing everything.
After horrific attacks in Israel by Hamas and other armed groups that, according to Israeli authorities, resulted in 1,200 people killed and the abduction of civilians, at least 200 hostages held in Gaza also remain in danger, and ongoing indiscriminate rocket fire into Israel places civilians at risk.
Humanitarian pauses of a few days will bring a brief respite. But halting the fighting for a matter of days is nowhere near enough to address the catastrophic suffering or relieve the horrifying harm to civilians. We must act now.
A negotiated ceasefire would:
- Put a stop to unlawful attacks by all parties, halt the mounting death toll in Gaza and enable aid agencies to get life-saving aid, water and medical supplies into the strip
- Allow hospitals in Gaza to receive life-saving medicines, fuel and equipment they desperately need and to repair damaged wards
- Provide opportunities to negotiate the release of all hostages detained in Gaza
- Allow for independent international investigations to take place into war crimes committed by all parties to help end long-standing impunity, which continues to produce further atrocities
Palestinians and Israelis deserve a future where they can live free from violence and see an end to the fatal human rights violations that continue to destroy so many lives. Challenging the Israeli authorities' system of apartheid over Palestinians is now more urgent than ever.
AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman, with Juan González.
We turn now to Gaza, to Israel threatening to launch a ground invasion of Rafah, where over a million displaced Palestinians have sought refuge. On Monday, President Biden hosted King Abdullah of Jordan at the White House. During public remarks, Biden initially described Israel’s operation in Rafah as, quote, “our operation.”
PRESIDENT JOE BIDEN: As I said yesterday, our military operation in Rafah — the major military operation in Rafah should not proceed without a credible plan, a credible plan for ensuring the safety and support of more than 1 million people sheltering there.
AMY GOODMAN: Jordan’s King Abdullah condemned Israel’s plan to attack Rafah and called for a ceasefire and the creation of a Palestinian state.
KING ABDULLAH II: We cannot afford an Israeli attack on Rafah. It is certain to produce another humanitarian catastrophe. The situation is already unbearable for over a million people who have been pushed into Rafah since the war started. We cannot stand by and let this continue. We need a lasting ceasefire now. This war must end. … Seven decades of occupation, death and destruction have proven beyond any doubt that there can be no peace without a political horizon. Military and security installations are not the answer. They can never bring peace. Civilians on both sides continue to pay for this protracted conflict with their lives.
AMY GOODMAN: We go now to Toronto, where we’re joined by Dr. Yasser Khan. He’s a Canadian ophthalmologist and eye surgeon who recently returned from a humanitarian surgical mission at the European Hospital in Khan Younis in Gaza.
Dr. Khan, welcome to Democracy Now! If you can describe what you saw there in Khan Younis, the level of the injuries, how crowded the European Hospital was, the threats people were facing there?
DR. YASSER KHAN: Thank you very much for having me.
Well, you know, I look at the impending invasion of Rafah and the attacks on Rafah, and I know, because I’ve seen it — I know what’s going to happen. I know the casualties, and I know how much worse it’s going to get.
When I was in Khan Younis a few weeks ago — I’ve been to over 40 different countries, you know, doing humanitarian work, anywhere from in Africa, Asia and South America. And what I saw in Khan Younis were the most horrific scenes in my entire life, and I hope I never see them again. It was just — you know, the bombings were going on every few hours at that point in time. The Israeli forces were about a kilometer away. And the mass casualties kept on coming in.
And it was mostly — I mean, the majority of the patients that I treated were children, anywhere from the age of 2 to 17. I mean, I saw horrific eye and facial injuries that I’ve never seen before, eyes shattered in two 6-year-old children with shrapnel that I had to take out, eyes with shrapnel stuck inside, facial injuries. I saw orthopedic injuries where — you know, limbs just cut off and dangling. I saw abdominal injuries that were just horrific. And it was just mass chaos. There was children on the floor, unattended to, with head trauma, people suturing patients without anesthesia on the ground. It was just mass chaos and really horrific, horrific scenes.
And I know that now with the bombing going on in Rafah and scenes of children hanging exploded and, you know, half their bodies cut off and hanging on a wall because they’ve been exploded — I mean, those are scenes going on now. So I know exactly what my colleagues are going through right now in Rafah and in Gaza, basically.
JUAN GONZÁLEZ: And, Doctor, you were working shifts of 12-, 13-hour days. Can you talk about the conditions of the medical staff and the doctors you worked alongside with? Where did you sleep? Were you able to eat? Could you talk about those conditions you faced?
DR. YASSER KHAN: Well, the doctors were amazing. I mean, the Palestinian doctors were amazing. Their dedication and their will to resist dying and staying alive was amazing. They’re talented. But they have nothing. There’s no antibiotics. There’s no painkillers. On the last day I was leaving, we ran out of morphine, which is very important in a lot of orthopedic injuries.
So, patients were — I mean, the whole European Gaza Hospital was, at the time — now everything I’m saying and — everything I saw is much worse now. But, basically, it was overcrowded, about 300, 400% over capacity. There was patients and bodies lying all over the hospital floor, inside and outside. They had orthopedic devices coming from their legs or their arms. They were getting infected, they were in pain, because they were on the floor, so the conditions weren’t very sterile. And if they survived amputation the first time, the infection would get them, because then they’d have to be amputated after.
A lot of the kids that I saw — and more than 60% of the patients I saw were children — they’re thin. They had no fat on them. They’re starving, because, as you know, Israel has had a food blockade since this war on Gaza started. And so, they’re all thin, with no fat, starving. And they were coming in, and, you know, it was just — and we didn’t have enough supplies, enough gauze, enough antibiotics, enough instruments even — the instruments are rusting — to kind of, you know, deal with the mass trauma.
AMY GOODMAN: Dr. Khan —
DR. YASSER KHAN: I stayed in the hospital — yes, please.
AMY GOODMAN: Dr. Khan, this is Democratic Senator Chris Van Hollen of Maryland speaking Monday ahead of a vote on the $95 billion aid package to Israel, Ukraine and Taiwan.
SEN. CHRIS VAN HOLLEN: Madam President, I want that to sink in. Kids in Gaza are now dying from the deliberate withholding of food. In addition to the horror of that news, one other thing is true: That is a war crime. It is a textbook war crime. … And that makes those who orchestrate it war criminals.
AMY GOODMAN: That’s Democratic Senator Chris Van Hollen on the floor of the U.S. Senate. Dr. Khan, you’re talking about the thinness of the children, of the whole population.
DR. YASSER KHAN: Yeah. Well, you know, Amy, it’s — you know, from what I saw and what I experienced when I was on the ground, speaking to officials, speaking to the doctors there, and this whole — you know, one of the whole aspects of this war on Gaza, you know, the genocidal intent of Israeli politicians, the Israeli army has been clear. What is really bizarre is they haven’t hid it. They have openly called for it. They have openly called for epidemics.
And so, as a healthcare professional, the attack on the healthcare system has been unprecedented. I mean, the viciousness of it, the killing machine that Israel has unleashed on the healthcare system, I think, is unprecedented. Hospitals have been bombed. When the doctors have tried to repopulate them, they’ve been — you know, sniper fire with drones has prevented them from going in.
They’ve attacked the sewage system, the water system, so the sewage mixes with the drinking water. And you get diarrheal diseases, bacterial diseases. You know, cholera, typhoid is not far away. Hepatitis A is epidemic there now. They’re living in cramped spaces.
They have killed over 300 or 400 healthcare workers, doctors, nurses, paramedics. Ambulances have been bombed. This has all been a systematic sort of — you know, by destroying the healthcare system, you’re contributing to the genocide.
What’s going on is now there’s 10,000 to 15,000 bodies that are decomposing. So, it’s raining season right now in Gaza. So all the rainwater mixes with the decomposing bodies, and that bacteria mixes with the drinking water supply, and you get further disease.
They have kidnapped about 40, 45 doctors, that have been specifically targeted. They have targeted specifically specialists who are, you know, one-offs. So, like, the one nephrologist in the Gaza Strip was targeted. The pathologists, hospital chiefs and directors have all been targeted through drones or targeted missile strikes.
And, you know, so the whole thing is that if the bombings are not going to get you, then disease will surely get you, because they’re all malnourished. So, as you know, if you’re malnourished, your immune system is weaker, so you’re more susceptible to disease. But there’s no antibiotics.
You know, the amount of amputations I saw in children, for example — both arms, one arm, one leg, both eyes gone, you know, both eyes amputated, basically, out of their eye socket — you know, it’s amazing. I mean, it takes about — you know, if this was done properly in a nonwar scenario, one amputation in a child, a child will need about nine to 12 surgeries by the time they’re an adult, you know, for prosthetic fitting and whatnot. Now, in this case, first of all, it’s a war situation. They have not been done properly, fair enough, because you have to rush it. But secondly, who is going to take care of these children? Most of them mostly children. Because their parents are gone. Their uncles are dead. Their grandfathers and grandmothers are dead.
And so, you know, the Israeli killing machine has been vicious. I mean, they’ve used drones. When I was there, I was speaking to doctors who were there, and they told me that they’ve used drones like the Hellfire drone, that is an explosive drone. It fires off these discs once it implodes or explodes. And these discs are very unique, and they cause unique amputations. Most amputations occur at the weak points, like the elbow or the knee. But they cause, you know, mid-thigh, mid-arm amputations, which are much more complicated. And they fire off this shrapnel.
And, you know, from what the doctors are telling me, that what I believe is that they’re using weapons on the civilian population that have never been used before, because from what I heard, based on my experience, you know, Israel has a very strong defense industry, and buyers like weapons that are battle-tested. So, if you can put a label to your new weapon that it’s battle-tested, that increases the value of it. And they’re experimenting with these weapons, from what I’ve heard and from what I saw, in a civilian-dense population. So, it’s just — it’s been vicious, really, really vicious.
AMY GOODMAN: Dr. Yasser Khan, I want to thank you for being with us, Canadian ophthalmologist, eye surgeon, based in Toronto, Canada, just recently returned from a humanitarian surgical mission at the European Hospital in Khan Younis in Gaza.
When we come back, we’ll be joined by climate scientist Michael Mann, just awarded a million dollars in a defamation lawsuit against two right-wing critics. Back in 20 seconds.
Each Palestinian home has two hearths: the space where the family eats and the kitchen, where the food is prepared. These rooms are where the fires of life and hospitality burn most brightly.
When I visit Khan Younis, one of the popular family meals we enjoy together is maghluba (“upside down” in Arabic): a large, savoury cake of rice, vegetables and chicken cooked in a large pot. When the meal is ready, the pot is turned upside down and the family gather around to await the unveiling, when the pot is lifted off to display the yellow rice, red tomatoes and deep brown aubergines. Every dish of maghluba is a family celebration.
Today, with the destruction of Khan Younis, and of my family home there, it feels like my life has been turned maghluba. My youngest son, Aziz, cannot understand how a home can disappear. He still carries all the emotions and the fond memories of his auntie’s kisses. “Mom?” he asks incessantly. “Who will be left when we visit this summer? What will be left?”
President Joe Biden and other leading American officials have publicly urged Israel not to invade the overcrowded Gaza city of Rafah without ensuring the protection of civilians, but the administration reportedly has no plan to impose consequences if the Netanyahu government launches the ground assault without heeding U.S. warnings.
Three unnamed U.S. officials toldPolitico's "National Security Daily" newsletter on Tuesday that "no reprimand plans are in the works, meaning Israeli forces could enter the city and harm civilians without facing American consequences."
Trita Parsi, executive vice president of the Quincy Institute for Responsible Statecraft, wrote in response to Politico's reporting that "Biden can stop this but chooses not to."
"Instead, he only resorts to calling Netanyahu an 'asshole' behind his back," Parsi added. "This is leadership?"
Around 1.4 million people, most of them displaced from other parts of
the Gaza Strip, are currently in Rafah, which is roughly a quarter the
size of the U.S. city of Baltimore.
Some are
desperately trying to flee ahead of an Israeli invasion, gathering their few remaining belongings and leaving the city without any clear direction or assurance of safe passage.
"They need to be protected," Biden said of Rafah's civilians following a White House meeting with the king of Jordan on Monday.
But that same day, White House National Security Council spokesman John Kirby said during a press briefing that "we are going to continue to support Israel" after a reporter asked whether Biden has "ever threatened to strip military assistance from Israel if they move ahead with a Rafah operation" that doesn't protect civilians.
Leo Varadkar, Ireland's Taoiseach (or prime minister), strongly criticized Israel Tuesday, accusing the country of becoming "blinded by rage" as it doubles down on plans to launch a ground offensive on the southern Gaza city of Rafah, where Israeli forces previously told hundreds of thousands of displaced Palestinians to seek shelter.
Speaking to lawmakers in the Irish parliament, Varadkar said it was "very clear" to him that Israel is "is not listening to any country in the world," even the United States.
"They [Israel] have become blinded by rage. And they are going to, I believe, make the situation much worse for their own security in the long term by going down the path they are going," the Irish leader said.
Varadkar said an Israeli ground offensive on the border city of Rafah "should not happen," drawing attention to the 1.3 million Palestinians who are "taking refuge there."
Other members of the Irish government joined Varadkar in condemning Israel this week including Trade Minister Simon Coveney, who accused the country of acting like a rogue state and behaving "like a monster to defeat a monster."
The United States is monitoring Israel’s military activities in Gaza under a recently established program that “systematically” tracks reports of suspected civilian harm by forces using U.S.-made weapons, State Department spokesman Matthew Miller said.
“We do seek to thoroughly assess reports of civilian harm by authorized recipients of U.S.-provided defense articles around the world, including under the Civilian Harm Incident Response Guidance, the CHIRG,” Miller said during a news briefing Tuesday.
As The Washington Post first reported in September, the CHIRG system provides a way for officials to formally investigate reports of civilian harm by partner governments suspected of using U.S.-origin arms and recommend penalties in response — including the suspension of weapons sales. The system, which was introduced before Hamas’s Oct. 7 attack and Israel’s military response in Gaza, is intended to reduce civilian collateral damage incidents.
In Tuesday’s briefing, Miller specified that the process was “not intended to function as a rapid response mechanism.” Instead, he said, the system was designed to shape future policies and to pressure U.S. military allies to follow international humanitarian law during warfare.
