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Calling Dr. Mengele, Calling Dr. Mengele

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Alasdair Cochrane works at an organization called the Centre for the Study of Human Rights in the UK.  The journal Bioethics has just published Cochrane’s article “Undignified Bioethics” (subscription required), in which he argues that the concept of inherent human dignity should be rejected. Cochrane correctly notes that treating all humans as though they possess inherent dignity merely by virtue of the fact that they are human gets in the way of the really nifty medical experiments we could perform on the defenseless among us if we were to jettison that notion:

This conception of dignity as inherent moral worth certainly seems coherent enough as an idea. Indeed, we can also see why this conception of dignity is employed in certain debates around bioethics. For if all individual human beings possess dignity, then they should not be viewed simply as resources that we can treat however we please. To take an example then, it may be that we could achieve rapid and significant progress in medical science if we were to conduct wide-ranging medical experiments on groups of human beings. However, because human beings have dignity, so it is argued, this means that they possess a particular quality that grounds certain moral obligations and rights. These obligations and rights restrict what we may permissibly do to them. As such, inflicting great harms on individual humans, as would be inflicted in medical experiments, is impermissible on the grounds that human individuals possess dignity. The dignity of individual human beings prevents us from doing certain acts to them, even if those acts would lead to great social benefits.

Therefore, we need to “argue” over which of us humans are exempt from medical experimentation and which of us are fair game for the Mengele wannabes:

Obviously, given controversies over abortion, stem cell research, genetic interventions, animal experimentation, euthanasia and so on, bioethics does need to engage in debates over which entities possess moral worth and why. But these are best conducted by using the notion of ‘moral status’ and arguing over the characteristics that warrant possession of it. Simply stipulating that all and only human beings possess this inherent moral worth because they have dignity is arbitrary and unhelpful. . . . I urge for an undignified bioethics.

This is where materialism inevitably leads. Cochrane believes that human beings are purely material – nothing but matter in motion. Given that premise, how can one argue with his logic? Why should we not treat objects like, well, objects. In a materialist world “justice” is a meaningless word, and the strong exploit the weak for their own ends.

I wonder if Cochrane would stick to his position if we conducted the “argument” he urges upon us and decide that foppish Brit materialists fall in the “exploit at will” category?

Comments
[...] the materialist is utterly certain in his heart that objective morality exists, his denials notwithstanding.[...]
I failed to see this on the first reading. Are you sure about this? This does not seem to really jive with the thoughts voiced by many materialists. Why would they all be lying or deluded? Is there any behavior that makes you believe they secretly believe in an objective morality?hrun0815
January 10, 2010
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There is no need for “dignity” in the discussion of bioethics.
So you and Cochrane agree. Does that mean you also support Mengele-style experiments? And if not, why not?hrun0815
January 10, 2010
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O'Leary:"But it is not always so simple. For many studies, it would be no use enrolling if you don’t have the problem. " Phase I studies are the overwhelming majority of them anyway) conducted to determine not only how hte drug 'treats' the body but also how the body 'treats' the drug. In short Phase I trials are used to determine the toxicokinetics (bioavailability, absorption parameters,rate of excretion, and half-life) as well as the toxicodynamics (those parameters associated with metabolism, route of excretion) to name but a few of the types of data gathered in a Phase I clinical trial. Phase I trials are not concerned with efficacy but with safety and determining dosing regimes. Enrolling unhealthy people in a Phase I trial would be a major shoot-in-the-foot confounding factor in trying to determine the above mentioned parameters. It would be very much a worthwhile enterprise to enroll disease-free people in Phase I trials. You get the best and most accurate data available gathered to answer the questons that a Phase I clinical trial asks. Phase II clinical trials are concerned with both safety and efficacy on a smaller scale that will occur in a Phase III clinical trial. The question is should a healthy person no longer be permitted to make a decision to participate in a risky behavior without losing his ability to make decisions, i.e., put all his/her stuff into a trust. O'Leary:"Shouldn’t the researchers at least insist that some medical personnel agree that I have arthritis before I am enrolled? " For the overwhelming majority of Phase I clinical trials the answer would be, No. For example a patient having arthritis could possibly have a history of taking any number of medications to treat their arthritis. It is well known that induction of metabolic enzymes occurs with many drugs. If you re trying to determine dosing, route of excretion, metabolic rate, metabolite formation, half-life, ect. all of yoru data would be skewed due the effect of enzyme induction. Using the healthies human available is very much desired in Phase I trials.Acipenser
January 9, 2010
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There is no need for "dignity" in the discussion of bioethics. One has to wonder why there is a need for "ethics" in the discussion of bioethics.Mung
January 8, 2010
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This concept of “undignified bioethics” would seem to contraindicate two portions of what I learned as the ‘Georgetown mantra’ (philosophical principles governing bioethics): beneficence and nonmaleficence. The fact that it also violates a patient’s autonomy is another mark against it.
Barb, leaving all this confusion about the inconsistency of materialists aside, why do you think a term like 'dignity' is needed to describe bioethics governed by 'beneficence and nonmaleficence'?hrun0815
January 8, 2010
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So what is your point?
I guess my point is that it seems ridiculous that you engage in the writing of any materialist that uses such words (ethics, moral, justice, dignity, love, hate, desire, ...). Following your logic, they are so deeply inconsistent that everything they write is essentially complete gibberish. For example, you seem to suggest that Cochrane wants '“argue” over which of us humans are exempt from medical experimentation and which of us are fair game for the Mengele wannabes'-- presumable to perform experimentation that would 'would lead to great social benefits'. But that also is complete nonsense for a materialist. Why would a 'matter in motion' care about 'great social benefits'?hrun0815
January 8, 2010
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Hrun0815 writes “And yet, virtually every materialist lives as if words like “ethics”, “morality”, “justice” and “dignity” actually do have a meaning.” Of course they do. An objective transcendent moral standard exists, and materialists largely live by that standard even as they deny it. It’s like the Hindu who denies that objective reality exists but still looks both ways before he crosses the street. The Hindu does not want to get run over by an objective bus, and the materialist is utterly certain in his heart that objective morality exists, his denials notwithstanding. So what is your point?Barry Arrington
January 8, 2010
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There is an English Common Law doctrine of "necessity" - one may do things to save one's life or the lives of others which might not otherwise be prudent or even lawful acts. The doctrine assumes that human life is valuable, at least to the persons who have it. Thus, a security guard might risk her life to shoot someone who was planning to kill a crowd of people at a public gathering - and she could say later in her own defense, hey, I was only doing my job. Most juries here would buy that. One problem for the person who is asked to be a "power of attorney" for an ill friend or relative is to distinguish between treatments that might be worth paying for, even if risky (doctrine of necessity) and ... other promoted offers.O'Leary
January 8, 2010
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In a sense, words like “ethics” and “bioethics” are meaningless to materialists, as honest materialists like Will Provine will readily admit.
And yet, virtually every materialist lives as if words like "ethics", "morality", "justice" and "dignity" actually do have a meaning.hrun0815
January 7, 2010
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hrum0815 writes: “Following your argument, even the term ‘ethics’ or ‘bioethics’ should be completely meaningless to a materialist. And why would he ‘urge’ anything either? It’s all just matter in motion.” In a sense, words like “ethics” and “bioethics” are meaningless to materialists, as honest materialists like Will Provine will readily admit.Barry Arrington
January 7, 2010
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By the way, for everybody who does not have access to the full text, here is the conclusion of the paper. It may clarify to folks who don't have access to the text the argument that Cochrane is making.
This paper has attempted to give dignity the benefit of the doubt. I have surveyed what I consider to be the best and most plausible conceptions of dignity, and have rejected them all. Dignity as virtuous behaviour should be rejected on the grounds that it is either trivial or overly demanding. Dignity as the inherent moral worth of all human beings should be rejected on the grounds that it is arbitrary and rests on controversial premises. Kantian dignity should be rejected on the grounds that it excludes too many from the moral community and is unhelpful in delineating our moral obligations. Dignity as species integrity should be rejected on the grounds that it wrongly associates a flourishing life with the possession of normal species functionings. Given that these are the best conceptions of dignity available, and that all are flawed, it would be preferable to purge dignity from bioethics. However, and as mentioned above, several scholars have pointed out that the term is deeply ingrained in bioethical debate, so attempting to do away with it is equivalent to ‘whistling in the wind’.29 I disagree. Just because an ethical term is popular does not mean that we are under an obligation to keep it. Trends in ethical discourse change, and scholars can affect that change, even if only minimally. If concepts are unclear, it is the job of scholars to push that they be clarified. Moreover, if concepts are flawed and unhelpful, it is the job of scholars to push that they be rejected. In the case of dignity in bioethical discourse, I take the latter view. As such, I urge for an undignified bioethics.
hrun0815
January 7, 2010
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This is where materialism inevitably leads. Cochrane believes that human beings are purely material – nothing but matter in motion. Given that premise, how can one argue with his logic? Why should we not treat objects like, well, objects. In a materialist world “justice” is a meaningless word, and the strong exploit the weak for their own ends.
Well, I for one can argue with his logic-- and so should you: Following your argument, even the term 'ethics' or 'bioethics' should be completely meaningless to a materialist. And why would he 'urge' anything either? It's all just matter in motion.hrun0815
January 7, 2010
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Denyse, You have probably gone oft to bed like a sensible person but have been off debating ID with Catholics and one has made some rather extraordinary claims. It is on the Joe Carter blog at First Things. Here is the link to my last comment. If you then work your way up you will see my other comments as well as a couple others but especially someone named R. Hampton. For all I know he could be a priest. http://www.firstthings.com/blogs/firstthoughts/2010/01/05/a-walk-to-the-moon/comment-page-1/#comment-6814 I would be interested in your take on this. Is the Church going to go medieval and proclaim Darwinian evolution as dogma? Will ask StephenB the same.jerry
January 6, 2010
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shackleman at 32: Just a note or two: The difficulty is that there can be a huge divide between a 38 year old man and an 83 year old woman, in terms of what they might reasonably be expected to do. This issue actually came up here in Canada when the government was considering delisting some drugs, due to higher risk of strokes. Well, the really old ladies said - you expected this, of course - so what? The really old ladies might have a stroke anyway. Meanwhile, they had less pain from various illnesses. This is the sort of problem that all senior care faces - the need to balance life quality with health risks.O'Leary
January 6, 2010
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This concept of "undignified bioethics" would seem to contraindicate two portions of what I learned as the 'Georgetown mantra' (philosophical principles governing bioethics): beneficence and nonmaleficence. The fact that it also violates a patient's autonomy is another mark against it.Barb
January 6, 2010
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I'm not saying Cochrane is advocating for that, I'm saying it's not too big a leap to go from what he's stated in his article to such a scenario that I described. I link human dignity to ethics, but I'm no expert on the subject. If you see a connection between the two, then my potential scenario seems to fit. If you don't see the connection between dignity and ethics, then perhaps my scenario doesn't fit. Besides, I was just clarifying my position for Ms. O'Leary, and suggesting that the "go for it" attitude in reference to Phase I trials is perhaps a bit flippant in the light of the data I've seen.shackleman
January 6, 2010
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shackleman #30:
“They’re dying anyway”, a medical researcher who agrees with Cochrane might say, “It’s better for society if we experiment with this drug, even if it causes the patient indescribable suffering. Withhold from the patient the potential risk of side effects lest they be more likely not to agree to the trial.”
We have no evidence that Cochrane is advocating or endorsing anything remotely like withholding the risk of side-effects from trial subjects, or advocating experiments on cancer patients because of a "they'll die anyway" attitude. There's a comment thread where Barry Addington is being asked to present evidence that this is Cochrane's position, but he hasn't so far.waterbear
January 6, 2010
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"I acknowledge crippling side-effects, but what if you know you are dying anyway? " We're all dying anyway every minute of every day. Is quantity more valuable than quality? Trust me, the word "crippling" doesn't really begin to adequatley describe the suffering some of these Phase I trials caused. In my position, I was able to view the data. It's no wonder one PM suggested to me to *never* agree to a Phase I trial. It was far better in her opinion to just go on and die. But, it is a personal choice with complicated and varied and very important considerations. The trouble is, if we seriously consider removing human dignity as a requisite criterion on which to base some of our opinions, and more importantly our medical advice (should we be in a position to offer such advice), then what would stop someone from withholding information from patients who are considering Phase I trials (of the terminally ill variety)? "They're dying anyway", a medical researcher who agrees with Cochran might say, "It's better for society if we experiment with this drug, even if it causes the patient indescribable suffering. Withhold from the patient the potential risk of side effects lest they be more likely not to agree to the trial."shackleman
January 6, 2010
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shackleman at 27: Yes, thanks, that is exactly the delicate matter I adverted to above. Everyone here where I live supposes that people may lawfully try to save their lives, however they can. As you say, extending life can cause unpleasant outcomes - but it might also mean seeing a long-lost relative or friend. I acknowledge crippling side-effects, but what if you know you are dying anyway? Based on what I have walked through with various people, I would say ... go for it!O'Leary
January 6, 2010
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While Phase I trials are not always performed on healthy people they are usually performed on healthy people.waterbear
January 6, 2010
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Phase I trials are not always performed on healthy people. I once worked as the lead Network Engineer for a Cancer Pharm Research company. Phase I trials in that field often include terminally ill patients and often because the side effects of the experimental drugs likely will be as severe as the terminal illness they were attempting to treat. Many times the success of a Phase I trial of this kind was measured by how much longer patients lived while on the drug as opposed to a placebo, and extending lives just weeks or months was considered an enormous success, even if by doing so the new drug caused debilitating, painful, or crippling side effects.shackleman
January 6, 2010
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What you quote from Exodus is not experiment, it is an act of anger, which can be and usually is spontaneous
Really? Neither anger nor spontaneity are mentioned. The master might just be cold-heartedly beating his slave for warped fun or out of curiosity and it would still apply. Still, this is probably a matter for theologians to wrestle with once a properly God-created hierarchy is established in research.waterbear
January 6, 2010
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O'Leary #23:
I don’t have arthritis, so should I waste everybody’s time and money while gobbling roast beef sandwiches in the lounge during a study of arthritis, and then being bored for twenty minutes while wearing only a gown?
You have a loose grasp of the concept of medical research. In a Phase 1 clinical trial, which is the example being used, you would likely be under close scrutiny for several days, not for 20 minutes or until you got bored.
Shouldn’t the researchers at least insist that some medical personnel agree that I have arthritis before I am enrolled?
No, for reasons already given. Phase 1 clinical trials are done in healthy volunteers to make it easier to spot adverse reactions and to check that the drug's action matches the developers' predictions.
But suppose the drug under test threatens a high rate of bone cancer – but no study participant actually knows this fact?
If such a threat was known about by the drug developers then the trial would be unlikely to receive the Institutional Review Board's ethics approval. If it did pass IRB review and the developers don't disclose the risk to the test subjects then that is clearly unethical, and almost certainly criminal as well. But if a drug or procedure is being developed and a risk exists but the benefits are so great that the review board permits it, and that risk is clearly disclosed to the test subjects, and the test subjects consent to the test anyway - with no gain to themselves but only because they see it could help other people - you would conclude they are not of sound mind? Then remove decision making about their own medical, financial and legal affairs from them and put it in the hands of a trustee? This would seem to punish great altruism of the kind which has helped us all.waterbear
January 6, 2010
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waterbear, What you quote from Exodus is not experiment, it is an act of anger, which can be and usually is spontaneous, not that that justifies it. Experiment is calculated in every case, and is torture, and usually death, at least with respect to vivisection. On the premise of evolution, all differences with respect to the dignity of human life is a sentiment, as Lewis rightly pointed out, and the consequences that he posits of cutting up imbeciles, etc., do logically follow, whereas Exodus was a law for the seed of Abraham at a particular time for a particular people in a particular place, not normative for all people at all places and times. Besides, we are in the New Covenant now, a new dispensation in which the Law has been fulfilled by Jesus and we are no longer under it nor subject to it. We are now in a dispensation of Grace.Clive Hayden
January 6, 2010
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waterbear at 19 and acispenser at 20: Yes, many clinical trials are conducted with healthy volunteers. But it is not always so simple. For many studies, it would be no use enrolling if you don't have the problem. I don't have arthritis, so should I waste everybody's time and money while gobbling roast beef sandwiches in the lounge during a study of arthritis, and then being bored for twenty minutes while wearing only a gown? Shouldn't the researchers at least insist that some medical personnel agree that I have arthritis before I am enrolled? But suppose the drug under test threatens a high rate of bone cancer - but no study participant actually knows this fact? Of course, it may come to the knowledge of some persons, as such things often do ... often these persons are called journalists. That was all I meant when I said that a person who thought it wise to participate in such tests should have their affairs in the hands of a trustee. Who is legally responsible to handle all health and financial matters in a prudent way - at least, where I live.O'Leary
January 6, 2010
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Clive #21: While I would certainly agree that we are “worth more than many sparrows”, I think regulating experiments such that they “conform to a hierarchical order created by God” as Lewis suggests could raise at least as many questions as it answers. Would a master, for instance, be allowed to experiment on his slaves as long as the slave doesn't die immediately?waterbear
January 6, 2010
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The question of human dignity and scientific experiment was addressed by C. S. Lewis in his essay Vivesection. Here is a portion of the essay: The only rational line for the Christian vivisectionist to take is to say that the superiority of man over beast is a real objective fact, guaranteed by Revelation, and that the propriety of sacrificing beast to man is a logical consequence. We are “worth more than many sparrows”, and in saying this we are not merely expressing a natural preference for our own species simply because it is our own but conforming to a hierarchical order created by God and really present in the universe whether any one acknowledges it or not. The position may not be satisfactory. We may fail to see how a benevolent Deity could wish us to draw such conclusions from the hierarchical order He has created. We may find it difficult to formulate a human right of tormenting beasts in terms which would not equally imply an angelic right of tormenting men. And we may feel that though objective superiority is rightly claimed for men, yet that very superiority ought partly to consist in not behaving like a vivisector: that we ought to prove ourselves better than the beasts precisely by the fact of acknowledging duties to them which they do not acknowledge to us. But on all these questions different opinions can be honestly held. If on grounds of our real, divinely ordained, superiority a Christian pathologist thinks it right to vivisect, and does so with scrupulous care to avoid the least dram or scruple of unnecessary pain, in a trembling awe at the responsibility which he assumes, and with a vivid sense of the high mode in which human life must be lived if it is to justify the sacrifices made for it, then (whether we agree with him or not) we can respect his point of view. But of course the vast majority of vivisectors have no such theological background. They are most of them naturalistic and Darwinian. Now here, surely, we come up against a very alarming fact. The very same people who will most contemptuously brush aside any consideration of animal suffering if it stands in the way of 'research' will also, on another context, most vehemently deny that there is any radical difference between man and the other animals. On the naturalistic view the beasts are at bottom just the same sort of thing as ourselves. Man is simply the cleverest of the anthropoids. All the grounds on which a Christian might defend vivisection are thus cut from under our feet. We sacrifice other species to our own not because our own has any objective metaphysical privilege over others, but simply because it is ours. It may be very natural to have this loyalty to our own species, but let us hear no more from the naturalists about the 'sentimentality' of anti-vivisectionists. If loyalty to our own species, preference for man simply because we are men, is not a sentiment, then what is? It may be a good sentiment or a bad one. But a sentiment it certainly is. Try to base it on logic and see what happens! But the most sinister thing about modern vivisection is this. If a mere sentiment justifies cruelty, why stop at a sentiment for the whole human race? There is also a sentiment for the white man against the black, for a Herrenvolk against the non-Aryans, for 'civilized' or 'progressive' peoples against 'savages' or 'backward' peoples. Finally, for our own country, party or class against others. Once the old Christian idea of a total difference in kind between man and beast has been abandoned, then no argument for experiments on animals can be found which is not also an argument for experiments on inferior men. If we cut up beasts simply because they cannot prevent us and because we are backing our own side in the struggle for existence, it is only logical to cut up imbeciles, criminals, enemies or capitalists for the same reasons. Indeed, experiments on men have already begun. We all hear that Nazi scientists have done them. We all suspect that our own scientists may begin to do so, in secret, at any moment." http://www.irishantivivisection.org/cslewis.htmlClive Hayden
January 6, 2010
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O'Leary @ 10 As waterbear stated Phase I clinical trials are not conducted with people who are ill (that would be a confounding factor for the purpose of the trial) but rather use healthy individuals. The purpose of Phase I trials is to describe the pharmacokinetics and pharmacodynamics of the new drug. These people are certainly advised that harm may occur and at times it does occur. Along with the examples provided by waterbear we could add thalidomide to that list. The question is to your assertion that these people should have their possessions removed from them as well as their decision making capabilities simply because they volunteer to be experimental subjects.Acipenser
January 6, 2010
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O'Leary at 10: People volunteering for Phase 1 clinical trials are not normally "people who have not felt that current medications help them, and are willing to try a new one", nor should they be the people to undertake such a trial. Phase 1 clinical trials are normally conducted in healthy volunteers specifically to test whether the drug is metabolised as expected and because adverse reactions are easier to spot. While people volunteering for such a trial are not "volunteering for harm" the possiblity cannot be ruled out and Phase 1 clinical trials can result in great harm to the subjects, such as the trial of the TGN1412 leukemia and arthritis drug.waterbear
January 6, 2010
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Sorry Steve, can't buy that line of reasoning. I don't even see it as morally consistent, because it doesn't explain what the criteria is to determine valuable from non-valuable human life, or who gets to determine what that criteria ought to be and why, or whether or not we can even know if such criteria exists beyond one's own personal preference. This is moral mish-mash and meaningless muddle as far as I can tell. I'll go out on a limb and say that either A) all human life has dignity and worth OR B) none has. There is no middle ground, because any in-between position implies the existence of a criteria to distinguish the one from the other. What is that criteria and where has it been established that it is so? This is the question for which guys like Cochrane have no answer. By his lights its "B" above...no human life has dignity and worth. But then that leaves him with no good reason for wanting to use these undignified humans for experiments to help humanity. At best its inconsistent; at worst, incoherent.DonaldM
January 6, 2010
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