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A Voice for Private Physicians Since 1943

AAPS News May 2024 – Servitude

Volume 80, no. 5  May 2024

The 13th Amendment to the Constitution reads: “Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction.”

This forbids the shameful practice of chattel slavery, under which human beings were treated like property. Slaves themselves could own nothing, and in most places were forbidden to work for wages. (A few were able to buy their freedom in this way.) Owners could abuse and even kill them—or, in perhaps the most feared scenario, tear families apart. For decades, freed slaves searched for their children, parents, or siblings; as late as 1905, newspapers carried ads by people desperate for information on lost family (tinyurl.com/j5bhkyc4, tinyurl.com/4jntc8zv).

But how far does the Amendment go in banning “involuntary servitude” for persons whose body is not physically owned?

Consider the 1856 wording that supported  the 1861 Emancipation Edict, which preceded Lincoln’s 1863 Proclamation: “You can yourself understand that the present order of owning souls cannot remain unchanged” (https://tinyurl.com/2p9bsvmj).

This Edict freed more than 23 million serfs and was known as one of the greatest accomplishments in history for human freedom. Czar Alexander II, who reigned 1855–1881, became known as the “Great Liberator,” for which he was beloved around the world, writes Cynthia Chung (ibid.). Both President Lincoln and Czar Alexander were assassinated. Servitude lives on.

Merriam-Webster defines “servitude” as “a condition in which one lacks liberty especially to determine one’s course of action or way of life.”

After gaining their freedom, blacks were still treated as second-class citizens. There were “Jim Crow” laws and government policies. After campaign promises of equal treatment, Woodrow Wilson suddenly imposed racial segregation in the civil service, with devastating effect on blacks, who were serving at all levels (https://tinyurl.com/3kwh25cx).

Franklin Roosevelt signed an executive order forbidding racial discrimination by defense contractors:  “The sole qualifications for a worker…should be his loyalty and his professional or technical ability and training” (https://tinyurl.com/27888zy4). Harry Truman desegregated the U.S. armed forces in 1948.

The civil rights movement of the 1960s aimed to have a “color-blind” society. What an irony if its result was constant racial divisiveness and strife, resegregation to exclude whites, the upending of professional standards, and a new servitude.

The Civil Rights Act of 1964, Title II, prohibits segregation or discrimination on the basis of race, color, religion, or national origin in places of public accommodation involved in interstate commerce. The constitutionality of the act was immediately challenged in Heart of Atlanta Motel v. U.S. The owner, who had previously refused to accept black customers, argued that the act was an invalid exercise of Congress’s power to regulate interstate commerce; that it violated the 5th Amendment’s guarantees of due process and just compensation for the taking of private property because it deprived him of the right to choose his customers; and that it violated the 13th Amendment’s prohibition of involuntary servitude because it compelled him to serve certain customers.

In  a 9–0 decision, the U.S. Supreme Court held that the hotel’s policy affected interstate commerce and rejected all the constitutional arguments (https://tinyurl.com/49fzr6bz).

Since 1964, Congress has enacted more laws against discrimination in employment, lending practices, and education, and expanded the prohibited practices to include age, sex, disability, and sexual orientation. The Equal Employment Opportunity Act of 1972 created a Commission with expansive authority to enforce regulations and subregulations, and manage more than 80,000 complaints annually.

With affirmative action and now Diversity, Equity, and Inclusion (DEI or DIE), structural racism is assumed to exist on the simple lack of proportional representation in any field.

With the addition of “sexual orientation” and the legalization of same-sex marriage, the idea of “public accommodation” has expanded far beyond having to provide a meal, transportation, or lodging, but to provide certain personalized services. Photographers and bakers have been tied up in court for years arguing for a 1st Amendment right not to serve same-sex weddings. But is a person not allowed to turn down a job for any reason, even if he has no societally recognized religion backing him? Or is he obligated to work for members of governmentally protected groups and provide a product that they demand? Is this involuntary servitude if the option is not to work in one’s chosen occupation at all?

The tipping point may have been reached with the Biden Department of Education’s interpretation of “sex” in Title IX to include “gender identification,” thus allowing men to compete in women’s athletics. At least 15 states have filed lawsuits. Worse, if parents do not serve the transgender agenda, Child Protective Services could take their children; schools are mandatory reporters (https://tinyurl.com/2dc7s8d4).

Physicians are also supposed to serve, as Biden HHS is incorporating Education’s definitions into regulations for §1557 of the Affordable Care Act, and Medicare Part B is newly defined as federal funding for services. Failure to provide “affirming” services, even if patient would be harmed, is now “discrimination.”

Russia and the ‘American System’

In 1840, American slave cotton was the centerpiece of the British Empire’s world cheap-labor system. In 1862, the first critical phase of the Civil War, Lincoln was aware that both France and England were preparing to intervene on the side of the Confederacy, and he sent an urgent letter to the Russian Foreign Minister Gorchakov.

Gorchakov replied: “We are very, very anxious that…any course should be pursued—which will prevent the division which now seems inevitable. One separation will be followed by another; you will break into fragments.” The Russian Navy arrived on both the east and west coastlines of the U.S. in the autumn of 1863. In this way, Russia may have saved the Union (Chung, op. cit.).

Czar Alexander stated that he did this out of love for Russia, because he did not want Great Britain to be left in control of modern industrial development. He recognized the “American system” as the only system to have successfully challenged the system of empire, which he identified as the root of all slavery. As economist Henry C. Carey stated in The Harmony of Interests (1851):

One [system] looks to pauperism, ignorance, depopulation, and barbarism; the other in increasing wealth, comfort, intelligence, combination of action, and civilization. One looks towards universal war; the other towards universal peace. One is the English system; the other,…the American system,…the only one ever devised [with] the tendency of…elevating while equalizing the condition of man throughout the world.

What happened to Russia? How did Bolshevism triumph over the movement toward an enlightened constitutional monarchy? Was Lenin’s 1917 coup  a “color revolution,” a staged event, orchestrated by foreign [British] intelligence services? Richard Poe suggests that Bolshevism was the answer to the threat that a strong Russia posed to British global dominance (tinyurl.com/ycx5r9sv). This obscure, convoluted history may   yield clues pertaining to what is happening to America.

Why Russophobia Now?

On Apr 29, Tucker Carlson published an interview with Russian philosopher Aleksandr Dugin, whose books amazon refuses to sell. Dugin said that the West has progressed far beyond  the classical liberalism of individual freedom and liberation from slavery. The new liberalism demands liberation from any identity that transcends the individual—from the church, the nationalist state, the family, and even gender. The ultimate step is liberation from humanity—transhumanism (tinyurl.com/zbwp5s8c).

Tucker asked why progressive Americans, who had defended the Soviet system for nearly 80 years, and even participated in Stalinism, suddenly hate Russia. Dugin said they had discovered that Putin is a political leader who is strongly defending the traditional values that they intend to abolish. The hatred is not just a mood: “It’s metaphysical.”

“There is ever a peculiar connection, a sympathy of feeling and affection…between these [the lower classes] and the highest order, that of gentlemen. In society,… it is the middle [class] which is the region of disorder and confusion and tempest.”

Kenelm Henry Digby, c. 1848, spiritual leader of Young England

Parallels: Pro-Slavery/Abortion Arguments

From comments posted by Nathan Prindler:

· “This slave/baby is my property/body. You can’t tell me what to do with it.”

· “My property/body rights come before the rights of a slave/fetus.”

· “No one is forcing you to have slaves/abortions; mind your own business.”

· “If slavery/abortion ends, most of these slaves/babies wind up on the street without a job.”

· “Slavery/abortion is in the best interest of the Africans/babies. The world can be a cruel place, so it’s actually best for them to enslave/abort them.”

· “Slavery/abortion was vindicated by the Supreme Court. It’s already been decided. It’s settled law.”

· “Slaves/fetuses aren’t really people; they aren’t like us; they’re physically different; therefore we can own/kill them.”

· “Slavery/abortion has been around for thousands of years. It’s never going away. We might as well have a safe and legal system in place for it” (https://tinyurl.com/4atfpykk).


By March, 1840, the Communist movement in Paris was deemed sufficiently threatening that a German newspaper denounced it, saying, “The Communists have in view nothing less than a levelling of society—substituting for the presently-existing order of things the absurd, immoral and impossible utopia of a community of goods” (Augsburger Allgemeine Zeitung, Mar 11, 1840).

Karl Marx’s Communist Manifesto was published in 1848. The founding father of communism was “Gracchus” [François-Noël] Babeuf, writes Richard Poe. Marx and Engels called Babeuf the first modern communist. More than 50 years before their manifesto, a group of French radicals calling itself the Conspiracy of Equals was preaching classless society, abolition of private property, and the need for revolutionary action.

 Babeuf derived many of his ideas from British mentors, at least some of whom were British intelligence operatives, such as James Rutledge, who called himself a “citizen of the universe” and preached the abolition of private ownership. Marx was also influenced by British mentors, at least some of whom are known to have been intelligence operatives. Marx had family connections with the British aristocracy. One common idea of various influencers was hatred of the bourgeoise.

Is Communism a British invention (Poe, op. cit.)?

AAPS Calendar

June 12. Pennsylvania chapter webinar with Do No Harm.

July 13. Missouri chapter meeting, Lake Ozark, MO.

Sep 18-21. 81st Annual Meeting, San Antonio, TX.

AAPS Defends Ohio Law Protecting Children

          In an amicus brief in the Supreme Court of Ohio, AAPS supports the Saving Ohio Adolescents from Experimentation Act and the Save Women’s Sports Act, enacted in January as H.B. 68 by overriding the governor’s veto. Implementation of the bill has been blocked by an injunction from a lower court.

  The law protects children from transgender surgery. Children are not able to give informed consent for this mutilating surgery.

The brief’s argument focuses on natural law, which is embodied in the Ohio Constitution. “The strongest judicial ruling against slavery prior to the Civil War was expressly based on natural law, and was rendered by the Ohio Supreme Court,” the brief states. Natural law, referred to in the Declaration of Independence although not in the U.S. Constitution, is the basis for many fundamental rights, including the right to self defense.

“H.B. 68 is analogous to laws against statutory rape, which no one would claim are unconstitutional,” AAPS’s brief explains.

Feds Plan to Circumvent State TG Laws

Through its litigation against HHS to enforce a Freedom of Information Act (FOIA) request for Assistant Secretary Levine’s communications regarding pediatric “transgender clinics,”  America First Legal has obtained emails regarding behind-the-scenes meetings with “gender affirming care providers” in states that have banned these practices. Providers of chemical castration and genital mutilation are seeking federal cover for attempts to evade state laws (https://tinyurl.com/3etkjmmh).

TG Child Removed from Home; Cert Denied

The U.S. Supreme Court declined to hear the appeal of parents whose child was removed from their home by the state of Indiana (M.C. and J.C. v. Indiana Department of Child Services, No. 23-450). The agency had received two reports of abuse related to the child’s transgender identity. While it conceded that parents were “fit,” it removed the 16-year-old anyway. Parents stated that the removal and placement of their son in a “gender-affirming” home was because of their Christian belief that children should be raised in accordance with their sex, but the state claimed it was because of the child’s eating disorder (https://tinyurl.com/5955b2dt).

The petition for certiorari argued:

 [T]he numbers of transgender youth are rising, matched by governmental willingness to remove gender-dysphoric children from their parents’ custody. Indiana’s tack—blame a comorbidity and dodge adjudication of parental fitness—provides a playbook that any state can use to eviscerate bedrock constitutional protections while guaranteeing they remain insulated from review. 

  About 70% of children with gender dysphoria have a serious mental health comorbidity, but “parents who want to treat the comorbidity without affirming the dysphoria—based on their beliefs and a growing body of research—are gambling with the custody of their children” (https://tinyurl.com/43esje55).

Indiana claimed mootness when the child came of age. As the brief pointed out, if Indiana is correct, “all child welfare cases will become unreviewable when the child turns 18. That is textbook capable-of-repetition-yet-evading-review.”

Tip of the Month: Beware of private equity monopolizing medical practices. The Colorado attorney general intervened against U.S. Anesthesia Partners of Colorado, Inc. (USAP), run by a New York City private equity firm. USAP bought up many anesthesia practices in Texas and then expanded into Denver. “By 2021, USAP bought out all its major competitors and established control of surgical anesthesia at the two largest hospital systems in the Denver area, accounting for more than 70% of health plan reimbursements,” the Colorado attorney general discovered. Harmful results included “onerous non-compete restrictions on health care professionals, and patients often facing delays or outright cancellation of their surgeries,” the State found. In February Colorado required USAP to divest its exclusive contracts at five hospitals, and to relax and ultimately end its non-compete restrictions on physicians (https://tinyurl.com/27yb9f6k).

Medicare Part B Swept under Title IX

The Department of Health and Human Services (HHS) has changed its long-standing position and for the first time will consider Medicare Part B payments as a form of Federal financial assistance for purposes of triggering civil rights laws (tinyurl.com/22haezh7).

“In determining whether a covered entity violated section 1557 by denying or limiting a health service sought for the purpose of gender-affirming care, OCR [the Office of Civil Rights] will continue to consider evidence that the covered entity would provide that same service for other purposes,” states the Federal Register (https://tinyurl.com/mr2a9678). So, if a urologist performs an orchiectomy for cancer, might he also be obliged to do it for “gender affirmation”?

“Given the wide-sweeping effect of HHS’s declaration in the final rule, this is an area ripe for potential legal challenges,” according to McDermott Will & Emery (tinyurl.com/2tv73kjb).

The March through Legal Institutions

The Civil Rights Act has expanded into every sphere, public and private, metastasizing far beyond its original purpose and prohibiting more than 30 kinds of discrimination, including against persons with criminal records, welfare users, and drug addicts. It was made possible by educational theory inculcating multiculturalism, which constitutes a new moral order based on identity, inclusion, recognition, respect, and equity. The new form of law, a hybrid of civil and criminal law, has the goal of a leftist form of Sharia, writes Alexander Riley, “a…very Western, secular, up-to-date alternative to the Ministry for the Propagation of Virtue and the Prevention of Vice.”

The “emergence of the bizarre, reality-rejecting doctrine of ‘disparate impact’ after the passage of civil rights legislation was a singular moment in American legal history.” When empirical evidence of discrimination disappears, the state looks for it “in a fantasy world of invisible structures and ghostly forces.”

While the Left is the most vigorous proponent of this expansive doctrine, the mainstream Right does everything possible to avoid criticizing it. Civil Rights is holy writ. “Conservatives” would not dare allow mention of repeal. But once we have sounded its depth, we must do everything we possibly can to thwart the “antidiscrimination” regime (Chronicles, April 2024).


Déjà Vu. We see a number of striking similarities between the COVID-19 situation in which physicians who did not comply with the official COVID narrative were often attacked and destroyed, and the observational study by Andrew Wakefield 20 years ago. Both situations involved pharmaceutical companies that did not want any negative information circulated about their vaccines. Their supporters said the “science was settled,” and the vaccine-autism connection was a “debunked myth.” Now, a recent meta-analysis published in 2019 (https://doi.org/10.3389/fncel.2019.00385) makes the same association between autism and GI changes as Dr. Andrew Wakefield did.  And, apparently HHS has compensated 62 patients with autism for “injuries described as vaccine-induced brain damage.” According to the article, researchers are afraid to do studies on GI disease and autism because of what was done to Dr. Wakefield.  

Lawrence R. Huntoon, M.D., Ph.D., Lake View, NY

Hills Not to Die On. In 2017, pronouns were not really a thing. Now the right to be called he, she, they or some fancy of your own concocting is backed by the full force of the government of the U.S. The EEOC says that banning misgendering and bathroom restrictions for trans people “logically extends” from the U.S. Supreme Court’s 2020 Bostock ruling that added sexual and gender identity as a protected category under Title VII of the Civil Rights Act. This decision was given us by rock-ribbed originalist Neil Gorsuch, effortlessly twisting the English language into a supersized pretzel to demonstrate why the Framers were totally on board with 57 genders. A land of legalisms is not the same as a land of laws—and the ra-ra Right’s retreat to the Supreme Court as every hill not to die on was surrendered has proved strategically disastrous. Objecting to the abolition of biological sex isn’t a conservative hill. So the left proceeded with its demolition of human biology while Paul Ryan worked on his tax cut—and now America leads the world in the mutilation and sterilization of pre-pubescent schoolgirls. This hill has transitioned into a pit of hell. In the post-9/11 self-deluding blather, we could at least say that, unlike Islam, we don’t slice body parts off little girls. Now we do. The Left made a bonfire of “the facts of life”—while the right stood by and watched.

Mark Steyn, https://tinyurl.com/2433ab6b

RIP, Trans Agenda? Evidence mounts that “gender-affirming care” (chemical castration and genital mutilation), harms children. A Swedish study, which followed more than 300 patients for 30 years (https://tinyurl.com/2n54uhpx), showed that those who underwent sex reassignment surgery had a suicide rate 19 times higher than population controls. Medical outcomes were dismal.

For most children, gender dysphoria is transient. There is no justification to “treat” a condition that is likely to go away on its own. Given the absence of benefit and presence of substantial risk, any medical “treatment” would constitute a violation of medical ethics and an act of malpractice. Legal bans are needed. Sex change surgeries have increased four-fold in the past decade, while the rate of complications exceeds 50%. 

Mark McDonald, M.D., https://tinyurl.com/2hphftz4

Scotland: from Enlightenment to Insanity. As predicted, Scotland Police was deluged with 4,000 complaints in the first day after passage of a new hate crime law. Under this law, a person found to have been verbally “abusive” or “insulting” toward a transgender person, in person or online, could be imprisoned for up to 7 years. In case I ever visit Scotland, I am stating for the record that Dr. Rachel Levine is beautiful.

Craig Cantoni, Tucson, AZ

First Breakaway. In what’s likely to be a watershed moment, the Massachusetts Institute of Technology has become the first elite private university to end the use of diversity statements for faculty hiring (https://tinyurl.com/cjfnk2ve).

Willie Soon, Ph.D., Salem, MA

TG Foreign Policy. According to a federal grant posting, the Biden State Department wants to train at least 200 activists to advocate for transgender rights in India as part of a program ostensibly designed to advance America’s “national interests.” Preference would be given to “trans and intersex community leaders” (https://tinyurl.com/zcsh94wz).

Joseph Scherzer, M.D., Paradise Valley, AZ

The Big Medical Short. Beware of big corporations  trying to be direct primary care (DPC). When private equity firms acquire physician practices, the intended end goal is to sell the entity so investors can see a return on investment. Exits within three to eight years are a natural part of the private equity cycle.

Buying private practices is a losing proposition. Corporations are replacing doctors with non-doctors, trashing the already terrible medical system we have. Walgreens and Walmart are losing tons of money on primary care. They are burning it all to the ground. It’s like the insanity where apes take over the world in Planet of the Apes. Our only hope is the small, individually owned practices that keep the system going. 

Douglas Farrago, M.D., https://tinyurl.com/5cms6zut

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