Active Symbols

Visual representations of religious symbols continue to puzzle judges. Lacking empirical data on how images communicate, courts routinely dismiss visual religious symbols as “passive.” This Article challenges the notion that symbols are passive, introducing insights from cognitive neuroscience research to Establishment Clause theory and doctrine. It argues that visual symbolic messages can be at least as active as textual messages. Therefore, religious messages should be assessed in a medium-neutral manner in terms of their communicative impact, that is, irrespective of their textual or visual form. Providing a new conceptual framework for assessing religious symbolic messages, this Article reconceptualizes coercion and endorsement—the dominant competing approaches to symbolic messages in Establishment Clause theory—as matters of degree on a spectrum of communicative impact. This focus on communicative impact reconciles the approaches to symbolic speech in the Free Speech and Establishment Clause contexts and allows Establishment Clause theory to more accurately account for underlying normative concerns

Licensing Knowledge

When professionals give advice, they disseminate professional knowledge to their clients. Professional advice is valuable to clients because they gain access to a body of knowledge they do not otherwise possess. To preserve the accuracy, and hence the value, of this knowledge transfer, the First Amendment should protect professional speech against state interference that seeks to alter the content of professional advice in a way that contradicts professional knowledge. But before professionals can give professional advice, they are routinely subject to licensing by the state. This seemingly creates a tension between state involvement in professional licensing and protection against state involvement in professional speech. This Article provides a theoretical framework to reconcile professional speech protection with professional licensing. Under this theory, the interests underlying First Amendment protection of professional speech and those underlying state licensing are the same: preserving the reliability of expert knowledge by guarding professionals\u27 competence and protecting the dissemination of reliable professional advice to the client

Public Health Originalism and the First Amendment

Current First Amendment doctrine has set public health regulation and protections for commercial speech on a collision course. This Article examines the permissibility of compelled public health and safety warnings after the Supreme Court’s decision in National Institute of Family & Life Advocates v. Becerra (NIFLA) through the lens of a concurrence to the Ninth Circuit’s en banc decision in American Beverage Ass’n v. City & County of San Francisco (American Beverage II) suggesting that only health and safety warnings dating back to 1791 are presumptively constitutional under the First Amendment. Rejecting this form of “public health originalism,” this Article first assesses the current doctrinal landscape of compelled public health and safety warnings in the context of commercial speech. It then turns to the history of such warnings, revealing that contrary to apparent assumptions underlying “public health originalism” in its deregulatory form, laws compelling speech including to protect public health existed in the framing era and were not thought to clash, in the modern sense, with individual liberties, including the freedom of expression. Finally, this Article offers a reading of NIFLA in light of the underlying normative interests of speakers and listeners that attempts to reconcile contemporary First Amendment doctrine and compelled public health and safety warnings

Expert Knowledge in First Amendment Theory and Doctrine

In this dissertation, through three separately published articles, I interrogate the role of expert knowledge in First Amendment theory and doctrine. I argue that expert knowledge ought to play a prominent role in answering doctrinally relevant empirical questions, as in the case of incorporating a scientifically grounded understanding of visual perception into Establishment Clause inquiries concerning religious symbols. Moreover, the generation and dissemination of expert knowledge itself is worthy of First Amendment protection, for example in protecting professional speech. And expert knowledge should determine the scope of First Amendment protection for professional advice. There is, in other words, a close but often underappreciated connection between expert knowledge and the First Amendment. In Active Symbols, I challenge the assumption sometimes articulated in Establishment Clause case law involving religious symbols that visual representations of religious symbols are merely “passive” as compared to textual (spoken or written) religious references. Drawing on one relevant body of expert knowledge—cognitive neuroscience—I argue that images are at least as “active” as text. The lack of judicial expertise on the empirical question of how visual images, as opposed to spoken or written words, communicate has led to a distortion in the development of Establishment Clause doctrine. This distortion can be remedied by taking relevant expert knowledge into consideration where such knowledge can answer germane empirical questions that are doctrinally relevant but tend to be outside the realm of judicial expertise. Professional Speech argues that the First Amendment protects the communication of expert knowledge by a professional to a client-within a professional-client relationship for the purpose of giving professional advice. The First Amendment thus provides a shield against state interference that seeks to prescribe or alter the content of professional speech. The key to understanding professional speech, I suggest, lies in the concept of the learned professions as knowledge communities. First Amendment protection for professional speech can be justified on all traditional grounds: autonomy interests of the speaker and listener, marketplace interests, and democratic self-government. Unprofessional Advice provides a theory to identify the range of valid professional advice for First Amendment purposes. Building on the concept of the professions as knowledge communities, this article explores the range of professional advice that may be given consistent with the professional knowledge community’s common ways of knowing and reasoning and the respective profession’s agreed upon methodology. Because knowledge communities are not monolithic, there is a range of knowledge that is accepted as good professional advice. Advice falling within this range should receive robust First Amendment protection. Advice not within this range, however, is subject to malpractice liability, and the First Amendment provides no defense

Borrelia valaisiana resist complement-mediated killing independently of the recruitment of immune regulators and inactivation of complement components

Spirochetes belonging to the Borrelia (B.) burgdorferi sensu lato complex differ in their resistance to complement-mediated killing, particularly in regard to human serum. In the present study, we elucidate the serum and complement susceptibility of B. valaisiana, a genospecies with the potential to cause Lyme disease in Europe as well as in Asia. Among the investigated isolates, growth of ZWU3 Ny3 was not affected while growth of VS116 and Bv9 was strongly inhibited in the presence of 50% human serum. Analyzing complement activation, complement components C3, C4 and C6 were deposited on the surface of isolates VS116 and Bv9, and similarly the membrane attack complex was formed on their surface. In contrast, no surface-deposited components and no aberrations in cell morphology were detected for serum-resistant ZWU3 Ny3. While further investigating the protective role of bound complement regulators in mediating complement resistance, we discovered that none of the B. valaisiana isolates analyzed bound complement regulators Factor H, Factor H-like protein 1, C4b binding protein or C1 esterase inhibitor. In addition, B. valaisiana also lacked intrinsic proteolytic activity to degrade complement components C3, C3b, C4, C4b, and C5. Taken together, these findings suggest that certain B. valaisiana isolates differ in their capability to resist complement-mediating killing by human serum. The molecular mechanism utilized by B. valaisiana to inhibit bacteriolysis appears not to involve binding of the key host complement regulators of the alternative, classical, and lectin pathways as already known for serum-resistant Lyme disease or relapsing fever borreliae

The impact of the temporal sequence of cranial radiotherapy and platin-based chemotherapy on hearing impairment in pediatric and adolescent CNS and head-and-neck cancer patients: A report from the PanCareLIFE consortium.

The impact of the temporal sequence by which cranial radiotherapy (CRT) and platin-based chemotherapy (PCth) are administered on sensorineural hearing loss (SNHL) in pediatric and adolescent central nervous system (CNS) and head-and-neck (HN) cancer patients has not yet been studied in detail. We examined the ototoxic effects of sequentially applied CRT and PCth. This study included children and adolescents with CNS and HN tumors who participated in the multicountry PanCareLIFE (PCL) consortium. Audiological outcomes were compared between patients who received CRT prior to PCth and those who received it afterwards. The incidence, degree and posttreatment progression of SNHL, defined as Muenster classification grade ≥MS2b, were evaluated in 141 patients. One hundred and nineteen patients were included in a time-to-onset analysis. Eighty-eight patients received CRT prior to PCth (Group 1) and 53 patients received PCth before CRT (Group 2). Over a median follow-up time of 1.6 years, 72.7% of patients in Group 1 experienced SNHL ≥ MS2b compared to 33.9% in Group 2 (P < .01). A time-to-onset analysis was performed for 74 patients from Group 1 and 45 patients from Group 2. Median time to hearing loss (HL) ≥ MS2b was 1.2 years in Group 1 and 4.4 years in Group 2 (P < .01). Thus, audiological outcomes were better for patients who received CRT after PCth than before. This finding should be further evaluated and considered within clinical practice in order to minimize hearing loss in children and adolescents with CNS and HN tumors