When the Classroom Is Not in the Schoolhouse: Applying Tinker to Student Speech at Online Schools

Despite the overwhelming increase in students’ Internet use and the growing popularity of online public schools, the United States Supreme Court has never addressed how, or if, schools can discipline students for disruptive online speech without violating the students’ First Amendment rights. What the Supreme Court has addressed is how school administrators can constitutionally discipline students within traditional schools. In a landmark decision, Tinker v. Des Moines Independent Community School District, the Supreme Court announced the now famous principle that students do not “shed their constitutional rights to freedom of speech or expression at the schoolhouse gate.” Still, the Court continued, school administrators can discipline students when their speech “materially disrupts classwork or involves substantial disorder.” In a later case, the Court stated that free speech rights for students on campus are “not automatically coextensive with the rights of adults in other settings.” In this Comment, I suggest that in order to provide a workable standard that balances online students’ free speech rights with online schools’ obligations to maintain an appropriate learning environment for all students, the Supreme Court should apply Tinker, without its exceptions, to speech made by students at online schools

When the Classroom Is Not in the Schoolhouse: Applying Tinker to Student Speech at Online Schools

Despite the overwhelming increase in students’ Internet use and the growing popularity of online public schools, the United States Supreme Court has never addressed how, or if, schools can discipline students for disruptive online speech without violating the students’ First Amendment rights. What the Supreme Court has addressed is how school administrators can constitutionally discipline students within traditional schools. In a landmark decision, Tinker v. Des Moines Independent Community School District, the Supreme Court announced the now famous principle that students do not “shed their constitutional rights to freedom of speech or expression at the schoolhouse gate.” Still, the Court continued, school administrators can discipline students when their speech “materially disrupts classwork or involves substantial disorder.” In a later case, the Court stated that free speech rights for students on campus are “not automatically coextensive with the rights of adults in other settings.” In this Comment, I suggest that in order to provide a workable standard that balances online students’ free speech rights with online schools’ obligations to maintain an appropriate learning environment for all students, the Supreme Court should apply Tinker, without its exceptions, to speech made by students at online schools

Soluble receptor for advanced glycation end products in COPD: relationship with emphysema and chronic cor pulmonale: a case-control study

<p>Abstract</p> <p>Background</p> <p>The receptor for advanced glycation end products (RAGE) is a multiligand signal transduction receptor that can initiate and perpetuate inflammation. Its soluble isoform (sRAGE) acts as a decoy receptor for RAGE ligands, and is thought to afford protection against inflammation. With the present study, we aimed at determining whether circulating sRAGE is correlated with emphysema and chronic cor pulmonale in chronic obstructive pulmonary disease (COPD).</p> <p>Methods</p> <p>In 200 COPD patients and 201 age- and sex-matched controls, we measured lung function by spirometry, and sRAGE by ELISA method. We also measured the plasma levels of two RAGE ligands, N-epsilon-carboxymethyl lysine and S100A12, by ELISA method. In the COPD patients, we assessed the prevalence and severity of emphysema by computed tomography (CT), and the prevalence of chronic cor pulmonale by echocardiography. Multiple quantile regression was used to assess the effects of emphysema, chronic cor pulmonale, smoking history, and comorbid conditions on the three quartiles of sRAGE.</p> <p>Results</p> <p>sRAGE was significantly lower (p = 0.007) in COPD patients (median 652 pg/mL, interquartile range 484 to 1076 pg/mL) than in controls (median 869 pg/mL, interquartile range 601 to 1240 pg/mL), and was correlated with the severity of emphysema (p < 0.001), the lower the level of sRAGE the greater the degree of emphysema on CT. The relationship remained statistically significant after adjusting for smoking history and comorbid conditions. In addition, sRAGE was significantly lower in COPD patients with chronic cor pulmonale than in those without (p = 0.002). Such difference remained statistically significant after adjusting for smoking history, comorbidities, and emphysema severity. There was no significant difference in the plasma levels of the two RAGE ligands between cases and controls.</p> <p>Conclusions</p> <p>sRAGE is significantly lower in patients with COPD than in age- and sex-matched individuals without airflow obstruction. Emphysema and chronic cor pulmonale are independent predictors of reduced sRAGE in COPD.</p

Strangers or Friends?: A Proposal for a New Spirituality-in-Medicine Ethic

We argue that debate regarding whether and how physicians should engage religious concerns has proceeded under inadequate terms. The prevailing paradigm approaches dialogue regarding religion as a form of therapeutic technique, engaged by one stranger, the physician, upon another stranger, the patient. This stranger-technique framework focuses the debate on questions of physicians' competence, threats to patients' autonomy, and neutrality regarding religion, and in so doing, it too greatly circumscribes the scope of physician-patient dialogue. In contrast, we argue that dialogue regarding religion is better approached as a form of philosophical discourse about ultimate human concerns. Such moral discourse is often essential to the patient-physician relationship, and rather than shrinking from such discourse, physicians might engage patients regarding religious concerns guided by an ethic of moral friendship that seeks the patient's good through wisdom, candor, and respect