Biological Citizenship and the Children of Same-Sex Marriage

In 2015, the Supreme Court ruled that states could not, consistent with the Due Process Clause, deny same-sex couples the right to marry. To allow otherwise, said the Court, would “harm and humiliate the children of same sex marriage.” Thus, it was hoped that marriage equality would provide greater security for the children of same-sex couples. And the need for such protections are increasingly important given that, with advances in assisted reproduction techniques, it is easier than ever for same-sex couples to become parents. Indeed, when it comes to procreation, same-sex marriages and opposite-sex marriages are becoming much more alike. But there remains an obvious difference between the two. Namely, same-sex couples are unable to procreate without the assistance of a third-party, meaning that although both parents in a same-sex marriage may qualify as legal parents, only one (at most) will qualify as a biological parent. But from a constitutional perspective, should that distinction matter? The Supreme Court, in both Obergefell and its recent decision in Pavan v. Smith has indicated that, when it comes to the governmental benefits associated with marriage, the answer is “no.” Nonetheless, within the realm of immigration law, the State Department is using the absence of biological ties against the children of same-sex marriage, and on that basis, denying them United States citizenship. Although nothing in the Immigration and Naturalization Act requires that citizens, in order to transmit citizenship, possess a biological relationship with their children born abroad, the State Department has begun denying citizenship petitions on behalf of children from same-sex couples simply because the citizen parent, despite being the child’s legal parent, is not the biological parent. This Article argues that the State Department’s approach is not only unreasonable and, thus, not entitled to Chevron deference, but more importantly, is an unconstitutional infringement of both the right to marry and the right to parent, as those rights have developed by the Supreme Court. In sum, the State Department’s practice provides a poignant example of both the ongoing discrimination and the challenging questions that remain, post-Obergefell, in the quest for true marriage equality

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically