Republican debate highlights foreign policy differences (The Christian Science Monitor)

Saturday nighta€?s Republican debate saw no major stumbles or gaffes, nothing in what CBS News and the National Journal ostentatiously called a€?The Commander-in-Chief Debatea€

In fact, of all the (it only seems like) hundreds of debates so far, this one seemed the most substantial, focusing on national security and foreign affairs – life-and-death issues that President Obama polls relatively well in.

While the range of differences stretched from tough to tougher – except for Ron Paul’s isolationism and Jon Huntsman's more experienced, more nuanced outlook – there were points at which differences were highlighted.

MONITOR QUIZ: Weekly News Quiz for Nov. 6-11, 2011

Still, nothing happened to alter the basic candidate ranking as post-debate polls are likely to show – Mitt Romney and Herman Cain neck-and-neck at the top and Newt Gingrich enjoying a boomlet that may or may not last.

“The debate illustrated again that the divide in the GOP presidential field on foreign policy is between those who know what they are talking about and those who don’t,” observed Jonathan Tobin, senior online editor of the neoconservative Commentary magazine.

“A clear grasp of war and peace issues won’t transform Rick Santorum into a first tier candidate from an also-ran,” Tobin blogged following the debate. “But his lack of command of the issues does make it difficult, if not impossible, for Herman Cain to put forward a plausible argument for himself as a potential president…. While it must be admitted that he’s come a long way from the comical ignorance he displayed on this topic when he began his campaign, he still came across as the weakest of all the contenders.”

IN PICTURES: Republicans in the 2012 presidential race

Unable to tout his signature “9-9-9” tax scheme (although he did throw in another “9” citing what he said are the number of countries with nuclear weapons) or to exhibit his folksy style, which would have seemed inappropriate given the debate’s focus, Cain fell back on the cautious and fuzzy.

Several times when debate moderators tried to pin him down, he said he’d have to consult with military commanders – “a dodge that allowed him to avoid being drawn into several topics moderators pressed on,” as Jonathan Martin and Ginger Gibson at Politico.com put it.

Cain is definitely against torture, he said, although that does not include waterboarding as “enhanced interrogation.”

Here was a subject on which Ron Paul and Jon Huntsman stood out as the only ones opposed to the controversial interrogation procedure banned under international law, opposed by former POW Sen. John McCain, and for which Japanese officers were prosecuted by the United States after World War II.

Rep. Paul called waterboarding “immoral” and “impractical.”

"We diminish our standing in the world and the values that we project, which include liberty, democracy, human rights and open markets, when we torture," Huntsman said. "We lose that ability to project values that a lot of people in corners of this world are still relying on the United States to stand up for."

Most of the presidential hopefuls applauded the recent killing of major Al Qaeda figures, including Osama bin Laden and Anwar al-Awlaki. (Again, Ron Paul was the major exception.) That and the winding down of wars in Iraq and Afghanistan a€“ favored by most Americans a€“ made it harder for them to criticize the Obama administration on its approach to terrorism.

"I don't think there's a very strong narrative," Bush administration spokesman Tony Fratto told the Associated Press. "Is it a significant issue for a majority of Republican voters? No. It's not."

But recent reports of Iran’s activities to develop nuclear weapons gave an opening to threaten tougher sanctions and even a US military strike.

"If we re-elect Barack Obama, Iran will have a nuclear weapon. And if you elect Mitt Romney, Iran will not have a nuclear weapon," said Romney.

Rick Perry’s most memorable point of the evening was his statement that “every country is going to start at zero dollars” in American foreign aid. “Does that include Israel,” the moderator quickly asked? “Absolutely,” Perry said.

“Obviously Israel is a special ally and my bet is we would be funding them at some substantial level,” he said. “But it makes sense for everyone to come in at zero and make your case.”

Heading off what could have been seen as anything less than full support of Israel – an essential for any American politician seeking national office –  @PerryTruthTeam quickly tweeted, “Perry is a friend to Israel, understands challenges faced by the country.”

Still, the comment drew criticism.

“Perry's idea is bad news for Israel and shows how little he understands its needs,” wrote former CIA officer Bruce Riedel, now a senior fellow in the Saban Center at the Brookings Institution.

Perry’s proposal “would have a very disruptive impact on Israeli military planning and Israeli security,” Riedel wrote at Newsweek’s Daily Beast web site. “The reality is military budgets are planned on a multi-year cycle. Friends don't rethink their friendships each fiscal year.”

IN PICTURES: Republicans in the 2012 presidential race

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US Supreme Court opens, likely to wade into health care debate (The Christian Science Monitor)

Washington – The 2011-2012 US Supreme Court term, set to begin Monday, is best described by a case that isn’t even on the docket yet.

It now seems inevitable that the justices will agree to hear the legal challenge to President Obama’s health care reform law, the Affordable Care Act.

The case, HHS v. Florida, would instantly transform the high court’s upcoming nine-month session from an interesting and important collection of legal disputes into an historic constitutional showdown with major political implications – in a presidential election year.

MONITOR QUIZ: Weekly News Quiz for Sept. 25-30, 2011

The legal challenge threatens one of President Obama’s most ambitious accomplishments, the attempted wholesale reformation of the health care insurance market to extend health insurance to millions of Americans who otherwise couldn’t afford it.

Usually, the Supreme Courta€?s term is defined on the eve of the first Monday in October by the array of cases the justices have already agreed to hear and decide.

The unusual feature of the start of this year’s term is that the “Obamacare” case isn’t the only blockbuster looming on the high court’s horizon. In the weeks ahead, the justices are set to consider taking up a string of other potential landmark cases that could further transform the new term into a clash of constitutional titans. They include disputes examining:

‧ Whether the Second Amendment protects a right to carry a gun in public places for self-defense.

‧ Whether the use of racial preferences in university admissions programs is unconstitutional.

‧ Whether Arizona’s tough immigration law, SB 1070, is preempted by federal statutes and the more gentle policy positions embraced by the Obama administration.

‧ Whether large crosses erected on public roadsides in Utah and a Ten Commandments display in an elected judge’s courtroom in Ohio violate the separation of church and state.

Bleeping dirty words on TVIn addition to that unprecedented cluster of potential mega-cases, the high court is already set to hear a dispute involving the power of the Federal Communications Commission to punish broadcast television stations for showing brief nudity or failing to bleep dirty words during prime time programming.

The case, FCC v. Fox Television, will examine whether the FCC’s indecency enforcement procedures violate the First and Fifth Amendments. At issue is the government’s attempt to police the public air waves to prevent not only obscene material, but also indecent communications offensive to a family-oriented audience.

The current indecency enforcement effort stems from a 1978 high court decision that upheld sanctions against stations that broadcast comedian George Carlin’s famous routine on the seven dirty words you can’t say on the public air waves.

For years, the FCC enforced a policy against the systematic and repeated use of offensive words, most of which had been identified – effectively and repeatedly – by Mr. Carlin.

In 2001, the FCC changed course. It began enforcing a prohibition not just on systematic indecency but also on the use of fleeting expletives – dirty words blurted out during a prime time program. Several celebrities during music award programs on Fox used the “F-word,” and the “S-word.” In addition, an episode of ABC’s NYPD Blue featured a scene revealing a woman’s bare buttocks.

The FCC declared the programs “indecent.”

The broadcasters fought back with a lawsuit, claiming the FCC’s censorship was ill-defined and difficult to decipher. The Second US Circuit Court of Appeals in New York agreed and struck down the FCC’s policy as unconstitutionally vague.

The government defends the FCC policy, noting that broadcasters had been given fair notice.

Legal analysts are watching the case to see if the court uses it to affirm traditional indecency standards or instead requires a more permissive policy in light of widespread use of the Internet and cable television.

“I think the thing that will interest the court most is just the prospect of chilling” and whether the FCC policy provides the requisite degree of clarity, John Elwood, an appellate specialist and former law clerk to Justice Anthony Kennedy, told a recent briefing at the National Chamber Litigation Center.

“One thing that makes [Justice Kennedy] really passionate, is will people know whether they can broadcast something,” Mr. Elwood said. “If it is a close question whether you can broadcast Schindler’s List because there are naked people in concentration camps, that is going to give him a lot of heartburn.”

In an important case involving the First Amendment’s separation of church and state, the justices will consider whether a former teacher at a Lutheran elementary school can sue the church-run school for alleged disability discrimination and retaliation.

The case is Hosanna-Tabor Evangelical Lutheran Church and School v. EEOC and Cheryl Perich.

School officials argue that the lawsuit is barred under the “ministerial exception,” a legal doctrine which blocks employment-related lawsuits against religious organizations filed by employees who perform important religious functions.

The ministerial exception is designed to insulate religious groups from interference and second-guessing by judges and others about how the group is carrying out its religious mission. It applies to pastors, priests, and rabbis.

The issue in the Lutheran school case is whether it also applies to a teacher who spent most of her day presenting a secular curriculum to her students, but who also was a “commissioned minister” who taught religious classes and led the children in prayer.

Douglas Laycock, a University of Virginia law professor representing the Lutheran school, says the case could trigger “a revolution in relations between church and state.”

“The ministerial exception is limited to employees who perform functions important to the employer’s religious mission,” he writes in his brief to the court. He says the teacher was dismissed for violating church rules and that the courts cannot decide her claim without becoming involved in underlying religious disputes.

“Allowing her claim to go forward would leave the church unable to control who teaches the faith to the next generation,” Mr. Laycock writes.

Lawyers for the teacher counter that generally applicable anti-discrimination laws are fully enforceable and “need not give way to religious exercise.”

The teacher is not asking any court to take sides in a religious dispute, her lawyers say. Rather, she merely seeks a determination of whether her dismissal violated generally applicable provisions of a federal anti-discrimination law.

The disputed status of JerusalemIn Zivotofsky v. Clinton, the high court will wade into a clash between Congress and the executive branch over a sensitive matter of foreign affairs – the disputed status of Jerusalem.

Because Jerusalem is a disputed territory and a major source of disagreement in Middle East peace talks, the US government has tried to remain neutral on the Jerusalem issue.

As a result, children born in Jerusalem to US citizens are listed on birth documents as having been born in Jerusalem. No country is noted on the State Department documents.

Pro-Israeli members of Congress who disagree with this neutral posture, sponsored and passed a law directing the State Department to record the place of birth as Jerusalem, Israel.

The issue came to a head following the birth of Menachem Zivotofsky, a US citizen, in Jerusalem. His mother applied for a passport for her infant son and asked that the place of birth be recorded as Jerusalem, Israel. When the State Department refused, the parents sued to enforce the federal statute.

A federal judge threw the case out, saying it presented a political question best left to the elected branches of government to iron out. The federal appeals court in Washington affirmed.

In agreeing to take up the parents’ case, the high court asked both parties to address an additional issue: Whether Congress’s Jerusalem law impermissibly infringes on the president’s power to recognize foreign sovereigns?

Neil Kinkopf, a law professor at Georgia State University, says the added question may telegraph a decision in the president’s favor.

During a recent Supreme Court preview briefing, Professor Kinkopf told the American Constitution Society that four of the nine justices had prior work experience arguing separation of powers issues on the side of the president.

They include Justices Elena Kagan, Antonin Scalia, Samuel Alito, and Chief Justice John Roberts.

This prior experience, he said, will “orient the court to look favorably on the president’s position.”

But Kinkopf warned, “The way they do it could have dramatic consequences because Congress has other powers and the president has other exclusive powers, like the commander-in-chief power.”

How the court resolves the Jerusalem issue could set the stage for larger confrontations, he says.

“Can Congress use its spending power to limit the way the president exercises the commander in chief power?” Kinkopf asks.

“Could Congress say to the president no money may be spent for military operations in Libya, or no money may be spent for a surge in Iraq,” he asked.

Two important Fourth Amendment cases are also high on the court’s docket this term.

In Florence v. Board of Chosen Freeholders, the justices have agreed to decide whether the government has the power to order the routine strip search of persons detained by law enforcement regardless of how minor the offense or any individual assessment of his or her likelihood to be carrying a weapon or contraband.

Tracking criminal suspects' carsThe court will also decide in United States v. Jones whether the Fourth Amendment allows law enforcement officials to install a GPS tracking device on a suspect’s car to conduct continuous round-the-clock surveillance without first obtaining a judicially-authorized warrant.

By far the most significant case of the term – and perhaps for a generation – will be the constitutional challenge to the Affordable Care Act.

Did Congress act within its commerce clause powers when it approved the ACA’s individual mandate?

The ACA requires every American to purchase a government-approved level of health insurance or pay a penalty.

Opponents say never before has the US government required citizens to purchase a private service or face punishment. Supporters say the measure is well within Congress’s power to regulate interstate commerce.

A panel at the Eleventh US Circuit Court of Appeals in Atlanta voted 2 to 1 to strike down the individual mandate as exceeding Congressional authority. A different panel at the Sixth Circuit in Cincinnati ruled that the mandate did not violate commerce clause restrictions. A third panel at the Fourth Circuit in Richmond threw the case out on other grounds.

“The federal government’s assertion of power, under the commerce clause … is unprecedented, lacks cognizable limits, and imperils our federalist structure,” the Eleventh Circuit majority declared.

In a brief urging the high court to take up the case, US Solicitor General Donald Verrilli said the Eleventh Circuit had jettisoned “the considered judgment of the elected branches of government – after years of study and deliberation – on how to address a crisis in the national health care market.”

He added: “The minimum coverage provision is squarely within Congress’s power to regulate interstate commerce, lay and collect taxes, and enact legislation.”

“The court of appeals’ contrary decision is fundamentally flawed and denies Congress the broad deference it is due in enacting laws to address the nation’s most pressing economic problems and set tax policy,” he wrote.

It is now up to the Supreme Court to resolve the disagreement. Initial briefs have already been filed. Reply briefs are expected by the end of the month. The court could announce in November whether it will hear the case, and which questions it will decide. A final decision could be expected by late June.

The ACA is one of the Obama administration’s greatest achievements – an attempt to fundamentally reshape the provision of health insurance nationwide. But it is also controversial. Attorneys general from 26 of the 50 states are co-litigants who urged the Eleventh Circuit to declare the law unconstitutional.

The reform effort has also split the nation. That division is expected to continue and deepen with each stage of the litigation extending well into the 2012 presidential campaign.

MONITOR QUIZ: Weekly News Quiz for Sept. 25-30, 2011

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Governor Perry comes out swinging at debate (Reuters)

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Euro zone bond debate raises pressure on Merkel (Reuters)

BERLIN/FRANKFURT (Reuters) – Leading German business groups called on Monday for joint euro zone bond issuance, despite their government's opposition, and the European Central Bank showed its intent to defend Italy and Spain.

The ECB spent a record 22 billion euros ($31 billion) on government debt last week, to try to halt the spread of the euro zone debt crisis.

Spanish and Italian bond yields, which had soared to dangerous levels, fell back as a result of the central bank's support, which marked its first bond purchases for 19 weeks.

The ECB is keen to put the ball back in the court of euro zone governments, but despite some internal opposition stepped into a vacuum until the bloc's rescue fund acquires new powers to intervene in the secondary bond market.

Most experts say the latest measures will only buy some time whereas common bond issuance could solve the currency area's intractable debt crisis by allowing all its members to borrow at affordable rates.

But the idea of so-called "Eurobonds" has been fiercely opposed by Berlin, which is fearful such a step would push up German borrowing costs and reduce incentives for weaker euro zone members like Greece to reform their economies.

A German government spokesman was emphatic -- German Chancellor Angela Merkel and French President Nicolas Sarkozy will not discuss common euro zone issuance at a meeting in Paris on Tuesday because Berlin does not think it is a good idea.

"The German government has said on numerous occasions that it does not believe Eurobonds make sense and that's why they will not play any role at tomorrow's meeting," spokesman Steffen Seibert said.

However, a deepening of the debt crisis over the past weeks, with big member states like Italy, Spain and even France coming under pressure, has convinced some Germans to reconsider, even if top government officials continue to rule it out.

The president of Germany's BGA export association became the first senior industry head to back the idea, telling Reuters all other avenues for fighting the crisis had been exhausted.

"The alternative is the markets attack Italy, then France, we lose our AAA rating and then it's our turn. This is a downward spiral that would lead to a worldwide depression," Anton Boerner said in an interview.

"What have we achieved then?" Boerner said. "We'll end up paying three times over. This way we pay just once."

His view was backed by the head of Germany's trade association for small- and mid-sized companies, Mario Ohoven, who said Eurobonds could be introduced with guarantees to cap German liability. Other German trade groups remain opposed.

The head of the center-left Social Democrats, Sigmar Gabriel, also backed the idea, telling German public television station ARD late on Sunday that euro zone countries should be able to raise 50-60 percent of their funding through such joint issues if they agreed to certain conditions.

"States that use Eurobonds would have to agree to give up a degree of sovereignty over their own budgets," Gabriel said.

After unveiling tougher austerity plans in return for ECB help, Italian Economy Minister Giulio Tremonti said a common euro zone bond would stop markets forcing high-debt economies in the bloc to the brink. "We would not have arrived where we are if we had had the euro bond," he said at the weekend.

GOVERNANCE IN FOCUS

With common debt issuance off the agenda, Merkel and Sarkozy are instead expected to discuss improving economic governance.

Officials have said they could agree to regular meetings of euro zone leaders -- a longstanding French demand -- and enlarge the role of European Council President Herman van Rompuy to make him a spokesman for the euro.

These steps could bring greater policy discipline in the 17-nation bloc, which has regularly sowed confusion in the markets by talking with disparate voices, but are unlikely to assuage concerns about the high debt of certain countries in the bloc.

Both German Finance Minister Wolfgang Schaeuble and Economy Minister Philipp Roesler gave interviews over the weekend in which they spoke out against euro zone bonds.

German media reports have said a working group within Merkel's CDU party has been studying the idea of Eurobonds in greater detail, suggesting some may be open to it. But leading members of the party and other northern European member states, such as the Netherlands and Finland, remain vehemently opposed.

Merkel, whose popularity has sunk to its lowest level in nearly five years according to some recent polls, could face a revolt within her coalition and Germany's broader economic policy establishment if she agreed to joint bond issuance.

Her coalition partners, the Free Democrats (FDP) and the Bavarian Christian Social Union (CSU), are seen as dead-set against the idea.

The leadership of the FDP have set a meeting for Wednesday to discuss their stance on the euro crisis, while the Secretary-General of the CSU, the Bavarian sister party to Merkel's CDU, attacked the opposition SPD for its support of common bonds.

"The SPD must say what type of tax increases it wants to raise to get the umpteen billion euros for Eurobonds to aid Greece and other Dolce-Vita countries," Alexander Dobrindt said

in comments to business daily Financial Times Deutschland.

Boerner of the BGA said, however, that Eurobonds may be the only solution that can prevent the markets from launching new assaults on euro zone members.

"We must show the markets that we are ready to use the appropriate tools, and that means Eurobonds signed off by Germany," said Boerner. "We need Eurobonds with strict conditions attached. We need this and we need it fast."

(Additional reporting by Brian Rohan, writing by Noah Barkin, editing by Mike Peacock)

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Reagan looms over debt debate inspiring both sides (AP)

WASHINGTON – Ronald Reagan might as well be sitting in on the troubled debt talks, so frequently is his memory invoked by both sides. But for vastly different reasons. Conservative Republicans praise the 40th president's steely advocacy for smaller government and lower taxes.

President Barack Obama and his Democratic allies praise Reagan because, they say, he was the sublime compromiser, willing to work with Democrats such as House Speaker Thomas P. "Tip" O'Neill of Massachusetts to forge landmark tax and Social Security deals and willing to raise the federal debt ceiling so the government could keep borrowing to pay its bills.

Can both be true?

In fact, both camps are experiencing a touch of Reagan amnesia.

Debt talks between Obama and House Speaker John Boehner came to a grinding halt Friday night when Boehner abruptly broke them off, raising new uncertainties that a deal could be struck to avert a threatened government default.

Reagan did push through deep, across-the-board cuts in tax rates in his first year of the presidency in 1981, fulfilling a campaign promise.

But the following year he signed the largest peace-time tax increase in U.S. history, the Tax Equity and Fiscal Responsibility Act of 1982. He raised taxes in every succeeding year of his presidency except the last. As California governor, Reagan also signed the biggest tax increase in state history.

"There was a consistency to Reagan on taxes, which was basically that he cut them when he could, but raised them when he had to. He was not dogmatic on this issue, as his current day followers seem to think," said economist Bruce Bartlett, a senior policy analyst in the Reagan White House and a top Treasury official in President George H.W. Bush's administration.

Bartlett noted that Reagan's tax increases took back about half of his signature 1981 tax cut. When he left office in 1989, federal taxes accounted for 18.4 percent of the nation's gross domestic product, compared with the 18 percent average for the two decades before he took office. By contrast, tax revenues are forecast to be just 14.4 per cent of GDP in 2011.

Some tea party-courting Republicans cite Reagan's low-tax, small-government mantra as they insist they won't support any increase in the government's borrowing power past Aug. 2, unless significant budget cuts are made and taxes kept constant.

Yet during Reagan's two terms, he presided over 18 increases in the debt ceiling. He even publicly scolded Congress for playing hardball politics with the debt limit and bringing the nation "to the edge of default before facing its responsibility." That's a passage the White House and congressional Democrats are now fond of recycling to their advantage.

Obama has been paying new homage to the former Republican president he once called transformative as he remains locked in a standoff with Republicans.

"Ronald Reagan worked with Tip O'Neill and Democrats to cut spending, raise revenues and reform Social Security," Obama noted a few days ago. "That kind of cooperation should be the least you expect from us."

In a recent exchange with House Majority Leader Eric Cantor, R-Va., Obama complained that House Republicans weren't giving an inch on raising taxes and were frustrating compromise efforts. According to Cantor, Obama ended the meeting saying, "Can you imagine Ronald Reagan sitting here?"

It was an apparent suggestion that Reagan would have been more accommodating or less likely to engage in political trench warfare.

The facts: The big 1980s domestic-policy deals cited by Obama happened at a time when there were more politically moderate members in both parties than in these highly polarized times, and when congressional leaders had more flexibility in finding common ground.

It's true that Reagan did not engage as much in the day-to-day bargaining. The big bipartisan agreements of the Reagan years were mostly cobbled together by O'Neill's forces and moderate Republican leaders such as Sens. Howard Baker of Tennessee and Bob Dole of Kansas, and Rep. Barber Conable of New York.

Still, Reagan and O'Neill clearly liked each other and enjoyed socializing. Although House Speaker John Boehner, R-Ohio, played golf with Obama and had tried for a "grand bargain" compromise with him, their relationship does not seem to be anywhere near at the same comfort level as that between Reagan and O'Neill, two gregarious Irish-Americans.

That may have become clear late Friday, when the talks collapsed, with each side blaming the other.

Looking back to the 1980s, with the exception of a few major deals like on Social Security, the day-to-day dealings between the Reagan administration and O'Neill were largely contentious and partisan.

Yet that Social Security agreement remains a model for those who yearn for less partisan times now.

Threats of approaching economic chaos were as much in the air in early 1983 as they are now, as Social Security was fast running out of money and benefit checks were at risk.

The eventual deal that rescued the program involved changing Social Security tax-rate schedules, imposing income taxes on the benefits of higher-income individuals, and raising the retirement age in steps to 67 for those born after 1960. It was put in play by a bipartisan commission headed by Republican economist Alan Greenspan, later to become chairman of the Federal Reserve.

It was fine-tuned by a high-level group of nine House and Senate members.

That bipartisan group met in secret locations for weeks to hammer out the final details, remembers Paul Light, who at the time was a congressional fellow with Conable, the senior Republican on the House Ways and Means Committee and one of the negotiators.

The talks coincided with the Washington Redskins' march to the team's Super Bowl victory over the Miami Dolphins in January 1983.

"The Gang of Nine could actually sit around the table and say, `Go Redskins.' That just created camaraderie that I don't see now," said Light, now a public policy professor at New York University. "And the compromise lasted 30 years, which isn't bad."

So in the end, how can Reagan be both a hero to Republicans for arguing against tax increases — and to Democrats for agreeing to them?

"That's what made him such an incredibly good politician," said Stephen Hess, a presidential scholar at the Brookings Institution.

Reagan was a master of blurring distinctions with compelling rhetoric, Hess suggested.

"People often see in him what they want to see, or what they are looking for. And that has been certainly true of other great politicians in their time as well."

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Alzheimer's debate: Test if you can't treat it? (AP)

PARIS – Picture yourself in Barbara Lesher's shoes: 54 years old and fearing you are developing Alzheimer's disease.

"I don't remember if I had a bath," said Lesher, who lives north of Harrisburg, Pa. "It took me two hours to follow a recipe. I drove to my childhood homestead the other week instead of my own home. It's really scary."

Doctors are arguing about whether to test patients for signs of the incurable disease and tell them the results.

The debate raged this past week at the Alzheimer's Association International Conference in France, where research on new methods — easier brain scans, an eye test, a blood test — made it clear there soon may be more such tools available.

Here's why it's an issue: Many people have brain plaques, suggesting they might be developing Alzheimer's even if they don't have any symptoms. This plaque can be seen decades beforehand and does not ensure someone will get the disease. Many also won't live long enough to develop symptoms.

For those who do have Alzheimer's, there are no good treatments. Current drugs ease symptoms — they work for half who try them and for less than a year on average. Most experts think treatment starts too late, but there's no evidence that starting sooner or learning you have brain plaque will help. Experts are divided.

"We have to look for patients or signatures of the disease at earlier stages," urged Dr. Harald Hampel of the University of Frankfurt, Germany.

But Dr. Kenneth Rockwood of Dalhousie University in Halifax, Nova Scotia, Canada, says there is no data "to show that knowing makes any difference in outcomes. Until we do, this is going to be a tough sell."

More than 35 million people worldwide have Alzheimer's, the most common form of dementia. In the U.S., more than 5 million do — 13 percent of those 65 and over, and 43 percent of those 85 and up, a rapidly growing group.

Still, half of people who meet medical criteria for dementia have not been diagnosed with it, the Alzheimer's Association estimates. And many who are told they have Alzheimer's or are assumed to have it really don't.

Even when researchers use the best cognitive tests to enroll people in clinical trials, about 10 percent ultimately are discovered not to have the disease, said William Thies, the Alzheimer's Association's scientific director.

"The Alzheimer's drugs don't work in these folks, so there's no reason to expose them to those risks," said Thies, long an advocate of early diagnosis.

Misdiagnosis is a lost opportunity to help. A new medication or combination of medications may suddenly make someone appear demented. Brain fog can occur after surgery and abate over time. Sleep problems are common in older people and can cause profound confusion that can be misinterpreted as dementia, according to research presented at the conference by Dr. Kristine Yaffe of the University of California, San Francisco.

"Some of these are treatable" by avoiding naps during the day or treating sleep apnea, in which brief interruptions of breathing cause people to wake during the night, Yaffe said. Snoring is a big sign. Older people with sleep problems are more likely to be put in nursing homes, she said.

Dr. R. Scott Turner, director of the memory disorders program at Georgetown University Medical Center, has seen that all too often.

"I'm certainly in the camp that screening should be done," he said. Many patients are simply declared to have dementia without testing to see if they have another condition.

"Sometimes it's thyroid disease, or depression, or vitamin B-12 deficiency — something that's very treatable," he said.

Testing someone with symptoms is far less controversial than testing people with no symptoms but a lot of fear. Doctors worry that these newer methods, such as an easier type of brain scan that's expected to be available within months, will be directly marketed to the public, prompting expensive and excessive testing based on fear.

"The phrase you often hear is that the 'Big A' (Alzheimer's) has replaced the 'Big C' (cancer)" as a major source of fear, said Dr. Jason Karlawish, a University of Pennsylvania ethicist specializing in dementia issues.

Recent guidelines by the U.S. National Institute on Aging and the Alzheimer's Association say these tests should be used only in research until they have been standardized and validated as useful and accurate tools.

A researcher using one of these tests, such as a spinal fluid check for a substance that may predict Alzheimer's risk, has no obligation to disclose the results to a patient until there is a meaningful treatment for the disease, Karlawish argued at the conference.

The more symptoms a patient has, the more justified it is to help understand what is known about possible reasons, he said.

Lynda Hogg of Edinburgh, Scotland, is very glad her doctors diagnosed her Alzheimer's in 2006. She is doing exceptionally well on one of the existing drugs and is in a clinical trial for an experimental one she hopes will help her and help advance knowledge in the field.

At a discussion connected with the conference, she said the early diagnosis helped her get financial and legal matters in order and serve on the Scottish Dementia Working Group and the board of Alzheimer's Disease International.

"I am certain involvement keeps me focused and involved in society," she said.

The Alzheimer's Association says early diagnosis and evaluation can bring the following benefits:

‧ Treatment of reversible causes of impairment.

‧ Access to drugs that help treat symptoms.

‧ Inclusion in clinical trials that give expert care.

‧ Avoiding drugs that can worsen cognition.

‧ Letting others know of a need for help managing medicines and daily life.

‧ Easing anxiety about the cause of symptoms.

‧ Access to education, training and support services.

‧ The ability to plan for the future.

Lesher, the woman from Pennsylvania, wishes she had a clearer picture of what lies ahead for her.

"Not being able to get diagnosed is the must frustrating thing in the world," she said.

___

Online:

National Institute on Aging: http://www.nia.nih.gov/Alzheimers

Alzheimer's Association: http://www.alz.org

National Alzheimer's Plan: http://bit.ly/fFWWCT

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Churches debate whether to marry gays (AP)

NEW YORK – After same-sex marriage becomes legal here on July 24, gay priests with partners in the Episcopal Diocese of Long Island will head to the altar. They have to. Their bishop set a nine-month deadline for them to marry or stop living together.

Next door, meanwhile, the Episcopal bishop of New York says he also expects gay clergy in committed relationships to wed "in due course." Still, this longtime supporter of gay rights says churches in his diocese are off limits for gay weddings until he receives clearer liturgical guidance from the national denomination.

As more states legalize same-sex marriage, religious groups with ambiguous policies on homosexuality are divided over whether they should allow the ceremonies in local congregations. The decision is especially complex in the mainline Protestant denominations that have yet to fully resolve their disagreements over the Bible and homosexuality. Many have taken steps toward acceptance of gay ordination and same-gender couples without changing the official definition of marriage in church constitutions and canons. With the exception of the United Church of Christ, which approved gay marriage six years ago, none of the larger mainline churches has a national liturgy for same-sex weddings or even blessing ceremonies.

The result is a patchwork of church policies in states where gays can civilly wed — not only for lay people, but also for gay clergy who want to marry their partners.

"It's a challenge for us," said Tony De La Rosa, administrator of the Presbytery of New York City, a regional body of the Presbyterian Church (U.S.A.). "I think this is a moment of great tumult in the sights of the church."

The New York regional body of the United Methodist Church issued a statement reminding local congregations that the Methodist Book of Discipline bars any celebration of same-gender unions, but encouraged congregants to "extend God's love" to each other, "particularly those with whom we disagree."

Just last Sunday, the Presbyterian Church formally lifted barriers to ordination for gays and lesbians who are not celibate, although individual congregations had been hiring gay pastors and conducting same-sex blessing ceremonies for years. De La Rosa expects a similar mix of responses to gay marriage laws, even though a minister who conducts a same-gender marriage is at risk of possible disciplinary action by the denomination since the ceremonies are not officially authorized. De La Rosa, who is gay, said he does not plan to wed because the marriage would not be recognized in California, where he and his partner are residents.

New York churches can look for guidance to religious leaders in the five other states where gay marriage is already legal: Massachusetts, Connecticut, Vermont, New Hampshire and Iowa, plus the District of Columbia.

The New England Synod of the Evangelical Lutheran Church in America, which includes four of the five states with gay marriage, issued a document stating that pastors can choose to solemnize same-sex marriages in individual churches that give their approval. The Upstate New York Synod, which oversees Lutheran churches in the Albany area, distributed that document to local leaders ahead of an upcoming discussion on the gay marriage law. The Evangelical Lutheran Church in America formally abolished a celibacy requirement for gay and lesbian clergy more than a year ago, but still defines marriage as between one man and one woman.

The Rev. David Preisinger, an assistant to the Upstate New York bishop, said the bishop has indicated that she will not take action against clergy who perform the ceremonies. He said churches in his region have already received several requests for weddings and believes they will take place soon.

"There are some congregations that are very open to it and others that don't want anything to do with it," Preisinger said.

The Episcopal Church blazed a trail, and enraged fellow Anglicans worldwide, in 2003 by consecrating the first openly gay bishop, V. Gene Robinson of New Hampshire. On same-sex marriage, Episcopal dioceses have been guided by a 2009 resolution from the General Convention, the church's top national policy body, that asked for a "generous pastoral response" to gay couples, especially in states with same-sex marriage or civil unions.

However, bishops disagree about what the resolution means. Each has cited the measure when issuing dramatically different policies.

Even before the New York legislature had passed the gay marriage bill last month, Bishop Gladstone Adams, who leads the Syracuse-based Episcopal Diocese of Central New York, had asked the local liturgy committee to draft a rite for same-gender marriage. Adams said individual priests and parishes could decide whether to conduct the ceremonies. He has not yet set a policy on marriage for clergy living with same-gender partners.

In the Diocese of New York, Bishop Mark Sisk said local priests could bless couples who marry elsewhere in a civil ceremony, but could not solemnize the marriages.

"I do not believe that resolution ... empowered bishops to authorize clergy to perform such marriages," Sisk wrote in a statement. "Nor do I believe that it is appropriate for clergy to circumvent the vows we have taken by becoming separately licensed by the state to perform such marriages."

His position stunned many Episcopalians. The New York diocese is considered so gay-friendly that the local chapter of the national Episcopal gay advocacy group, Integrity, focuses instead on outreach to other gay and lesbians seeking a religious community, according to Mary O'Shaughnessy, New York City coordinator for the organization.

Sisk's spokesman said the bishop won't move forward without an approved liturgy. Episcopalians are drafting prayers for blessing same-gender couples that advocates hope will be accepted next year by the General Convention.

O'Shaughnessy said she was disappointed by Sisk's decision, but said he has "unequivocally" supported gay and lesbian rights and she understands that he has a broad constituency to consider, including parishes in the diocese that lie outside of Manhattan.

Long Island Episcopal Bishop Lawrence Provenzano said there is nothing "punitive" about the nine-month period he set for clergy to marry their partners — a length of time he said was similar to an academic year. No one will be disciplined for failing to meet the deadline. Instead, he said he would handle each priest's situation on a case-by-case basis. He noted that some private employers are considering restricting domestic partner benefits to those who are legally married.

"I need to be mindful that the church has always asked people to live in committed monogamous, faithful relationships," Provenzano said. "I won't allow heterosexual clergy to live in a rectory or church housing without the benefit of marriage. When one puts it in that context, then you see how it all begins to make sense."

The Rev. Christopher Hofer, pastor of the Episcopal Church of St. Jude in Wantagh, on Long Island, said he has heard no complaints from other gay or lesbian clergy about the policy. Hofer plans a "big" August wedding in his parish with his partner of 17 years, Kerry Brady. They live in the church rectory, where on a recent evening they waited together for a messenger to deliver their wedding rings.

"I think Bishop Provenzano's statement was not only fair, but beyond generous. It gives people time, acknowledging that there's a financial component involved, and recognizing that some may not choose to live together," Hofer said. "Now that the state is recognizing civil marriage, we as priests, perhaps deacons too, who are in committed relationships, have a choice: We either live what we preach, to become civilly married, or we choose to live apart."

No other Episcopal dioceses in states with same-gender marriage have set an explicit deadline for gay clergy to marry their live-in partners.

Episcopal Bishop John Chane, of the Diocese of Washington, allowed local priests to perform same-sex marriages in parishes that approved the ceremonies, but did not ask clergy to marry or live alone. He said it wouldn't be fair, since so few states recognize the marriages, and state and federal laws like the Defense of Marriage Act are still in effect and "deny the human rights and disrespect the orientation" of gays and lesbians. He said five gay clergy have married in the Diocese of Washington since same-sex marriages started last year.

. At St. James Episcopal Church, Fordham, in the Diocese of New York, the Rev. Tobias Haller, plans to wed his male partner of more than three decades at the end of this month, but not in his parish. The couple plans a civil ceremony only.

"We had our church wedding 31 years ago," Haller said, of a private blessing they had received from a rector.

Haller said he understands and accepts Sisk's approach to the issue. The bishop meets with gay and lesbian clergy in the diocese every few months and had previously discussed his hope that they would marry their partners if they had the chance, Haller said.

"It makes sense to me," Haller said. "It's certainly a standard bishops would expect of heterosexual clergy."

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Rachel Zoll can be reached at twitter.com/rzollAP

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U.S. news media debate naming Strauss-Kahn accuser (Reuters)

NEW YORK (Reuters) – By now, anyone following the Dominique Strauss-Kahn sexual assault case knows plenty about the woman who accused him: her age, origins, work history, relatives and, most recently, a series of lies and misstatements she gave to investigators.

But one detail has remained concealed by major U.S. media: her name.

Citing the unique stigma of rape, American news outlets have for decades refused to identify victims and alleged victims of sexual assault, even as they investigate their backgrounds.

As recent revelations raise doubts about the credibility of Strauss-Kahn's accuser, and the attempted rape case against the former International Monetary Fund chief appears close to collapse, news organizations have begun to revisit these long-held policies.

"It's an ethical minefield," said Adam Penenberg, a journalism professor at New York University. "It puts everybody in an impossible position."

The woman's name has already been published by numerous news outlets in Europe and Africa, where accusers' names are more routinely reported.

An Internet search will reveal it is on hundreds of websites. Some journalism experts say that renders the convention of anonymity increasingly meaningless.

No major U.S. news organization has yet revealed the woman's name, even as her credibility has been seriously questioned.

"Editors here have discussed the situation as new developments have emerged in this case," said Phil Corbett, the New York Times' associate managing editor for standards.

"As of now, the authorities continue to consider the woman to be the victim in an alleged sexual assault, and we have stuck to our normal practice of not identifying her."

Editors at Reuters debated the issue and decided the woman should remain unidentified, said Jim Gaines, the global head of ethics, standards and innovation.

"It was very brief, because we all know what the rule is," Gaines said. "It's hard to anticipate the circumstances under which we would name her, unless she named herself."

WHEN SHOULD POLICY CHANGE?

Are there circumstances that would justify dropping the policy and identifying the woman?

Several editors said a dismissal of the charges against Strauss-Kahn would probably be insufficient to convince them to use his accuser's name, unless, for example, authorities seek to charge her with perjury for suspicion of lying under oath.

"I would distinguish between charges being dropped and charges being brought against her," said Roger Smith, the national editor for the Los Angeles Times.

Corbett said there is no "clear, bright line" that would indicate when to use her name.

Journalists are not legally bound to conceal the identities of sexual assault victims -- the U.S. Supreme Court has ruled that news outlets may use them if legally obtained. But with rare exceptions, the media have refrained from doing that.

One exception was NBC News' decision in 1991 to identify the woman who accused a Kennedy family member, William Kennedy Smith, of raping her. That sparked a national conversation about privacy and the media's responsibility to rape victims.

The prevailing view, then as now, is that sexual assault is uniquely damaging and worthy of an exception.

"The reality is that as journalists, we have a special responsibility to help ensure that women feel safe reporting sexual assault. It's not like other crimes," said Bruce Shapiro, head of the Dart Center for Journalism and Trauma at Columbia University in New York.

FEAR OF SACRIFICING PRIVACY

Some experts say there is also a societal obligation to encourage victims to come forward without fear of sacrificing their privacy.

"What about the next woman, and the one after that?" said Alisa Solomon, a journalism professor at Columbia.

A handful of journalists assert the practice of withholding victims' names runs counter to journalism's goal of providing a complete and truthful account.

One dissenter is Geneva Overholser, who as editor of the Des Moines Register won the 1991 Pulitzer Prize for public service for a series about a woman's ordeal as a rape victim.

"We're setting ourselves up to do something that feels very much like social work, not journalism, and that's not our role," said Overholser, now the director of the School of Journalism at the University of Southern California.

To Overholser, the debate in the Strauss-Kahn case only underscores the problem with concealing the name in the first place. By splashing his name and photo across front pages while withholding hers, she said, there is an implicit judgment that one side is wrong and the other is right.

"If anything, it helps continue the stigma," she said. "We're signaling to rape victims that they have to go and sit in a dark corner."

(Reporting by Joseph Ax, editing by Jesse Wegman and Grant McCool)

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