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Medical Whistleblower Advocacy Network

Human Rights Defenders

“All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.”

 Universal Declaration of Human Rights

Article 1

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Human Rights Law and Returning Veterans

Medical Whistleblower is an advocacy network, providing information and support to those who report medical fraud, patient abuse and neglect and human rights violations. In 2009 Dr. Janet Parker DVM, Executive Director of Medical Whistleblower, brought a shadow report to the United Nations in Geneva to report that there was not adequate protection for those who report human rights abuses. Medical Whistleblower is dedicated for those who cannot speak for themselves, the vulnerable in society and to those who are Medical Whistleblowers and the Defenders of Human Rights.

It is hard to personally face the mind wrenching trauma of war. When veterans return from combat to their families and their communities, those adaptations that made them effective in a wartime environment are no longer effective and can be detrimental to full inclusion into their communities. Our combat veterans may not perceive themselves as vulnerable, however Post Traumatic Stress Disorder can make the most fearsome warrior vulnerable.

One essential aspect of PTSD trauma is the exposure of the person to events which were life-threatening and over which the individual had no control. So treatment for PTSD must include the right to have control over the choice of treatment options. Giving the PTSD patient this control is very empowering for them. Supportive services should include all viable treatment options, especially non drug therapies proven over years of professional assessment by the Veterans Administration to be viable treatments for PTSD such as Cognitive Behavioral Therapy and EMDR.

Medication side effects are the #4 leading cause of death in the U.S. annually (JAMA 1998). Yet, few people receive adequate information when medication is prescribed. Veterans have the right to make informed, intelligent choices about medications and natural alternatives to maximize the benefits and minimize the risks of treatment. There are effective treatment strategies for PTSD that do not use drug therapy. Cognitive Behavioral therapy and EMDR have both proven effective treatment for PTSD. Veterans and their families should have social support services that are independent of Pharmaceutical Company pressure and financing. Veterans have the right to informed choice of care and should be given all options including non drug options. Veterans have the right to have dedicated experienced peer counselors who understand their needs and relate well to them in a personal way. Veterans have the right to have strong advocates working for them to get answers and to be a part of the decision making process at the Veteran's Administration.

Many veterans are understandably fearful of the new drug therapies especially if they read the reports of adverse side effects or have themselves experienced these negative effects themselves. But this should not mean that our veterans do not get care. We should be in the habit of providing care and support in a manner that takes into account the needs and social preferences of the individual veteran, not a one pill fits all mentality. Many veterans are now refusing to engage with social services because of the fear of the drug treatment being forced on them; instead they face divorce, lost of family, loss of employment and eventually homelessness where they live on the street, in tent cities and under bridges.

Homeless veterans is greater than the number of service persons who died during that war -- and Desert Storm and  Iraq.  Now the problem facing our veterans is a human rights issue. Those who have served our country deserve better care upon return to their communities than they are currently receiving. It is a shocking statistic that about one-third of the adult homeless population has served their country in the Armed  Services. Approximately 131,000 Veterans (male and female) are homeless on any given night and perhaps twice as many experience homelessness at some point during the course of a year. Many other Veterans are considered near homeless or at risk because of their poverty, lack of support from family and friends, and dismal living conditions in cheap hotels or in overcrowded or substandard housing. Right now, the number of homeless male and female Vietnam er and Afghanistan veterans are also appearing in the homeless population. It is inconceivable that PTSD is not related to the realities of facing life in a combat zone. 

The Pharmaceutical Industry wants to use the returning veterans as a huge potential pharmaceutical drug customer base. With the US government picking up the tab, the Pharmaceutical companies are lobbying heavily to increase their expected profits from the sales of drugs for PTSD sufferers. The huge numbers of returning veterans are a prime target of their sales efforts. Big Pharma pours lots of money into the political campaigns of those who support their agenda. The Big Pharmaceutical Companies have persons on the President's New Freedom Commission on Mental Health that are pushing to do wholesale marketing of SSRI's and other mind altering drugs to veterans with PTSD.

When SSRI antidepressants such as Prozac, Paxil and Zoloft were first introduced in the late 1980's and early 1990's there were reports of increasing violent behavior including suicide and homicide. There were in 2003 reports by British authorities and the U.S. Food and Drug Administration about unpublished studies showing an increased risk of suicide in children and teenagers taking Paxil. Prior reports of suicidal and homicidal acts in adults taking SSRIs have been minimized by the pharmaceutical company defenders and mainstream doctors, who claim that suicide is common in depression anyway.  

The recent violence Nov. 5, 2009 at Fort Hood in Texas in which a military psychiatrist shot and killed 13 people and wounded 30 others gives us good reason to reconsider these psychiatric drug treatments for military personnel and veterans. This incident reminded me of the Northern Illinois University mass shootings where former grad student Stephen Kazmierczak killed 5 students and wounding dozens of others before committing suicide himself. This gunman had been taking the drug Paxil prior to his mass killings. The drug manufacturer had been deliberately withholding information about violent behavior as an adverse effect of the medication. See the insightful article by Drs. Healy, Herxhiemer and Menkes on Antidepressants and Violence: Problems at the interface with medicine and law. Now the drug Paxil carries a black box warning about homicide and suicide.

Sept 14, 2004, an FDA panel voted 18 to 5 to require manufacturers of all antidepressants to add black box warnings to their product labeling. A month later, the FDA adopted the panel's recommendations. The warning reads in part:

"Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with Major Depressive Disorder (MDD) and other psychiatric disorders. Anyone considering the use of [Drug Name] or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior."

The warning specifically links antidepressant use to suicidal behavior in four percent of kids on these drugs compared to two percent for kids on placebos.

Although it is true that no type of antidepressant is helpful in every clinical case, it is also true that SSRIs can create a unique combination of side effects that may severely impair judgment and impulse control in individual patients. Excessive doses of antidepressants can cause brain dysfunctions including disorientation, confusion, and cognitive disturbances. In combat veterans suffering PTSD, impulsive behavior, especially if coupled with impaired cognitive functioning, can be dangerous. Antidepressants can also trigger similar, manic-like symptoms in people whose depression is part of a manic-depressive syndrome, which often gets overlooked when people are given SSRIs.

NAMI - National Alliance on Mental Illness is not a consumer run organization although it is a nonprofit nongovernmental organization with tax exempt status. NAMI gets 56% of its financial funding directly from the Pharmaceutical Industry. NAMI provides to the public educational information about psychiatric drugs. This information does not include the potential severe side effects of some of these drugs such as suicide and homicide. NAMI has been reaching out to veteran's spouses and families at battered women's shelters, domestic violence counseling centers and other similar social support systems to try to get the families to pressure veterans to stay on these medications, even when there are significant adverse side effects. This in pharmaceutical industry talk is called customer compliance and customer retention. NAMI because of its dependence on Pharmaceutical Industry funding refuses to give accurate information about adverse side effects to veteran's families and pushes for high drug doses that will increase pharmaceutical company profits. They also push for lifelong therapy when that may not be necessary. The direct result of interfering with the right of patients and their families to have accurate information increases the possibility of family violence. Often what would be best for the patient would be a decrease in dosage or even a change in medication or in some cases going off medication and a loss of a drug using consumer.

Medical Whistleblower wants all veterans to know that on July 30, 2010 the President of the United States Barack Obama signed the United Nations Convention on the Rights of Persons with Disabilities (CRPD) which is a international treaty defining the rights of persons with disabilities under international human rights law. Although not yet ratified, it is the first international treaty on disability rights. All disabled veterans including those with PTSD should have their Human Rights honored. I ask you as advocates for the returning veterans to look carefully at the treaty that the President signed. It contains strong language that protects the rights of our vulnerable disabled veterans. Please join me in encouraging the ratification of the CRPD. Do this for all the veterans you know who have served their country honorably and deserve to have their human rights protected. Please acquaint yourself with the excellent work of Theresia Degener in regards to the rights of those with a mental health disability. Please note these relevant sections of the Convention on the Rights of Persons with Disabilities (CRPD)
http://www1.umn.edu/humanrts/instree/disability-convention2006.html

Wounded Veterans Return Home

Returning Veterans - What Kind of Welcome?

There are now VA employees known as Transition Patient Advocates, whose job is to reach out to our newest veterans and their families. We follow one Advocate in Pennsylvania as he helps veterans learn about their benefits and navigate the VA system. Visit http://www.patientadvocate.va.gov/ to find a Patient Advocate near you. See http://www1.va.gov/opa/feature/amerve... for the Section 508 compliant version of this video.

 

"Those who have long enjoyed such privileges as we enjoy, forget in time that men have died to win them."

-- Franklin D. Roosevelt

Veterans Transitional Outreach Program

Veterans and Suicides

Veterans and PTSD Facts

The Department of Veterans Affairs says that the military has diagnosed 78,000 cases of PTSD among veterans but the real number is closer to 800,000.  Less than half of these veterans will seek medical help.  

PTSD causes unemployment:  Post-9/11 veterans have an unemployment rate of “10.9 percent, compared to 8.5 percent unemployment overall. And “more than 20 percent of young Iraq and Afghanistan war veterans were unemployed last year.”

 PTSD is destructive of family life and increases divorce: A 2005 Pentagon study found that the divorce rate for Iraq and Afghanistan veterans was up 78 percent since 2003.

 PTSD Leads To Domestic Violence: According to military mental health experts, “The increasing number of veterans with [PTSD] raises the risk of domestic violence.

 PTSD Leads To Homelessness: While only 10 percent of the population, veterans make up one-third of the homeless population. The VA “estimates 107,000 veterans are homeless on any given night.

 PTSD and suicide: Studies show that having PTSD correlates to having a higher chance of committing suicide; over “50 percent of all trauma survivors worldwide will attempt suicide in their lifetimes.” The National Institute of Health estimates that people suffering from PTSD are six times more likely to committ suicide. American veterans now account for one in every five suicides.

“People grow old only by deserting their ideals, Macarthur had written. Years may wrinkle the skin, but to give up interest wrinkles the soul. You are as young as your faith, as old as your doubt; as young as your self-confidence, as old as your fear; as young as your hope as old as your despair. In the central place of every heart there is a recording chamber. So long as it receives messages of beauty, hope, cheer and courage, so long are you young. When your heart is covered with the snows of pessimism and the ice of cynicism, then, and then only, are you grown old. And then, indeed as the ballad says, you just fade away.”

 Douglas MacArthur quotes (American General who commanded the Southwest Pacific Theatre in World War II, 1880-1964)

Veterans and Suicide 2

Care of War Veterans returning home - Scientific articles

  • Researchers estimate that more than 300,000 U.S. veterans of the wars in Iraq and Afghanistan (20% of the 1.6 million) have sustained a mild traumatic brain injury (TBI), also known as concussion, with the majority going untreated.  Care of War Veterans with Mild Traumatic Brain Injury — Flawed Perspectives, Charles W. Hoge, M.D., Herb M. Goldberg, B.A., B.Ed., and Carl A. Castro, Ph.D.   N Engl J Med 2009; 360:1588-1591April 16, 2009 
  • Reconstructing Lives — A Tale of Two Soldiers  December 21, 2006, Okie S.,N Engl J Med 2006; 355:2609 - 2615 One had traumatic brain injury (TBI), which has been called the signature wound of this war. Both also had symptoms of post-traumatic stress disorder (PTSD). Among more than 22,600 U.S. soldiers wounded in the conflicts in Iraq, Afghanistan, are returning home as of November 4, 2006,  This article explores the challenges and problems facing them in their reintegration.  
  • Critical care services are highly valued because they can often restore function in patients with acute life-threatening illnesses. In this context, advances in medical science have led to increased expectations for favorable outcomes of episodes of critical illness, even when the patient has severe coexisting chronic disease.  The Healing Power of Listening in the ICU, Craig M. Lilly, M.D., and Barbara J. Daly, Ph.D, R.N.,N Engl J Med 2007; 356:513-515February 1, 2007 
  • Americans as Survivors by Dr. Lifton.  September 1, 2005,  N Engl J Med 2005; 353:957 - 958Most exposed persons manifest impressive resilience or quick recovery from their initial responses to the trauma.  Post-traumatic stress disorder (PTSD) developed in only a minority of those exposed to combat in Vietnam, Iraq, and Afghanistan.
  • Acknowledging the Psychiatric Cost of War  Post-traumatic stress disorder (PTSD), because there is better information about this disorder than about others and because PTSD was the biggest problem noted in the responses to an anonymous survey among those returning from active military service. July 1, 2004, Friedman M.J., N Engl J Med 2004; 351:75  - 77
  • Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care Deployment stressors and exposure to combat result in considerable risks of mental health problems, including post-traumatic stress disorder (PTSD), major depression, substance abuse, impairment in social functioning and in the ability to work, and the increased use of health care services.July 1, 2004,Hoge C.W., Castro C.A., Messer S.C., et al., N Engl J Med 2004; 351:13 - 22

 

 

"The real rulers in Washington are invisible and exercise power from behind the scenes."

Justice Felix Frankfurter

(1882-1965) U.S. Supreme Court Justice

Secret Deals in Court Cases Hide the Truth about SSRI's

The pharmaceutical industry wants to use the returning veterans as a huge potential pharmaceutical drug customer base. With the US government picking up the tab, the pharmaceutical companies are lobbying heavily to increase their expected profits from the sales of drugs for Post Traumatic Stress Disorder (PTSD) sufferers. The huge numbers of returning veterans are a prime target of their sales efforts. Big Pharma pours lots of money into the political campaigns of those who support their agenda.  These huge pharmaceutical companies have persons on the President's New Freedom Commission on Mental Health that are pushing to do wholesale marketing of selective serotonin reuptake inhibitors (SSRI's) and other mind altering drugs to veterans with PTSD.  The constantly expanding prison population is another target for the SSRI drug marketing and especially those prisoners facing re-entry and who will soon have Medicaid/Medicare to pay their pharmaceutical bills.

 

When SSRI antidepressants such as Prozac, Paxil and Zoloft were first introduced in the late 1980's and early 1990's there were reports of increasing violent behavior including suicide and homicide. There were in 2003 reports by British authorities and the U.S. Food and Drug Administration about unpublished studies showing an increased risk of suicide in children and teenagers taking Paxil. Prior reports of suicidal and homicidal acts in adults taking SSRIs have been minimized by the pharmaceutical company defenders and mainstream doctors, who claim that suicide is common in depression anyway.

 

The recent violence Nov. 5, 2009 at Fort Hood in Texas in which a military psychiatrist shot and killed 13 people and wounded 30 others gives us good reason to reconsider these psychiatric drug treatments for military personnel and veterans. This incident reminded me of the Northern Illinois University mass shootings where former grad student Stephen Kazmierczak killed 5 students and wounding dozens of others before committing suicide himself.  This gunman had been taking the drug Paxil prior to his mass killings. The drug manufacturer had been deliberately withholding information about violent behavior as an adverse effect of the medication.   Now the drug Paxil carries a black box warning about homicide and suicide. (See the insightful article by Drs. Healy, Herxhiemer and Menkes on Antidepressants and Violence: Problems at the interface with medicine and law.)

 

On Sept 14, 2004, an FDA panel voted 18 to 5 to require manufacturers of all antidepressants to add black box warnings to their product labeling.  A month later, the FDA adopted the panel's recommendations. The warning reads in part: "Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with Major Depressive Disorder (MDD) and other psychiatric disorders. Anyone considering the use of [Drug Name] or any other antidepressant in a child or adolescent must balance this risk with the clinical need.  Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior."  The warning specifically links antidepressant use to suicidal behavior in four percent of kids on these drugs compared to two percent for kids on placebos.

 

No type of antidepressant is helpful in every clinical case or even indicated.  As a class of drugs SSRIs can create a unique combination of side effects that may severely impair judgment and impulse control in individual patients. Excessive doses of antidepressants can cause brain dysfunctions including disorientation, confusion, and cognitive disturbances.  In combat veterans suffering PTSD, impulsive behavior, especially if coupled with impaired cognitive functioning, can be dangerous. Antidepressants can also trigger similar, manic-like symptoms in people whose depression is part of a manic-depressive syndrome, which often gets overlooked when people are given SSRIs.

 

Is public safety enhanced when “patients” are given SSRI’s and are persons on SSRI’s less likely to do gun violence?  The pharmaceutical corporations would lead you to believe that a person taking these drugs is less likely to commit suicide and less likely to do gun violence to others.  But is that really true?

 

The use of secret settlements to withhold information about a known harm of a pharmaceutical drug was very evident in the Fentress case, in which the Kentucky Supreme Court found that lawyers who engaged in an ongoing trial after a secret settlement had already been reached. Judge Potter said their conduct showed "a serious lack of candor with the trial court, and there may have been deception, bad faith conduct, abuse of the judicial process or perhaps even fraud." [Potter v. Eli Lilly & Co., 926 S.W.2d 449, 454 (Ky. 1996).]

 

In summary the Fentress case was about a violent incident in September 1989.  Joseph Wesbecker armed himself with an AK-47, walked into the Louisville printing plant where he had worked, and started shooting his former co-workers.  After killing eight people, wounded twelve more, and the man finished matters by committing suicide with his gun. Only one month before, Wesbecker had begun taking Prozac.  The known problems of violent behavior of patients on this medication had been withheld from the public, governmental regulators and even medical professionals.  The lawyers for the shooting victims soon focused on the drug Prozac, manufactured by Eli Lilly, as the cause for Wesbecker's unexpected violence.  With the sales of the drug Prozac at $1.7 billion in 1994 there was a lot at stake in this legal case. The Plaintiff's counsel had information about the withholding of research findings regarding another Eli Lilly drug Oraflex. In 1985, Lilly had pled guilty to twenty-five criminal counts of failing to report adverse reactions to Oraflex, including four deaths, to the Food & Drug Administration. But then suddenly during the trial the Oraflex evidence was no longer going to be presented to the court.

 

There was an experienced and astute Judge on the case John Potter, who suspected something was afoul despite the lawyers' denials and their references to a damages phase, Potter suspected that a deal had been made before closing argument.  When the plaintiffs didn't file a notice of appeal, Potter became suspicious and thus called in the lawyers from both sides for consultation.  But the lawyers continued to deny that a settlement had been reached.  When the appeals court ruled against Judge Potter saying he no longer had jurisdiction, Potter was not satisfied and appealed the case to the Kentucky Supreme Court.  Finally in a Supreme Court hearing, lawyers for both sides finally acknowledged that they had indeed settled all money issues and had agreed to go through only the liability phase of the trial no matter what the result.  Judge John Potter took the "high road," acting consistently with the judiciary's responsibility, and protecting the public interest.  Thus the role of the judiciary in deciding matters of privacy and sealed records is an important balancing act of sometimes competing interests but which must also take into account the public's right to know especially when there is a compelling public interest.

 

Human Rights Resources

Web-based International Human Rights Law Libraries

Office of the High Commissioner for Human Rights (International Human Rights Instruments): http://www2.ohchr.org/english/law/

University of Minnesota Human Rights Library: http://www1.umn.edu/humanrts

General Resources on Human Rights and Disability

ACT (Advocating Change Together) (Information on disability rights advocacy particularly for self-advocates with developmental disabilities): http://www.selfadvocacy.org

Theresia Degener and Yolan Koster-Dreese, eds., Human Rights and Disabled Persons: Essays and Relevant Human Rights Instruments (Martinus Nijhoff Publishers 1995).

Disabled Peoples' International, Ratification Toolkit (On ratification advocacy for the Convention on the Rights of Persons with Disabilities): http://www.icrpd.net/ratification/en/index.htm

Disabled Peoples' International, Implementation Toolkit (On implementation advocacy for the Convention on the Rights of Persons with Disabilities): http://www.icrpd.net/implementation/en/index.htm

National Council on Disability, Understanding the Role of an International Convention on the Human Rights of People with Disabilities: An analysis of the legal, social, and practical implications for policy makers and disability and human rights advocates in the United States (May 2002): http://www.ncd.gov/newsroom/publications/2002/unwhitepaper_05-23-02.htm

Gerard Quinn and Theresia Degener, et. al., Human Rights Are for All: A Study on the Current Use and Future Potential of the UN Human Rights Instruments in the Context of Disability (OHCHR, February 2002): click here

United Nations Department of Economic and Social Affairs (Website offering info on the UN Program on Disability and disability specific resources): http://www.un.org/disabilities

World Enable (Internet accessibility initiative providing information on a range of topics, including the Convention on the Rights of Persons with Disabilities): http://www.worldenable.net


USEFUL RESOURCES ON LIVING INDEPENDENTLY AND WITH DIGNITY IN THE COMMUNITY

Access Living center for independent living:
http://www.accessliving.org

Canadian Association of Independent Living Centers (CAILC):
http://www.cailc.ca

Disability Rights and Independent Living Movement in the United States. University of California:
http://bancroft.berkeley.edu/collections/drilm

The Independent Living Philosophy: Ten Principles. Rockland Independent Living Center:
http://www.rilc.org/principles.htm

Supported Decision-making, Planned Lifetime Advocacy Network:
http://www.plan.ca/Programs_Decisions.php

HUMAN RIGHTS INSTRUMENTS

The African Charter on Human and Peoples' Rights
http://www1.umn.edu/humanrts/instree/z1afchar.htm

Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT)
http://www.unhchr.ch/html/menu3/b/h_cat39.htm

Convention Concerning Indigenous and Tribal Peoples in Independent Countries (ILO No. 169)
http://www1.umn.edu/humanrts/instree/r1citp.htm

Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)
http://www.un.org/womenwatch/daw/cedaw/

International Convention on the Elimination of All Forms of Racial Discrimination (ICERD)
http://www.unhchr.ch/html/menu3/b/9.htm

Convention on the Rights of the Child (CRC)
http://www1.umn.edu/humanrts/instree/k2crc.htm

International Convention for the Protection of the Rights of Migrant Workers and Members of Their Families (ICRMW)
http://www1.umn.edu/humanrts/instree/n8icprmw.htm

Convention on the Rights of Persons with Disabilities (CRPD)
http://www1.umn.edu/humanrts/instree/disability-convention2006.html

Declaration on the Rights of Indigenous Peoples
http://www1.umn.edu/humanrts/instree/declra.htm

European Convention for the Protection of Human Rights and Fundamental Freedoms
http://conventions.coe.int/Treaty/en/Treaties/Html/005.htm

ILO Convention 159 (concerning Vocational Rehabilitation and Employment (Disabled Persons)
http://www.ilo.org/ilolex/english/convdisp1.htm

Inter-American Convention on Human Rights
http://www1.umn.edu/humanrts/oasinstr/zoas3con.htm

International Covenant on Civil and Political Rights (ICCPR)
http://www1.umn.edu/humanrts/instree/b3ccpr.htm

International Covenant on Economic, Social and Cultural Rights (ICESCR)
http://www.unhchr.ch/html/menu3/b/a_cescr.htm

Take action -- click here to contact your local newspaper or congress people:
Give Veterans Right to Choose Non Drug Options for PTSD

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.”
 
― Leo Buscaglia

Medical Whistleblower Advocacy Network

MEDICAL WHISTLEBLOWER ADVOCACY NETWORK

P.O. 42700 

Washington, DC 20015

MedicalWhistleblowers (at) gmail.com

CONTACT

"Never impose on others what you would not choose for yourself."  Confucius

"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat."

Theodore Roosevelt- Excerpt from the speech "Citizenship In A Republic", delivered at the Sorbonne, in Paris, France on 23 April, 1910