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Where will medicine be 20 years from now?
The nature of my work recently has taken me into the realm of futurists – scientists whose sole job is to predict the most accurate view of the future based on current trends in technology, medicine, education, world events, etc. While it's never an easy thing to say what exactly the future holds for humanity, we can get a good idea of some of the possibilities.In the book Foresight 20/20: A Futurist Explores the Trends Transforming Tomorrow, authors Jack Uldrich and Simon Anderson lay out several theoretical scenarios that could take place as early as 2020.Regarding health care:"Jonathan Rothberg, a life sciences technology pioneer and the CEO of gene sequencing technology company Ion Torrent, has claimed that sometime in 2013, society will have the ability to sequence a human genome in under two hours for the bargain price of $1,000. To put this in some perspective, it helps to consider the first human genome project was completed in 2001 for the sum of three billion dollars. The project has already had major implications for the health-care industry and the way we prevent and treat disease. Alas, fast and inexpensive gene sequencing is just a small part of the incredible changes already occurring in the field of health care.By the beginning of the next decade, in addition to the developments in genomics, continued advances in information technology, biotechnology, nanotechnology, robotics, data mining, artificial intelligence, sensors, and social networking will have transformed the face of modern medicine. What follows is a scenario involving one individual with a single ailment."Future Scenario"On October 21, 2020, Roger Martin, a sixty-seven-year-old, underemployed attorney, suffered a massive heart attack while tending to a small plot of land on an urban farm in a once thriving suburb of Atlanta. Had the event occurred ten years earlier, Roger, an early adopter of the “P4” (predictive, preventive, personalized, and participatory) mobile medicine, would not have made it to the hospital alive.The first sign of impending danger came when sensors in Roger’s shirt detected an unusually high pulse. Unbeknownst to Roger, his shirt sent a wireless alert to his “PMD” (personal mobile device) so it could begin more closely monitoring his other vital signs. After noting his symptoms, it compared them—along with his medical history and genetic file—to its vast database of all known diseases and injuries. Among the possible causes were a number of serious conditions, so it also contacted his primary physician, who immediately contacted Roger via mobile video connection.“How are you feeling, Roger?”“Fine,” he replied, “maybe a little tired, but nothing out of the ordinary.”Seeing that Roger looked a little pale, the doctor asked him if he had his permission to activate a mesh network of nanoscale diagnostic chips that had been placed inside Roger’s body following his first heart attack in 2017.“What if it’s another false alarm?” asked Roger, who had been contacted by his doctor in response to a similar situation last year.“I’m not 100 percent sure that it isn’t,” replied his doctor. “The technology’s still far from perfect, but I don’t want to take a chance. Do you?”“No, but are you sure the signals from those little nanobots won’t do more harm than good?” asked Roger, who was still nervous about the chips’ efficacy after hearing various reports from some news organizations, hinting at the possibility that activated chips could be contributing to the recent rise in reported cancer cases.“The rise in rates has nothing to do with the chips themselves,” said the doctor, “and everything to do with our ability to detect cancer at an ever earlier stage. If you need further evidence,” continued the doctor, “I suggest you query your personal assistant (which was actually just a sophisticated algorithm) on your PMD. It’ll confirm your worries are nothing more than an insidious urban myth. I can’t believe it still persists in this day in age.”Moments later, after gaining Roger’s approval, the network of nanometer-sized circuits patrolling Roger’s arteries was activated and began sampling his blood. Within seconds, the doctor was made aware that the level of C-reactive proteins in Roger’s blood was abnormally high.The doctor’s voice took on a more serious and ominous tone. “Roger, I want you to sit down, stop whatever you’re doing and take a deep breath.” Roger did as the doctor instructed.“Now, I want you to remain calm—and please know that I’m going to be with you the entire time—but there’s a good chance you’re on the verge of having a serious heart attack. The nearest hospital has been alerted, and an ambulance is already on its way.”“You’re kidding, right? I’m just feeling a little tired. All I’ve been doing is working outside—getting some fresh air and exercise like you suggested.”“Just relax, Roger. Over the last few years, I’ve come to appreciate the computer’s ability to more quickly and accurately diagnose health-care-related issues than either I—or my patients—can. Plus, better to be safe than sorry, right?”“Yeah, I guess,” replied Roger pensively as his breath became more labored. In an attempt to lighten the mood, he added, “I hate to think what this will do to my insurance rates.”By the time the ambulance had arrived, Roger was thankful it had because he had begun to feel constricted in his chest. Then, only moments after being placed in the ambulance, Roger went into full cardiac arrest. The paramedics were prepared and followed the new protocol established by the American Medical Association in 2018.Normally, Roger would have been taken to Emory University hospital, but due to traffic congestion and the severity of his condition, the ambulance was rerouted to an outpatient clinic located just off the freeway. Once there, Roger was whisked away on a gurney to a “clean” room where he was anesthetized and prepped for surgery. Then, in a procedure that would have been all but unthinkable even five years earlier and which was approved the previous year by the Food and Drug Administration for emergency situations, a robotic surgical device was wheeled into the room and positioned over Roger. With only a nurse and a young attending doctor in the room, a heart specialist located in Havana—connected via a secure, redundant fiber optic Internet connection—began guiding the thin, flexible arms of the device through the intricate surgical procedure using nothing but hand-gesture technology.When the surgery was completed just twenty-three minutes later, all that was visible on Roger’s chest was a Band-Aid-sized incision where the robotic arm had entered his chest cavity to insert a temporary stent. Roger awoke a little later and was greeted by a split screen display showing the heart surgeon and his primary physician. “You’re lucky to be alive,” said his doctor. “I’d now like to introduce you to the person responsible for extending your life, Dr. Daniela Famosa. Under the recently passed International Health Services Act, she was able to perform your surgery from Cuba.” Roger smiled and nodded in her direction.“During the operation,” said Dr. Famosa, “I harvested some of your stem cells and, with your permission, I’d like to have them transferred to the Institute for Regenerative Medicine at Wake Forest University where they will grow you a new, fully compatible artery. If all goes according to plan it should be ready in two weeks and can be inserted the week before Thanksgiving. Based on your personal health record and history of patients with a similar health background to you, you should even be able to travel over the holidays if you want.”“You’ll have to stay away from the eggnog this year,” added Roger’s doctor with a wink.Later that afternoon, Roger was discussing his outpatient treatment with “Cindy”—a computer animated avatar program on his PMD that acted as his personal nurse. The avatar, which Roger also liked to call his “cyber twin sister,” was responsible for continuously monitoring his health status in addition to scanning the latest health-care information in order to recommend and deliver Roger the best possible care.“Based on your genetic profile and the presence of the following genes—SMAD3 and CXCL 12,” said Cindy in a soothing and reassuring voice, “we know that the blood thinner warfarin—Type C3—will be best for you during this interim period. It’s also recommended that you not take it with any of the other following drugs.” His cyber twin went to list those drugs that Roger was to avoid, including the new antidepressant he had been prescribed. (In early 2020, the FDA was forced to pull the leading electronic brain stimulant treatment for depression after numerous patients in the first test group began losing feeling in their legs and feet.)“I realize this is a lot of information for you to process right now. Don’t worry,” continued Cindy, “I’ll remind you when to take your medication.” In a tone that then offered just the slightest hint of admonition, the avatar added, “When your heart is ready, we’ll also do a better job of keeping you on track with your exercise regimen.” Roger voiced his approval.“Are there other questions I can answer for you?” queried Cindy.“Well,” said Roger, who, in spite of avatars’ growing popularity the past few years, was still a little surprised with how natural it felt to be conversing with a virtual nurse, “Could you tell me a little more about the how the doctors are going to grow my new artery and install it?”“Sure.” Cindy promptly called forth the 3D digital scans of Roger’s heart and showed him the blocked artery that had been color-highlighted for his convenience. The avatar went on to explain how plaque, fatty substances, cholesterol, cellular waste, and calcium had been slowly building up over time and this combination was the main culprit of his heart attack.Once Cindy was confident that Roger understood the cause of his heart attack—which she figured out by using facial recognition technology to scan his physical reaction to the information that was being presented—she went on to show him how his new artery would be grown. Cindy called up a short video tutorial produced by the Institute of Regenerative Medicine, demonstrating how a small scaffold would first be constructed using biocompatible material and a 3D printer and how that scaffold was then seeded with Roger’s own stem cells and cultured until an artery replacement of precise proportions was grown. “There’s virtually no chance your body will reject the new part,” said Cindy. The avatar explained other treatment options to Roger along with the costs and benefits of each procedure. “I’m happy to arrange a conversation with a doctor if you have any additional questions, but I recommend the replacement surgery.”Roger asked Cindy a few questions regarding his insurance coverage and what costs he would be responsible for; but once he was satisfied with those answers, Roger indicated he didn’t have any additional questions. The avatar then began preparing him for outpatient services.“The first thing we’ll need to do is outfit you with a new line of sensor-embedded clothing. Your current wearable bands are pretty good in terms of monitoring your vital signs, but as an extra precaution we’ll want to keep extra close tabs on you during your recovery period.” Continuing, Cindy said, “I have also taken the liberty of putting together a list of friends and colleagues who have either had heart attacks or have lived with someone who has had one.” Knowing that Roger was the type of person who responded better to scientific information, Cindy added, “Past heart attack patients who have joined health networks are 37 percent less likely to suffer a repeat heart attack within the next five years. They also experience an increase in life expectancy of 2.8 years over those who don’t.” To make the point more vivid, Cindy displayed the information in a visually compelling format. She added, “A good way to use your network is to enroll in Healthy Hearts — your insurance provider’s new game to encourage an active and healthy lifestyle. It’s possible your rates could go down in the future if you score above the eightyfifth percentile.”Two months after his successful artery replacement surgery, Roger received a small scale 3D model of a human heart when he refilled his personally tailored heart medication prescription. It was a discount offer from a new biotech company that had only recently begun growing and marketing human hearts. Roger activated the computer chip inside the model, which then displayed an advertisement on this PMD. The ad read: “It’s not too soon to begin thinking about your next heart. You can never know when you’ll need it, but it sure ‘beats’ the alternative.” Roger then called up Cindy and asked her what the odds were that he would need a new heart by the year 2030.“If you continue to follow the recommended therapy and exercise, 42 percent,” replied Cindy. “Just as an FYI, due to your projected increase in life expectancy, the odds of your contracting prostate cancer have also increased. But don't worry, I'll keep a close eye on all the indicators and notify you if any action is necessary.”“Thanks.” Roger turned back to his PMD and directed his personal assistant to revise his finances so that he could afford his new heart when the time came."– Jack Uldrich & Simon Anderson, Foresight 20/20 - A Futurist Explores the Trends Transforming Tomorrow (2012)
Are scientists on the verge of finding out how to slow down aging and increasing how long humans live?
Aubrey de Grey explains the science of aging wonderfully.TLDR: 7 symptoms/causes of aging, what is on the horizon to fight aging, what can a person do today.The takeaway from Aubery’s presentation is that classification over parts of a problem is power over that problem. He explains that there are 7 core components or processes to aging which are as follows:He proposes 7 core elements of aging and long-term fixes to each of them. Many of these “fixes” or cures are likely to see clinical trials if not public release in the next 10–30 years.A prominent google executive has been quoted saying he believes biological immortality to now be possible because we can currently extend the average lifespan by 30 years and in 30 years we will be able to extend the average lifespan by another 30 and so on. This belief that biotech is advancing at an equal to linear rate or greater than linear rate when compared to our current aging is a fascinating proposition.A few of the technologies that I am excited about are:Metformin - Is widely considered to be a very safe drug and is approved by the FDA for diabetes treatment. It is now being researched as an anti-aging supplement. Dr. Peter Attia says that we basically age at the rate at which we process sugar. Metformin regulates the pancreatic enzymes that control sugar absorption. This drug is cheap and a potentially widely available option with a price tag of less than 10 cents per day. Acarbose is also another medication being explored. Clinical trials are underway.Senolytic drugs - So called Sentient cells are cells that have died but are still around releasing inflammatory histamines that damage nearby cells. These increase in number as we age and are closely related to many of the other signs and symptoms of aging. A new class of drugs called senolytic are being developed to rid the body of these cells. Clinical trials are underway.Early cancer screening - We are reaching an era where cancer detection will be as simple as a blood test at your yearly physical. Some of the tests in clinical trials are able to detect tumors at <1/10th the size of what is necessary to detect them on an MRI. This means that traditional chemotherapy could quickly become a thing of the past and that early treatment with >90% cure rates will become the norm.Personalized medicine - Combine this with early screenings and you get a really powerful tool. With whole genome sequencing costing less than USD $300 doctors can now use this information to pick the best drug for each patient individually.Stem cell therapy - Stem cells are “baby cells” unprogrammed cells that can program themselves into different types of tissues. Stem cell therapy is, in its most basic form, injecting unprogrammed cells into damaged tissue or tissue needing revitalization. This gets a lot more technical depending on the type of tissue damaged and treatment. There are various sub-fields within the study of stem cells. Some treatments are even using methods to grow whole new organs! Ultimately, stem cells are able to revitalize whole sets of tissues and organs to slow the aging process.Gene therapy - This is really the ultimate ends for the biotech industry where the fight against aging is concerned. Gene therapies of various types have the potential to elongate telomeres or repair damaged DNA. Therapies for specific conditions have already started clinical trials however, most of the important trials involving aging are in their infancy. Clinical trials and public release will be closer to that 30 year mark. This is the farthest away as this type of research and therapy is inherently dangerous to participants; research will be slow-going.Additionally, a few simple changes that can be made today which could increase longevity:Social connectedness - The number one indicator of longevity is not what we eat, not if we exercise not our genes but how connected we feel to others. Subjective closeness in relationships is a strong predictor of longevity and health as we age.Stress reduction - Stress is also pretty highly correlated with premature aging. Taking up some yoga or a mindfulness practice is a good idea.Healthy habits - Says it all: Sleep enough! Drink plenty of water. Eat healthy: lots of leafy greens and root vegetables as a base. Exercise regularly.Fasting - Fasting has shown some promising results in the battle against aging. This goes for both intermittent fasting and water fasting. There is a growing body of research that suggests that fasting decreases intracellular and extracellular waste and toxins as well as providing other cleansing benefits. Additionally, fasting tends to reset the body’s metabolism. A particularly interesting result when discussing fasting and aging is the mitochondrial support it provides. Fasting may make our little powerhouses more efficient and may actually increase mitochondrial density (number of mitochondria) in the cells of the body. By varying the input molecules (fat burning, not food) we make them work in a different way than they are used to which in-turn may make them more efficient. Definitely look at a few fasting guides before trying to see what might work best for you.Calorie restriction - Similar to fasting, calorie restriction has been shown to slow the aging process. Again, repeating the words of Dr. Peter Attia, we basically age at the rate at which we process sugar. Process less sugars, age slower. That simple.Anti-oxidant supplementation - A primary cause or symptom of aging is an increase of damaging free radicals, this is known as oxidative stress. I would not suggest supplements touted as being “anti-oxidant” but I would suggest eating plenty of blueberries. Word of warning, there are some studies that say over-doing this could be damaging. Again, a good place to start fighting oxidative stress is to lower sugar intake.Magnesium supplementation - Back for a third time to the words of Dr. Peter Attia, we basically age at the rate at which we process sugar. Magnesium is a mineral that modulates the production of enzymes produced by the pancreas. These are the enzymes responsible for processing sugar. This makes magnesium one of the best anti-aging supplements.Anti-inflammatory supplementation - Widespread inflammation is a primary symptom that everyone will experience as they age. Inflammation is part of the immune response and is good when localized or fighting illness. Long-term, wide-spread inflammation is the damaging kind and is part of a self-perpetuating cycle. Being mindful of the inflammatory foods we eat and the actions we take that can cause inflammation is a good start. A person could also consider anti-inflammatory supplementation either with natural spices like turmeric or a low-dose over-the-counter anti-inflammatory. Drug stores sell baby-aspirin for daily use for those who are at risk of heart-attack. This is a good, safe option to start with. Additionally, standard over the counter pain relievers are shown to decrease psychogenic pain which can help facilitate a better sense of subjective well-being and a better sense of subjective social connectedness. One of the primary factors in longevity.Home - Peter AttiaLearn how to live longer, be healthier, and optimize your performance. Peter Attia explores strategies and tactics to increase lifespan,...https://peterattiamd.com/Study Examines Whether Blood Test Can Identify Early CancersA blood test combined with imaging tests detected tumors—some at an early stage—in women without a history of cancer or any symptoms, a recent study showed. The liquid biopsy, called CancerSEEK, also mistakenly indicated some women had cancer when additional testing determined they did not.https://www.cancer.gov/news-events/cancer-currents-blog/2020/cancerseek-blood-test-detect-early-cancerWhole Genome Sequencing DNA TestWhy Whole Genome Sequencing DNA Test? Whole Genome Sequencing (WGS) decodes all 6.4 billion DNA base pairs in the human genome including the complete set of all 20,000 genes, mitochondrial DNA, and the Y chromosome. The sequencing of the first human genome cost over $3 billion , but today we have brought the price below $300 . Personal genome sequencing enables the discovery of all genetic variation in every individual gene and produces the most comprehensive and accurate genetic test results . The graphic below compares a full genome sequencing with incomplete DNA tests such as DNA genotyping and whole exome sequencing which decode only a few stretches of DNA. Beware of consumer genetic testing companies that decode less than 0.02% of your DNA!https://nebula.org/whole-genome-sequencing-dna-test/Center for Individualized Medicine - Pharmacogenomics for PatientsDetailed information for patients regarding drug-gene (pharmacogenomic) testing from the Mayo Clinic Center for Individualized Medicine.https://www.mayo.edu/research/centers-programs/center-individualized-medicine/patient-care/pharmacogenomics/pgx-profile-service/pharmacogenomic-pgxSenolytic - WikipediaAmong the class of small molecules under basic research to determine if they can selectively induce death of senescent cells A senolytic (from the words senescence and -lytic , "destroying") is among a class of small molecules under basic research to determine if they can selectively induce death of senescent cells and improve health in humans. [1] A goal of this research is to discover or develop agents to delay, prevent, alleviate, or reverse age-related diseases. [2] [3] A related concept is "senostatic", which means to suppress senescence. Research [ edit ] Possible senolytic agents are under preliminary research, including some which are in early-stage human trials. [4] [ clarification needed ] The majority of candidate senolytic compounds are repurposed anti-cancer molecules, such as the chemotherapeutic drug dasatinib and the experimental small molecule navitoclax . [5] [6] Senolytic candidates [ edit ] See also [ edit ] References [ edit ] ^ Childs, Bennett G; Durik, Matej; Baker, Darren J; van Deursen, Jan M (8 December 2015). "Cellular senescence in aging and age-related disease: from mechanisms to therapy" . Nature Medicine . 21 (12): 1424–1435. doi : 10.1038/nm.4000 . PMC 4748967 . PMID 26646499 . ^ Kirkland, James L.; Tchkonia, Tamara (August 2015). "Clinical strategies and animal models for developing senolytic agents" . Experimental Gerontology . 68 : 19–25. doi : 10.1016/j.exger.2014.10.012 . PMC 4412760 . PMID 25446976 . ^ van Deursen, Jan M. (16 May 2019). "Senolytic therapies for healthy longevity" . Science . 364 (6441): 636–637. Bibcode : 2019Sci...364..636V . doi : 10.1126/science.aaw1299 . PMC 6816502 . PMID 31097655 . ^ Baumann, Kim (27 July 2018). "Rejuvenating senolytics" . Nature Reviews Molecular Cell Biology . 19 (9): 543. doi : 10.1038/s41580-018-0047-5 . PMID 30054558 . S2CID 51726136 . ^ Blagosklonny, Mikhail V (28 October 2014). "Selective anti-cancer agents as anti-aging drugs" . Cancer Biology & Therapy . 14 (12): 1092–1097. doi : 10.4161/cbt.27350 . PMC 3912031 . PMID 24345884 . ^ Slack, Cathy; Alic, Nazif; Partridge, Linda (6 January 2016). "Could cancer drugs provide ammunition against aging?" . Cell Cycle . 15 (2): 153–155. doi : 10.1080/15384101.2015.1118905 . PMC 4825846 . PMID 26587873 . ^ a b Baar, Marjolein P.; Brandt, Renata M.C.; Putavet, Diana A.; Klein, Julian D.D.; Derks, Kasper W.J.; Bourgeois, Benjamin R.M.; Stryeck, Sarah; Rijksen, Yvonne; van Willigenburg, Hester; Feijtel, Danny A.; van der Pluijm, Ingrid; Essers, Jeroen; van Cappellen, Wiggert A.; van IJcken, Wilfred F.; Houtsmuller, Adriaan B.; Pothof, Joris; de Bruin, Ron W.F.; Madl, Tobias; Hoeijmakers, Jan H.J.; Campisi, Judith; de Keizer, Peter L.J. (March 2017). "Targeted Apoptosis of Senescent Cells Restores Tissue Homeostasis in Response to Chemotoxicity and Aging" . Cell . 169 (1): 132–147.e16. doi : 10.1016/j.cell.2017.02.031 . PMC 5556182 . PMID 28340339 . ^ a b Hernandez-Segura, Alejandra; Nehme, Jamil; Demaria, Marco (June 2018).https://en.wikipedia.org/wiki/SenolyticTrueNorth Health CenterTrueNorth Health Center was founded in 1984 by Drs. Alan Goldhamer and Jennifer Marano. The integrative medicine approach they established offers participants the opportunity to obtain evaluation and treatment for a wide variety of problems. The staff athttps://www.healthpromoting.com/What is oxidative stress? - PubMedOxidative stress, defined as a disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses, is discussed in relation to its possible role in the production of tissue damage in diabetes mellitus. Important free radicals are described and biolo …https://pubmed.ncbi.nlm.nih.gov/10693912/
What is the role of the President of India?
WORK/ROLE (DUTIES) OF THE PRESIDENT OFINDIAINTRODUCTION:The primary duty of the President is to preserve, protect and defend the constitution and the law of India as made part of his oath (Article 60 of Indian constitution). The President is the common head of all independent constitutional entities. All his actions, recommendations (Article 3, Article 111, Article 274, etc.) and supervisory powers (Article 74(2), Article 78 c, Article 108, Article 111, etc.) over the executive and legislative entities of India shall be used in accordance to uphold the constitution. There is no bar on the actions of the President to contest in the court of law.I. LEGISLATIVE POWERS:Legislative power is constitutionally vested by the Parliament of India of which the president is the head, to facilitate the law making process per the constitution (Article 78, Article 86, etc.). The President of the Republic summons both the Houses (The House of the People and 'The Council of States') of the Parliament and prorogues them. He can dissolve the Lok Sabha.The President inaugurates Parliament by addressing it after the general elections and also at the beginning of the first session every year per Article 87 (1). The Presidential address on these occasions is generally meant to outline the new policies of the government.All bills passed by the Parliament can become laws only after receiving the assent of the President per Article 111. After a bill is presented to him, the President shall declare either that he assents to the Bill, or that he withholds his assent from it. As a third option, he can return a bill to Parliament, if it is not a money bill, for reconsideration. President may be of view that a particular bill passed under the legislative powers of parliament is violating the constitution, he can send back the bill with his recommendation to pass the bill under the constituent powers of parliament following the Article 368 procedure. When, after reconsideration, the bill is passed accordingly and presented to the President, with or without amendments, the President cannot withhold his assent from it. The President can also withhold his assent to a bill when it is initially presented to him (rather than return it to Parliament) thereby exercising a pocket veto on the advice of prime minister or council of ministers per Article 74 if it is inconsistent to the constitution. Article 143 gave power to the president to consult the Supreme Court about the constitutional validity of any issue. President shall assent the constitutional amendment bills without power to withhold the bills per Article 368 (2).When either of the two Houses of the Parliament of India is not in session, and if the government feels the need for an immediate procedure, the President can promulgate ordinances which have the same force and effect as an act passed by Parliament under its legislative powers. These are in the nature of interim or temporary legislation and their continuance is subject to parliamentary approval. Ordinances remain valid for no more than six weeks from the date the Parliament is convened unless approved by it earlier. Under Article 123, President as the upholder of the constitution shall be satisfied that immediate action is mandatory as advised by the union cabinet and he is confident that the government commands majority support in the Parliament needed for the passing of the ordinance into an act and Parliament can be summoned to deliberate on the passing of the ordinance as soon as possible. The promulgated ordinance is treated as an act of Parliament when in force and it is the responsibility of the President to withdraw the ordinance as soon as the reasons for promulgation of the ordinance are no longer applicable. Bringing laws in the form of ordinances has become a routine matter by the government and President, but the provisions made in Article 123 are meant for mitigating unusual circumstances where immediate action is inevitable when the extant provisions of law are inadequate. Re-promulgation of ordinances after failing to get approval within stipulated time of the both houses of parliament is unconstitutional act by the President. President should not incorporate any matter in an ordinance which is violating the constitution or needs amendment to the constitution. The President should take moral responsibility when an ordinance elapses automatically or is not approved by the Parliament or violating the constitution.II. EXECUTIVE POWERSPer Article 53, the executive power of the country is vested in the President and is exercised by President either directly or through officers subordinate to him in accordance with the chapter 1, part V of the Constitution. When parliament thinks fit it may accord additional executive powers to the president per Article 70 which may be further delegated by the president to the governors of states per Article 160. Union cabinet with Prime Minister as its head, should aid and advice the President in performing his functions. Per Article 74 (2), the council of ministers or Prime Minister are not accountable legally to the advice tendered to the President but it is the sole responsibility of the President to ensure compliance with the constitution in performing his duties.III. JUDICIAL POWERSThe primary duty of the President is to preserve, protect and defend the constitution and the law of India per Article 60. The President appoints the Chief Justice of the Union Judiciary and other judges on the advice of the Chief Justice. He dismisses the judges if and only if the two Houses of the Parliament pass resolutions to that effect by a two-thirds majority of the members present.Attorney General for India who is the Indian government's chief legal advisor, is appointed by the President of India under Article 76(1) and holds office during the pleasure of the President. If the President considers a question of law or a matter of public importance has arisen, he can also ask for the advisory opinion of the Supreme Court per Article 143.IV. APPOINTMENT POWERSThe President appoints, as Prime Minister, the person most likely to command the support of the majority in the Lok Sabha (usually the leader of the majority party or coalition). The President then appoints the other members of the Council of Ministers, distributing portfolios to them on the advice of the Prime Minister.The Council of Ministers remains in power at the 'pleasure' of the President.The President appoints 12 members of the Rajya Sabha from amongst persons who have special knowledge or practical experience in respect of such matters as literature, science, art and social service.The President is responsible for making a wide variety of appointments. These include:1. Governors of States2.The Chief Justice, other judges of the Supreme Court and High Courts of India2. The Chief Minister of the National capital territory of Delhi (Article 239 AA 5 of the constitution)3. The Attorney General4. The Comptroller and Auditor General5. The Chief Election Commissioner and other 6. 6. Election Commissioners7. The Chairman and other Members of the Union 8. Public Service Commission8. Vice-Chancellor of the central university and academic staff of the central university through his nominee9. Ambassadors and High Commissioners to other countries (only through the list of names given by the Prime Minister).V. FINANCIAL POWERSA money bill can be introduced in the Parliament only with the President’s recommendation.The President lays the Annual Financial Statement, i.e. the Union budget, before the Parliament.The President can take advances out of the Contingency Fund of India to meet unforeseen expenses.The President constitutes a Finance commission after every five years to recommend the distribution of the taxes between the centre and the States.VI. DIPLOMATIC POWERSAll international treaties and agreements are negotiated and concluded on behalf of the President. However, in practice, such negotiations are usually carried out by the Prime Minister along with his Cabinet (especially the Foreign Minister). Also, such treaties are subject to the approval of the Parliament. The President represents India in international forums and affairs where such a function is chiefly ceremonial. The President may also send and receive diplomats, i.e. the officers from the Indian Foreign Service. The President is the first citizen of the country.VII. MILITARY POWERSThe President is the Supreme Commander of the Indian Armed Forces. The President can declare war or conclude peace, on the advice of the Union Council of Ministers headed by the Prime Minister. All important treaties and contracts are made in the President's name. He also appoints the chiefs of the service branches of the armed forces.VIII. PARDONING POWERSAs mentioned in Article 72 of the Indian Constitution, the President is empowered with the powers to grant pardons in the following situations.Punishment is for an offence against Union LawPunishment is by a Military CourtSentence is that of death.The decisions involving pardoning and other rights by the President are independent of the opinion of the Prime Minister or the Lok Sabha majority. In most cases, however, the President exercises his executive powers on the advice of the Prime Minister and the cabinet.IX. EMERGENCY POWERSThe President can declare three types of emergencies: national, state and financial, under articles 352, 356 & 360 in addition to promulgating ordinances under article 123.1. National emergencyA national emergency can be declared in the whole of India or a part of its territory for causes of war or armed rebellion or an external aggression. Such an emergency was declared in India in 1962 (Indo-China war), 1971 (Indo-Pakistan war), and 1975 to 1977 (declared by Indira Gandhi).Under Article 352 of the India Constitution, the President can declare such an emergency only on the basis of a written request by the cabinet of ministers headed by the Prime Minister. Such a proclamation must be approved by the Parliament with two thirds majority within one month. Such an emergency can be imposed for six months. It can be extended by six months by repeated parliamentary approval-there is no maximum duration.In such an emergency, Fundamental Rights of Indian citizens can be suspended. The six freedoms under Right to Freedom are automatically suspended. However, the Right to Life and Personal Liberty cannot be suspended.(Article 21)The President can make laws on the 66 subjects of the State List (which contains subjects on which the state governments can make laws).Also, all money bills are referred to the President for approval. The term of the Lok Sabha can be extended by a period of up to one year, but not so as to extend the term of Parliament beyond six months after the end of the declared emergency.National Emergency has only been proclaimed in India twice till date. It was declared first in 1962 by President Sarvepalli Radhakrishnan, during the Sino-Indian War. The second emergency in India was from 1975-77 proclaimed by President Fakhruddin Ali Ahmed, with Indira Gandhi as Prime Minister.2. State emergencyIf the President is fully satisfied, on the basis of the report of the Governor of the concerned state or from other sources that the governance in a state cannot be carried out according to the provisions in the Constitution, he can proclaim under Article 356 a state of emergency in the state. Such an emergency must be approved by the Parliament within a period of 2 months.Under Article 356 of the Indian Constitution, it can be imposed from six months to a maximum period of three years with repeated parliamentary approval every six months. If the emergency needs to be extended for more than three years, this can be achieved by a constitutional amendment, as has happened in Punjab and Jammu and Kashmir.During such an emergency, the President can take over the entire work of the executive, and the Governor administers the state in the name of the President. The Legislative Assembly can be dissolved or may remain in suspended animation. The Parliament makes laws on the 66 subjects of the state list.A State Emergency can be imposed via the following:By Article 356 – If that state failed to run constitutionally, i.e. constitutional machinery has failedBy Article 365 – If that state is not working according to the direction of the Union Government issued per the provisions of the constitution.This type of emergency needs the approval of the parliament within 2 months. It can last up to a maximum of three years via extensions after each 6-month period. However, after one year it can be extended only if1. A state of National Emergency has been declared in the country or in the particular state.2. The Election Commission finds it difficult to organise an election in that state.The Sarkaria Commission held that presidents have unconstitutionally misused the provision of Article 356 many times for achieving political motives, by dismissing the state governments although there was no constitutional break down in the states. During 2005, President's rule was imposed in Bihar state, misusing Article 356 unconstitutionally to prevent the democratically elected state legislators to form a government after the state elections.There is no provision in the constitution to re-promulgate president's rule in a state when the earlier promulgation ceased to operate for want of parliaments approval within two months duration. During 2014 in Andhra Pradesh, president's rule was first imposed on 1 March 2014 and it ceased to operate on 30 April 2014. President's rule was promulgated after being fully aware that the earliest parliament session is feasible in the end of May 2014 after the general elections. It was reimposed again unconstitutionally on 28 April 2014 by the president.3. Financial emergencyArticle 282 accords financial autonomy in spending the financial resources available with the states for public purpose. Article 293 gives liberty to states to borrow without any limit to its ability for its requirements within the territory of India without any consent from the union government. However union government can insist for compliance of its loan terms when a state has outstanding loan charged to the consolidated fund of India or an outstanding loan in respect of which a guarantee has been given by the Government of India under the liability of consolidated fund of India.Under article 360 of the constitution, President can proclaim a financial emergency when the financial stability or credit of the nation or of any part of its territory is threatened. However, until now no guidelines defining the situation of financial emergency in the entire country or a state or a union territory or a panchayat or a municipality or a corporation have been framed either by the finance commission or by the central government.Such an emergency must be approved by the Parliament within two months by simple majority. It has never been declared. A state of financial emergency remains in force indefinitely until revoked by the President.The President can reduce the salaries of all government officials, including judges of the Supreme Court and High Courts, in cases of a financial emergency. All money bills passed by the State legislatures are submitted to the President for approval. He can direct the state to observe certain principles (economy measures) relating to financial matters.
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