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That’s not an easy question to answer.It would seem intuitive that, for a brain disorder such as stroke, clinical assessment should include the examination of memory, thinking, and mood. However, until quite recently, the focus has been on the physical manifestations of stroke, and neuropsychological aspects have received far too little attention. There is now mounting evidence that cognitive impairment after stroke is a significant contributor to disability, and its prevalence tends to increase sharply with advancing age. However, studies on the prevalence, course, and prognosis of poststroke cognitive disorders have produced wildly conflicting results. In fact, the symptoms of poststroke cognitive impairment are not well defined, and are misunderstood and misdiagnosed by many clinicians.This post is quite long, because I'm not sure what you're really asking. It's divided into three main sections, to make it easier to find the information you want:(1) What categories of cognitive impairment can be caused by ischemic brain stroke?Stroke can have a wide range of effects on brain function, from mild poststroke cognitive impairment (PSCI) to overt poststroke dementia (PSD). Our understanding of these effects is undergoing rapid change, This section discusses the current terminology used in the recent research literature, and how each category of impairment is defined.(2) Whether, when, and why will cognitive dysfunction (PSCI and/or PSD) occur after an ischemic stroke?Does ischemic brain stroke always cause cognitive impairment? No. This section discusses the frequency with which each type of impairment is caused in stroke survivors, how soon after stroke the impairment is seen, and some of the factors affecting a given stroke survivor's likelihood of suffering long-term cognitive impairment.(3) What sorts of behavioral changes can be caused by poststroke cognitive impairment?Both sections (1) and (2) might just be technobabble to the layman who's never encountered what stroke can do, other than the obvious physical difficulties such as a paralyzed arm. It occurred to me that you might really be wondering whether the strange behaviors of a loved one were actually caused by stroke, or by something else. This third section describes the more common, and some of the more unusual, behavioral changes that stroke can cause.(1) What categories of cognitive impairment can be caused by ischemic brain stroke?The terminology surrounding poststroke cognitive impairment is changing, so let's start there, for clarity.The term "vascular cognitive impairment (VCI)" has been proposed as an umbrella term to recognize the broad spectrum of cognitive and behavioral changes associated with vascular pathology. The most common causes of VCI are small-vessel disease, large-vessel disease, and strategic infarcts that may be either cortical or subcortical. VCI may also be the result of hypoperfusion, hemorrhage, and hereditary conditions (for example, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, CADASIL). All of these subtypes of VCI may appear poststroke. Even when poststroke dementia (PSD) and poststroke cognitive impairment (PSCI) are not purely vascular in origin, they can at least partly be regarded as categories of VCI.Poststroke dementia (PSD) is defined as any dementia occurring after stroke, including vascular dementia, Alzheimer’s disease, other neurodegenerative dementias, or mixed dementia. (Note that vascular lesions often coexist with Alzheimer's disease pathology and other lesions, and the presence of multiple pathologies greatly increases the odds of dementia.) The concepts PSD and PSCI usually refer to conditions occurring after symptomatic strokes with corresponding ischemic findings on neuroradiological imaging. However, seemingly asymptomatic strokes – a common incidental finding in patients both with and without symptomatic strokes – add to the vascular burden of the brain and can affect cognitive function. Dementia can even be caused by non-focal neurological changes found in patients with transient ischemic attack (TIA).Poststroke cognitive impairment (PSCI) is a common and under-recognised problem that may eventually lead to dementia (PSD). Two major issues hampering PSCI research include the lack of a clear-cut definition and a lack of highly specific and sensitive screening tools that accurately predict PSCI. PCSI is currently defined as failure in any cognitive domain after stroke, including attention and processing speed (sustained attention, divided attention, selective attention, information processing speed); frontal-executive function (planning, decision making, working memory, responding to feedback/error correction, novel situations, overriding habits, mental flexibility, judgment); learning and memory (immediate memory, recent memory -- including free recall, cued recall -- and recognition memory); language (naming, expressive, grammar and syntax, receptive); visuoconstructional-perceptual ability (construction, visual perception, and reasoning); praxis-gnosis-body schema (praxis, gnosis, right/left orientation, calculation ability, body schema, facial recognition); and/or social cognition (recognition of emotions and social cues, appropriate social inhibitions, theory of mind, empathy.)However, studies on the prevalence and progression of PSCI vary wildly as to the number of domains that must be impaired, the number of tests per domain, how domains are defined, and specific cut-offs used to define impairment. Early definitions of PSCI were based on the concept of mild cognitive impairment (MCI), primarily framed as a precursor to Alzheimer’s disease. (Note that there are several different types of MCI; and two-thirds of MCI patients will not progress to Alzheimer's.) The definition of MCI (and, accordingly, earlier definitions of PSCI) often requires intact basic activities of daily living (ADLs). However, stroke patients often have substantial physical impairments that interfere with ADLs, independent of cognitive function. Therefore, it has recently been recommended that requirements for intact ADLs should be specific to instrumental ADLs (IADLs) that are associated with cognition (e.g. managing money). This is consistent with the recent DSM-5 criteria which emphasize impairment in IADLs as a distinguishing factor between major and minor neurocognitive disorders. The new criteria also do not require memory impairment as a core symptom of PSCI or PSD. In stroke, it may be possible to have severely disabling cognitive problems but still retain memory. This latter change will be a major leap forward in studying and understanding poststroke cognitive function.Even without progression to PSD, milder levels of cognitive impairment may result in reduced participation in rehabilitation and poor adherence to treatment. PSCI predicts suboptimal recovery in activities of daily living, which in turn results in a lower quality of life (and a heavier burden on caregivers.)(2) Whether, when, and why will cognitive dysfunction (PSCI and/or PSD) occur after an ischemic stroke?The studies that have been conducted on neuropsychological aspects of stroke have produced conflicting results. Various studies have concluded that some stroke survivors may show no cognitive deficits, whereas the cognitive function of others may decline, initially decline and then improve, decline and then remain stable, and/or may progress to dementia over time. How many stroke survivors follow each of these poststroke profiles is unknown, since different studies reached widely different conclusions. The differences in prevalence and progression reported by different researchers may be related to differences in the diagnostic criteria (see above), the cognitive tests used, the timing of the testing (i.e., how soon after stroke the first cognitive testing is done, and how frequently follow-up testing is done, and long the follow-up period is), history of previous stroke, stroke location, the volume of the lesion, the presence of large‐ and small‐vessel disease, population sample (clinical- versus population-based, ages, gender, etc), inclusion/exclusion criteria for those patients to be tested, ethnicity, and the presence of neurodegenerative pathology. In some patients, the initial poststroke cognitive state may reflect prestroke cognitive decline or delirium. On top of all of this, some researchers have concluded that cognitive outcome following a stroke is dependent on sociodemographic, health, and stroke‐related risk factors, not just on the properties of the stroke itself and the overall pre-stroke vascular burden of the brain.For example, population or sampling characteristics, such as study setting (hospital or community), inclusion of patients with recurrent stroke, or inclusion of patients with pre-stroke cognitive impairment or dementia, can lead to variation in estimates of PSCI or PSD prevalence. Exclusion of patients who have difficulty undergoing cognitive testing (e.g., have severe aphasia due to the stroke) may be unavoidable, but can also effect prevalence estimates. Some publications state that up to 78% of patients show some cognitive deficits within 1 month after the stroke. However, delirium is quite common in the days and weeks immediately following a stroke. (Studies have reported an incidence of delirium as high as 48% in the acute phase of stroke.) Delirium, which has a rapid onset, is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment. Because symptoms of delirium and dementia can be similar, diagnosis of one in the presence of the other can be tricky. Ergo, erroneously high figures for the prevalence of cognitive deficits may be produced by studies that assess cognitive function within a month or two of the stroke; and those that went on to conduct additional assessments months later might have reported initial cognitive decline followed by some degree of recovery, whereas what was actually being observed was the resolution of the delirium. Most of the higher quality studies did not attempt to establish baseline poststroke cognition until three months after the stroke.One of the biggest flaws is the method(s) used to evaluate cognitive function. Even though there is an enormous amount of evidence that domain-specific cognitive tools are essential to capture the impact of PSCI and/or PSD, the vast majority of studies have relied exclusively on short, simple screening tests such as the Mini-Mental State Examination (MMSE) and/or Montreal Cognitive Assessment (MoCA). There are far too many factors that can affect the outcome of these simplistic tests for either one to be used to diagnose cognitive impairment, let alone estimate its severity. Both tests were initially developed to quickly screen for the possibility of Alzheimer's in outpatient settings rather than to identify cognitive defects in stroke patients. These tests have low sensitivity for the most commonly affected cognitive domains after stroke, such as executive function and processing speed. Moreover, PSCI is usually accompanied by additional cognitive deficits, such as aphasia/language dysfunction, vision loss, apraxia and spatial neglect, for which the tests are not sensitive and may greatly underestimate cases of cognitive impairment involving specific neurological deficits (e.g., aphasia). A 2019 systematic review on the cognitive screening tools used in the diagnosis of PSCI concluded that studies on PSCI have relied almost exclusively on nonspecific cognitive screening tools; that it is very well established that they are hopelessly inadequate for this purpose; and that a comprehensive standardized battery of neuropsychological tests is needed to fully capture the effects of stroke on cognitive function; even multidomain screening tools such as the new Oxford Cognitive Screen (OCS) are superior for the diagnosis of PSD and PSCI.Keeping all of this in mind, studies have generally concluded that, six months poststroke, roughly half of stroke survivors have neurocognitive disorders, two-thirds of whom have PSCI, and one-third of whom have PSD. Due to the inadequacies of the assessment tools that have been used, the prevalence of PSCI and PSD are undoubtedly higher. A study involving a population free from pre-stroke cognitive decline found that 57% suffered from cognitive impairment one year after stroke, only one third of whom developed a purely vascular cognitive disease. Poststroke cognitive impairment in the remainder was complex with a high coexistence of vascular and degenerative changes.Temporal aspects of cognitive impairment in patients (e.g., whether patients remain stable, improve, or decline) have often been ignored. Most of the studies that attempted to address this essential feature used screening tools such as the MMSE to judge the severity of cognitive problems. As noted above, the MMSE was never intended for this purpose and is hopelessly inadequate for it, despite its widespread use. Moreover, many studies have been cross-sectional, which are inadequate for addressing temporal aspects -- only longitudinal studies yield accurate information on progression. Finally, as more is learned about poststroke cognitive function, it becomes clear that a relatively long follow-up is needed to fully capture the impact of a stroke on the brain. Acute stroke may cause both a sudden cognitive decline and accelerated cognitive decline that is persistent over time. Very recent studies have concluded that cognitive function can decline in a delayed fashion, suggesting an indirect, more gradual onset rather than (or in addition to) a direct, sudden onset; any study with a short follow-up time period is unlikely to capture the full extent of a delayed decline. Delayed decline has been reported in approximately one‐third of patients. Several reasonably reliable studies with follow-up periods as long as five years have concluded that the delayed development of incident dementia remains up to 9 times greater than among an age-matched population for ≥5 years after stroke. Decline in cognitive function, however, is not inevitable; ~2.7 to 20% stroke survivors with PSCI but no dementia may eventually recover, depending on age and provided there is no recurrent stroke.Studies that combined sophisticated imaging techniques with extensive neuropsychological tests have produced the most reliable information, although these are few and far between. One excellent, and very interesting, example is a 2018 paper on a prospective, hospital-based study used 3-T MRI and a comprehensive standardized battery of neuropsychological tests 6 months after the index event to define the neuroimaging determinants of poststroke cognitive performance and their relative contributions. Data were available for 356 patients, 326 [91.6%] of whom had experienced an ischemic stroke.Half of the patients were found to have cognitive impairment six months poststroke.Of the many different MRI markers, the presence of a lesion within a small "strategic" site (i.e., the right corticospinal tract, left antero-middle thalamus, left arcuate fasciculus, left middle frontal gyrus, or left postero-inferior cerebellum) was the main determinant of poststroke cognitive performance and accounted for 22.5% of the observed variance in the global cognitive score.Stroke volume, total medial temporal lobe atrophy, and brain tissue volume were independent but weaker determinants, together accounting for an additional 11.8% variance in the global cognitive score.The total stroke volume accounted for only a small proportion (4.3%) of the variability in cognitive performance.The white matter hyperintensity (WMH) burden, presence of microbleeds, and dilated perivascular spaces were not independent determinants.This study emphasizes the fact that, regardless of their volume, lesions in strategic areas have a key role in the occurrence of poststroke neurocognitive disorders. Strategic strokes accounted for poor cognitive performance in patients with both a small stroke volume and no cerebral atrophy. Routine assessment of important cognitive domains is an essential part of the clinical workup. When clinical exam and neuroimaging show that there is involvement of strategic locations of the brain, assessment of the function for major brain networks should also be made. These include the domains for language, attention and spatial orientation, object recognition, memory, and motor planning and control.Also, atrophy has been one of the most controversial MRI markers for poststroke cognitive performance. Data from this 2018 study indicate that cerebral atrophy is associated with cognitive impairments. The researchers hypothesize that post-ischemia neurodegeneration in the subcortical region is probably one of the main contributors. Their results also emphasize the role of medial temporal lobe atrophy in poststroke neurocognitive disorders, independently from a potentially associated Alzheimer's disease. Medial temporal lobe atrophy may be related to delayed ischemic injury in hippocampal areas associated with selective vulnerability in a pure vascular process.Unfortunately, the cross-sectional design of this 2018 study made it impossible to investigate the relationship between MRI markers and long-term cognitive performance.The increasing use of MRI is influencing, and may even exaggerate, the estimate of the vascular burden behind cognitive impairment, because vascular changes are more apparent than degenerative ones in neuroradiology. On the other hand, depending on their location, vascular lesions may be more influential than they appear to be, disrupting interconnections between several distal regions. This applies, for example, to lesions in the basal ganglia and to the deep white matter, which damage the frontal-subcortical network and associate with executive dysfunction. The thalamus is another example of a strategic infarct location that may also cause amnestic dysfunction, in addition to executive defects.(3) What sorts of behavioral changes can be caused by poststroke cognitive impairment?I tripped across an interesting paper, Stroke and Behavior by Victor W Mark, describing the more common, and some of the more unusual, behavioral changes that stroke can cause. It's intended for the clinician, but it occurred to me that the answer I've written above might just be gibberish to the layman who's never encountered what stroke can do, other than the obvious physical difficulties, such as a paralyzed arm ... and that you might be asking your question because you wonder whether the changes you're observing in your loved one were actually caused by stroke, or something else. I'll briefly summarized what the paper had to say, but if you want to learn more, I'd suggest you contact Dr Mark to ask for a copy of the full publication: Stroke and Behavior | Request PDFDoctors and researchers primarily assess the impact of stroke in the controlled environment of the clinic or laboratory, using tests and materials that are assumed to simulate daily living activities, but that actually fail to represent the demands of the "real world" on the stroke survivor. Notably, performance is generally evaluated in response to the doctor’s prompting (“on command”), whereas much of real life occurs spontaneously, without prompting, and in a much more familiar environment. These differences can lead to marked differences in behavior between laboratory and home settings that you'll rarely find discussed in the research literature.Also note that behavioral studies of stroke primarily assess its acute effects, i.e., changes that take place shortly after the stroke. However, the severity as well as the quality of the behavioral effects of stroke may change considerably over the long run.In some languages -- for example, Chinese -- tone production during speech is crucial for interpreting individual word meanings in those languages. In addition, stroke survivors who had received less formal education are believed to develop more severe symptoms in many cognitive domains. The paper warns that many researchers have studied adults from industrialized societies who were formally well-educated and whose native language was nontonal (i.e., a language in which a word’s meaning is not affected by its intonation). The behavioral changes after stroke among patients who fall outside of these characteristics -- for example, patients from rural China -- are less well understood. On top of that, stroke survivors with severely impaired speech are usually excluded from studies on the impact of stroke on behavior, even those that involve nonverbal cognition tests. Hence, there is also little understanding of the impact of stroke on nonverbal communication in stroke patients.The following are some of the types of cognitive symptoms that can be caused by stroke. The paper also sometimes provides information on how such symptoms are diagnosed in stroke survivors, and some limited information on rehabilitation.Executive functions: Dr Mark says, "This very broad category refers to processes that regulate other functions, in the same way that a company’s executive controls subsidiary operations (eg, marketing, hiring, promotion, production, support services) without directly being involved with them." Generally speaking, executive functions involve planning (which requires abstraction), initiation, staying mindful of task objectives (working memory), prioritizing goals, sequencing activities for specific goals, and inhibiting attention to irrelevant stimuli (minimizing distraction).Disturbances to executive function after stroke can cause lack of spontaneity, distractibility, performing multistep operations in the wrong order, failure to inhibit behaviors that are inappropriate to a situation (eg, laughing while attending a funeral), or performing actions repeatedly for a goal or in response to stimulation, but needlessly ("perseveration"). In “recurrent perseveration”, a subtype of perseveration that is common in aphasia, patients uncritically repeat a response that they had provided to a previous question, but now, when given a new question, is inappropriate.The presence of executive dysfunction after a stroke is thought to predict limited functional recovery, and to interfere with the patient's ability to respond to rehabilitation efforts. Apparently, executive dysfunction after acute stroke is very common, with figures as high as 50% to 75% having been reported. However, it is very difficult to assess executive dysfunction, because the tests often involve lengthy, laborious procedures and/or require patients to understand complex instructions or give spoken responses. The requirements for understanding and responding to complex instructions often end up with a large number of aphasic patients being excluded from executive function studies.Language: Aphasia, which is one of the most common cognitive disturbances caused by stroke, is difficulty in communicating using language. Language is the ability to encode ideas into words or symbols for communication to someone else, and includes speaking, understanding the speech of others, reading, writing, gesturing (including sign language), and using numbers. Aphasia must be distinguished from speech dysarthria, mutism, aphonia (inability to vocalize), and hearing loss, which affect the physical ability to produce or hear speech, but do not selectively affect the symbolic aspects of speech. For example, stroke survivors with dysarthria experience “slurred” or “mumbled” speech due to limited lip, tongue and jaw movement; and there may be changes in pitch, or vocal quality (e.g., hoarseness or breathiness.)Aphasia occurs in about one-third of acute stroke patients and predicts worse survival than in nonaphasic stroke patients. By six months after stroke onset, aphasia may improve in more than one-half of patients and completely resolve in about 38%.Aphasia primarily results from left hemisphere injury (whether the patient is left- or right-handed.) However, aphasic disorders may rarely be caused by right hemisphere stroke, which is called crossed aphasia. The impairments that follow right hemisphere stroke are often subtle and difficult to recognize, including the patient having impaired interpretation of the social signals in discourse (such as failing to notice when another individual wants to end discussion), misunderstanding ambiguity, and producing meandering topics during speech expression.While aphasia often becomes less severe, the character of the aphasic disturbance may itself change during the patient's recovery. For example, global aphasia (typified by markedly impoverished speech comprehension and production) may change to Wernicke aphasia (fluent but nonsensical speech and poor comprehension); Broca aphasia (good comprehension, poor speech production) may resolve to anomic aphasia (good comprehension and fluency, but with word-finding difficulties). While nonfluent aphasia often gives way to fluent aphasia, fluent aphasia does not change to nonfluent aphasia.Stroke may also affect the use and/or interpretation of speech intonation, called aprosodia. "Affective aprosodia" is the disturbed interpretation or expression of emotional tone in speech; and "linguistic aprosodia" is the disturbance of nonemotional tone, for example, the conveyance of emphasis (“!”) or interrogation (“?”) in a sentence. In such disorders, the problem is not with word selection or sentence construction, but rather with determining the speaker’s social perspective (Is he angry?) or need for information (Is she asking a question?). Aprosodia is not associated with damage to any particular brain area or side. Testing is complicated by the need to rely on contrived situations that may not represent ordinary conditions for communications.Apraxia of speech can also be caused by stroke. This disturbance involves the inconsistent production of speech sounds (particularly consonants, depending on whether they are initial vs later in a word), and is considered a deficit of planning speech movements. This inconsistency thus differs from speech dysarthria. Associated difficulties include slowed rate of speech and abnormal rhythm and intonation. The disorder often is found with concurrent nonfluent aphasia. Reliable diagnosis and treatment have not been well-developed; its incidence in stroke is undetermined.Attention: Attention is the process of enhancing detection of a signal or stimulus from the environment, to the point where it can then be acted upon. Inattention caused by stroke may either be lateralized or nonlateralized with respect to the environment.The lateralized deficit is termed "unilateral spatial neglect" (neglect for short) and is a topic of intense research. This interest may be in part because the disorder, like aphasia, is easily noticed. For example, the patient with acute severe neglect consistently gazes toward the side of hemispheric damage (Vulpian sign), in the absence of oculomotor palsy. When patients with acute neglect combined with hemiplegia (total or partial paralysis of one side of the body) are asked to clap their hands, often they wave only the relatively good hand toward the body midline repeatedly without accommodating the lack of mobility in the other hand. This "one-handed clapping" is known as the Eastchester clapping sign. There is a general decrease in the initiation of action, and in exploring toward the contralateral side of space. Such problems can hamper locomotion (including car or wheelchair navigation), eating, grooming, reading, and protecting the paralyzed limbs from injury during transfers between bed and chair. Unilateral spatial neglect may even occur in one’s imagination, for example, when describing a familiar space that is out of view. Patients are often unaware of their attentional deficit and/or associated unilateral limb paralysis.Neglect is almost invariably opposite the side of hemispheric injury rather than on the same side of injury. It is about equally common after left versus right hemisphere damage, but right unilateral neglect is typically milder and resolves more rapidly.Neglect initially occurs in about one-half of all stroke survivors, but its incidence quickly diminishes, so that by about three months after the stroke, only ~30% of survivors still have neglect. However, standard neglect assessments may underestimate its prevalence. For example, standard pen-and-paper assessments may not detect neglect, whereas requesting the patient to perform everyday activities such as self-grooming or finding one’s way in a wheelchair may produce evidence of neglect.Patients with neglect are also susceptible to nonlateralized deficits of attention, including difficulty sustaining attention (or vigilance) over several minutes, and slowed response times. The finding that acute neglect may be a biomarker for chronic disability or impaired nonlateralized visuospatial processing, even in the absence of demonstrable neglect suggests that it may not be neglect per se that is most disabling, but rather an associated general inattention disorder. Unfortunately, there has been little investigation into nonspatial attentional deficits, their effect on daily living activities, epidemiology, and natural history, let alone controlled trials of rehabilitation.Memory: When referring to memory here, we are not including the “working memory” that was indicated to be an executive function (i.e., remaining constantly mindful of a fact or task requirement), but rather the process of either learning information or reconstituting it whenever necessary without staying mindful of it (episodic memory). Routine screening tests such as the MMSE ask the patient to repeat 3 unrelated words (e.g., apple, penny, table) immediately, to ensure the patient heard and understood the words, and then to recall those words after a few minutes’ delay (typically 5 minutes) as a brief clinical assessment of memory. Most Alzheimer's patients are unable to recall the words, even in the earliest stages of the disease. Impaired memory may occur in only ~11% of acute stroke patients -- and yet, until very recently, stroke survivors were not considered to have dementia unless they had impaired memory. This requirement was based on the hallmark symptom of Alzheimer's disease, not on any understanding of the severity of the impact stroke can have on the human brain. Moreover, to this day, the vast majority of the research literature on the prevalence and severity of cognitive dysfunction caused by stroke relies on brief screening tools such as the MMSE. Note, too, that unlike most cognitive disorders, verbal memory may continually worsen over the years after a stroke, relative to healthy individuals of the same age.Emotion: Stroke can provoke a wide variety of emotional changes which tend to follow a sequence rather than occurring all at once.Initial changes may include the “catastrophic reaction” and pseudobulbar affect. Catastrophic reaction refers to short-term marked irritability, anger, anxiety, or sadness when prompted to perform a task within the first few days of stroke onset. For example, patients with acute fluent aphasia with poor speech comprehension (Wernicke aphasia) may display marked agitation. After recovery from the aphasia, patients have reported that they had felt terrified, yet they believed that they could comprehend speech ordinarily, despite clinical observations to the contrary. Pseudobulbar affect is disinhibited crying or laughter that does not match the patient’s mood. The condition has a large number of synonyms, including emotionalism, emotional incontinence, pathologic affect, pathologic laughter and crying, and pseudobulbar palsy. Pseudobulbar affect has not been studied comprehensively. Its prevalence after stroke has been reported to range from 18% to 58%. The condition can be readily misdiagnosed as depression, with which it may co-occur. Stress can aggravate the pathologic display of affect.True depression emerges a few weeks after stroke onset. In stroke survivors, depression comprises a combination of sad mood, lack of initiative, steady state rather than cyclic emotional changes, lowered self-esteem, and feelings of guilt, particularly after patients have interacted with the complex world outside of the intensive care unit. depression is exceedingly common, ranging from 40% to 60% of patients, depending on the sample. The relationship between stroke and depression is bidirectional: depression itself is a risk factor for subsequent stroke, including fatal stroke, for unclear reasons. depression carries with it an increased risk of suicidal ideation, particularly in the first 2 years. Depression is also a biomarker for general cognitive impairment147,148 and impaired activities of daily living. Fortunately, conventional antidepressant medications are efficacious for poststroke depression. Improvement in depression is associated with improved self-care skills.Poststroke fatigue, which can co-occur with other poststroke conditions such as depression, also develops relatively late after stroke onset. In stroke survivors, "fatigue" refers to declining cognitive ability that is associated with the feeling of physical or mental strain, which can disrupt even simple routine activities. Poststroke fatigue may be found in the absence of pronounced neurologic deficits and is associated with failure to return to employment. It tends to be a chronic disorder. It has a reported prevalence ranging from 23% to 75%.Informal observations noted that the attitude of the stroke survivor toward the paralyzed arm may be affected. For example, patients with right hemiplegia and global (or severe) aphasia may reach over with the left hand and repeatedly mobilize the limp arm in the first few hours after stroke onset. In contrast, patients with left hemiplegia after stroke are more apt to demonstrate marked hatred for the arm, a condition that is called misoplegia.Apathy refers to the combination of lack of goal-directed behaviors and diminished interest and concern. The incidence of poststroke apathy is 20% to 25%. The condition does not occur invariably with depression, but it does place patients at high risk for depression and suicidal ideation. Apathy has not been investigated very thoroughly in stroke patients.Diminished empathy may also follow stroke. Empathy refers to the ability to adopt the perspective of another individual with concern for that person’s goals. The study of empathy is a newly emerging focus in poststroke behavioral changes. According to a recent study, about one-half of the caregivers of patients recovering from right hemisphere stroke regarded the patients’ loss of empathy as one of their greatest stressors. As discussed under "language" above, right hemisphere stroke can make it difficult for a stroke survivor to understand sarcasm, which is one aspect of reduced empathy.Movement: The behavioral regulation of movement, particularly limb movement, can be significantly affected by stroke. As noted above, patients may exhibit unilateral motor neglect; however, another cause is learned nonuse. The difference between the two is that the former is considered to be based on a form of inattention, whereas the latter is thought to emerge from the combination of the inability of the partially paralyzed limb to perform routine self-care activities and the simultaneous compensation for such activities by the opposite, better functioning arm. Thus, learned nonuse is behaviorally conditioned by the circumstances of chronic hemiparesis (slight paralysis or weakness on one side of the body), leading to the persisting inhibition of spontaneous limb use for everyday activities.Motor neglect and learned nonuse of hemiparesis can both be improved with verbal prompting. However, the inverse relationship can also occur, i.e., movement can be inhibited after prompting. The difference depends on the extent of attention paid by the patient. For example, in the Foix-Chavany-Marie syndrome (aka anterior opercular syndrome), stroke survivors may be unable to perform movements of the mouth upon command, yet show normal movements in a more familiar context (which demands less attention), such as when presented food or in response to an emotional stimulus. A limb version of such automatic-voluntary dissociation has been proposed, termed exo-evoked akinesia, but has seldom been reported clinically. Functional movement disorder (aka conversion disorder or psychogenic neurologic disorder) is a different kind of exo-evoked akinesia that manifests as a movement failure when the patient attends to the affected limb or is commanded to move it, but improves with distraction.Ideomotor apraxia (or apraxia for short) is the failure to competently generate the movements that are specific to tool use or gestures, despite (a) having sufficient movement capability to perform nonspecific movements and (b) understanding the task requirements. The term is applied when the stroke survivor is unable to recreate movements specific to learned activities, rather than reflecting part of a more general memory disorder. Ideomotor apraxia is most often reported with respect to upper extremity function, less so for oral movements (eg, soda straw use or blowing out a match), and even less for leg use (eg, kicking a ball, stamping out a cigarette). Roughly 6-7% of stroke survivors exhibit apraxia. Apraxia is important to stroke care because it is a biomarker for impaired functional recovery.Alien hand syndrome is a mostly unilateral disorder that involves seemingly purposeful activities by one hand without the patient’s consciously intending them, as if an alternate personality were guiding them. Although various subtypes have been described, the two most often reported are frontal alien hand and callosal alien hand, named for the brain regions that are characteristically affected. Frontal alien hand involves the disinhibited grabbing of objects that are within reaching distance. Often it is then hard for the patient to release the object. Callosal alien hand involves one hand obstructing, repeating, or undoing the actions of the other hand that is under voluntary control. For example, a callosal alien hand may counteract blouse unbuttoning by the other hand. Alien hand in either form may be frustrating, humiliating, or even dangerous, such as when grasping a hot object or driving a car. Despite numerous case reports, the epidemiology of alien hand has rarely been studied because it is rare, accounting for less than 1% of stroke patients in one series.Sensory processing: Agnosias, in which a given sensory system is functioning normally but the brain misinterprets the signals from the system, are not unusual after stroke, but are not studied as much as the disorders described above, for several reasons. For example, because these disorders mostly arise from damage to posterior parts of the cerebrum, they often occur little or no effect on motor control and therefore are less likely to warrant inpatient rehabilitation. In addition, it is not unusual for patients with these disturbances to be unaware of these problems (the condition of anosognosia). [Speaking from my experience with agnosias in Alzheimer's patients, the caregiver is typically unaware of the problems, as well, and cannot begin to understand why the patient is behaving in a given way. In Alzheimer's, agnosias come and go, which further confuses efforts to figure out what is going on.]Visual agnosias may be chronic in 20% of stroke survivors. Those with loss of visual awareness -- at least for stationary objects -- to one side may initially be unaware of this loss. If they lack pronounced cognitive disorders, they can often readily discover their visual field limitation through interacting with the environment or through clinical education, and may learn to compensate for visual loss by increasing their head or eye movements to one side. However, a large percentage exhibit highly disorganized visual exploration, even in their preserved visual field for unclear reasons, and are vulnerable to accidents at busy traffic intersections or in other cluttered environments. Simple coaching and practice or formal oculomotor training may help to minimize this problem.A rare poststroke symptom of visual agnosia is the inability to recognize objects despite being capable of making elementary judgments about their properties, e.g., size and shape. Similarly, patients with auditory agnosia can point to sounds and describe some of their properties (eg, “clicking” when listening to a thumb moving along a pocket comb) without being able to specify the object responsible. A similar disturbance attends the rarely reported instance of tactile agnosia.A peculiar but little studied disorder involves the difficulty that stroke patients may have with connecting familiar percepts or concepts to each other. In particular, stroke survivors, particularly those with aphasia, were unable to color in line drawings of familiar objects with the expected colors (eg, banana / yellow). Instead, they significantly often chose unexpected colors, even though color blindness was excluded. This, accordingly, is termed color association disorder. A right hemisphere stroke patient without aphasia, however, used just a couple of colors in a line drawing of multiple familiar objects in a single plausible outdoor scene.Although such a disorder would seem to have little clinical relevance, the researchers noted that aphasic patients may also be prone to other abnormalities of percept matching, namely inability to match sounds that they heard to the most likely object in a picture array (eg, meow / cat). They also could not properly simulate object use when they were shown objects (eg, swing the arm when shown a hammer). The latter is a standard assessment of apraxia. The real-life implications of such difficulties when measured under laboratory conditions is not yet clear, but suggest a fundamental difficulty with abstraction.Hallucinations, although rare, can also follow stroke. Typically, the hallucinations are of the visual kind, i.e., seeing something that isn't there. The stroke patient may see simple geometric shapes or complex objects, or have uncontrollable reexperiencing of objects that had just been viewed (palinopsia, or visual perseveration).Still other visual disturbances for which the clinician should be aware include alexia (the inability to interpret writing or print despite being able to see it), achromatopsia (loss of color vision from brain injury), and prosopagnosia (difficulty recognizing familiar faces). The auditory analog of prosopagnosia -- i.e., the impaired ability to recognize familiar voices -- is termed phonagnosia and has been reported in stroke, but rarely studied.For more reading:https://www.researchgate.net/publication/328287207_Neuroimaging_Determinants_of_Poststroke_Cognitive_Performance_The_GRECogVASC_Study to request a copy of the full paperPuy L, Barbay M, Roussel M, Canaple S, Lamy C, Arnoux A, Leclercq C, Mas JL, Tasseel-Ponche S, Constans JM, Godefroy O. Neuroimaging Determinants of Poststroke Cognitive Performance: The GRECogVASC Study. Stroke. 2018 Nov;49(11):2666-73.This large and detailed cross-sectional study used a comprehensive, standardized neuropsychological battery to explore all cognitive domains; and assessed cognitive performance after adjusting for demographic factors to eliminate confusion between demographic factors and MRI determinants. It was not restricted to dementia or to the presence of cognitive impairment but rather analyzed the cognitive score as a continuous variable; this reflects cognitive performance more accurately and is not affected by discretization errors.Poststroke Neurocognitive Disorders Are Mostly Defined by Strategic LesionsBrainin M, Teuschl Y. Poststroke Neurocognitive Disorders Are Mostly Defined by Strategic Lesions. Stroke. 2018;49:2563–2564.These experts published an assessment of the Puy et al study.Prevalence and short‐term changes of cognitive dysfunction in young ischaemic stroke patientsPinter D, Enzinger C, Gattringer T, Eppinger S, Niederkorn K, Horner S, Fandler S, Kneihsl M, Krenn K, Bachmaier G, Fazekas F. Prevalence and short‐term changes of cognitive dysfunction in young ischaemic stroke patients. European journal of neurology. 2018 Nov 29.Most studies on poststroke cognitive impairment involve older patients. In general, the burden of cerebrovascular disease and the severity of cognitive impairment increase with age. Pinter et al studied young ischaemic stroke patients (18-55 years) for the presence and development of neuropsychological deficits.Using the Oxford Cognitive Screen to Detect Cognitive Impairment in Stroke Patients: A Comparison with the Mini-Mental State ExaminationMancuso M, Demeyere N, Abbruzzese L, Damora A, Varalta V, Pirrotta F, Antonucci G, Matano A, Caputo M, Caruso MG, Pontiggia GT. Using the Oxford cognitive screen to detect cognitive impairment in stroke patients: a comparison with the Mini-Mental state examination. Frontiers in neurology. 2018 Feb 28;9:101.ScienceDirectHu GC, Chen YM. Post-stroke dementia: epidemiology, mechanisms and management. International Journal of Gerontology. 2017 Dec 1;11(4):210-4.Domain-specific versus generalized cognitive screening in acute strokeDemeyere N, Riddoch MJ, Slavkova ED, Jones K, Reckless I, Mathieson P, et al. Domain-specific versus generalized cognitive screening in acute stroke. J Neurol (2016) 263:306–15.ScienceDirectKapasi A, Schneider JA. Vascular contributions to cognitive impairment, clinical Alzheimer's disease, and dementia in older persons. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease. 2016 May 1;1862(5):878-86Trajectory of Cognitive Decline After Incident StrokeLevine DA, Galecki AT, Langa KM, Unverzagt FW, Kabeto MU, Giordani B, Wadley VG. Trajectory of cognitive decline after incident stroke. JAMA 2015 Jul 7;314(1):41-51.Post‐stroke cognitive impairment is common even after successful clinical recoveryJokinen H, Melkas S, Ylikoski R, Pohjasvaara T, Kaste M, Erkinjuntti T, Hietanen M. Post‐stroke cognitive impairment is common even after successful clinical recovery. European Journal of Neurology. 2015 Sep;22(9):1288-94.Diagnostic criteria for vascular cognitive disorders: a VASCOG statementSachdev P, Kalaria R, O'Brien J, et al. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement. Alzheimer Dis Assoc Disord. 2015;28:206–18https://s3.amazonaws.com/academia.edu.documents/42982662/Underestimation_of_cognitive_impairments20160223-14304-1tp1wv.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1552353397&Signature=V8yclxqU%2BoKcwr7cqQdKocep0K8%3D&response-content-disposition=inline%3B%20filename%3DUnderestimation_of_cognitive_impairments.pdfChan E, Khan S, Oliver R, Gill SK, Werring DJ, Cipolotti L. Underestimation of cognitive impairments by the Montreal Cognitive Assessment (MoCA) in an acute stroke unit population. Journal of the neurological sciences. 2014 Aug 15;343(1-2):176-9.Delirium in Acute StrokeShi Q, Presutti R, Selchen D, Saposnik G. Delirium in acute stroke: a systematic review and meta‐analysis. Stroke. 2012; 43:645–649.Incidence and Prognosis of Transient Neurological AttacksBos MJ, van Rijn MJ, Witteman JC, Hofman A, Koudstaal PJ, Breteler MM. Incidence and prognosis of transient neurological attacks. JAMA 2007 Dec 26;298(24):2877-85.

Q : What was Germany's growth rate during Hitler's reign after World War 2?Thanks to Wiki.Economy of Nazi GermanyHitler at a ground breaking ceremony for the completed Reichsautobahn highway sectionPrisoner work–force in the construction of the Valentin submarine pens for U-boats, 1944LocationThe Third Reich and German-occupied Europe; forced labour predominantly from Nazi occupied Poland and the Soviet UnionPeriodGreat Depression and World War II (1933–1945)The German's economy, like those of many other western nations, suffered the effects of the Great Depression with unemployment soaring around the Wall Street Crash of 1929.[1] When Hitler became Chancellor in 1933, he introduced policies aimed at improving the economy of Nazi Germany. The changes included nationalization of key industries, autarky, and the tariffs on imports. Wages increased by 10.9% in real terms during this period.[2] However, nationalization and a cutting off of trade meant rationing in key resources like poultry, fruit, and clothing for many Germans.[3]In 1934 Hjalmar Schacht, the Reich Minister of Economics, introduced the Mefo bills, allowing Germany to rearm without spending Reichsmarks but instead paying industry with Mefo bills (Government IOU's) which they could trade with each other.[4] Between 1933 and 1939 the total revenue amounted to 62 billion marks, whereas expenditure (at times comprising up to 60% rearmament costs) exceeded 101 billion, thus causing a huge deficit and national debt (reaching 38 billion marks in 1939 and coinciding with Kristallnacht (November 1938) and with intensified persecutions of Jews and the outbreak of World War II.)[5][6] By 1938 unemployment was practically extinct.[7]Contents1 Political economy of Nazi Germany2 Hitler's views on economics3 Pre-war economy: 1933–19393.1 Record-high military spending3.2 Assessments of historical knowledge4 Wartime policies: 1939–19454.1 Forced labour4.2 Wartime production5 See also6 References7 Bibliography8 Further readingPolitical economy of Nazi GermanyEarly in his political career, Adolf Hitler regarded economic issues as relatively unimportant. In 1922, Hitler proclaimed[how?][to whom?20 Reichsmark notethat "world history teaches us that no person has become great through its economy but that a person can very well perish thereby", and later concluded that "the economy is something of secondary importance".[8] Hitler and the Nazis held a very strong idealist conception of history, which held that human events are guided by small numbers of exceptional individuals following a higher ideal. They believed that all economic concerns, being purely material, were unworthy of their consideration. Hitler went as far as to blame all previous German governments since Bismarck of having "subjugated the nation to materialism" by relying more on peaceful economic development than on expansion through war.[9]For these reasons, the Nazis never had a clearly defined economic programme. The original "Twenty-Five Point Programme" of the party, adopted in 1920, listed several economic demands (including "the abolition of all incomes unearned by work," "the ruthless confiscation of all war profits," "the nationalization of all businesses which have been formed into corporations," "profit-sharing in large enterprises," "extensive development of insurance for old-age," and "land reform suitable to our national requirements"),[10] but the degree to which the Nazis supported this programme in later years has been questioned. Several attempts were made in the 1920s to change some of the program or replace it entirely. For instance, in 1924, Gottfried Feder proposed a new 39-point program that kept some of the old planks, replaced others and added many completely new ones.[11] Hitler refused to allow any discussion of the party programme after 1925, ostensibly on the grounds that no discussion was necessary because the programme was "inviolable" and did not need any changes. At the same time, however, Hitler never voiced public support for the programme and many historians[who?] argue that he was in fact privately opposed to it. Hitler did not mention any of the planks of the programme in his book, Mein Kampf, and only talked about it in passing as "the so-called programme of the movement".[12]Hitler's views on economicsHitler's views on economics, beyond his early belief that the economy was of secondary importance, are a matter of debate. On the one hand, he proclaimed in one of his speeches that "we are socialists, we are enemies of today's capitalistic economic system",[13] but he was clear to point out that his interpretation of socialism "has nothing to do with Marxian Socialism," saying that "Marxism is anti-property; true Socialism is not."[14] At a later time, Hitler said: "Socialism! That is an unfortunate word altogether... What does socialism really mean? If people have something to eat and their pleasures, then they have their socialism."[12] In private, Hitler also said that "I absolutely insist on protecting private property... we must encourage private initiative".[15] On yet another occasion he qualified that statement by saying that the government should have the power to regulate the use of private property for the good of the nation.[16] Shortly after coming to power, Hitler told a confidant: "There is no license any more, no private sphere where the individual belongs to himself. That is socialism, not such trivial matters as the possibility of privately owning the means of production. Such things mean nothing if I subject people to a kind of discipline they can't escape...What need have we to socialize banks and factories? We socialize human beings".[17] He clearly believed that the lack of a precise economic programme was one of the Nazi Party's strengths, saying: "The basic feature of our economic theory is that we have no theory at all."[18] While not espousing a specific economic philosophy, Hitler employed anti-semitic themes to attack economic systems in other countries, associating ethnic Jews with both communism ("Jewish Bolsheviks") and capitalism, both of which he opposed.[19][20] Hitler also believed that individuals within a nation battled with each other for survival, and that such ruthless competition was good for the health of the nation, because it promoted "superior individuals" to higher positions in society.[21] At Berchtesgadenin July of 1944, Hitler gave his final speech in front of an audience. Drafted by Albert Speer, he emphasised the "self-responsibility of industry". After the war was won "private initiative of German business will experience its greatest moment". Hitler also expressed his belief in "the further development of humanity through the promotion of private initiative, in which alone I see the precondition for all real progress."[22]Pre-war economy: 1933–1939The Nazis came to power in the midst of Great Depression. The unemployment rate at that point in time was close to 30%.[23] Hitler appointed Hjalmar Schacht, a former member of the German Democratic Party, as President of the Reichsbank in 1933 and Minister of Economics in 1934.[23] At first, Schacht continued the economic policies introduced by the government of Kurt von Schleicher in 1932 to combat the effects of the Great Depression. The inherited policies included a large public works programs supported by deficit spending – such as the construction of the Autobahn network – to stimulate the economy and reduce unemployment.[24]Gross national product and GNP deflator, year on year change in %, 1926 to 1939,in Germany. Source: From data of Statistisches Bundesamt publication Pdf-file of German publication.The Great Depression had spurred state ownership in most Western capitalist countries. This also took place in Germany in the years prior to the Nazi political takeover. The Nazi Party election programs supported nationalization of major industries, though the Nazi government included a few actual policies of privatization in the 1930s.[25] Between the fiscal years 1934/35 and 1937/38, privatization was a small source of revenue for Germany’s Treasury, representing only 1.4 percent of total fiscal revenues.[26]Among companies that were privatized, were the four major commercial banks in Germany that had all come under public ownership during the prior years; Commerz– und Privatbank, Deutsche Bank und Disconto-Gesellschaft, Golddiskontbank and Dresdner Bank. Instead of making important investment decisions, and determining the use to which their funds were to be put, the private banks merely had to provide the technical facilities for covering government expenditure or financing new investment—the volume and composition of which had been previously settled by the government.[27]Also privatized were the Deutsche Reichsbahn (German Railways), at the time the largest single public enterprise in the world, the Vereinigte Stahlwerke A.G. (United Steelworks), the second largest joint-stock company in Germany (the largest was IG Farben) and Vereinigte Oberschlesische Hüttenwerke AG, a company controlling all of the metal production in the Upper Silesian coal and steel industry. The government also sold a number of shipbuilding companies, and enhanced private utilities at the expense of municipally owned utilities companies.[28]Meanwhile, the Nazis replaced the existing trade unions with the German Labour Front, controlled by the Party. It banned strikes, sacks and lockouts. The Chamber of Economics (whose president was appointed by the Reich minister of economics) absorbed all existing chambers of commerce. By 1934 these two groups merged somewhat when the Chamber of Economics also became the economics department of the Labour Front. To aid this, a board of trustees run by representatives of the party, Labour Front and Chamber of Economics was set up to centralize economic activity.[29]When it came to retail and small business, in order to coordinate workers and small businessmen, shop councils and the so-called Courts of Honour were set up to monitor retail units. Unlike Italian Fascism, Nazism perceived workers and employers in each enterprise as families; each with different roles. In real terms this meant that wages, working hours and general business practices were determined by worker councils (whose members ranged from 2 - 10) and employers, seeking a compromise.[30]In June 1933, the "Reinhardt Program" for infrastructure development was introduced. It combined indirect incentives, such as tax reductions, with direct public investment in waterways, railroads and highways.[31] It was followed by similar initiatives resulting in great expansion of the German construction industry. Between 1933 and 1936, employment in construction rose from only 666,000 to over 2,000,000.[32]Cars and other forms of motorized transport became increasingly attractive to the population, and the German motor industry boomed.[33] However, the government in Berlin banned many types of vehicles and allowed the production of only 19 different models of cars and trucks.[34] Combined with rubber shortages it created by 1939 a “drastic restrictions on the use of motor vehicles”.[35]Record-high military spendingIn 1936, military spending in Germany exceeded 10% of GNP, higher than any other European country at the time, after years of limitations imposed by the Versailles Treaty. Military investment also exceeded civilian investment from 1936 onwards.[36] Hitler faced the choice between conflicting recommendations. On one side a "free market" technocratic faction within the government, centered around Reichsbank President Hjalmar Schacht, Minister of Economics Walther Funk and Price Commissioner Dr. Carl Friedrich Goerdeler calling for decreased military spending, free trade, and a moderation in state intervention in the economy. This faction was supported by some of Germany's leading business executives, most notably Hermann Duecher of AEG, Robert Bosch of Robert Bosch GmbH, and Albert Voegeler of Vereinigte Stahlwerke AG.[37] On the other side the more politicized faction favored autarkic policies and sustained military spending.[38] Characteristically, Hitler hesitated before siding with the latter, and in August issued the "Four-Year Plan Memorandum" ordering Hermann Göring to have the German economy ready for war within four years.[39][40]The “Four-Year Plan” increased state intervention in the economy and siphoned off resources from the private sector for rearmament. Rearmament fell short of Goering’s goals, and the plan resulted in shortages and rationing for most German citizens.Historians such as Richard Overy have argued that the importance of the memo, which was written personally by Hitler, can be gauged by the fact that Hitler, who had something of a phobia about writing, hardly ever wrote anything down, which indicates that Hitler had something especially important to say.[41] The "Four-Year Plan Memorandum" predicated an imminent all-out, apocalyptic struggle between "Judeo-Bolshevism" and German National Socialism, which necessitated a total effort at rearmament regardless of the economic costs.[42]In the memo, Hitler wrote:Since the outbreak of the French Revolution, the world has been moving with ever increasing speed toward a new conflict, the most extreme solution of which is called Bolshevism, whose essence and aim, however, are solely the elimination of those strata of mankind which have hitherto provided the leadership and their replacement by worldwide Jewry. No state will be able to withdraw or even remain at a distance from this historical conflict...It is not the aim of this memorandum to prophesy the time when the untenable situation in Europe will become an open crisis. I only want, in these lines, to set down my conviction that this crisis cannot and will not fail to arrive and that it is Germany's duty to secure her own existence by every means in face of this catastrophe, and to protect herself against it, and that from this compulsion there arises a series of conclusions relating to the most important tasks that our people have ever been set. For a victory of Bolshevism over Germany would not lead to a Versailles treaty, but to the final destruction, indeed the annihilation of the German people...I consider it necessary for the Reichstag to pass the following two laws: 1) A law providing the death penalty for economic sabotage and 2) A law making the whole of Jewry liable for all damage inflicted by individual specimens of this community of criminals upon the German economy, and thus upon the German people.[43]Hitler called for Germany to have the world's "first army" in terms of fighting power within the next four years and that "the extent of the military development of our resources cannot be too large, nor its pace too swift" [italics in the original] and the role of the economy was simply to support "Germany's self-assertion and the extension of her Lebensraum".[44][45] Hitler went on to write that given the magnitude of the coming struggle that the concerns expressed by members of the "free market" faction like Schacht and Goerdeler that the current level of military spending was bankrupting Germany were irrelevant. Hitler wrote that: "However well balanced the general pattern of a nation's life ought to be, there must at particular times be certain disturbances of the balance at the expense of other less vital tasks. If we do not succeed in bringing the German army as rapidly as possible to the rank of premier army in the world...then Germany will be lost!"[46] and "The nation does not live for the economy, for economic leaders, or for economic or financial theories; on the contrary, it is finance and the economy, economic leaders and theories, which all owe unqualified service in this struggle for the self-assertion of our nation".[46]World prices for raw materials (which constituted the bulk of German imports) were on the rise. At the same time, world prices for manufactured goods (Germany's chief exports) were falling. The result was that Germany found it increasingly difficult to maintain a balance of payments. A large trade deficit seemed almost inevitable. But Hitler found this prospect unacceptable. Germany began to move away from partially free trade in the direction of economic self-sufficiency.[47] Hitler was aware of the fact that Germany lacked reserves of raw materials, and full autarky was therefore impossible. Thus he chose a different approach. The Nazi government tried to limit the number of its trade partners, and, when possible, only trade with countries within the German sphere of influence. A number of bilateral trade agreements were signed between Germany and other European countries (mostly countries located in Southern and South-Eastern Europe) during the 1930s. The German government strongly encouraged trade with these countries but strongly discouraged trade with any others.[48]Main article: Adolf Hitler § Rearmament and new alliancesBy the late 1930s, the aims of German trade policy were to use economic and political power to make the countries of Southern Europe and the Balkans dependent on Germany. The German economy would draw its raw materials from that region, and the countries in question would receive German manufactured goods in exchange.[49] Germany would also leverage productive trade relationships with Spain, Switzerland and Sweden in areas ranging from iron ore imports and clearing and payment services.[50] Throughout the 1930s, German businesses were also encouraged to form cartels, monopolies and oligopolies, whose interests were then protected by the state.[51]Assessments of historical knowledgeA major historiographical debate about the relationship between the German prewar economy and foreign policy decision-making was prompted in the late 1980s, when the British Marxist historian Timothy Mason claimed that an economic crisis had caused a "flight into war" in 1939. Mason argued that the German working-class was opposed to the Nazi dictatorship in the over-heated German economy of the late 1930s.[52] However, Mason’s thesis was debunked by historian Richard Overy who wrote that Germany's economic problems could not explain aggression against Poland and that the reasons for the outbreak of war were due to the ideological choices made by the Nazi leadership. For Overy, the problem with Mason's thesis was that it rested on the assumptions not shown by records.[53] Overy argued that there was a difference between economic pressures induced by the problems of the Four Year Plan, and economic motives to seize foreign industry, materials and reserves of neighboring states.[54] Meanwhile, Adam Tooze argued that from 1939 onwards, in spite of the military successes in the West, the German economy became dependent on vital imports from the East.[55] Tooze saw this as a reason for Hitler to attack the Soviet Union, because "[t]he Third Reich had no intention of slipping into that kind of humbling dependence that Britain now occupied in relation to the United States, mortgaging its assets and selling its secrets, simply to sustain its war effort".[56] Up to Operation Barbarossa the German economy could not "do without Soviet deliveries of oil, grain, and alloy metals."[57] The Four-Year Plan was discussed in the controversial Hossbach Memorandum, which provides the "minutes" from one of Hitler's briefings. The Four-Year Plan technically expired in 1940.[58]Wartime policies: 1939–1945Main articles: SS-Wirtschafts-Verwaltungshauptamt, DEST, Deutsche Wirtschaftsbetriebe, and ArbeitseinsatzMonowitz concentration camp Buna-Werke (Auschwitz III)Hermann Göring had built up a power base that effectively controlled all German economic and production matters from the invasion of Poland in 1939. In 1942 the growing burdens of the war and the death of Fritz Todt in 1942 saw the economy move to a full war economy under the efficient[59] leadership of Albert Speer. Due to state control, business had little entrepreneurial freedom[34] in a regime that has been described as "command-capitalism".[60] In place of ordinary profit incentives guiding the economy, financial investment was regulated as per the needs of the state. The profit incentive for businessmen remained, but was greatly modified; Nazi agencies replaced the profit motive that automatically allocated investment, and the course of the economy.[61] Rationing was introduced in 1939. Britain immediately put their economy on a war footing, Germany resisted equivalent measures until later in the war. They were ideologically opposed to women participating in the work force. The top personal income tax rate in 1941 was 13.7% in Germany as opposed to 23.7% in Great Britain.[62]The beginning of the Hitler's war resulted in a British blockade which seriously restricted German access to world markets. Petroleum, sugar, coffee, chocolate and cotton were all extremely scarce. Germany used coal gasification to replace petroleum imports to a limited extent, and relied on Romanian oilfields at Ploiesti. Germany was dependent on Sweden for the majority of their iron ore production, and relied on Spain and Portugal to provide tungsten. Switzerland continued to trade with Germany, and was very useful as a friendly neutral to Germany. Until the declaration of war of the Soviet Union, the Third Reich received massive supplies of grain and raw materials from the USSR, which they paid for with industrial machinery, weapons and they even sold German designs for a battleship. This economic dependence on the Soviet Union was exemplified when in spring 1940 the Soviet Union asked for two chemical plants as compensation for raw materials. The Germans declined after intervention of the military.[56]Cherkashchyna Ukrainians being deported to Germany to serve as slave labor (OST-Arbeiter), 1942During the war, as Germany acquired new territories (either by direct annexation or by installing puppet governments in defeated countries), these new territories were forced to sell raw materials and agricultural products to German buyers at extremely low prices. Hitler's policy of lebensraum strongly emphasized the conquest of new lands in the East, and the exploitation of these lands to provide cheap goods to Germany. In practice, however, the intensity of the fighting on the Eastern Front and the Soviet scorched earth policy, meant that the Germans found little they could use and, on the other hand, a large quantity of goods flowed into Germany from conquered lands in the West. For example, two-thirds of all French trains in 1941 were used to carry goods to Germany. Norway lost 20% of its national income in 1940 and 40% in 1943.[63]Fiscal policy was also directed towards exploitation of conquered countries, from which capital was to be gathered for German investments. Banks, such as Bank Emisyjny w Polsce, were created to manage local economies.[64]Forced labourMain articles: Forced labour under German rule during World War II and OST-ArbeiterEven before the war, Nazi Germany maintained a supply of slave labour. "Undesirables" (German: unzuverlässige Elemente), such as the homeless, homosexuals, and alleged criminals as well as political dissidents, communists, Jews, and anyone else that the regime wanted out of the way were imprisoned in labour camps. Prisoners of war and civilians were brought into Germany from occupied territories after the German invasion of Poland. The necessary labour for the German war economy was provided by the new camp system, serving as one of the key instruments of terror. Historians estimate that some 5 million Polish citizens (including Polish Jews) went through them.[65]Polish-forced-workers' badgeIn German-occupied Poland, the network of slave labor camps contained 457 complexes with dozens of subsidiary camps scattered over a broad area. At the Gross-Rosen concentration camp (to which Polish nationals were brought in from the annexed part of Poland) the number of subcamps was ninety seven (97).[66] Under Auschwitz, Birkenau, and Auschwitz III (Monowitz) with thousands of prisoners each, the number of satellite camps was forty-eight (48).[67][68] Stutthof concentration camp had forty (40) subcamps officially and as many as 105 subcamps in operation,[69] some as far as Elbląg, Bydgoszcz and Toruń, 200 kilometres (120 mi) from the main camp.[70][71] The Deutsche Reichsbahn acquired new infrastructure in Poland worth in excess of 8,278,600,000 złoty,[72] including some of the largest locomotive factories in Europe, the H. Cegielski – Poznań renamed DWM, and Fablok in Chrzanów renamed Oberschlesische Lokomotivwerke Krenau as well as the locomotive parts factory Babcock-Zieleniewski in Sosnowiec renamed Ferrum AG later tasked with making parts to V-1 i V-2 rockets also.[73] Under the new management, formerly Polish companies began producing German engines BR44, BR50 and BR86 as early as 1940 with the use of slave labor.[74]Hundreds of thousands of people in occupied territories were used as slave labour by leading German corporations including Thyssen, Krupp, IG Farben, Bosch, Blaupunkt, Daimler-Benz, Demag, Henschel, Junkers, Messerschmitt, Philips, Siemens, and Volkswagen,[75] on top of Nazi German startups which ballooned during this period,[76] and all German subsidiaries of foreign firms including Fordwerke (Ford Motor Company) and Adam Opel AG (a subsidiary of General Motors).[66] By 1944, slave labour made up one quarter of Germany's entire work force, and the majority of German factories had a contingent of prisoners.[77] In rural areas the shortage of agricultural labour was filled by forced laborers from the occupied territories of Poland and the Soviet Union. The children of these workers were unwanted in Germany,[78] and usually murdered inside special centres known as Ausländerkinder-Pflegestätte.[79]Wartime productionThe proportion of military spending in the German economy began growing rapidly after 1942, as the Nazi government was forced to dedicate more of the country's economic resources to fight a losing war. Civilian factories were converted to military use and placed under military administration. From mid 1943 on, Germany switched to a full war economy overseen by Albert Speer. By late 1944, almost the entire German economy was dedicated to military production. The result was a dramatic rise in military production, with an increase by 2 to 3 times of vital goods like tanks and aircraft, despite the intensifying Allied air campaign and the loss of territory and factories. Restaurants and other services were closed to focus the German economy on military needs. With the exception of ammunition for the army, the increase in production was insufficient to match the Allies in any category of production. Some production was moved underground in an attempt to put it out of reach of Allied bombers.From late 1944 on, Allied bombings were destroying German factories and cities at a rapid pace, leading to the final collapse of the German war economy in 1945 (Stunde Null). Food became drastically scarce. Synthetic fuel production dropped by 86% in eight months, explosive output was reduced by 42% and the loss of tank output was 35%.[80] The Allied bombing campaign also tied up valuable manpower, with Albert Speer (Germany's Minister of Armaments) estimating that in the summer of 1944 between 200,000 and 300,000 men were permanently employed in repairing oil installations and placing oil production underground.[81]

- - - - - - - - - -In response to others:In response to my down-thread comment:“… Rather discriminatory, and whimsically and baselessly so. I see no reason presented as to why anyone else has superior rights over otherwise legally equal separate individual born people ...”Prior post:“… What specifically do you disagree with? …”Okay, where do we start?Of course, why is there any call at all for any law paying attention, as if law has any jurisdiction within the sovereign body of a separate individual born person?Does anyone have any basis or support for such invasion from within our founding and definitive documents and principles?There’s really no need to even review the list in the prior post until a basis is established first as to the items in the list existing as tethered in any way to the purpose of law.Personal?Fine.Publish a book, write an advice column.Law?Um … no.- - - - -Now to the list from the prior post, a list that has no reason or basis for existing in law, certainly not until the above objection is overcome.Abortion would be legal until 22 weeks pregnancy for any reason.This requires invasive awareness and reporting of someone’s legally private medical information, which is not legally discoverable by anyone else.Why inflict this on only a subset of otherwise legally equal people?Why inflict this over only one medical procedure?Doctors would be free to refuse to perform elective abortions, but would be required to provide referrals.For at least 50+ years in the US, if any goods and services and opportunities are available to the public, then those goods, services, and opportunities must be equally available to all legally equal people.If someone prefers to select their customers, prefers to only offer their goods, services, and opportunities to only a selection of their own choosing, they can go private, like a religion or a private club with non-public access.Otherwise, serves black people at a white-person-owned lunch counter, provide equal access for people in wheelchairs, photograph a same-sex marriage ceremony regardless of the photographer’s discomfort with same-sex partnersing, bake the so-called gay wedding cake, deliver the so-called gay flowers for a same-sex wedding celebration, rent the wedding chapel to whomever applies, and so on.Arbitrary discrimination in public accommodations is prohibited for a reason.A legal reason.“… Bbuutt … it’s a personal service …”Just like photography or wording on a printed T-shirt, a service-for-hire that belongs to the buyer, not the seller, it’s the buyer’s speech, not the seller’s.This is settled law, well precedented.For a reason.Prior to abortion, the woman would receive counseling to make sure that she is not being forced or coerced, to get her help if she had been a victim of rape, and to make sure she is aware of her alternatives.Because … the law establishes religion and treats otherwise legally equal people differently because of their sex/gender?Why would the law require someone be lectured on vegan vegetarian macrobiotic diet, massage, meditation, yoga and other exercise modalities before being legally allowed to access fulfilment of their doctor prescriptions for hear and blood vessel repair?I’m all for it … as personal marketing.But inflicted by law?Something about prohibitions against establishing religion comes to mind.You may think that other people need to be lectured at before they make decisions that you may not think you agree with ( even though others who have equally protested against abortion have gone off and gotten their own abortion immediately without ascending to any intermediary “permission” from anyone - hypocrisy will out ).Abortion wouldn’t be directly publicly funded, but organizations that include the service would be, and secular insurance companies would be required to cover the procedure.Again, why would the law arbitrarily discriminate in the paying of state-licensed physician’s prescriptions and procedures for only some people, for only some prescriptions and procedures?Military and other federal, state, and local government employees?The homeless, the imprisoned, the institutionalized?Second class citizenship much?Minors would have to get parental consent for abortion, just like for any medical procedure, but if consent wasn’t granted they could get it from a judge instead.Finally the presentation of reasons, perhaps legal reasons for differentiating between one otherwise legally equal public resident and another legally equal public resident - age of legal majority.And finally there is the presentation of “all” medical procedures, not arbitrarily one procedure.However, there is no basis for claiming that parents or a judge have superior jurisdiction inside the sovereign body of a separate individual born person of any age, especially considering that “sexual intercourse” is a usual activity before pregnancy, there is no equivalent parental or judge prior approval or restraint of such activity, and such activity is legally private and not discoverable by others without the express permission of the participants, at least the pregnant participant to divulge their own legally private activities that do not depend on anyone else’ permission or knowledge or approval.I believe the appropriate aphorism is “… putting the cart before the horse …” or “… closing the barn door after the horse has left …” ( agrarian references ! ) when trying to regulate and control pregnancy first, after the inability to regulate and control sexual intercourse.Arbitrary much?After 22 weeks, abortion would only be legal if at least two doctors agreed that the fetus would not survive infancy and would be in unmanageable pain, or if abortion was necessary to save the life or long term physical health of the mother, and induction or a c section were not possible (this could be approved afterwards in cases of medical emergency if it were determined that the doctor was acting in good faith and had made a reasonable decision based on available information).Great marketing for second-opinion doctors to make money.Why not for every operation?Why not for everyone?Arbitrary much?Why not for everything?Why not the same for auto construction or repair - legally required paid estimates by two state-licensed mechanics or certified factories before any construction or repairs are permitted ( Ford must get paid second opinions from Chrysler and General Motors, before building a vehicle, for example ) - after all, automobiles are highly regulated for pollution and safety, and so on?Why not the same for building construction or repair - legally required paid estimates by two state-licensed architects and construction contractors before any construction or repairs are permitted - after all, buildings are highly regulated for safety and ADA Americans with Disabilities access, and so on?And so on, and so on.Are you suggesting that the taxpayer cover the cost of legally required second opinions?Doctors have a special financial gift to tap into extra income by legal fiat?Special interests lobbyist much?And again, there is no legal basis in our founding and definitive documents and principles for anyone having superior rights over the inborn unalienable equal rights of an already existing separate individual born person.We instituted our government to secure our individual rights.Not to subordinate our individual rights to other people’s ignorance, fear, and hateful bigoted prejudice.Or even subordinate anyone to other people’s supposedly good intentions ( which, as they say, lead to hell )Just sayin’.- - - - - - - - - -Prior post:“… The reason the government should get involved is to prevent murder, which is what the non medical killing of a viable fetus is, pure and simple murder. This isn’t just refusing to donate a kidney, it’s deliberately, actively ending someone’s life, the same as if I stabbed you in the heart …”Thank you for calling on “murder” as the reason you believe that the government should regulate abortion.Thank you, that is about the government, sort of.However:we do not have preventative policing, we prosecute crimes after the fact, not before they happen.“murder” applies to a born person, not an unborn non-person,the government has no jurisdiction inside the sovereign body of an already born separate individual person.Please stop.Please take some time to go and read our credo and promise of our Declaration of Independence, our contract of our Constitution, Amendments, and case law, and keep reading and exploring and following references until you can find any basis in our founding and definitive documents and principles for the government to regulate abortion.In our founding and definitive documents and principles.Thank you.- - - - -PS - Your inventive ad hoc faux definition of murder implies that medical killing cannot be murder, somehow - what, doctors and nurses and hospital staff are immune to malpractice liability for their patient’s death, pharmaceutical and medical equipment manufacturers are immune from liability for the deaths of people who suffer and die from using their defective products, and so on?Please, stop, go away, and look stuff up.- - - - - - - - - -So, you’re having difficulty pausing, and going off to read our credo and promise of our Declaration of Independence, our contract of our Constitution, Amendments, and case law, eh?I’ll wait while you find a basis in our founding and definitive documents and principles for the government to regulate and prohibit abortion.- - - - -Especially considering that your reiterations aren’t making much sense on their own, regardless of being untethered from our founding and definitive documents and principles.Prior post:“… 1. It is illegal to commit murder. Obviously someone can’t be arrested until after the fact, but the law bans it, just as it should ban post viability abortion (and in many states does) …”I appreciate there are laws not based on our Constitution that are written by legislators, especially legislators vying for re-election, who hope to get their voters enraged and energized to vote for them, and so they often write laws that have no constitutional basis, but only are vehicles for getting their voters to the ballot box.Abortion was made illegal by legislation … until it was adjudicated to be a constitutionally recognized, supported, and protected right, thereby nullifying legislative prohibitions ... and yet legislators are still at it, trying to make a Constitutionally recognized, supported, and protected right illegal once again.The way Republicans are trying to make it illegal for black people to vote - endless circuitous laws to undo a Constitutionally recognised, supported, and protected right.Though you say there are laws against abortion, you, and the legislators, have not established any basis in our founding and definitive documents and principles for the government to regulate and prohibit abortion.I’ll wait while you find a basis in our founding and definitive documents and principles for yout call for the government to regulate and prohibit abortion.- - - - -Prior post:“… 2. Murder applies to whoever the government decides it applies to. Some states extend it to the unborn under certain circumstances, others don’t. Murder is a legal concept …”Calling abortion murder does not make it so.Though murder has many different legal interpretations and classifications, manslaughter, degrees, and so on, it is generally considered to be killing a separate individual born person.A zygote/fetus isnot separate,not individual,not born,not a person.You yourself assessed a zygote/fetus as potential, as potentially viable.Not separate,not individual,not born,not a person.And it’s inside the jurisdiction of an existing separate individual born person.Aanndd ssoo … what is the basis in our founding and definitive documents and principles for your call for the government to regulate and prohibit abortion?- - - - -Prior post:“… (and no, denying someone a kidney isn’t murder anywhere, nor is refusing to donate food, charity isn’t required, but you can’t actively end someone’s life whether you are a doctor or otherwise) …”I’m not sure I understand how you find a difference - in both cases an entity of some sort will die if you do not donate your body to save it.So if you cannot identify a difference, then what is your basis in our founding and definitive documents and principles for your call for the government to find a difference?- - - - -Prior post:“… 3. The government very much has control of people’s bodies. Hence regulations on drug use, prostitution, euthanasia, and yes, abortion …”Where is there any basis our founding and definitive documents and principles for the government to regulate “drug use”, “prostitution”, “euthanasia”, such that it informs your call for the government to similarly regulate and prohibit abortion?“Drug use” is mostly “regulated” by state-licensed-physician’s prescription, so, are you saying that if there’s a state-licensed-physician’s prescription for an abortion, then there’s no problem?“Prostitution” regulates money transactions, but does not regulate interpersonal behavior and sexual activity, so, are you suggesting that if abortion is free, then there is no problem?“Euthanasia” is killing a separate individual born person, by someone who is not threatened or at risk or invaded, perhaps you are thinking of assisted suicide, so, are you saying that self-requested voluntary abortions are no problem?- - - - -We can volloy all year, all decade, and get nowhere, you will still believe that government should regulate and prohibit abortion, and I will still believe that government has no jurisdiction.I have tethered my presentation to our founding and definitive documents and principles:We instituted our government to secure our individual rights,our inborn unalienable equal individual rights,to our own life, to our own liberty, and to our own pursuit of our own happiness,without discrimination in government and public accommodations.Considering thata fertilized-egg, embryo, blastocyst, zygote, fetus is not born,… and considering thatit is inside the body of an already existing separate individual born person,… then the government has no basis for jurisdiction.I’m asking you to substantiate your beliefs, that government should regulate and prohibit abortion, by establishing a basis in our founding and definitive documents and principles for the government to regulate and prohibit abortion.Thanks for exploring this.- - - - - - - - - -Prior post:“… The Constitution doesn’t say anything about abortion …”Nor breathing.Your point?- - - - -Prior post:“… States may pass any laws they want as long as it doesn’t directly contradict the Constitution …”Nope.States pass unconstitutional laws all the time.The most recent round of anti-same-sex-marriage laws is an excellent example, resolved by being tossed as unconstitutional by the Supreme COurt.The recent round of anti-abortion legislation is another example, waiting for the Republicans to push their own presumably anti-abortion judges onto the Supreme Court.- - - - -Prior post:“… If you sell heroin and get caught you are in trouble, and arguing that there is nothing prohibiting you from doing it in the Constitution is not going to get you out of it …”What is it that you believe is in our founding and definitive documents and principles that empowers the government to regulate and prohibit selling heroin, such that it informs you that the government is similarly empowered to regulate and prohibit abortion?And again, are you saying that it’s a money thing - “… selling …” - such that if abortion did not involve the transactional exchange of money, there would be no problem?- - - - -Prior post:“… My problem is actively killing a human being, equal in value to you and I, simply because the person carrying it wants it dead …”Jurisdiction?What about our founding and definitive documents and principles gives the government jurisdiction inside the body of an already existing separate individual born person?- - - - -I appreciate your “… problem …”, but all your protestations belong outside government.Write a book, blog, preach on the street corner to anyone who will listen.Your audience is those who may participate in pregnancy, should they decide to listen to you.Your audience is not the government.Claiming that the government has listened before to compromise the inborn unalienable equal rights of otherwise legally equal people is not a basis for the government to regulate and prohibit abortion.“… because we’ve gotten away with it so far …” is not an argument born of our founding and definitive documents and principles.- - - - -Here, I’ll do the work.The closest you come to establishing governmental jurisdiction is to claim that the fetus is potentially viable.However, you have not established any basis for government disregarding and invading the jurisdiction of an already existing separate individual born person.The “… potentially viable …” has no basis in our founding and definitive documents for overriding the inborn unalienable equal rights of an already existing separate individual born person.Because that’s what we instituted our government for:to secure our inborn unalienable individual rights,not to secure any imagined rights of the “… potentially viable …” but not separate, not individual, not born, non person,And definitely not as superior to already existing separate individual born persons.You are claiming that some class of separate individual born people can only have recognition, support, and protection of their otherwise inborn unalienable supposedly equal rights if they uniquely can justify their rights to people they have never met, to people who have never met them, to people who have absolutely nothing to do with their lives.To elected legislators and judges.Whimsically.Arbitrarily.Discriminatorily.Only some class of people demoted to such second-class citizenship.And therein lies the second offence against inborn unalienable individual equal rights - discrimination.Government has no jurisdiction inside the body of an already existing separate individual born person.And government is prohibited from discriminating between otherwise legally equal people.No, you have not found any basis in our founding and definitive documents and principles for government jurisdiction, nor for government to discriminate, by regulating and prohibiting abortion.All you have offered is:“… because we’ve gotten away with it so far …”and “… because I have a problem with it …”- - - - - - - - - -Prior post:“… A viable fetus is a person, and should be recognized as such by law. They are potentially capable of being born and surviving, meaning that they are not reliant on the body of the pregnant woman. The law should be about protecting people. This includes viable fetuses …”I appreciate your claim about “persons” … somewhere.You seem unable to acknowledge that your supposed “person” isnot separatenot individualnot bornand therefore not a person… and jurisdictionally, it is INSIDE an already existingseparateindividualbornperson,… who just happens to be in the jurisdiction of a government that was instituted to secure their rights, not the supposed imagined-by-you rights of whatever else you think has rights.The meta message I hear from you is directed at people who can participate in pregnancy, because they have jurisdiction over whatever goes on inside their bodies.Your message is not directed at government because government was instituted to secure the rights of separate individual already born people, who have jurisdiction over whatever goes on inside their bodies.While I appreciate your invention of a “person” by some other definition :“… potential viability if only their jurisdiction somehow magically changed from outside the government’s jurisdiction to inside the government’s jurisdiction …”… no, you have not established any basis in our founding and definitive documents and principles for government to regulate and prohibit abortion just because you’ve decided to move the definition of a “person” to be whatever you think it means ( some believe a “person” begins at egg-and-sperm fertilization, some people believe a person begins at conception”, which is funny, because “conception” is a religious term, and it’s something the pregnant person does, not something a sperm and egg do, but reality and making sense are not some people’s forte ).Nor have you tethered your call for legalized discrimination to any founding and definitive documents and principled.Again, I get it, I understand your point - if we change the legal definition of “person”, then you believe that government would have jurisdiction inside an already existing person.That still does not legally demote that already born person to second class citizenship overriding their own jurisdiction over the inside of their own body.Nor does that permit discrimination.You seem to be agreeing with me - that our founding and definitive documents and principles do not support having government regulate and prohibit abortion, so we’d have to “amend” our constitution to:make potentially pregnant people second class citizenswith special discrimination to have no jurisdiction over the inside of their own bodies.What was it you wrote?“… I would not want to live in a society of people who disagree …”We’ve fought long and hard for legal inclusive equality and equal autonomy for women.Your challenge would beto find a legal way to prevent abortion without eliminating inclusive equality,without eliminating sovereignty over one’s own body,and without discriminating between legally equal people.Making personal appeals to people who can become pregnant?Others suggestearly and comprehensive sex and “contraceptive” education,freely and readily available “contraceptives”,financial, health, housing, food, education, employment support for pregnant people and their children,especially after birth.Do you think you can move the fundamentalist religionist conservatives and Republicans to do that?- - - - - - - - - -Prior post:“… conjoined twins …”Separate individual born person includes conjoined because they are … wait for it … born.No need to do a thought experiment comparing conjoined twins to abortion.Analogies are best used to learn about something new to us by exploring something that we think is familiar to us.Such as:what if another born person attached themselves to us, would government be responsible for separating them from us?what if a non-born attached themselves to us, would government be responsible to separate it?what if another born person attaches a non-born to us, would government be responsible for separating us?Those explorations may help us understand aborting a pregnancy, and perhaps killing the non-born, versus already born conjoined twins.- - - - - - - - - -Regardless, your desire for government to “care” about the non-born is not based on our founding and definitive documents and principles.And ignores the individual rights of the already born.And government regulating and prohibiting abortion is also arbitrary baseless discrimination.Thanks for confirming what I have been telling you all along.You have shared nothing new.I fully understand your personal preference regarding the unborn.- - - - - - - - - -Prior post:“… I don’t see birth as being morally defining …”Yes, I know that.Our founding and definitive documents and principles see birth as legally defining regarding jurisdiction.As I wrote, your protestations are appropriate for books, blogs, street-corner preaching, to those who can participate in pregnancy and are willing to listen.Your own personal preferences for your own self are inappropriate for our government to take action on in the form of regulating and prohibiting abortion because we instituted our government to secure the rights of already born individuals, individuals whom you seem to ignore throughout this discussion, individuals whom our government has an assigned duty not to ignore.- - - - - - - - - -Prior post:“… Nowhere in any of our founding documents does it say that birth is morally defining. No where!!! You just made that shit up and haven’t even been able to cite specifically what you are referring to …”Founding and definitive documents and principles.I have no idea where or why you are stuck on the “… morally …” anything.I wrote about:legally,jurisdiction,discrimination.“Morals” are a personal thing, not a government thing.See https://www.quora.com/What-would... for the references you seek.All I’ve ever asked you for is a basis in our founding and definitive documents and principles for government to regulate and prohibit abortion, and you have found none, exceptto claim that right to life includes the unborn.there have been laws and supreme court decisions regulating and prohibiting abortion,you consider it immoral to kill the unborn.None of which are supported by our founding and definitive documents and principles.And you have not addressed the rights of the born, nor discrimination by government, regarding regulation and prohibition of abortion.You have proclaimed your preferences.It’s up to you to find a basis for government to enforce your preferences on others, considering:legally,jurisdiction,discrimination.Thank you.- - - - - - - - - -Prior post:“… None of these things have to do with whether or not someone is born according to the Constitution. It isn’t mentioned anywhere!!! I feel like I’m talking to a fucking brick wall …”Yes, I appreciate that you find it impossibly hard to use a search ( [ Ctrl ] [ F ] ) for the word “born” in our founding and definitive documents and principles when you open them in any program ( web browser, PDF reader, word processor ), especially when I quoted some of them in this thread and referred you to re-read them.That brick wall you are facing is your own inability to look stuff up, even to read stuff when it’s quoted to you in this thread, and reference linked to you again.Here, a third direction:https://www.quora.com/What-would...- - - - - - - - - -Prior post:“… None of those are about whether it’s ok to kill someone who hasn’t been born. I’ve got to say that usually I’m a pretty strong constitutionalist, but you are way too hung up on 240 year old documents and not enough on basic humanity …”Yes, I clearly see the brick wall you have built for yourself that prohibits you from seeing beyond it.Our contract of our Constitution, Amendments, case law, legislation, do not “permit” or “allow” anything.Because “law”, “government”, have no rights to give, to “permit”, to “allow”, to say “its ok to” do something.We the people, individually, have all the rights just by being born.Inborn unalienable individual equal rights.For example,I don’t need written permission from “law” or “government” in order to breathe.The right to breath is not written anywhere.Because it does not belong to “government” or “law”.The right to breathe belongs to me, as an separate individual born person, it’s one of my many non-enumerated inborn unalienable equal individual rights.Some rights have been adjudicated and enumerated, such as the right to privacy, the right to abortion, the Constitutionally recognized, supported, and protected right to abortion.Before it was enumerated, we already had those rights, those rights to privacy and abortion, but because they were challenged, they had to be fought for and won and adjudicated and enumerated in order to protect them.“… The price of freedom is eternal vigilance ...”.Yes, we have to fight for our rights, constantly fight for our rights, fight against those who would take them away.- - - - -Prior post:“… None of those are about whether it’s ok to kill someone who hasn’t been born. I’ve got to say that usually I’m a pretty strong constitutionalist, but you are way too hung up on 240 year old documents and not enough on basic humanity …”You seem to be forgetting the “… basic humanity …” of the already existing separate individual born person.You seem to be calling for their inborn unalienable equal individual rights to be disregarded.You seem to be calling for their Constitutionally recognized, supported, and protected rights to be disregarded.That’s why I suggested that your protestations are best served via free speech venues to any audience who cares, anyone who may become involved in pregnancy.But your protestations have no place in government or law, who already have the assigned duties to secure the individual rights of born people.The unborn are not within the jurisdiction of government and law.Because they are in the jurisdiction of the sovereign body of an already born person.- - - - -I hear you loud and clear, especially when you agree that your preferences are not in the constitution, when you write:“… usually I’m a pretty strong constitutionalist, but you are way too hung up on 240 year old documents and not enough on basic humanity …”In other words, you are saying:“… yes, the constitution does not give jurisdiction to the state to regulate or prohibit abortion, so instead of the constitution, I am appealing for extra legal respect for what I call basic humanity, regardless of the constitution …”Which is how I have assessed your presentation all along.You agree with my assessment of your presentation.But you argue as if you disagree.Again, your protestations are best served via free speech venues to any audience who cares, anyone who may become involved in pregnancy.But your protestations have no place in government or law, who already have the assigned duties to secure the individual rights of born people.The unborn are not within the jurisdiction of government and law.Because they are in the jurisdiction of the sovereign body of an already born person.- - - - -We have been down this exact same discussion with every one of our diological iterations.I am guessing that you will be satisfied if I responded:You’re right, abortion is horrible and should be regulated and prohibited as the government and the law see fit.Perhaps, equivalently, I will be satisfied if you responded:You’re right, abortion is a constitutionally protected right, but I want pregnant people to know that it’s horrible nonetheless, and I want to persuade them not to do it.Our discussion has hardly evolved over the course of many many rounds.- - - - - - - - - -Prior post:“… I am absolutely not going to respond the way you want me to. You have only made me more firm in my position through your peskyness …”No one can make another person believe anything or behave in any particular way.That’s pretty much the whole point of this dialog.I take responsibility for my beliefs and my behaviors.- - - - - - - - - -Question added by User-12742834866209874091 “… What would your ideal set of abortion laws look like? (What would your ideal set of abortion laws look like?) …” #917034319 · Thank · Report · 27 Nov 2019 11:50 AM.