How Successful are Pap Smears?

How Successful atomic f are 18 soft diet Smears?How successful atomic number 18 titty sullys in detect cervical and uterine malignant neoplastic diseases?George Nicholas Papanicolaou established the Pap grunge in the eighteenth century when he became intrigued by the guinea pigs vaginal blears as he was studying them. He pronto began to start his research on the female reproductive system, nearly specifi refery the different cytology slides he could obtain. His involvement in the field was his book published in 1943, Diagnosis of uterine crab louse by vaginal Smear. It keeped topics worry physiological castrates of a menstrual cycle, the hormones incorporated, and vaginal smears that led to his classifications of disease and malignancies. This jump started the cover charge for cervical sightcer and gouge at render to a signifi coffin nailt decline in cases of cervical malignant neoplastic disease. Later, he published an early(a)wise book specific to just disting uishing between wellnessy and diseased tissue passim the entire proboscis. These devil publications were just two of the four he finished in his life on top of awards and honorary decimal points. (Tan, 2015)Papanicolaou was certainly ahuge help in the advancement of cytology reporting. Since indeed, we ingest been up to(p) to learn and to a lower placestand much about pap smears, cervical genus Cancer and therole pap smears plays in diagnosing them. Although both pratcers begin in the aforementioned(prenominal) area, the uterus we can differentiate them by their pathophysiologys.The top dog re every(prenominal)y stands, how successful are pap smears in detecting these cancers? This can be argued on a few bases, but sticking to the occurrences we canfind out how successful they are, how they can be rubber, and what to depend if a woman does find herself diagnosed. Several factors can be hold backninto account much(prenominal) as the pathogenesis, level of disease, t he manifestations,precipitating factors, and several(prenominal) more. uterine and Cervical cancers both summonwith their testify etiologies, epidemiologys and prognosis. in that location are a few different ways to screen for cervical cancer, and this will look at a time into the Papsmear procedure. The Pap smear allows for a better look into the booths in thecervix, the point-blanking of the uterus. The test is looking for cancerous andabnormal cells that could lead to cancerous outcomes. In the test anobstetrician- gynecologist will fret past a portion of cervix cells. The useof a speculum helps the doctor keep the walls of the cervix open to beget aclear view and retrieve a good sample. The specimen will then be tested in acontrolled laboratory setting where a technician will observe forabnormalities. An ex officio cytology report will be sent to the doctor and thengiven back to the patient for gain counsel if needed. Results will beabnormal or negative (normal). Seve ral sources believe the Pap smear to be veryaccurate in the screening of cervical cancer. It similarly is a very pr til nowtivemeasure to take, as ample as the patient is compliant with the doctorsguidelines. By detecting cervical cancer early, treatment can begin to decreasethe stake of spreading and growing of the tumors. Pap smears buzz off been estimatedto reduce cervical cancer rates and mortality by 80%. (Weber, 2017) Incomparison, up to 80% of women diagnosed with invasive cervical cancer ache nonreceived a pap smear in the past 5 old age. (Stppler)CIN or, cervicalintraepithelial neoplasia is a precancerous condition of abnormal cell growthon the cervix. Intraepithelial means that the abnormal cells are growing on thesurface or the epithelial tissue of the cervix. Neoplasia is referring to thegrowth of new cells. Signs and symptoms can be limpid but can in any case resembleseveral conditions that females could encounter. These symptoms can includeabnormal vaginal bl eeding, bleeding after in puddleal intercourse, pelvic pain,discharge, and pain during cozy intercourse. (Stppler) It is recommendedthat women start getting pap smears at the age or 21. This is or so important ifyou are human immunodeficiency virus positive or have a weakened immune system. (Weber, 2017)These screenings should continue from ages 21 to 29 with cytology unsocialevery 3 years. From ages 30-65, women should continue cytology screening everythree years and add HPV testing. After 65 no screening is necessary as longpast screenings are normal and no risque risk is present. (Boardman, 2018)Over the years professionalshave plant it difficult to all be on the same page about reporting. roughly levelsof abnormal results can include atypia, mild, moderate, severe dysplasia, andcarcinoma in situ. The creation of the Bethesda carcass has given one reportingsystem for all health care professionals. In 1988 the National Cancer Instituteheld a conference for the creation of this system, it was then re-evaluated in2001. There are four study classifications that make it easier for thisuniversal system to work. ASC-US This abbreviation stands for atypicalsquamous cells of unde termined significance. LSIL This abbreviation stands forlow- rove squamous intraepithelial lesion. Under the hoar system ofclassification, this crime syndicate was called CIN grade I. HSIL This abbreviationstands for high-grade squamous intraepithelial lesion. Under the old system ofclassification, this category was called CIN grade II, CIN grade III, or CIS.ASC-H This means atypical cells are present and HSIL can non be excluded.(Stppler)CIN cases are to the highest degree forever and a day stimulated by transmission system with oncogenic flakes of HPV or, Human Papillomavirus.There are 12 know types of high risk HPV, which are the most prevalentassociations with cervical cancer. Cervical cancer results from a genitalinfection with HPV, a known human carcinogen. Because most HPV infections aretransient or, passing in and out of existence in a patient, it causes onlytemporary changes in cervical cells. (National Cancer Institute, 2014)About 90% of HPV infections clear on their own inwardly months to yearswith no sequelae. (Boardman, 2108) This makes it difficult to catch the HPVinfection and in criminal cervical cancer. also frequent of screenings might beproblematic for several reasons. One being that treating these abnormalitiesthinking it was HPV but that went past anyways would cause unnecessary stresson the patient. Also, putting strain on the cervix several multiplication in any periodof time can weaken the tissue and could ultimately affect the womans fertility.Interestingly enough, it can take up to 20 years for a persistent infectionwith a high risk HPV to become cancerous. (National Cancer Institute, 2014) Lowrisk HPV infections rarely or to the highest degree never cause cervical cancer. (Boardman,2018) However if lesions are found and non treated, they are more than probablyto turn into cervical cancer. (National Cancer Institute, 2014) There are different levelsof cervical cancer that decipher the increase on epithelial tissue. CINgrade 1 is low grade neoplasia involves nigh one-third of the thickness ofthe epithelium. CIN 2 refers to the abnormal changes in about one to two-thirdsof the layer. CIN 3 is the most severe affecting over two-thirds of theepithelium. 5% of HPV infected patients will acquire CIN grade 2 or 3 lesionswith three years of infection. scarcely 20% of CIN 3 lesions progress to invasivecervical cancer within 5 years. Only 40% of CIN 3 lesions progress to invasivecervical cancer within 30 years. Genetics can also play a role in a womans development of cervical cancer genetic connection holds fewer than only 1% of cervical cancers. Women who have an affected first degree biological relative have a two fold relative risk of developing a cervical tumor compared with women who have a nonbiolog ic first degree relative with a cervical tumor. Some specific genetic factors have been shown to be in association. The tumor necrosis factor is involved with cell apoptosis and a high incidence of cervical cancer. Polymorphisms, a nonher gene dealing with apoptosis, have been conjugate to the increased rate of HPV and in turn, cervical cancer. Cervical cancer is the leading cause of cancer connect morbidity in developing countries, but is very uncommon in the unite States. Since 2004 rates have decreased by 2.1% per year in women younger than 50 years and by 3.1 per year in women 50 years of age and older. ACS reports 12,170 new cases of cervical cancer would be diagnosed in 2012. Age related demographics from 2004-2006 were highest among women from 50-79. But cervical cancer is doable to be present in any sexually expeditious woman. In terms of race, cervical cancer rates per 100,000 women in the US from 2005-2009 are across the advance Hispanic 11.8, African American 9.8, A merican Indian/ Alaska Native 8.1, White 8.0 and Asian/ Pacific island-dweller 7.2. Internationally, 500,000 women are diagnosed every year.Prognosis for cervicalcancer is very good, peculiarly when caught early. 5 year natural selection rates Stage1 greater than 90%, Stage 2 60-80%, Stage 3 nearly 50%, and leg 4 lessthan 30%. Treatment for this type of cancer is ordinarily bloodsucking on age,fertility or pregnancy plans. One procedure, LEEP, the loop electrosurgicalexcision procedure carries an electrical watercourse through a wire to remove abnormaltissue. Cryotherapy poverty-strickenzes the abnormal tissue. Laser therapy uses a beam of luminousness to remove or even destroy the cells. Conization can also be used with a wound and laser. (Boardman, 2018) In severe cases removal of the uterus, hysterectomyis sometimes necessary. Radiation, chemotherapy and surgery can sometimes beperformed in other extreme cases. However like any screeningtest on that point is always a ris k of inaccuracy in false negatives and falsepositives. (National Cancer Institute, 2014) In some cases a pap smear can befaulty and must be reported in an official capacity. Some examples of thiscould be drying artefact or excessive blood. The person reading the smearcould feel these are factors that affect the reading. Inflammation can also bea problem in a Pap smear reading. Inflammation can be from infection orirritation. (Stppler)Uterine cancer is defined asthe any invasive tumour of the uterine corpus and is the most common pelvicgynecological malignancy in the United States. Uterine cancer can also belabeled endometrial cancer. The most common type of uterine cancer specificallyis endometrioid adenocarcinomas. (Chiang, 2017) It is believed to have twoforms type 1 or oestrogen dependent and type 2, which is estrogen independent.(Holman 2012)Uterine cancer can start insmall areas or a go around multifocal mock up. Health care professionals canusually diagnose this type of can cer by the spreading pattern of the tumor.Usually the tumor will grow from the original location. This can tell thedoctor how far along the cancer is. Later tumor growth is seen throughmyometrial invasion and movement towards the cervix. The cancer itself can takefour different routes to spread out spatial relation the uterus. Direct or local extendsbeyond the uterus. Lymphatic, referring to exposure to the pelvic, para-aortic,and sometimes the lymph nodes. Hematologic goes march on reaching the lungs,liver, and bone metastatically. Lastly, peritoneal/ transtubular spreadresults in intraperitoneal implants. Staging of Uterine cancer,like most cancers, will depend on the amount of growth and spreading of thetumors. Clinical stage 1, which is the most common for patients, is strict tothe uterus. Stage 2 involves a large amount of the cervix. Stage 3 vaginal extension,adnexal mass, and/or suspicious retroperitoneal lymphadenopathy. Stage 4accesses the bowel and bladder and some other metastases around the body. Although pap smears areprominent for cervical cancer findings, it is non as helpful in uterine cancer.According to my findings, there are actually no screening regimens forasymptomatic women. The only screening mentioned is a transvaginal ultrasound,which determines the thickness in postmenopausal women. In the suspicion ofabnormalities, biopsies can be taken. Uterine cancer usually includes bothsurgery and radiotherapy. Other treatments follow a hormone regimen. Otherforms can use estrogen replacement therapy and Tamoxifen, which is usually usedfor breast cancer but can be used on endometrium tissue as well. (Holman 2012)Because of the early representation of the cancer, treatment is usuallysuccessful and most do non progress past stage 1. Recurrences can happen andusually do within 3 years of the original diagnoses, which occurs in half ofpatients. (Holman 2012)(Uterine Cancer)Symptoms of uterine cancercan range from genital discharge, pain, weight l oss, and change in bladder orbowel movements. However, postmenopausal bleeding is say to diagnose up to 90%of endometrial cancers. Another clinical finding would be glandular cells froma pap smear on a postmenopausal woman. Some risk factors are obesity,nulliparity, and late menopause. Diabetes and hypertension are also conditionsthat. little than 5% of this cancer is actually diagnosed when the woman isasymptomatic can increase the risk of uterine cancer. (Uterine Cancer) close to ofthe patients diagnosed with uterine cancer are obese, which can affect estrogenlevels. (Holman 2012)Over 50,000 cases of uterinecancer are diagnosed each year, leading up to 10,000 deaths per year. In womenalone, it leads to 4% of deaths related to cancer. 70-75% of cases arediagnosed at stage 1. In 2009, the survival rate for uterine cancer was 83.1%.(Chiang, 2017) A large majority of the population diagnosed are postmenopausaland ages 50-65, average age of 61. White women have the largest risk of u terinecancer in the United States compared to African American, Asian and Hispanicwomen. However, African American women have a larger rate of death.Interestingly, those women living in Asia or Africa have a a good deal smaller rate ofuterine cancer than Asian and African American women in the United States.Smoking actually has been shown to decrease your chance of endometrial cancer.The use of encumbrance pills has also been said to be a protective measurefor women. (Holman 2012)In conclusion, Pap Smearscan be resourceful ways of detecting cervical cancer but not at large uterinecancers. Pap smears are a great screening method for obstetrician-gynecologists and their patients to catch and prevent cervical cancer. Bydetecting cervical cancer early, prognosis is very good and very likely in mostcases. These quick diagnoses from pap smears and other sources has makecervical cancer a very uncommon cancer related death for women in the UnitedStates. Unfortunately for developing countr ies, lack of medical resources andresearch has made discovering cervical cancer difficult and fatal. With theBethesda System doctors from all over can classify cervical cancer the sameway. Pap smears are very accurate, but like any screening procedure there isalways the risk of false negatives or false positives. Although Pap smears haventbeen shown totally genuine to detect uterine cancer, there are several othermethods to find uterine cancer. The most obvious can be the presence of postmenopausalbleeding in women, which diagnoses most of the cases. Transvaginal ultra soundcan be used to determine the state of the womans uterine tissue. These and afew others have been said to be more reli subject than Pap smears. Counterpart toruling out Pap smear findings, one source does tell that if glandular cells arepresent than it might be uterine cancer. want cervical cancer, uterine canceris most always found in early stages or stage 1 to be exact. This earlydetection makes it only 4% of cancer related deaths in women. In doing my research it wasclear to me that Pap smears are in fact helpful in detecting cervical cancerbut not as much in uterine cancer. I only found one source that mentionedfindings from a Pap smear for uterine cancer. This was entirely interesting tome because they are in very similar areas of the womans reproductive system.In doing more research, it makes sense that a pap smear rarely diagnosesuterine cancer because it starts inside the uterus. The cervix being much lowerand away from the uterus makes it easier to obtain cells and much morereliable. Finding cervical cancer can be much more direct and easily obtained.Getting to the uterus safely is much more difficult. In further research I believe it would be interesting to look further into minimally invasive ways to detect uterine cancer. Another topic is using the any findings from a Pap smear in detecting cervical cancer to relate to prevention of uterine cancer. Lastly, the result of cervica l and uterine cancer on future pregnancy or on currently pregnant women. Works CitedUterineCancer. Uterine Cancer, www.csh.org.tw/dr.tcj/educartion/f/web/Uterine%20Cancer/index.htm.Boardman, Cecelia.Cervical Cancer. Practice Essentials, Background, Pathophysiology, 26Jan. 2018, emedicine.medscape.com/article/253513-overview.Chiang,Jing. Uterine Cancer. Background, History of the Procedure, Epidemiology, 6Dec. 2017, emedicine.medscape.com/article/258148-overviewuterine cancer.Holman , Laura. The Epidemiology of Endometrial Cancer. The Epidemiology of Endometrial Cancer, 2012, www.glowm.com/section_view/heading/The%20Epidemiology%20of%20Endometrial%20Cancer/item/236.Stppler,Melissa Conrad. Pap Smear Facts About the Procedure, bruise &Guidelines.MedicineNet, www.medicinenet.com/pap_smear/article.htmwhat_is_a_pap_smear_procedure.Tan, Siang Yong, andYvonne Tatsumura. George Papanicolaou (18831962) Discoverer of the PapSmear. Singapore Medical Journal, Singapore Medical Association, Oct. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4613936/. Weber,Michael. Pap Smear (Pap Test) Reasons, Procedure, & Results. Healthline,Healthline Media, 13 Mar. 2017, www.healthline.com/health/pap-smear.Should Hate Speech Be Protected as Free Speech?Should Hate Speech Be Protected as Free Speech?Question Should dislike language be protected by the objurgate of exhaust talk?IntroductionHate speech is a controversial and often misinterpreted term for speech intended to degrade, intimidate, or incite military unit or prejudicial action against an individual or a congregation of individuals establish on their race, ethnicity, national origin, religion, sexual orientation, or disability. The term has been taken to cover written as well as oral communication.My starting position is that scorn speech is not just one thing there can be at least four categories of abominate speech that we can address.By the end of this essay I hope to have shown satisfactoryly which, if any, types of nauseate speech could be protected by the undecomposed of unloosen speech.Right to reposition speech and port peradventure in a different era, the two could be seen as distinct, not just by name, but also in context.1The right of set free speech is a human, political or obliging right recognised and appreciated by states and their citizens. It is the right to communicate ones faiths and ideas using ones body and property to anyone who is unbidden to receive them. It was included in the First Amendment to the United States Constitution.2Although freedom of expression is sometimes used within an identical context, it nevertheless includes any act of seeking, receiving and move oning information or ideas, regardless of the medium used.Perhaps the most commonly cited definition is the one given by the United Nations in Art.19 of their UDHR3 adopted in 1948.4Along the same lines, Art.10 of theECHR5provides the right to freedom of expression, subject to certain restrictions tha t are in accordance with impartiality and necessary in a democratic society.It is important to appreciate that the two are largely intertwined, and to be read separately would be of no particular appreciate or help. For the purposes of this essay, I shall regard the two rights as two faces on the same side of a coin.Being part of a group of ideals or social goods even, the right of free speech is not specially protected from other ideals. It has to fight with such(prenominal)(prenominal) rights as right to private life, public security and democratic par amongst others. There is no precedence that the right for free speech must always prevail.The word of the First Amendment creates a defence force for individuals and a difficulty for the state to regulate similar acts in the United States, as well as a desire to abolish the limitations already imposed by other states.6When whitethorn the right of free speech be limited?It can easily be imagined that the time, place and way of something being said or written or expressed in any other form is subject to interrogatory as to its appropriateness or inappropriateness respectively that is subsequently reflected in regional legislations. This is not commonly objected to.There is another controversial excuse for limiting it and that has to do with its content.7 A classic example is the removeion of circulation of Nazi ideas in parts of Europe. This is only to be expected, gestateing that the UDHR was an attempt to stop the terror witnessed during that war from misadventure again.It is important however to understand that all is meant by limiting free speech or prohibiting hate speech is not preventing someone from exercising the right, but rather a subsequent punishment.Hate speechThe prohibition of hate speech is often anathematised by the advocates for the right of free speech. Following Smolla, it can be generically defined as a speech assault found on race, ethnicity, religion and sexual orientation or preference8.Brison attempts to colour it even more by delineate it as the speech that vilifies individuals or groups on the same basis and which is face to face smirch or constitutes a group libel9.Waldron also believes that hate speech is a form of group defamation10. I would think that defamation is more accommodate as we have already accepted that hate speech can be manifested both verbally and in writing.When can free speech include hate speech?There is, of course, a number of blood lines articulated to justify the importance of including hate speech in the right of free speech, however, lacking space, I will address only the four that I consider of greatest importance.Discovery of truthThis argument has two distinct streams of interpretation. According to the first, we come to know more truth if we allow a free marketplace of ideas.11Advocates of the second stream claim that allowing discussions set ahead truth and the interests of the right for free speech more than rest rictions, as it allows for comparing and contrasting arguments.Scanlon divides the possible participants in a trade of speech into speaker, auditory sense and bystanders.The value protected by both is truth itself the speaker has an interest in communicating an opinion the auditory sense and the bystanders have an interest in evaluating and challenging the said opinion.Central to this argument is the importance of reliable and rightful(a) information since it would be detri rational to knowingly spread opinions based on the unreliable and false information.12 comment that this argument, like the rest, covers not only the packaging of views and opinions, but also of the communication of facts that do not ask over evaluation, such as the names of professors in the University of Essexs Human Rights department.However, as Schauer points out, this value does not have an a priori precedence over other values.13Livelier apprehension and personal developmentAccording to J. S. Mill we come to apprehend the truth in a more lively way when we confront plenty who trash our beliefs or be confronted by them respectively.So essential is this discipline to a real understanding of honourable and human subjects that, if opponents to all-important truths do not exist, it is indinspensable to imagine them and supply them with the strongest arguments which the most skilful devils advocate can conjure up.14Eric Barendt addsRestrictions on what a man is allowed to say and write, or to hear or read, inhibit the growth of his personality. People will not be able to develop intellectually and spiritually, unless they are free to formulate their beliefs and political attitudes through public discussion, and in response to the criticisms of others.15Greenawalt provides further inputBy affording tidy sum an opportunity to hear and digest competing positions and to explore options in conversations with others, freedom of discussion is thought to promote independent judgment and c onsiderate decision, what might be characterized as autonomy.16The speaker here has an interest in influencing the thought and conduct of others through speech. Furthermore, according to Joseph Raz, the audience has an interest in hearing expressed ideas that may potentially reassure and validate their lifestyles. 17Democratic participationThis has been elaborated best by Cass Sunstein.Free speech is to be protected because it facilitates the democratic articulation, aggregation and balancing of interests, and is necessary if the people are to be able to decide for themselves the candidates they think most suitable for public office and the policies that public officials should pursue. This argument links free expression with a commitment to political equality and a belief in democratic maladroitness.18The argument presupposes that the citizens of a democratic state have the right of free speech and are not negligent in exercising it fully. Democracy translates loosely into power of the people and by definition, for the sovereignty of the people to be effective, public opinions should be formulated free of any control or intervention by the government.As such, the speakers interest is in providing an opinion on matters of public-political life, while the main audience has an interest in hearing the views of others, and gaining an understanding of political views and preferences.The argument of the right of autonomyIn considering a law that prohibits speech, Scanlon writesIn order to be protected by such a law a person would have to concede to the state the right to decide that certain views were false and, once it had so decided, to prevent him from hearing them advocated even he might wish to19He goes on to argue that that since an supreme persons reason is sovereign over her own decisions, it is incompatible with her autonomy to be protect from certain evaluative views, or factual information, even if only to avoid the harm to her of coming to have fals e beliefs.20Greenwald describes such intervention as viewpoint discrimination21, the very thing that the First Amendment is employed to counter.This corresponds to the right of the audience not to have restrictions on their range of options to choose from in order to formulate an free decision.Let us now examine the kinds of hate speechTargeted vilificationSpeech directed at specific individuals or small group and with the intention to harm and insult the audience. The speaker consciously selects the wording for its potential to achieve just that.22 Contrary to what Brison argues, I would argue that it should include non-face-to-face acts, such as cases when is not direct but sufficiently specific.23The content itself does not usually qualify adequately as an impudence of fact, expression of an evaluative opinion or even of a valid political preference, since it is usually based on false accusations.Also, the speaker cannot barricade behind the right of autonomy and argue that non -racists are let over racists, since having a right of autonomy does not imply having the right to be racist and moreover clashes with the rights of others to be equally autonomous.It does not encompass the essence of the right, it does not promote the interests that the right seeks to, and it is not what is meant when the right for free speech is interpreted therefore we can conclude that targeted vilification should not be protected by the right to free speech.Diffuse vilificationThis is speech directed at a palsy-walsy or of mixed sentiments but larger audience than targeted vilification, but nevertheless has the same intentions to assault individuals based on the group they adhere to, or even the group itself, although they may not be the speedy audience.24 It usually employs symbols or banners with group specific insults.An example would be the Nazi march in Skokie, a village with a notable population of holocaust survivals and younger Jews. There is an evident intention to cause emotional distress and so, any speech or acts employed and political symbols used could not be excused as such, but as insulting, ruinous and intimidating.25A fair excuse would be that the averly distressed could avoid the march. To what extent this is possible depends on other factors such as prior sufficient advertising and the financial or effort overbearing on the victims part.This becomes more patent when the cost to pay to avoid the distress would mean losing ones work or avoiding communing areas or even becoming antisocial. This would clearly outweigh the interests of the speaker.Evidently, diffuse vilification promotes free speech interests at a far higher level than targeted vilification it can take the form of honest albeit mistaken at times expression of political and evaluative opinions, precisely because it is not targeted but addressed to a wider audience, which could be proactively met and discussed with an opposing group.Although in its honest and fair for m it should be protected by the right of free speech, in my opinion, the government has enough justification to interfere and attempt to control the manner in which it is expressed, and specifically by regulating the prohibition of speech, acts and symbols used for their potential to offend and/or to incite hatred and violence towards another social group.Advocating exclusionary policiesExclusionary policies are those that attempt to exclude certain social groups from equal participation in decision making and full enjoyment of their citizen and political rights. In its extreme form, this could include advocating genocide and ethnic cleansing.26The harm caused by a possible adoption and enactment of such policies is not easily outweighed, especially by the arguments for the discovery of truth and of personal development for obvious reasons.Following the argument for democratic participation, such cases constitute political speech, or part of, which the right of free speech clearly intents to protect. However, allowing the advocating of non-democratic ideals in a democratic society brackets democracy itself.I do not accept that democracy should succumb to such hypocritical arguments. I agree with what Rosenblum terms as militant democracy who attempts to defend itself. 27Even though state controls on political speech is restricting political equality, a democratic value, it is acceptable to do so when the speaker advocates anti-democratic values, even more so when they are advocating restriction on the political equality of others.From the perspective of the argument for autonomy, it can be argued that people should be allowed to exercise their right as sage sentient beings and consider, reflect upon, and decide for themselves which political speeches to support and which to strike down, without the need to cede their right to do so to any government.28However, how empirically justified is, or can, that be? What assures us that citizens will in fact make the right choices? What assures us that citizens will even bring themselves to consider such important and trying matters? Is it not the case that people who do concern themselves with such issues have a prior long time interest in them? How can we be sure that the citizens actually have the necessary mental capacities to fully comprehend the speech and its consequences?A democratic society is successful not only because of alleged equality, but also, because of alleged intellect. Following the notion of militant democracy not only there should be intervention to prohibit anti-democratic elements from exploiting democratic values, but also, there should be intervention to debunk, rebut and expose anti-democratic speeches. If the body of citizens is not able to comprehend it fully, the democratic government, assuming it is able to comprehend it, should step in.In my opinion, although this category is part of the general category of political speech, which the right of free speech inten ts to protect, it can take the form of anti-democratic speeches and incitement of hatred that may lead to horrid results. To this end, I conclude that this form of speech could be protected under the right of free speech, but the states should reserve their right to intervene in such circumstances that put into danger and jeopardize their very democratic nature.Harmful assertions of factThe notion that free speech should include the right to speak words that insult others, or saying what others do not like hearing, has become part of the modern societys pop wisdom heirlooms.The combined promotion of the values of truth, democratic participations and autonomy is indispensable, even though we cannot deny that even these assertions can cause tomb harm to individuals or groups.A fair objection to protecting these kinds of assertions I have found is what Margalit and Raz call the self-respect and dignity of group members, which are being threatened by such assertions.29This links to a r eversed interest for personal development on the part of the group members, especially when it comes to social groups set by ethnicity, where self-dignity and self-respect depends on the dignity and respect assigned to that group by others.However, can it not be said that a Kurdish minority in Turkey or the UK should be undetermined for their practice of FGM30 and to evaluative opinions and scrutiny from the rest of society about it, independently of their other dignity cognition and respect issues?In their extreme form, such factual assertions and evaluative opinions may lead to unjustified hate crimes and violence against innocent members of targeted groups. A classic example is the growing contempt that locals feel against immigrants in most countries.Even if top level surveys manage to prove that economic crisis, health system deterioration or other social harms are caused by immigrants, there is a huge leap from an empirical observation to undemocratic acts of violence.Milit ant democracy should step in here once again, not only to prohibit and punish such actions, but also, I would argue, to better regulate the matters revealed by such surveys.31Despite all these, harmful assertions of fact can be seen as promoting the interests embraced by the right of free speech. Even with harmful but not extreme assertions, an available remedy would be counter speech instead of restriction. This is possible because they are not mere vilification, but truthful and empirical assertions of honest intentions and therefore do not cause emotional distress.32In my opinion, a government should not be able to intervene by prohibiting the expression of such assertions, but they should be allowed to prohibit and punish individuals who misinterpret such assertions from resulting to hate crimes such as racial attacks.By saying this, one may think that I refuse to consider what some call group libel as hate speech worthy of being punished. This is not the case, since libel, de famation in general, is harmful yet untrue assertion. Even though some may differ as to the context of vilification, I take it to also have an element of faulty accusations.ConclusionI do not see hate speech to have just one singular face. As I have shown, it can be manifested in many different ways, which can in turn be judged on different grounds. Therefore it is inapplicable to argue that it should be either protected under the right for free speech in its entirety, or not at all.I am of the opinion that some forms of hate speech should be protected by the right of free speech, because of the benefits bestowed to society.Some other forms should not be protected states should take steps to better inform citizens about the different shades of hate speech and democratically establish legal frameworks to punish the ones that fall on the negative side of the spectrum.1 Due to the frustratingly large portion of the first draft of my essay spent on citing relevant treaties and articles defining the two rights, and assuming that the reader is familiar with them already, I have decided to include the definitions in footnotes, as they do not count towards the total word count. I do realise that this is inelegant, but I am exercising my right of autonomy to promote my personal interest, namely of not being penalised. release me.2 First Amendment to the United States Constitution reads as follows Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof or abridging the freedom of speech, or of the press or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.3 United Declaration of Human Rights4 Article 19 of the UDHR states that Everyone has the right to freedom of opinion and expression this right Includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.5 European Co nvention on Human Rights6 UK Sec. 18 (1) of thePublic identify Act of 1986 France Sec 24 of the Press Law of 1881 Denmark Article 266 (b) of the Danish Criminal Code The Netherlands Articles 137 (c) and 137 (d) of the Dutch Criminal Code7 i.e. the grounds cited in ICCPR and ECHR are content relevant.8 Smolla, 1991, 1529 Brison, 1998, 31310 Waldron, 2009, 1600-160111 Justice Holmes obiter dictum in Abrams v. United States, 250 U. S. 616 (1919).12 Cohen (1993 211, 229).13 Schauer (1982 23, 33).14 Mill15 Barendt (1985 14).16 Greenawalt (1989a 143-5).17 Raz (1991 311).18 Sunstein (1993 xvi-xvii).19 Scanlon (1972 217).20 Ibid.21 Greenawalt (1995 32).22 Greenawalt (1995 49).23 i.e. threatening letters, vandalism and so on and so forth.24 But may be bystanders.25 The fact that a march in virtually every other village or even a march in the same place but without the symbols would not constitute diffuse vilification but would rather be political speech only proves the dishonest intentions of the marchers. (Feinberg 1985 86).26 With notable examples the anti-Semitic speeches in Nazi Germany, anti-Greek and anti-Armenian speeches in Turkey, 1910-192227 Nancy Rosenblum (2008 412-455).28 i.e. the ban of Nazi parties from political life in Denmark29 Margalit and Raz (1990 119).30 Female Genital Mutilation31 Although not relevant to this essay, I would argue that the right of free move and work is a lot like the right to free speech in the sense that it is important but militant democracy should intervene to prevent it from harming a democratic state. A failed example of this would be Italys policy which only allowed a very limited percentage of immigrants. Surely, a middle position would be more successful.32 For example, a Kurdish should have been able to reflect upon the issue of FGM before encountering an adversary of the practice.