The problem with the program, according to critics, is that it sometimes nets non-criminal illegal immigrants, including victims of domestic abuse. Police sometimes arrest (and fingerprint) both parties in instances of domestic violence, then later charge the person determined to be the likely perpetrator and release the other(s) without filing charges. In the three counties that wanted to be removed from Secure Communities, police said the program could deter undocumented immigrants from reporting crime and lessen overall public safety.

But when law enforcement officials in San Francisco mentioned this concern to Venturella, he was reportedly confused and said he hadn’t heard of such a concern, according to a lawyer who was briefed on the Tuesday meeting.

“David Venturella was confused by the domestic violence problem,” Angela Chan, a staff attorney with Asian Law Caucus who has been critical of Secure Communities, told TWI. “ICE didn’t have much of a response. I don’t know if they were being disingenuous and they hadn’t heard of it, but it’s a pretty common criticism of the program.”

ICE did not respond to multiple requests for comment.

In general, Chan said she was told community policing concerns were not addressed by ICE officials during the meeting in San Francisco on Tuesday. But such concerns have been a central tenet of why counties asked to be removed from the program in the first place — and have gotten a reasonable amount of media attention.

The Washington Post reported on Nov. 1 about a Hyattsville, Md., woman who called the police after a fight with her partner. The woman, who is in the country illegally, claims the call put her on the radar of a local police officer who later charged her with illegally selling phone cards, an allegation she denies. The charge was thrown out, but her fingerprints had already been shared with immigration authorities under Secure Communities, and she now faces deportation.

ICE officials told the Post the agency has the right to pursue deportation if it discovers someone is in the country illegally:

“ICE cannot and will not turn a blind eye to those who violate federal immigration law,” said Immigration and Customs Enforcement spokesman Brian Hale. “While ICE’s enforcement efforts prioritize convicted criminal aliens, ICE maintains the discretion to take action on any alien it encounters.”

In other situations, critics of the Secure Communities program say that police make two arrests and then determine who is the victim of abuse once at the station — but after fingerprints have begun to make their way into the hands of immigration authorities.

The immigration system has some protection for victims of domestic violence: As I mentioned yesterday, foreign-born spouses of Americans can petition for citizenship on their own — bypassing abusive spouses — if they can prove abuse. For undocumented immigrants, U visas are available to victims of certain crimes, including domestic violence. These visas grant victims the right to remain in the United States and work legally, but are granted based on the discretion of law enforcement agencies, which sometimes differ on what crimes merit the visas.

But the Slate piece does a good job of laying out a few perspectives. Hundreds of men who married foreign-born women claim their wives accused them of domestic abuse to exploit the 1994 Violence Against Women Act, which allows victims of abuse to remain in the country even if they leave their marriage. Some of the men may be lying, but immigration agents and lawyers say this type of fraud does happen — though it is likely uncommon.

The problem is figuring out whether closing the loophole that allows for this type of fraud is worth the risk of deterring real domestic violence victims from reporting their abuse:

The opportunity for fraud may be a small harm that’s necessary to prevent more serious wrongdoing. Before the act was passed, only an American spouse could file an application for a marriage visa. This meant that an abusive husband or wife could threaten to withhold immigration sponsorship as a tool of control. VAWA tried to change that, by allowing abused spouses, parents, or children of American citizens or permanent residents to “self-petition,” that is, to file for permanent residency themselves. [...]

The relatively lenient standard of proof is in place for good reason. Several decades of research show that the dynamics of domestic abuse make it difficult for women to report and document the crimes against them. A wife may be financially reliant on her husband, or she might come from a culture that discourages involving outsiders in family matters. Making it more difficult for battered immigrant women to get help would clearly be a step in the wrong direction. “I am quite ok with what I believe to be the miniscule number of fraud cases that might slip through an otherwise good, working system,” Alizabeth Newman, a law professor at the City University of New York, wrote in an August 2009 e-mail to a group of domestic abuse advocates reviewing the VAWA immigration provision. Newman has a point: Interviewing applicants and investigating the evidence they provide would be expensive. It may not be cost-effective to weed out the likely very small number of bogus claims.

The broader issue of marriage fraud — foreign-born men and women entering or buying into marriages for the sake of legal residence in the United States, or Americans faking marriage certificates to bring foreigners into the country in exchange for cash — is interesting because of the difficulty of detecting it. Although it’s impossible to say how often fraudulent marriages happen, the Government Accountability Office reported in 2006 that benefit fraud, including marriage fraud, is a serious problem.

The pro-enforcement Center for Immigration Studies claims marriage to a United States citizen is the easiest and most common path to citizenship. According to one report, about one-third of applicants who show up to their investigation interviews in New York are denied for faking the marriage, and nationwide about 20,000 naturalization applications were denied on suspicion of fraud in the 2005 fiscal year.

There have been some high-profile cases lately: A Harry Reid staffer left his campaign in October after Fox News reported she had faked a marriage for money, and a Mexican actress and her American husband were charged with marriage fraud in April. Other reports involve groups that find American men and women who will marry and petition for foreign spouses for pay, or file multiple visa applications based on fake marriage certificates.

But there are high costs to engaging in marriage fraud. If a visa applicant is determined to have entered into a marriage to evade immigration laws, his or her application must be denied by U.S. Citizenship and Immigration Services. (That is, unless he or she is able to prove spousal abuse, as mentioned above.) Immigration agents investigate visa petitions filed by spouses — USCIS even recently instructed its agents on how it could use social networking sites such as Facebook to figure out whether marriages were fraudulent.

Immigration advocacy groups, for their part, argue that marriage fraud should be taken seriously, but say pro-enforcement groups like Center for Immigration Studies miss the point by claiming fake marriages run the risk of allowing terrorists to enter the country. Immigration Impact, the blog of the pro-reform Immigration Policy Center, says the real concern is fighting human traffickers who use fake marriages to bring women to the United States for sexual exploitation and reducing backlogs on family-based immigration so real couples can be united.

The alleged assault occurred five years ago. A man entered the alleged victim’s apartment and had sex with her while she was drunk, she says. As she passed in and out of consciousness, she says she told him “no” and tried to push him away. If he had been a stranger, the case may have played out differently, but he was a former lover, and she had invited him over.

Those circumstances seem to have made all the difference to Buck. [...]

He said the facts in the case didn’t warrant prosecution. “A jury could very well conclude that this is a case of buyer’s remorse,” he told the Greeley Tribune in March 2006. He went on to publicly call the facts in the case “pitiful.”

If he had handled it with a little more sensitivity, the victim, who does not want her name used, says it is possible she may have accepted the decision and moved on. But Buck’s words — as much as his refusal to prosecute — still burn in her ears.

“That comment made me feel horrible,” she told the Colorado Independent last week. “The offender admitted he did it, but Ken Buck said I was to blame. Had he (Buck) not attacked me, I might have let it go. But he put the blame on me, and I was furious. I still am furious,” she said.

Buck is leading by a small margin in his race against Sen. Michael Bennet (D-Colo.), but his support is already seriously lagging among female voters on account of his views on abortion and birth control, not to mention various additional off-color remarks:

Buck’s problems connecting with women voters in the Senate race likely began with his support for Amendment 62, the Personhood Amendment, which would make even some common forms of birth control illegal. He also said people should vote for him in the primary instead of former Lt. Gov. Jane Norton because he doesn’t wear high heels.

The latest news about Buck’s record prosecuting rape cases as district attorney has the potential to sink his support among women (and men, for that matter) still further.

Documents obtained by Michigan Messenger show two high-profile Michigan State University basketball players have been accused of committing sexual assault on campus in August. Despite the allegations, prosecutors have declined to take up the case, and the victim disputes the reasons offered for not bringing charges.

Unfortunately, the situation that the story documents is not a unique one. Even though federal law makes reporting campus crime mandatory, sexual assault is under-reported, and no one knows quite how widespread a problem it is. Last year, the Center for Public Integrity reported:

Limitations and loopholes in the federal mandatory campus crime reporting law, known as the Clery Act, are causing systematic problems in accurately documenting the total numbers of campus-related sexual assaults. [...] Available data suggest that, on many campuses, far more sexual offenses are occurring than are reflected in the official Clery numbers.

The U.S. Department of Education also has a responsibility to investigate cases in which victims of sexual assault on campus allege that their school mishandled their case. But, the Center reported, the department’s Office of Civil Rights pursues few cases and rarely levies punishments on schools.

Afghan women could serve as ideal messengers in humanizing the ISAF role in combating the Taliban because of women’s ability to speak personally and credibly about their experiences under the Taliban, their aspirations for the future, and their fears of a Taliban victory. Outreach initiatives that create media opportunities for Afghan women to share their stories with French, German, and other European women could help to overcome pervasive skepticism among women in Western Europe toward the ISAF mission.

There is a general sense of unease among human rights activists about the future of Afghanistan if there’s a negotiated settlement of the war with Taliban elements, even despite the women’s rights abuses perpetrated by the Karzai government and its allies. It’ll be the subject of what might be a fraught conference at the U.S. Institute of Peace next week. For anyone concerned about human rights, it’s a vexing, haunting question, and one that creates an increased need to listen to the voices of Afghan women as they try to consolidate what gains they have made in post-Taliban Afghanistan.

This analysis, however, outlines a surefire way to cynically discredit those voices precisely when they’re needed most. The easiest recourse to marginalization is to portray someone as a CIA stooge. “Media events that feature testimonials by Afghan women would probably be most effective if broadcast on programs that have large and disproportionately female audiences,” the Red Cell analysis advises. What a disservice that would be to some of the bravest people on the planet, who’ve had to endure so much, to be used as a sales pitch for a war.

Pakzad is in Washington for the next several days to press that case to a number of U.S. officials, including aides to Amb. Richard Holbrooke, the special representative for Afghanistan and Pakistan, and on a variety of fronts. Beyond attempting to preserve women’s parliamentary representation, Pazkad, the recipient of a State Department ‘Women of Courage’ award in 2008, wants the U.S. and its allies to press Karzai on allowing women to help draft the terms of any reconciliation offer to Taliban insurgents.

“We’re not just looking at women in parliament, but women at the local and national level,” Pazkad said after a breakfast event on the Hill sponsored by the United Nations’ Development Fund for Women and the Women Thrive Worldwide non-governmental organization. “We need the international community to push the Afghan government that they should not support any reconciliation with the Taliban without women’s presence.”

As he announced in the London international conference on Afghanistan in January, Karzai is going to draft a reconciliation proposal to present to the heretofore-disinterested Taliban leadership. “We don’t want to stand against the draft when it is made,” Pakzad said. “We would like to be there while they make the draft. We don’t want our rights to be bargained [away]. We don’t want compromising. We need real, equal positions in the making of important decisions for our country.” If Karzai ignores Pazkad’s concerns, he could turn a glimmer of hope for the end of the war into a looming human rights catastrophe, considering Taliban rule during the 1990s made Afghanistan one of the worst places on earth to be a woman.

Pazkad said representatives from her Herat-based organization, Voice of Women in Afghanistan, met with Mohammed Masoom Stanekzai, the Karzai aide responsible for drafting the reconciliation offer, a few days ago, while she herself was traveling to Washington. Even so, she added, “Advocacy doesn’t mean being invited. We raise our voices.”

Sen. David Vitter (R-La.) (WDCpix)

When a preventive-health panel stirred a storm last November by scaling back its guidelines for breast cancer screening among 40-somethings, Congress was quick to intervene. Indeed, it took just 17 days before senators unanimously agreed to bar the government from using those recommendations to inform federal coverage policies — public or private.

The message was clear: More screenings, not fewer, are better for women’s health.

[Congress1] Yet as the dust settles and Washington’s attention shifts elsewhere, some prominent physicians are questioning the wisdom of the congressional decision to swoop in so quickly to dismiss the expert recommendations. Writing this month in the Journal of the American Medical Association, or JAMA, these doctors are blasting Congress for politicizing an issue they say is better left to medical science.

It’s not a new argument. Preventive care specialists and some journalists were making it in November. Still, that a respected medical journal has returned to the issue now is a good indication that, even if the Democrats’ plans for health reform have hit a wall after last week’s special Senate election in Massachusetts, the thorny debate over preventive health care is far from dead.

“Screening is not simply about benefit, it also causes important harms,” Steven Woloshin and Lisa M. Schwartz, both physicians at Dartmouth Medical School, wrote in the Jan. 13 issue of JAMA. “To make good decisions about screening, patients should understand the trade-offs.”

In the case of routine mammograms, the authors contend, the benefits for women in their 40s are minimal. Without screenings, 3.5 of 1,000 40-somethings will die from breast cancer over the next decade, they note. With screenings, 3 of 1,000 will succumb to the disease — meaning that it requires 2,000 tests to save one life.

“For most women with cancer, screening generally does not change the ultimate outcome,” Woloshin and Schwartz argue.

On the flip side, they say, the harms can be considerable. In some cases, the test comes back mistakenly positive, subjecting the patient to the devastating, if temporary, thought that she’s got a life-threatening disease. In other instances, the test uncovers slow-growing cancers that, even if never found, pose no threat to the patient through her lifetime. The treatment of those latent cancers exposes women to the harms associated with surgery, chemotherapy, or radiation — as well as the constant fear of recurrence.

Steven H. Woolf, a physician at the Virginia Commonwealth University School of Medicine, said those harms shouldn’t be taken lightly.

“Advocates of mammography and cancer survivors often belittle these harms, but a moral duty exists when subjecting millions of asymptomatic women to a procedure that benefits relatively few,” Woolf wrote in the same issue of JAMA. “Whether hundreds of women should endure the consequences of inaccurate mammograms to save one woman’s life is a legitimate ethical question.”

The controversy spins around new recommendations, crafted by the U.S. Preventive Services Task Force, suggesting that 40-something women should no longer get routine annual mammograms, but instead should talk first to their doctors about the potential harms associated with those tests. The task force also recommended that routine screenings for older women occur every two years, rather than annually.

[A clarifier is in order here: Routine mammograms refer, under current protocols, to the annual tests given to asymptomatic women aged 40 and up. Diagnostic screenings, on the other hand, occur after a lump or other abnormality is detected. The task force controversy surrounded only the former. Some insurers cover only the latter.]

Many lawmakers defended the guidelines. But others pounced, voicing concerns that private insurers in search of greater profits — or governments in search of leaner budgets — might point to the guidelines as reason to scale back coverage of routine tests. It didn’t help that the recommendations were unveiled in the middle of the most ferocious health reform battle in generations, and that the Democrats’ reform bills would rely on certain task-force guidelines to steer minimum coverage standards for private insurers.

“This is when you start getting a bureaucrat between you and your physician,” Rep. Marsha Blackburn (R-Tenn.), warned at the time. “This is how rationing begins.”

The irony, of course, was that Blackburn was the bureaucrat accusing an independent panel of preventive-care experts of being bureaucrats — a dynamic which raised immediate questions about the capacity of Congress to weed out unnecessary procedures if lawmakers stand ready to riot each time medical science calls into question the entrenched habits of patients and providers.

“The politicalization of medical care is wrong,” Woloshin and Schwartz warn broadly. “Promoting screening irrespective of the evidence may garner votes but will not create healthier voters. It may do the opposite.”

No matter. Less than three weeks after the guidelines were published, the Senate stepped in with an amendment to the Democrats’ health reform bill prohibiting the government from using them to craft policy. Sponsored by Sen. David Vitter (R-La.), it passed unanimously without a tallied vote.

A second amendment, sponsored by Sen. Barbara Mikulski (D-Md.), bars insurance companies from denying coverage for a host of preventive-care services to be named later by the White House. Aside from mammograms, the provision is designed to cover screenings — at no cost to women — for other prominent diseases, such as diabetes, cervical cancer and heart disease. The Mikulski amendment passed 61 to 39.

“We don’t mandate that you have a mammogram at age 40,” Mikulski said on the Senate floor before the vote. “What we say is, discuss this with your doctor. But if your doctor says you need one, you are going to get one.”

Though mischaracterized in the press and misunderstood on Capitol Hill, that’s precisely what the panel had recommended.

“[T]he controversy was fueled by a chain of false premises,” wrote Woolf, a former member of the task force.

Still, there remains a great deal of disagreement within the medical community about the wisdom of the new guidelines. Wendie A. Berg, a Maryland-based radiologist specializing in breast cancer, said the panel’s conclusions are both “puzzling” and “problematic.”

“There are downsides associated with screening, but most women would not consider these harms,” Berg, also a consultant to Naviscan Inc., a manufacturer of imaging equipment, wrote in JAMA. “The overwhelming majority of women are willing to accept these downsides as part of the process of saving lives otherwise lost to breast cancer.”

The issue might go away for a while. In the wake of Republican Scott Brown’s Senate win in Massachusetts last week, the Democrats no longer have the 60 votes to usher a merged health reform bill through the upper chamber. The astonishing development has left party leaders at a loss for what to do next. Some are suggesting that they move on to other issues and return to health reform later in the year. Whenever they do, Woloshin and Schwartz have some advice.

“It is important for the public to remember that the goal of medicine is to help patients live healthier longer lives,” they wrote. “Sometimes more testing helps to reach the goal, but other times less testing does.

“Suggestions to do less may be as much in an individual’s interest as suggestions to do more.”

They would have to comply with complex audit standards and more importantly, they would have to collect an additional fee from each member of their plan, a step that could be expected to encounter broad resistance. (It is also not clear what the consequences would be for plan members who do not make the payment or whether non-payment would place them in arrears). The more logical response would be not to sell products that cover abortion services.

Even so, some abortion foes in the House are saying the Nelson amendment is too weak, leaving the possibility that the restrictions could become even more stringent during negotiations between the leaders in each chamber.

The Senate is expected to pass the enormous health reform bill later this week.

Sponsored by Sens. Ben Nelson (D-Neb.) and Orrin Hatch (R-Utah), the bill would have banned subsidized insurance plans offered on proposed insurance marketplaces from offering abortion coverage.

The health reform bill passed by the House last month includes such a restriction.

The amendment isn’t likely to get the 60 votes needed to pass, but its failure might not be the end of the debate. That’s because Democrats will likely need Nelson’s vote to pass the final bill sometime down the road, and the Nebraska moderate has threatened to withhold that support if strong anti-abortion language isn’t attached.

For supporters of abortion rights, the sticking point has been infuriating, if only because the Senate bill already retains the decades-old ban on federal funding of abortions. Indeed, under the legislation, women seeking abortion coverage would have to pay for it from their own pockets. The Nelson amendment — like the House provision — takes the prohibition a giant step further, effectively telling women that they can’t buy coverage for a legal medical procedure with their own money.

Sen. Claire McCaskill (D-Mo.) was quick to point that out this morning in an interview with CBS:

Let’s be clear, the bill as it stands does continue current law, which says no federal money can be used to fund abortions. [...]

What this amendment does is goes further, it actually says you can’t use private money in a private market for any kind of health services related to abortions. And frankly, I think that goes too far.

What’s fascinating here is that it’s been the free-market conservatives — and Nelson is one — who have led the opposition against allowing women to pay for a specific health insurance product on the open market with their own money. But of course those same conservatives also insisted on language in the Senate bill preventing illegal immigrants from buying any health insurance on the exchange, even at full price. Maybe if there were more Latinos in the upper chamber, that quandary might not have been so largely ignored.