Trump rips into ex-top spy who questioned his fitness for office

WASHINGTON — President Donald Trump traded verbal barbs Thursday with James Clapper, the former national intelligence chief, who has questioned Trump’s fitness to be in the Oval Office.

“James Clapper, who famously got caught lying to Congress, is now an authority on Donald Trump,” Trump tweeted. “Will he show you his beautiful letter to me?”

Clapper has denied lying to Congress. He says he misspoke a few years ago when he said the US was not collecting Americans’ data. Documents leaked by former National Security Agency contractor Edward Snowden later indicated widespread domestic surveillance.

Clapper told CNN that the “beautiful” letter referred to notes he wrote to both Trump and Democratic nominee Hillary Clinton the night before the November 8 election.

In the one to Trump — the only one that was delivered — Clapper wrote that he hoped the president would support the intelligence agencies’ practice of speaking “truth to power.” That’s a reference to sharing intelligence even if it runs counter to what a president believes or wants to hear.

On Jan. 6, before the inauguration, intelligence officials briefed Trump on their assessment of Russian meddling in the election and he was told about the existence of a dossier compiled by a former British intelligence officer. The dossier, which contained allegations of compromising personal and financial information about the president, was later released by a news organization.

Director of National Intelligence James Clapper listens to questions while testifying on Capitol Hill in Washington on Jan. 5, 2017, before the Senate Armed Services Committee hearing: "Foreign Cyber Threats to the United States." (AP Photo/Evan Vucci)

“Intelligence agencies should never have allowed this fake news to ‘leak’ into the public,” Trump tweeted. “One last shot at me. Are we living in Nazi Germany?”

Clapper took offense to that tweet, accusing Trump of characterizing “us as Nazis for having delivered truth to power.”

Earlier this week, the president cut loose in Arizona, angrily renewing his fight with the press over its coverage of his comments about the race-fueled violence in Charlottesville, Virginia. He opened his remarks with talk of unity but quickly erupted in anger, blaming the media for the widespread condemnation of his response to the violence in Charlottesville at a protest organized by white supremacists.

After the speech, Clapper said Trump’s access to America’s nuclear codes was “pretty damn scary” and raised concerns about Trump’s overall “fitness to be in this office.”

“Having some understanding of the levers that a president can exercise, I worry about, frankly, the access to the nuclear codes,” Clapper told CNN.

If “in a fit of pique he decides to do something about [North Korea’s] Kim Jong-un, there’s actually very little to stop him. The whole system is built to ensure rapid response if necessary. So there’s very little in the way of controls over exercising a nuclear option, which is pretty damn scary,” Clapper said.


Austrian Court Convicts Man Who Questioned Gassing of 6 Million Jews

An Austrian court has found a man who claimed the mass killings of 6 millions Jews in gas chambers under Adolf Hitler was a story made up by Jews guilty of violating the country’s anti-Nazi laws.

(Times of Israel)

They are sentenced him to a suspended 12-month prison term. Additionally, the man has been convicted of the crime of incitement for calling Muslims vermin.

The court in the western city of Feldkirch ordered him Monday to pay a fine of 1,440 euros ($1,690).

Both statements were made on Facebook. In claiming that the mass gassings were fiction, the man said Jews made up the story to make Adolf Hitler look bad should he have won the war.

The 34-year old acknowledged the postings were his. He is not being identified in keeping with Austrian privacy laws.

Netanyahu to be questioned by lawmakers on Gaza war report

The Knesset’s State Control Committee will host a special meeting with Prime Minister Benjamin Netanyahu in April to discuss the findings of a comptroller report on the 2014 Gaza war, committee head MK Karin Elharar announced on Tuesday morning.

The scathing report, prepared by State Comptroller Yosef Shapira, was due to be released Tuesday afternoon.

The probe is said to criticize the prime minister, defense minister and military for failing to adequately prepare for the Hamas attack tunnels used during the conflict, known in Israel as Operation Protective Edge.

“The prime minister will come to the State Control Committee because he must give answers to the bereaved families, to the fighters preparing for the next war and to the entire nation of Israel,” Elharar said in a statement.

According to the Yesh Atid Knesset member, she had been trying for an “endless amount of time” to set up such a meeting on the Gaza war, but Netanyahu “did everything he could to avoid it.”

Prime Minister Benjamin Netanyahu arrives at a Likud faction meeting in the Knesset, February 27, 2017. (Yonatan Sindel/Flash90)

As the report on the operation was due to be published, Elharar said she finally received a request from Netanyahu to hold the meeting.

“I will not allow the prime minister or anyone else to avoid giving answers on being better prepared for the next conflict,” she added.

The meeting is scheduled for April 19, her office said.

“But if it were up to me, this meeting would be held next week,” she said.

Earlier this month, Elharar’s committee granted the report its final approvals, though it will not be published in full. Elharar said some parts of the section on the tunnels would still be redacted as it contained “information that can be used against us.”

State Comptroller Yosef Shapira presents the State Comptroller's Report in the Knesset on November 1, 2016. (Yonatan Sindel/Flash90)

Leaked copies of the long-awaited report by State Comptroller Yosef Shapira indicate that it will criticize the army’s failures to prepare adequately for the threat of Hamas tunnels during the war, and chastise the political leadership for improperly managing the war effort.

According to some reports, Shapira is said to show bitter infighting among members of the security cabinet, especially between then-defense minister Moshe Ya’alon and then-economy minister Naftali Bennett.

As so much of it has been leaked ahead of its release, very little is likely to be shocking in the report, but its publication will allow politicians to discuss the topic more freely in public.

Speaking at his weekly Likud faction meeting, Prime Minister Benjamin Netanyahu rejected the claim that the military operation had been a failure, asserting instead it was in fact a resounding success.

“We hit Hamas with the hardest blow it has ever received. We killed around 1,000 Hamas terrorists, their senior officers. We took down the terror towers,” Netanyahu said. “We acted responsibly and with full coordination between the military and political echelons.”

Smoke rises from the rubble of the al-Zafer apartment tower following Israeli airstrikes Saturday that collapsed the 12-story building, in Gaza City, Sunday, August 24, 2014. (AP/Khalil Hamra)

The 50-day Operation Protective Edge began on July 7, coming on the heels of a large-scale terrorism crackdown operation in the West Bank that was prompted by the kidnapping and murder of three Israeli teenagers by Hamas terrorists the month before.

Throughout June and July, Gaza-based terrorist groups began firing missiles at Israel’s southern communities. The IDF responded to these rocket and mortar attacks with limited air and artillery strikes on launch sites, weapons caches and tunnel openings.

IDF infantrymen congregating around a tunnel entrance in Gaza, July 24, 2014. (Courtesy IDF Flickr)

Following a number of attacks on Israeli soldiers that used border-crossing Hamas tunnels, Protective Edge, which began as a response to rocket fire, became instead a tunnel-demolition mission.

By the war’s end on August 26, 2014, the IDF had targeted over 30 tunnels, 14 of which crossed into Israel. A total of 73 people — 67 soldiers, six civilians — died on the Israeli side of the conflict. In Gaza, more than 2,000 people were killed, with Israel putting the percentage of civilians killed at approximately 50 percent and Palestinians estimating it to be closer to 70%.

Israel said the high proportion of civilian Gazan deaths was the fault of Hamas, which squarely embedded its military infrastructure, including tunnel entrances and rocket launchers, in residential neighborhoods.

The military is said to be criticized in the report for failing to adequately prepare for the threat of Hamas tunnels and for not being forthright with the security cabinet about its “intelligence gaps,” a former top minister told The Times of Israel, on condition of anonymity.

Responding to questions from reporters on Monday, Defense Minister Avigdor Liberman declined to comment on the content of the report, saying he would do so after the embargo was lifted Tuesday afternoon.

IDF Chief of Staff Benny Gantz speaks with Israeli soldiers near the border with the Gaza Strip, on July 26, 2014. (IDF Spokesperson's Unit)

Benny Gantz, who was the IDF chief of staff during the war, stood up for Military Intelligence and its conduct during the war, at a conference for veterans of “Havatzalot,” an elite intelligence program, on Friday.

“During Protective Edge, there was intelligence that was excellent, terrific, accessible, but not always perfect. I am ready to go to the next campaign with the same intelligence that we had in the last one,” Gantz said, according to a report Sunday in the Yedioth Ahronoth daily.

On the attack side, opposition leader Isaac Herzog said Monday the report was an “indictment” against the political leadership during the military operation.

“This indictment doesn’t deal with receiving illicit gifts or with inappropriate personal behavior,” Herzog told his Zionist Union faction meeting, referring to the ongoing criminal investigations into the prime minister, “but rather with the failure of the country’s leadership, the disregard for human life, the abandonment of soldiers and officers and the citizens of the south.”

Zionist Union leader MK Isaac Herzog leads a faction meeting in the Knesset, on January 30, 2017. (Miriam Alster/FLASH90)

He added: “This indictment reveals how the prime minister and his security cabinet failed to understand the threats, to set a strategy to deal with them and to prepare the operation.”

According to Herzog, the only member of the security cabinet who acted appropriately during the war was Tzipi Livni, his number two in the Zionist Union faction, who sat next to him in the meeting. During the war, Livni served as justice minister.

Speaking to reporters earlier Monday, Livni said that the political brouhaha over the tunnel threat and the cabinet briefings was a distraction from the spectacular lack of strategy.

“We should have solved the problem [of Hamas’s terror tunnels] ahead of time. The fact that this wasn’t done by the time the operation began is a great failure,” Livni said.

Zionist Union MK Tzipi Livni at a faction meeting in the Knesset on January 16, 2017. (Hadas Parush/Flash90)

“Israel doesn’t have a strategy vis-à-vis the Palestinians generally or Gaza specifically,” she cautioned. “We don’t have to reach an agreement with Hamas, but we need to rally the world against Hamas so Israel has the legitimacy to act against the tunnels in any future operation.”

Yesh Atid chairman Yair Lapid on Monday accused Netanyahu of trying to cover up mistakes he had made rather than fixing them.

“What is more worrying than the mistakes is the denial,” Lapid said at the start of the Yesh Atid faction meeting. “The attempt to deal with public perception and politics and media spin comes at the expense of national security. That’s not how to run a country.”

Asked if, as a senior minister and member of the security cabinet at the time, he also bears responsibility. Lapid said that “the buck stops” with the prime minister, but added he didn’t think Netanyahu need resign over the report.

Top Trump adviser is fighting claims he questioned Holocaust history

WASHINGTON — One of five top foreign policy advisers to Republican presidential nominee Donald Trump is fighting allegations that he underplayed the extent of the Holocaust and sought to push Jewish employees out of the Pentagon during his tenure there.

Claims of anti-Semitic rhetoric and activity have been leveled against Joseph Schmitz, named to the Trump campaign in March, who when serving as Defense Department inspector general under the George W. Bush administration received formal complaints for counting his success in “firing the Jews” as a tenure achievement.

Schmitz also allegedly lectured an employee “on the details of concentration camps and how the ovens were too small to kill six million Jews,” wrote a complainant, Daniel Meyer, who once oversaw whistleblower cases at the Pentagon. His complaint, originally obtained and published by the McClatchy Company, is before the executive branch’s quasi-judicial agency called the Merit Systems Protection Board.

Schmitz has called the accusations defamatory, but reports of anti-Semitic tendencies at the top of the Trump team reinforce a narrative that has dogged the candidate for months: That his campaign has tolerated anti-Semitic and otherwise bigoted rhetoric from an “alternative Right” strain of the Republican Party.

McClatchy reports the original allegations leveled against Trump have now been cited in another case, in which an orthodox Jewish employee this week accused the department of fostering an anti-Semitic environment ever since Schmitz’s time there.

“The anti-Semitic environment began under a prior inspector general, Mr. Joseph Schmitz,” the complaint letter reads.

Schmitz served at the Pentagon through several allegations from Senate Republicans of illegal interference regarding memos on the use of torture during the Bush administration. He resigned in 2005 to work at Blackwater Worldwide, a private military company then employed in Iraq.

“Allegations of anti-Semitism are serious and deserve serious investigation and response,” the Anti-Defamation League, founded to combat anti-Semitism, said in a statement on Thursday night in reaction to the McClatchy report. “Candidates must ensure and convey that their advisers have highest standards of integrity.”

In anger, Obama questioned necessity of Israel’s qualitative military edge

WASHINGTON — Frustrated over a stall in an arms sale to Saudi Arabia, Obama once questioned the necessity of maintaining Israel’s qualitative military edge in the region, former Defense Secretary Leon Panetta said on Monday.

Panetta was confirming a report from Atlantic writer Jeffrey Goldberg, who attributed the claim to him in an article on Obama’s foreign policy doctrine published last March.

The former Pentagon chief said the White House, at the time, was deeply concerned that Israel was preparing to unilaterally strike Iran. Simultaneously, the administration was also hoping to complete with Riyadh a significant sale of fighter jets.

According to US law, the Defense Department must ensure that weapons sales to Mideast nations must comport with an American guarantee of Israel’s qualitative military edge (QME) in the region.

“We were going through a lot of contortions in order to deal with this issue, to develop the kind of technical responses that you have to develop in order to make sure that you protect Israel’s qualitative edge,” Panetta told the Washington Institute for Near East Policy at an event on Monday.

“And it’s not easy [to protect], okay– it’s not easy. It’s difficult. And the president kept asking, ‘why can’t we get this damn sale done?’ And every time I’d go in and say, ‘look, we’re working our way through it. We’ll get it done. But it’s not easy.'”

Jewish extremist leader questioned for incitement over anti-Christian article

Bentzi Gopstein, far-right extremist and head of the anti-assimilation group “Lahava”, was questioned by Judea and Samaria District Police on Thursday on suspicion of incitement for statements made against Christians.

The case involves an article he published on an ultra-Orthodox website last December in which he branded Christian missionaries “blood-sucking vampires” and called for them to be expelled from Israel.

He also wrote that “Christmas has no place in the Holy Land.”

The article came following a number of incidents in which Israeli extremists, including members of Lahava have been charged with vandalism and arson of Christian religious sites in Israel.

In a statement on Thursday, Gopstein said that “throughout the generations Jews were made to suffer by Christian missionaries” and that “it’s sad that now that we have a Jewish government, a Jewish Police Commissioner and Attorney General, the police find it fitting to question me for what I wrote against missionaries.”

As South Sudan bloodies itself, Israeli arms sales questioned

As attempts to broker a peace deal between the South Sudanese government and rebel leader Riek Machar sputter, Israeli activists are working to stanch the flow of Israeli arms into the conflict.

Though Machar agreed to the terms of the deal Thursday, South Sudan President Salva Kiir Mayarvit refused, demanding more time, even as the United States and United Nations threaten sanctions.

Both sides have been accused of human rights violations, in the two-year war. In documenting claims of ethnic cleansing, systemic rape, recruitment of child soldiers and more in the civil war, many also noted some of the weapons South Sudanese soldiers were armed with: Israeli Galil and Tavor rifles.

Israel has been providing the African nation with weapons, ammunition and training throughout its bloody civil war, according to Eitay Mack, a young attorney leading the charge against these arms sales.

Meretz MK Tamar Zandberg has been working with Mack to press the Defense Ministry for answers, while also trying to push forward legislation stymieing the alleged arms deals.

Some, however, maintain that the weapons, training and equipment are not bound for South Sudan’s civil war, but rather for its ongoing conflict with Sudan — a shared enemy with Israel.

The Defense Ministry, which oversees Israel’s sprawling defense industry, has refused to comment on weapons sales with any particular country.

‘It is as though we are helping ourselves’
Israel was one of the first countries to recognize South Sudan on July 10, 2011, establishing diplomatic relations with Juba only a day after the country’s independence.

The creation of an independent South Sudan was meant to put an end to its long-running war with Sudan.

The two countries, however, continue to fight over oil fields in the Abyei region, which both claim as their own.

If Israel is in fact selling weapons to South Sudan, it is to assist the South Sudanese in this conflict — not their civil war, Danny Yatom, a former head of the Mossad, told The Times of Israel.

Israel has allegedly targeted Sudan, which receives significant funding from the Iranian government, at least five times in recent years for smuggling weapons to Palestinian terrorists, including most famously in 2012 when Israeli aircraft were said to have bombed a weapons plant in the capital Khartoum.

“By helping South Sudan, which is the enemy of Sudan it is as though we were helping ourselves,” Yatom said, though he denied any direct knowledge of arms sales to South Sudan.

Data on arms sales to specific countries are kept secret, but overall sales to Africa increased dramatically in the years following South Sudan’s formation.

In 2009 Israel sold just $71 million worth of weapons to the continent. In 2013, that number more than tripled to $223 million, and it reached $318 million in 2014.

In addition to generating money for Israel, Yatom explained, the arms sales can also pave the way to warmer diplomatic ties.

‘Israel supports South Sudan. Iran supports Sudan. And ‘Peace unto Israel.”
But Zandberg rejected the argument that the arms sales were part of a proxy war Israel is fighting against Iran via South Sudan and Sudan.

“I think that’s an overly simplistic view of the situation,” she said.

Israeli rifles committing war crimes
Since the beginning of the fighting in 2013, international organizations have documented numerous atrocities against civilians.

“This recent upsurge [in fighting] has not only been marked by allegations of killing, rape, abduction, looting, arson and displacement, but by a new brutality and intensity,” the UN Mission in South Sudan reported in June.

But for all its severity, it is not a full-scale war with battalions, tanks and aircraft. It is being fought with machetes, grenades and rifles.

“The Israeli weapons that are getting there are playing an integral role in the fighting,” Zandberg said. “It’s hard for me as an Israel to think that this is happening in my name.”

Zandberg petitioned Defense Minister Moshe Ya’alon in May to cancel the licenses of the weapons companies doing business in South Sudan.

“It has become clear that it’s not possible to monitor the final destination of Israeli defense exports,” she wrote, “and there is an entirely legitimate concern that those exports are being used to carry out war crimes and crimes against humanity.”

Along with her letter, Zandberg included a nearly 20-page report by Mack, who she said is “entirely independent” in his work on this issue, detailing his findings and relevant legal considerations for the appeal.

“The main small arms used are assault rifles especially Kalashnikov… and short and long barrel Israeli-made Galil rifles,” Amnesty International reported in 2014.

A Vice News crew also captured footage of Israeli Galil ACE Model 21 rifles while filming the civil war, Mack noted.

“There exists ongoing cooperation between Israel and South Sudan’s internal security service. Israeli officials have installed and help operate a surveillance network for oversight and internal inspections of South Sudan,” Mack claimed in the accompanying report.

Zandberg received a response from the ministry nearly a month later, though it did not directly address her concerns about South Sudan.

“The defense export policy to all countries is periodically checked by the Defense Ministry, in cooperation with the Foreign Ministry and other authorities, in accordance with the security and political interests of the State of Israel, and this includes considerations of human and civil rights in the destination countries of the export,” Haim Blumenblatt, director-general of the Defense Ministry wrote.

“Of course, the existence of a civil war in the export destination country has consequences on the defense export policy to that country,” he added, the only allusion to the war-torn country in the response.

Zandberg also proposed new legislation that would require the oversight agency to reject a company’s request if it is believed the weapons may be used to commit human rights violations. The current law only requires “considerations regarding the end-user or the end-use.”

Zandberg proposed her bill before the Knesset disbanded for the summer, but it has yet to be voted on.

Weapons from Israel, China and Eastern Europe
Only Israel, China and some Eastern European countries have continued to sell weapons to the youngest nation in the world, and the international community has yet to declare an arms embargo on the battered region.

“Even if we are selling weapons to South Sudan, I don’t know of any restrictions on doing so,” Yatom said.

That may change soon. The US on Wednesday circulated a draft resolution to the Security Council calling for an arm embargo if peace is not reached by September 1, though Russia has expressed reservations.

There have already been seven ceasefires since the the bloody civil war began in 2013, but these were used by both sides to rearm.

As news of atrocities came to light, US President Barack Obama issued an executive order to stop arms sales South Sudan in 2014.

Yatom, however, claimed that this US embargo is in name only. “I don’t believe that,” Yatom said. “To the best of my knowledge, the United States is involved in South Sudan.”

In December of last year, the European Union, which includes some of the largest weapons contractors — Germany, France, Italy, the United Kingdom and Spain — similarly banned arms sales to the African nation.

Yatom does not believe Israeli weapons and systems are reaching the civil war. If they did, he said, he too would support an arms embargo on the country.

Dubi Lavi, head of the Israeli Defense Export Controls Agency, made a similar statement earlier this year in an interview with the Israeli financial newspaper Globes.

“We don’t want to see an Israeli weapon shooting a child or innocent person in any country,” he said, refusing to discuss South Sudan specifically.

“In places where we fear this can happen, we do not allow business deals,” he said.

Lavi’s department, however, is made up of just two people, Mack noted, making strict enforcement over the nearly 7,000 defense exporters an untenable goal.

This is not the first time Israel has sold weapons to countries accused of human rights violations.

Israel sold weapons to South Africa throughout the apartheid-era and to Guatemala during its 36-year civil war in which the military allegedly carried out a genocide against the native Mayan population. Israel even provided weapons to Iran in the 1980s for its war against Iraq.

Mack has petitioned to have the details of Israeli arms sales to Rwanda and Bosnia during the genocides there in the 1990s released, though they were denied on national security grounds late last year by a district court. Mack has since appealed those decisions and will argue before the Supreme Court later this year.

Benefit of End-Stage Chemotherapy Is Questioned

It is an excruciating question for cancer patients with a prognosis of only months to live. Should they try another round of chemotherapy?

Guidelines for oncologists say no for very sick patients, those who are often bedridden and cannot handle most daily needs themselves. But for patients who are more self-sufficient, chemotherapy is considered a reasonable option. Despite its well-known toxic side effects, many end-stage patients and their doctors have considered chemotherapy worth trying, believing it may ease discomfort or buy time.

Now, a study suggests that even those stronger patients may not benefit from end-of-life chemotherapy — and that for many their quality of life may worsen in their final weeks compared with patients who forego last-ditch treatment.

“It worsened quality of life for those that are relatively healthy, and those are the ones that the guidelines support treating,” said Dr. Charles Blanke, a medical oncologist at Oregon Health and Science University, who was not involved in the study. “Chemotherapy is supposed to either help people live better or help them live longer, and this study showed that chemotherapy did neither.”


Mr. Johnson died in 2012 at 39. His mother said she didn’t think the treatments made a difference.

The study, published Thursday in JAMA Oncology, followed 312 adult patients with a prognosis of six months or less to live. The patients, in six oncology clinics across the country, all had solid-tumor cancers that had metastasized. The types included lung, colon, pancreatic and breast cancer, among others. About half opted for end-stage chemotherapy.

After each died, researchers asked the relative or caregiver most knowledgeable about their well-being to rate the patient’s physical and psychological distress and overall quality of life in their last week of life. (The caregivers’ views were considered reliable because their assessment at the study’s outset matched the patients’ own quality-of-life assessments.)

For patients who were sicker at the start, caregiver ratings of their last week’s quality of life were similar whether they received chemotherapy or not. But for the 122 patients with fewer initial symptoms, results were striking. Of those receiving chemotherapy, 56 percent were reported to have lower quality of life in their last week, compared to 31 percent of those who did not have chemotherapy.

Holly G. Prigerson, a director of the Center for Research on End-of-Life Care at Weill Cornell Medical College and the study’s principal investigator, said she and colleagues had expected “the exact opposite.”

“The real kicker is it’s the people who are performing well, who are thinking they’re going to benefit, that didn’t,” she said.

Perhaps healthier patients might feel greater dismay from the side effects because they had “further to fall,” said Dr. Blanke, who cowrote an editorialabout the study.

Researchers also said there was no difference in survival between chemotherapy and non-chemotherapy groups. However, the study was not devised to measure survival, and experts cautioned against relying on those observations.


Voula Muckalli with a portrait of her mother, Joana, who died in 2014 of ovarian cancer. She said her family did not regret the chemotherapy she sought. CreditYana Paskova for The New York Times

Some oncologists said that while the study tackled a difficult question carefully, patients and doctors should avoid generalizing based on its results. Dr. Thomas E. Gribbin, an oncologist in Grand Rapids, Mich., noted that patients were seen between 2002 and 2008, before some newer chemotherapy drugs with fewer side effects or the ability to directly target certain tumors or cancer-causing mutations.

“Doctors have been learning who not to treat and I think this captures what we did 10 years ago,” Dr. Gribbin said. “A lot of the chemicals we would use today are not necessarily toxic to every organ in your body. And we have improvement in how we manage side effects.”

Most important, he and others said, is that chemotherapy advice to patients should be highly individualized.

“Some patients desire to live as long as possible, some people are looking for excellent quality of life all along, and some people want to hang on three months till their daughter’s wedding,” Dr. Gribbin said.

Dr. Lowell E. Schnipper, chairman of the American Society of Clinical Oncology’s task force on value in cancer care, said the organization’s guidelines, which were based on chemotherapy’slikelihood of diminishing end-stage tumors, “not the likelihood of improved quality of life” should remain for now. But he added that future guideline discussions would likely consider quality-of-life studies.

“I’m not ready to have a public proclamation saying the default position is no therapy unless every salvageable option is investigated and undertaken,” said Dr. Schnipper, clinical director of Beth Israel Deaconess’s cancer center in Boston. But he said the results supported the need to study treatment effects on well-being and to have candid conversations with patients. “What we really want to know is not if it gives you an extra six weeks, but were those six weeks like being in hell, or pretty good, or three of them were wonderful.”

Christopher Johnson, who died in 2012 at 39 from a rare kidney cancer, received late-stage chemotherapy because he “wanted to do anything he could to prolong his life,” said his mother, Ritchie Johnson, of Sugar Land, Tex. Looking back, she said, she would have advised against it because he had “huge side effects” and “the tumors were still growing.”


Brian Whalen, 75, is undergoing chemotherapy for pancreatic cancer. “I am not getting better and I do not expect to,” he said.CreditAdam Bird for The New York Times

”The quality of life was just not there,” she concluded.

Joana Muckalli of Brooklyn, whose ovarian cancer spread brutally, chose “chemo after chemo” until shortly before her death last year at 53, said her daughter, Voula. Mrs. Muckalli “wanted to prolong the chemotherapy” partly to see the birth of her first grandchild, her daughter said, sobbing as she recalled how, hours before she died, her mother told the baby “Grandma loves you so much.”

“To our family it seemed the only option,” she said, and “we don’t regret it.”

The new study was not a randomized trial, which might be ethically impossible, experts said. And some potentially useful information was either unavailable or not reported, including the type of chemotherapy and patients’ previous treatment history.

Why some chose end-of-life chemotherapy was unclear, although patients who did were more likely to have pancreatic or breast cancer and be younger, more educated, healthier and treated in academic medical centers.

Quality of life in the last week was assessed with three broad questions, providing only a snapshot. Dr. Prigerson said future studies should include monthly assessments with more detailed questions.

Oncologists said it was important to realize that patients’ situations and desires can change.

A pancreatic cancer patient of Dr. Gribbin’s, Brian Whalen, 75, has so far chosen chemotherapy. Its side effects are tolerable, he said, and he has survived months longer than initially predicted.

But, he said, “I am not getting better and I do not expect to.”

If side effects worsen or he becomes more disabled, Mr. Whalen said he would stop treatment. “I will not go out miserable. I would hope to be able to smile until my last day.”

New York prison escape: Killers still on the run as prison employee questioned

(CNN)There’s almost no doubt someone helped the killers get out. The question is who.

Richard Matt and David Sweat have been on the run for more than three days now. The convicted murderers apparently used power tools to cut out of their cells at the Clinton Correctional Facility in upstate New York, navigated a complex maze of pipes and popped out of a manhole, one block away.

Female employee questioned

An employee who tailored clothing at the prison is being questioned as a possible accomplice, a law enforcement source briefed on the investigation told CNN on Monday.

The woman knows the two escapees “very well,” the source said.

While the woman has not been arrested nor charged, criminologist Casey Jordan said the notion of a female employee succumbing to male inmates is certainly possible.

“I don’t want to admit that it happens, but I know women who have met men in prisons working there, and fallen in love, and quit their jobs and married them when they got out,” Jordan said.

“We call this, very often, hybristophilia. It is the psychological phenomenon where women are attracted to a bad boy. And sometimes the worse he is, the more deep the attraction.”

Matt and Sweat are indeed some of the worst of the worst.

Are New York prison escapees looking for payback?

Are New York prison escapees looking for payback? 02:30

Matt was convicted on three counts of murder, three counts of kidnapping and two counts of robbery after he kidnapped a man and beat him to death in December 1997, state police said. He was sentenced to 25 years to life in prison.

But he is also a veteran of prison breaks. In 1986, he escaped from an Erie County jail, the New York governor’s office said. Upon his capture, Matt was sent to a maximum security prison in Elmira, New York, on charges of escape and forgery. He was released from the Elmira Correctional Facility in May 1990.

Sweat was serving a life sentence without parole for killing sheriff’s deputy Kevin Tarsia in 2002.

The slain deputy’s brother, Steven Tarsia, said knowing Sweat is on the loose is “like living the nightmare over again.”

“I just hope he doesn’t come back here,” he said.

New York escapees’ violent pasts brings urgency

A well-planned escape

The complexity of the escape has astonished prison experts and Gov. Andrew Cuomo, who toured the inmates’ escape route.

“It was really unbelievable,” Cuomo said. “If it was a movie plot, you would say that it was overdone.”

He said the inmates cut through a cell wall that included steel a quarter-inch thick, maneuvered across a catwalk, shimmied down six stories to a tunnel of pipes, followed that tunnel, broke through a double-brick wall, cut into a 24-inch steam pipe, shimmied their way through the steam pipe, cut another hole so they could get out of the pipe, and finally surfaced through a manhole.

“This is one of the great escapes … that I’ve ever seen,” said bounty hunter Duane “Dog” Chapman, who has been working for over 35 years. “If they did as much planning to get away as they did to get out of the prison, they’re gone.”

From rain coats to helicopters: Amazing prison escapes

Phantom power tools

One enormous question is how Matt and Sweat got hold of power tools. Another is why guards didn’t hear the power tools being used.

Cuomo said it’s possible the tools came from contractors performing maintenance work on the 170-year-old prison in Dannemora. The company that employs the maintenance workers has been cooperating with the investigation, New York State Police Maj. Charles Guess said.

Another theory: Perhaps the female employee who worked on inmates’ clothing hid power tools in bundles of clothes, said Larry Levine, a former federal inmate and founder of Wall Street Prison Consultants.

As far as why guards apparently didn’t hear the power tools being used, CNN law enforcement analyst Tom Fuentes said it’s possible the cutting took place during the daytime — when noise from the maintenance workers may have drowned out the sound.

Staying under the radar

The governor announced a $100,000 reward for information leading to the capture of Matt and Sweat. But experts say the two men will do everything they can to stay under the radar.

“You know how you feel when you run a red light and you see a cop right there, you panic? Times 10, that’s what they feel like right now,” Chapman said.

He said he’s confident the two killers will get caught — but when that happens, officers will need to be extremely careful.

“These kinds of guys here will hold court in the street,” he said. “They have nothing to lose.”

Lessons for prisons

No one had managed to escape from the maximum security part of Clinton Correctional Facility in its 170-year history — until this past weekend.

Levine said the prison break should prompt older prisons to upgrade their infrastructure — perhaps by installing wall sensors and motion sensors.

Chapman said even prisons that have never had an escape should be on alert.

“Whatever a man can build, a man can break.”

Source: Employee questioned in New York prison escape

Story highlights
Source declines to comment on nature or extent of help worker may have provided
Killers left decoys to trick guards into thinking they were asleep
They left a sticky note with a smiley face reading, “Have a Nice Day!”

(CNN)An employee at the Clinton Correctional Facility in New York is being questioned as a possible accomplice in the escape of two convicted killers over the weekend, a law enforcement source briefed on the investigation confirmed to CNN.

The source would not comment on the extent of the woman’s involvement or the kind of help she may have provided.

The development comes after New York Gov. Andrew Cuomo said the inmates — Richard Matt and David Sweat — must have had help in carrying out the intricate plot, which involved using power tools to cut through steel walls and clambering through a maze of underground pipes, according to authorities.

“They wouldn’t have had the equipment on their own, that’s for sure,” Cuomo told CNN of the convicted killers, who cut their way out of the prison sometime after they were last seen at bed check Friday night.

In their place, the pair left decoys to trick guards into thinking they were asleep in their bunks — and a yellow sticky note with a smiley face. It read, “Have a Nice Day!”

Now, red-faced officials are looking for the men, who authorities say used the power tools to cut through the walls of their cells and shafts to freedom.

Despite a $100,000 reward and a manhunt involving some 250 law enforcement officials, Matt and Sweat — both serving lengthy sentences — were still on the loose Monday.

“They could be literally anywhere,” said Maj. Charles E. Guess of the New York State Police, which is leading the search.

Tricking the guards
People call the Clinton Correctional Facility in Dannemora, New York, “Little Siberia.”

That’s in part because of its remote location — in the sparsely populated northeast corner of New York, about 25 miles from the Canadian border.

And also because it’s in a region where wintry weather can persist more than half the year.

The facility has 2,689 inmates, and two of its most notorious inhabitants were Matt, 49, and Sweat, 35.

They apparently were last seen at 10:30 p.m. Friday during a standing count — head counts that are performed every two hours throughout the night when guards visually check to see whether inmates are in their bunks.

The pair tricked the guards by arranging things in the bunks to look “like people were sleeping … with these sweatshirt hoodies on,” Cuomo said.

The inmates — who occupied side-by-side cells — apparently cut through a steel wall using power tools.