9.1 Know Your Rights (Work in Progress)

At-A-Glance:

Consent and the Indian medical practitioner – PMC(opens in a new tab)

This section borrows from and is an Indian adaptation to some of the amazing and inspirational work done by the brave people of Canada in their website – StandUp Canada.

All sections in Red Font are work in progress in terms of adaptation to Indian laws & situation.



1. Natural Rights versus Legal Rights

We are now at the time where everyone needs to understand the difference between our rights (your natural rights) given to us from the divine consciousness and legal rights to decline medical treatment/ intervention/ procedure.

Natural rights are yours from birth – freedom is your birthright

These can include, but are absolutely not limited to:

  • being treated with respect and dignity and to provide same to others
  • earning a living to support you and your family and dependents
  • religious worship
  • expressing yourself however you choose
  • associating with whomever you please
  • going anywhere on divine green earth – where you want, when you want and for as long as you want 
  • saying NO to anything you do not want put on or inside your body, mind and consciousness.

You do not need to ask for permission from anyone for your Natural rights i.e your inalienable rights. The government did not give you these INHERENT rights, therefore, they cannot take them away. They were given to you from the moment of your arrival on this planet.

Legal rights are supposed to PROTECT your Natural inalienable rights

But they have been limited by man, or the state’s imposition on what they “deem” you are free to do.

  • man has decided, since the beginning of organized time, that we cannot be trusted to govern ourselves and thus the era of master/ slave began – are we still living this way today?

You must ask yourself this most fundamental question with respect to mandatory/ forced medical treatment – WHO OWNS YOUR BODY – YOU OR THE STATE?

Who owns your body – You or the State?

If you decide that YOU own your body, then all you have to do is JUST SAY NO to anything you do not want to touch your body – including mandatory injections.  I DO NOT CONSENT!

  • Saying NO means that you are NOT CONSENTING to medical treatment
  • Saying NO to forced mandatory vaccinations (any forced medical treatment actually) protects medical freedom in India

What about the consequences for taking this stand?

The point of taking a stand is to PROVOKE A RESPONSE, and to continue to provoke until they respond or change the law/rules/requirements.

Our ancestors during the Freedom Movement in India, against British Rule, lead us in this manner:

  • they employed nonviolent resistance to lead the successful campaign for our independence from the British rule and in turn inspired movements for civil rights and freedom across the world 
  • we have the absolute benefit of learning from history – we can do this, we must
  • this is civil disobedience – do not be afraid of this term – this is the ONLY way to change such unlawful policies during times of tyranny

The response may be discipline or termination from employment – what can you do? 

  • send a counter offer to your company/ employer addressed Human Resource department or any other relevant officer, stating your willingness to take the medical treatment offer with conditions and asking for details. Draft Letter – Questions to Employer.
  • send a Notice of Personal Liability for damages of lost income and other harms.
  • find an employment lawyer and sue for wrongful dismissal
  • file a complaint against your labour union to the Labour Commissioner of the District/ Division/ State/ Region/Central, if they are unwilling to grieve these mandates, for failure to properly represent you (Duty to Fair Representation)
  • file a victim statement to the Police to charge your employer with extortion and possibly assault under the Criminal Procedure Code of India
  • file a complaint against the Police Officer who will not do their job and charge your employer with extortion or possibly assault

The response may be denial of services from public spaces – what can you do? 

  • try and talk to the owner and let them know how their policy is violating your rights; the point is to let them know that you are trying to help them mitigate any risk of liability to them of further action you will take if they don’t change their policy
  • submit a complaint to the human rights tribunal for discrimination
  • send a Notice of Personal Liability for damages
  • file a civil lawsuit for damages

The response may be societal – your friends, family or neighbours may shun you – what can you do? 

  • try and talk to them; let them know that you are standing up for their rights too!
  • invite them to our Free Earth Alliance (FEA) Telegram Broadcast channel & public facing zoom meetings (stay in tune with FEA on our broadcast channel), so they can hear us, and we can have an opportunity to communicate with them directly.
  • share some of the documents/ articles we have put together for such situations (1.0, 2.0, 3.0 and others.)
  • pray for their ignorance and forgive them for not being in agreement with you taking a stand for medical freedom
  • find other like-minded individuals in your community and make new friendships, connections for support


2. Fundamental Rights of Living Beings and Citizens

1.0 Fundamental Rights as per the Constitution of India, drafted and ratified by “We The People”

https://www.mea.gov.in/Images/pdf1/Part3.pdf | https://ncert.nic.in/ncerts/l/keps202.pdf

2.0 The International Treaties Conventions and their Influence in India

http://www.legalservicesindia.com/article/2574/The-International-Treaties-Conventions-and-their-Influence-in-India.html

3.0 The Charter of Patient Rights by NATIONAL HUMAN RIGHTS COMMISSION, INDIA

https://nhrc.nic.in/document/charter-patient-rights

4.0 The Patients’ Rights Charter by NHRC were disseminated to all States/UTs for adoption and implementation vide MoHFW letter dated 02.06.2019

http://clinicalestablishments.gov.in/WriteReadData/9901.pdf

5.0 Charter of Patients’ Rights and Responsibilities (As approved by National Council for Clinical Establishments) As updated on 23rd August 2021

http://clinicalestablishments.gov.in/WriteReadData/3181.pdf

6.0 Ministry of Health and Family Welfare’s (GoI) directs States/ Union Territories (Governments) to implement the updated Charter of Patients’ Rights (dated 11.02.2022) in both letter and spirit.

https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1797699

7.0 CODE OF MEDICAL ETHICS REGULATIONS, 2002 (AMENDED UPTO 8th OCTOBER 2016)

(Published in Part III, Section 4 of the Gazette of India, dated 6th April,2002) by MEDICAL COUNCIL OF INDIA)

2.2 Patience, Delicacy and Secrecy:

Patience and delicacy should characterize the physician. Confidences concerning individual or domestic life entrusted by patients to a physician and defects in the disposition or character of patients observed during medical attendance should never be revealed unless their revelation is required by the laws of the State. Sometimes, however, a physician must determine whether his duty to society requires him to employ knowledge, obtained through confidence as a physician, to protect a healthy person against a communicable disease to which he is about to be exposed. In such instance, the physician should act as he would wish another to act toward one of his own family in like circumstances.

7.22 Research:

Clinical drug trials or other research involving patients or volunteers as per the guidelines of ICMR can be undertaken, provided ethical considerations are borne in mind. Violation of existing ICMR guidelines in this regard shall constitute misconduct. Consent taken from the patient for trial of drug or therapy which is not as per the guidelines shall also be construed as misconduct.

https://www.nmc.org.in/rules-regulations/code-of-medical-ethics-regulations-2002/

8.0 Universal Declaration of Human Rights

https://nhrc.nic.in/sites/default/files/UDHR_Eng_0.pdf

9.0 International Covenant on Civil and Political Rights (Ratification date for India – 10 Apr 1979)

https://nhrc.nic.in/sites/default/files/International%20Covenant%20on%20Civil%20and%20Political%20Rights.pdf

10.0 International Covenant on Economic, Social and Cultural Rights (Ratification date for India – 10 Apr 1979)

https://nhrc.nic.in/sites/default/files/International%20Covenant%20on%20Economic%20Social%20and%20Cultural%20Rights.pdf

11.0 Convention on the Rights of the Child (Ratification date for India – 11 Dec 1992)       

https://nhrc.nic.in/sites/default/files/Convention%20on%20the%20Rights%20of%20the%20Child.pdf

12.0 Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment

https://legal.un.org/avl/pdf/ha/catcidtp/catcidtp_e.pdf

13.0 Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment

http://www.un.org/ga/search/view_doc.asp?symbol=a/res/57/199



3. COVID measures that are Medical Treatments

All these measures require your “informed consent”. If you don’t want to consent to these or any other medical treatments or procedures, you do not have to.

COVID-19 injections (“vaccines”)
PCR applicator (“testing”)
antigen test
antibody test
masking
temperature taking
hand sanitizers
physical and social distancing


Definition of Medical Treatment

Anything that affects your health, whether physically, energetically, mentally, emotionally or psychologically

Table of COVID-19 Medical Treatments

Know what you are consenting to – PDF of Table available at end of document

Table of COVID-19 medical treatments – 1
Table of COVID-19 medical treatments – 2

What is Consent under Criminal Law?

The Criminal Procedure Code of India (the CrPC) defines a series of conditions under which the law will deem an absence of consent in cases of assault, notwithstanding, the complainant’s ostensible consent or participation. As stipulated in s.265(3), these include submission by reason of force, fear, threats, fraud or the exercise of authority, and codify the longstanding common law rule that consent given under fear or duress is ineffective – consent given under fear or duress is NOT consent.



4. You need to give “INFORMED” CONSENT before undergoing any Medical Treatment or Procedure

Informed consent means that the person who will administer the medical treatment or procedure, needs to INFORM you of all the benefits and risks associated with the medical treatment or procedure as well as all alternative treatments before you decide if you will consent or not.

Remember,  you still retain the right to REFUSE to consent, even after you have been properly informed as described above. This is MEDICAL FREEDOM.

However, there is a major problem with doctors’ hands being tied by their college, thereby effectively denying you the right to have ALL of the information they know. Their College issued a statement on April 30, 2021 stating “Physicians must not make comments or provide advice that encourages the public to act contrary to public health orders and recommendations“.  This is known as a gag order.  Not only is this unethical, but it is immoral.   [see 8.  Medical Censorship in Canada – Doctors Gag Order in Ontario]

How can anyone possibly give informed consent if they haven’t been told ALL of the risks and benefits?

Elements of sharing of information, for obtaining informed consent –

  • should be shared in simple wordings
  • language should be localized/ vernacular, if the concerned employee is not comfortable in English
  • benefits and risks associated with the medical treatment or procedure
  • all alternative treatments

Elements of consent – your expressed, informed and explicit consent must:

  • related to the treatment
  • be free, prior and complete INFORMED CONSENT
  • be given voluntarily orally and/or in writing
  • NOT be obtained through misrepresentation, force, threat, coercion or fraud by the person or organization seeking your consent
  • consent given, is revocable at any time before the medical treatment is given.
  • if any medical treatment is sought to be given in repetition/ sessions, then informed consent must be obtained before every instance of the medical treatment.
  • the information required to be shared should be up to date including latest anecdotal and empirical data and scientific studies

The laws are clear in India – without consent, either written or oral, no medical procedure and/or treatment may be performed; this is not a mere formality; it is an important individual inalienable right to have control over one’s own body (bodily sovereignty), even when medical treatment is involved; it is always the patient, not the doctor, who decides whether a procedure and/or treatment will be performed and consent cannot be IMPLIED. 

Whether there is any “Health Emergency” declared or not, Right to Informed Consent is a basic human right as per the Indian laws and NHRC’s Charter of Patients’ Rights ratified by Government of India. A doctor (public servant or private) who treats without valid consent is liable under the tort and criminal laws. The law presumes the doctor to be in a dominating position, hence the consent should be obtained after providing all the necessary information i.e. Informed Consent must be provided to the person to be vaccinated prior, free of cost, in simple/ vernacular language and with complete information.

Following official references provide the details about patients right to informed consent:

a) MCI (Medical Council of India) /NMC (National Medical Council ) Code of Ethics section 7.16
b) Annexure 8 of Standards for Hospital Level 1 by National Clinical Establishments Council set up as per Clinical Establishment Act 2010
c) The Consumer Protection Act, 1986
d) Drugs and Cosmetic Act 1940, Rules 2016 on Informed Consent

Article 21 of the Indian Constitution deals with prevention of encroachment upon personal liberty or deprivation of life of a person. The individuals have a legal right to autonomy and self determination, right to regulate treatment and the right to refuse any kind of life-sustaining artificial treatment.

The only exceptions is when a person is considered to not be in a conscious state. In such situation INFORMED CONSENT has to be taken as above, from the family/ caretaker of the concerned person. In any case such person then will also not be suitable for employment, and hence this is not such an important exception in terms of what we are discussing here.

Informed Consent in the Current COVID “Vaccination” Drive

In the current covid vaccination drive, the said vaccines have been conditionally approved for restricted use in emergency situation i.e. it has been given only emergency use authorisation – EUA.

Now the following questions arise with context to the current situation:

1) Is informed consent being provided to any age group? If Not, Why?

2) Even if in the states/ districts where health emergency under Epidemic Diseases Act 1897 / National Disaster Management Act 2005 has been invoked (with or without due process) the parents cannot be denied the right to informed consent for their minor son/ daughter. This stands true even if the child is being given the said vaccine inside the school premises where during emergency situation, the teachers/ principal/ director of the school become loco parenti (local parent). Why this massive violation of the rights of legal parents happening?

“This is a major legal victory for children, parental rights and informed consent. Government overreach such as this has dire implications for children’s health and the constitutional rights of citizens.” — Rolf Hazlehurst, senior staff attorney for Children’s Health Defense (CHD) who argued the case. https://childrenshealthdefense.org/defender/judge-rules-eleven-year-olds-vaccines-parents-consent/

Informed Consent Tips (1993) by The Office for Protection from Research Risks

The process of obtaining informed consent must comply with the requirements of 45 CFR 46.116. The documentation of informed consent must comply with 45 CFR 46.117. The following comments may help in the development of an approach and proposed language by investigators for obtaining consent and its approval by IRBs:

  • Informed consent is a process, not just a form. Information must be presented to enable persons to voluntarily decide whether or not to participate as a research subject. It is a fundamental mechanism to ensure respect for persons through provision of thoughtful consent for a voluntary act. Read More …

Get Your #InformedConsent Now

Informed consent is one of your basic human rights to freely accept (or not accept) a medical intervention, based on knowing the full risks, benefits, risks of not having it, and knowing your alternatives. Get your #InformedConsent now: https://www.pandata.org/informed-consent/ #HumanRightsDay2022

FDA on “Informed Consent”

This draft guidance, when finalized, will represent the Food and Drug Administration’s (FDA’s or Agency’s) current thinking on this topic. It does not create or confer any rights for or on any person and does not operate to bind FDA or the public. You can use an alternative approach if it satisfies the requirements of the applicable statutes and regulations. Read More …

Informed Consent under National Library of Medicine

Informed consent is the process in which a health care provider educates a patient about the risks, benefits, and alternatives of a given procedure or intervention. The patient must be competent to make a voluntary decision about whether to undergo the procedure or intervention.  Informed consent is both an ethical and legal obligation of medical practitioners in the US and originates from the patient’s right to direct what happens to their body. Implicit in providing informed consent is an assessment of the patient’s understanding, rendering an actual recommendation, and documentation of the process. Read More …

Informed Consent under Bio-medical Research

Informed consent is the result of tumultuous events in both the clinical and research arenas over the last 100 years. Throughout this time, the notion of informed consent has shifted tremendously, both due to advances in medicine, as well as the type of data being gathered. As such, informed consent has misaligned with the goals of medical research. It is becoming more and more vital to address this chasm, and begin building new frameworks to link this disconnect. Thus, we address three goals in this paper. First, we discuss the history of informed consent and unify the varying definitions of the term. Second, we evaluate the current research on the topic, classify them into themes, and attend to the problems therein. Lastly, we employ these themes of informed consent research mentioned previously to provide guidance and insight for future research in the arena. Read More …

Ethics and Informed Consent

Alan W. Partin MD, PhD, in Campbell-Walsh-Wein Urology, 2021

Elements of Informed Consent

Informed consent refers to the process by which a patient and medical provider discuss a proposed medical treatment, its anticipated consequences, potential risks and benefits, and alternatives. This process allows for open discussion between the provider and the patient and may theoretically help reduce medical errors, improve patient outcomes, and increase patient empowerment (Cordasco, 2013).

A comprehensive informed consent consists of four basic elements: (1) description of the clinical problem, the proposed treatment, and alternatives including no treatment; (2) discussion of the risks and benefits of the proposed treatment with comparisons to the risks and benefits of alternatives, and discussion of medical/clinical uncertainties regarding the proposed treatment; (3) assessment of the patient’s understanding of the information provided by the medical provider; and (4) solicitation of the patient’s preference and consent for treatment (Cordasco, 2013).

Read More …

Informed Consent For Minors

There are fixed guidelines outlining the exact age of consent for medical or surgical treatment. In India, ‘majority’ is achieved at an age of 18 years and considered a legal age for giving a valid consent for treatment as per Indian Majority Act, Guardian and Wards Act, and Indian Contract Act(11). A child below 12 years (minor) cannot give consent, and parents/guardian can consent for their medical/surgical procedures(12). A child between 12-18 years can give consent only for medical examination but not for any procedure(13).

For children who are orphans or unknown or street children, the court is appointed as a guardian and any procedures/treatment requires court per-mission(14). In case of emergency, when parents/guardians are not available to consent, a person in charge of the child like principal or school teacher can consent for medical treatment (loco parentis)(15). A legal age of 18 years has been set to consent for termination of pregnancy (MTP Act 1971), donation of blood and donation of organs (Transplantation of Human Organ Act 1994)(11).

https://www.indianpediatrics.net/dec2010/dec-1039-1046.htm

In an “emergency” situation, even when National Disaster Management (NDM) Act is applicable, then in case of absence of parents in school, the teacher/ principal (as loco parenti) can give informed consent for the medical intervention i.e. in this case the vaccine, but this will not be implied / applicable when the parent has given / submitted no consent (in writing) in advance itself.

Other Resources on Informed Consent

  1. Informed Consent Guidance by Hopkins Medicine
  2. https://pediatrics.aappublications.org/content/pediatrics/138/2/e20161484.full.pdf
  3. https://bioethicsarchive.georgetown.edu/pcsbi/sites/default/files/1%20Informed%20Consent%20Background%209.30.16.pdf
  4. https://www.who.int/bulletin/volumes/82/10/en/771.pdf?q=informed
  5. https://www.unep.org/ozonaction/informal-prior-informed-consent-mechanism
  6. Free, Prior and Informed Consent: Protecting Indigenous Peoples’ rights to self-determination, participation, and decision-making
  7. Digital tools in the informed consent process: a systematic review
  8. Consent and the Indian Medical Practitioner – PMC
  9. https://www.legalserviceindia.com/legal/article-2073-informed-consent.html
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779959/
  11. Law on consent and confidentiality in India: A need for clarity [PDF]

https://www.legalserviceindia.com/legal/article-2073-informed-consent.html

https://www.indianpediatrics.net/dec2010/dec-1039-1046.htm



5. Without Consent it is Assault

In Indian law, a patient must CONSENT to any medical treatment otherwise it’s a form of battery, otherwise known as an assault. It is important to note that there is assault as an intentional tort as well as assault under the Criminal Procedure Code of India.  An assault is any application of force on an individual without their consent. Medical doctors can be charged with assault and battery if the courts determine that informed consent, with all of the elements above, was not provided by the patient.

Textbook of Criminal Law (2nd edition 1983), at pp. 551-61. This section reads as follows: section 265

(3) For the purpose of this section, no consent is obtained where the complainant submits or does not resist by reason of

(a) the application of force to the complainant or to a person other than the complainant;

(b) threats or fear of the application of force to the complainant or to a person other than the complainant;

(c) fraud; or

(d) the exercise of authority

If you don’t think your employer is “exercising their authority” to force you to take a mandatory vaccine, think again.

The rationale underlining the criminalization of assault, society is committed to protecting the personal integrity both physical and psychological of every individual – having control over who touches one’s body and how, lies the core of human dignity and autonomy.



6. Your Patient Rights – Consent to Treatment

Alberta

British Columbia




7. Legal Rights to Refuse Medical Treatment

You have free will to make your own choices about your health with no reprisal for declining medical treatment or procedure. Medical, religious and philosophical objections to vaccination will likely surpass the employer’s health and safety obligations in the workplace.

1.  Provincial/Territorial Health Care Consent Acts [see 6. Your Patient Rights by Province and Territory – Consent to Treatment]

  • these Acts state all the elements of consent that you need in order to be properly “informed” before you decide or consent on any medical treatment
  • there is no “informed” consent because of the medical censorship [see 8. Medical Censorship in Canada]
  • you cannot give your “informed” consent because no one is telling you the truth about the health risks involved – if they did, would you still be willing to inject yourself with these experimental injections that are known to cause mild to severe adverse reactions including death? 

2.  Canadian Charter of Rights and Freedoms

  • section 2 (a) freedom of conscience and religion
  • section 7 – everyone has the right to life, liberty, and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice
  • you have the Right to Liberty – a protection of personal autonomy involving “inherently private choices” 
  • this aspect of liberty includes the RIGHT TO REFUSE MEDICAL TREATMENT
  •  section 15  – (1) Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability. 
  • your medical information is protected under this right

3.  Canadian Human Rights Act – the purpose of this Act is that all individuals should have an opportunity equal with other individuals to make for themselves the lives they are able and wish to have … without being hindered or prevented from doing so by discriminatory practices 

  • employees could refuse to be vaccinated on a protected ground for discrimination under the Act, and the employer has a duty to accommodate the employee to the point of “undue hardship”

Here are the PROTECTED GROUNDS for discrimination under section 3(1) of the Act:

  • race, national or ethnic origin, colour, religion, age, sex, sexual orientation, gender identity or expression, marital status, family status, genetic characteristics, disability and conviction for an offence for which a pardon has been granted or in respect of which a record suspension has been ordered

Here are the DISCRIMINATORY PRACTICES:

  • Section 5 deals with denial of good, service, facility or accommodation
  • Section 6 deals with denial of commercial premises or residential accommodation
  • Section 7 deals with employment 

4.  Canadian Bill of Rights 1960 – you have the right to decide what medical treatment you accept under section 1 (a) and (b)   

  • Section 1(a) the right of the individual to life, liberty, security of the person and enjoyment of property, and the right not to be deprived thereof except by due process of law; 
  • Section 1(b) the right of the individual to equality before the law and the protection of the law;  

While the Canadian Bill of Rights is not part of Canada’s Constitution, it was in fact Canada’s first federal law to protect human rights and fundamental freedoms and it still applies to only federal laws and government actions because provincial consent was not obtained (does not apply to provincial laws).



8. Medical Censorship in India – Doctors Gag Order

The Ontario College of Physicians and Surgeons have effectively removed the “informed” portion of “informed consent” by tying doctor’s hands from speaking out contrary to public health measures.  This is known as a gag order.  

On April 30, 2021, Ontario’s physician licensing body, the College of Physicians and Surgeons of Ontario (CPSO), issued a statement forbidding physicians from questioning or debating any or all of the official measures imposed in response to COVID-19. 

  • You will find their public statement below under PDF & JPG Downloads“.

The CPSO then went on to threaten physicians with punishment – investigations and disciplinary action.

What does this effectively do?  It ties doctors hands because they are not allowed to tell you anything that runs contrary to the public health narrative. This also means, that YOU are prevented from giving your true “informed” consent.

This is not only unethical, it is immoral.

Thousands of doctors in Canada and around the world responded to this unethical statement of orders by creating a DECLARATION OF NON-COMPLIANCE.

  • We regard this recent statement of the CPSO to be unethical, anti-science and deeply disturbing.
  • As physicians, our primary duty of care is not to the CPSO or any other authority, but to our patients.  

Please read this Declaration of non-compliance https://canadianphysicians.org/ 

  • use this in your defence to refuse medical treatment 
  • you have a legal right to be “informed” of the risks associated with any medical treatment; you need to be “informed” first, before you give your “consent” 


9. Your Medical Health is Protected by Privacy Laws

Your personal medical health and choices you make about your health are no one’s business but yours and your doctors! 

  • your medical health and the choices you make about your health are private, confidential and are not required to be disclosed to anyone “have you got the covid-19 vaccine yet?” – DO NOT RESPOND
  • employers have no right to ask you to disclose your medical health or ask you about any choice you will make about your health – THEY KNOW THIS 

Your privacy is protected under the Personal Information Protection and Electronic Documents Act, 2000 (PIPEDA) applies federally.

Here are the Provincial/Territory privacy laws for your Personal Health Information:

Alberta

collaboration/provincial-and-territorial-privacy-laws-and-oversight/



10. Stand in Your Power

We have had almost twenty-three months of lockdowns from March 2020. We have seen and lived the devastation this has caused. KNOW your LAWFUL RIGHTS and STAND UP for them. This would all be over if everyone knew how their natural and legal rights were being violated from the start. 

The only approval you ever need is your own – that’s the ultimate truth! Give yourself YOUR APPROVAL to stand up and say no.

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