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Can China Reverse Its Population Decline? Just Ask Sweden.

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Can China Reverse Its Population Decline? Just Ask Sweden.

China’s inhabitants has begun to say no, a demographic turning level for the nation that has world implications. Consultants had lengthy anticipated this second, nevertheless it arrived in 2022 a number of years sooner than anticipated, prompting hand-wringing amongst economists over the long-term impacts given the nation’s immense financial heft and its position because the world’s producer.

With 850,000 fewer births than deaths final 12 months, no less than in response to the nation’s official report, China joined an increasing set of countries with shrinking populations brought on by years of falling fertility and sometimes little and even detrimental web migration, a gaggle that features Italy, Greece and Russia, together with swaths of Japanese and Southern Europe and a number of other Asian nations like South Korea and Japan.

Even locations that haven’t begun to lose inhabitants, reminiscent of Australia, France and Britain, have been grappling with demographic decline for years as life expectancy will increase and ladies have fewer youngsters.

Historical past suggests that after a rustic crosses the brink of detrimental inhabitants development, there may be little that its authorities can do to reverse it. And as a rustic’s inhabitants grows extra top-heavy, a smaller, youthful technology bears the growing prices of caring for a bigger, older one.

Though China’s birthrate has fallen considerably during the last 5 many years, it was lengthy a rustic with a comparatively younger inhabitants, which meant it may stand up to these low charges for a very long time earlier than beginning to see inhabitants losses. Like many developed international locations, China’s older inhabitants is now swelling — a consequence of its earlier growth — leaving it able much like that of many rich nations: in want of extra younger folks.

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Nations such because the U.S. and Germany have been capable of depend on sturdy immigration, even with comparatively low birthrates. However for international locations with detrimental web migration, reminiscent of China, extra folks requires extra infants.

“The excellent news is that the Chinese language authorities is totally conscious of the issue,” mentioned Yong Cai, a sociologist on the College of North Carolina, Chapel Hill, who makes a speciality of Chinese language demographics. “The unhealthy information is, empirically talking, that there’s little or no they will do about it.”

That’s as a result of the playbook for reinforcing nationwide birthrates is a fairly skinny one. Most initiatives that encourage households to have extra youngsters are costly, and the outcomes are sometimes restricted. Choices embody money incentives for having infants, beneficiant parental depart insurance policies and free or backed youngster care.   

20 years in the past, Australia tried a “child bonus” program that paid the equal of almost 6,000 U.S. {dollars} a baby at its peak. On the time the marketing campaign began in 2004, the nation’s fertility price was round 1.8 youngsters per girl. (For many developed nations, a fertility price of two.1 is the minimal wanted for the inhabitants to stay regular with out immigration.) By 2008, the speed had risen to a excessive of round 2, however by 2020, six years after this system had ended, it was at 1.6 — decrease than when the money funds had been first launched.

By one estimate, the initiative led to a further 24,000 births.

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Dr. Liz Allen, a demographer at the Australian Nationwide College, mentioned that this system was largely ineffective and that publicly funded paternity depart and youngster care would have been a simpler use of taxpayer cash. “Authorities intervention to extend fertility charges is finest centered on addressing the problems that stop folks from having their desired household measurement,” she mentioned.

Consultants say the simplest initiatives handle social welfare, employment coverage and different underlying financial points. France, Germany and Nordic international locations like Sweden and Denmark have had notable success in arresting the decline in birthrates, typically by means of government-funded youngster care or beneficiant parental depart insurance policies.

However even the success of these efforts has had limits, with no nation capable of attain a sustained return to the two.1 substitute price. (The U.S. price fell under 2.1 within the Seventies, slowly rose again as much as the substitute price by 2007, then collapsed once more after the Nice Recession, to a present stage slightly below 1.7.)

“You’re not going to reverse the development, however when you throw within the kitchen sink and make childbearing extra engaging,  you might be able to stop the inhabitants from falling off a cliff,” mentioned John Bongaarts, a demographer on the Inhabitants Council, a analysis establishment in New York.

Sweden is usually cited as a mannequin for growing fertility charges, because of a government-boosted bounce in its birthrate. After introducing 9 months of parental depart within the Seventies and implementing a “velocity premium” in 1980 (which incentivized moms to have a number of youngsters inside a set interval), Sweden noticed fertility rise from round 1.6 early within the decade to a peak simply above the substitute price by 1990. (The nation has since elevated its parental depart to 16 months, among the many highest on the planet.)

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After that uptick, nevertheless, Sweden’s birthrate fell by means of the ’90s. During the last 50 years, its fertility price has fluctuated considerably, rising roughly in tandem with financial booms. And whereas the nation nonetheless has one of many highest fertility charges among the many most superior economies, over the previous decade it has adopted a trajectory much like that of most developed nations: down.

Current analysis suggests a cause Sweden’s fertility spikes had been solely momentary: Households rushed to have youngsters they had been already planning to have. Stuart Gietel-Basten, a demographer on the Hong Kong College of Science and Know-how, mentioned monetary incentives seldom improve the general variety of youngsters born, however as an alternative encourage households to reap the benefits of advantages that won’t final. The spikes, he added, can have unexpected penalties. “When you could have 50,000 youngsters born one 12 months, 100,000 the subsequent, after which 50,000 the 12 months after that, it’s actually unhealthy for planning and training,” he mentioned.

Few international locations have embraced pronatalist insurance policies as vigorously as Hungary, whose right-wing populist chief, Viktor Orban, is dedicating 5 p.c of the nation’s G.D.P. towards growing birthrates. The federal government encourages procreation by means of beneficiant loans that change into items upon the beginning of a number of youngsters, tax forgiveness for moms who’ve three youngsters, and free fertility remedies.

Across the time these efforts started underneath Mr. Orban in 2010, Hungary’s fertility price was simply over 1.2, among the many lowest in Europe. Over the 2010s, that price climbed to round 1.6 — a modest enchancment at a excessive value.

It stays to be seen how far China will go to stem its decline in inhabitants, which was set in movement when the nation’s fertility price started to plummet many years in the past. That drop started even earlier than the nation’s household planning insurance policies limiting most households to a single youngster, launched in 1979. Those that defied the foundations had been punished with fines and even compelled abortions.

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The official finish of Beijing’s one-child coverage in 2016, nevertheless, has not led to an increase in births, regardless of money incentives and tax cuts for fogeys. The nation’s fertility price rose barely round that point, however has fallen since, in response to information from the United Nations: from round 1.7 youngsters per girl, on par with Australia and Britain, to round 1.2, among the many lowest on the planet. That latest drop could possibly be a results of unreliable information from China or a technical impact of delays in childbearing, nevertheless it probably additionally displays a mixture of varied pressures which have mounted within the nation over time.

Though they’re now allowed to, many younger Chinese language should not fascinated about having massive households. Vastly extra younger Chinese language persons are enrolling in increased training, marrying later and having youngsters later. Raised in single-child households, some have come to see small households as regular. However the greater obstacle to having a second or third youngster is monetary, in response to Lauren A. Johnston, an economist on the College of Sydney who research Chinese language demographics. She mentioned many dad and mom cite the excessive value of housing and training as the primary impediment to having extra youngsters. “Folks can’t afford to purchase house for themselves, not to mention for 2 youngsters,” she mentioned.

China’s authorities may ease the burden on younger households by means of housing subsidies, prolonged parental depart and elevated funding for training and pensions, specialists say. Different coverage modifications, like reforming the nation’s restrictive family registration system and elevating the official retirement age — feminine blue-collar employees should retire at 50, for instance — may enhance the nation’s working-age inhabitants, assuaging a few of the financial pressure that comes with inhabitants decline.

Although the Chinese language are unlikely to seek out extra success than the Swedes in recovering a excessive fertility price, “there may be low-hanging fruit that may permit them to squeeze extra productiveness and better labor drive participation from the inhabitants,” mentioned Gerard DiPippo, a senior fellow on the Middle for Strategic and Worldwide Research.

All this factors to a Chinese language inhabitants, at present 1.4 billion, that’s prone to proceed shrinking. In distinction to economists who’ve forged China’s inhabitants decline as a grim signal for world development, many demographers have been extra sanguine, noting the advantages of a smaller inhabitants.

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John Wilmoth, director of the Inhabitants Division on the United Nations, mentioned that after many years of exponential development through which the world’s inhabitants doubled to greater than seven billion between 1970 to 2014, the doom-and-gloom assessments about declining fertility charges and depopulation are typically overstated. Japan has been battling inhabitants decline for the reason that Seventies, he famous, nevertheless it stays one of many world’s largest economies. “It has not been the catastrophe that folks imagined,” Mr. Wilmoth mentioned. “Japan shouldn’t be in a dying spiral.”

Worldwide, fertility stays above the substitute price, which implies that permitting extra immigration will proceed to be an possibility for a lot of developed nations, even people who traditionally haven’t relied on it: Earlier than the pandemic, web migration into Japan, whereas comparatively low, had been growing steadily.

With out immigration, pragmatic and noncoercive measures that encourage dad and mom to have households whereas pursuing careers — in addition to insurance policies that permit folks of their 60s and 70s to maintain working — are the important thing to managing detrimental inhabitants development, Mr. Wilmoth mentioned. “Inhabitants stabilization is total a superb factor,” he mentioned. “All societies have to adapt to having older populations. What actually issues is the velocity of change, and how briskly we get from right here to there.”

 

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L.A.'s newest dinosaur has its forever name

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L.A.'s newest dinosaur has its forever name

The people have spoken, and L.A.’s newest Jurassic-era resident has its forever name.

Dinosaur fans who responded to the museum’s request for input overwhelmingly chose to call the Natural History Museum’s new 70-foot-long sauropod “Gnatalie.”

More than 36% of roughly 8,100 participants in a public poll chose that name, which is pronounced “Natalie,” from among five options offered by the museum.

A rendering of the new dinosaur display at the Natural History Museum. Dinosaur fans who responded to a museum poll have decided to call the 70-foot-long sauropod “Gnatalie.”

(Frederick Fisher and Partners, Studio MLA, and Studio Joseph / NHMLAC)

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The punny moniker is a reference to the relentless swarm of gnats that plagued paleontologists, students, museum staff and volunteers during the 13-year effort to unearth the dinosaur’s remains from a quarry in southeast Utah. Museum staff nicknamed the dinosaur Gnatalie while they were still digging it up, a process that lasted from 2007 to 2019.

The long-necked, long-tailed skeleton will be the focal point of the NHM Commons, a $75 million welcome center currently under construction on the southwest end of the museum in Exposition Park. Slated to open this fall, the Commons will offer gardens, an outdoor plaza, a 400-seat theater and a glass-walled welcome center that can be toured without a ticket.

“The efforts of hundreds of people contributed to what you see here, ground to mount,” said paleontologist Luis Chiappe, director of the Dinosaur Institute at the Natural History Museum of Los Angeles County.

The specimen appears to be part of a new species, similar to the Diplodocus, which will be scientifically named in the future. Thanks to celadonite minerals that replaced organic matter during the fossilization process, the mounted skeleton has a unique greenish-brown hue.

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The skeleton is made up of about 350 fossils from six different animals whose bones washed into a river after death some 150 million years ago and commingled.

“We are delighted to see how many people voted and how much they loved our name for this unusual dinosaur,” said Lori Bettison-Varga, President and Director of the Natural History Museums of Los Angeles County.

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Mexico may legalize magic mushrooms. Will this traditional medicine lose its meaning?

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Mexico may legalize magic mushrooms. Will this traditional medicine lose its meaning?

Alejandrina Pedro Castañeda opened a brown paper package and pulled out a handful of magic mushrooms, which many residents of this Indigenous Oaxacan town tenderly refer to as “child saints” or “the little ones that sprout.”

Then she handed each of her six visitors — who had driven seven hours from Mexico City and paid up to $350 apiece for a healing retreat — a generously sized portion, prompting a few dubious looks.

It was nighttime, and the guests were sitting in a hut that was barely illuminated by two candles, making it difficult for them to see what they were about to eat.

Pedro Castañeda has used mushrooms in her healing practice for years and was comfortable stepping outside as the group crunched slowly in silence.

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One person said the fungi tasted like stale popcorn. Another tasted dirt.

The healer returned a few minutes later.

“Now we’re starting the trip,” she said. “Let’s go to work.”

Indigenous communities in Mexico have long considered psychedelic mushrooms to be intermediaries to the spiritual world. But their growing popularity outside of Mexico has spurred a debate over who should have access to them and whether science and Indigenous medicine can or should be reconciled.

Magic mushrooms have been used in Mesoamerican religious rituals since pre-Hispanic times. But it wasn’t until the 1950s that a New York banker and mushroom enthusiast named R. Gordon Wasson made them famous — perhaps too famous — in the Western world.

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(Alejandra Rajal / For The Times)

Some Indigenous healers are courting tourists. Scientists interested in their chemical properties have been studying mushrooms in hopes of developing treatments for depression and other mental health problems. And growing demand from recreational users has fueled a thriving black market.

Currently, the fungi can only be used in Indigenous rituals or in government-approved research. But a senate bill proposes making psilocybin, a psychedelic compound in the mushrooms, more widely available.

In addition to making psilocybin available to anyone with a doctor’s prescription, the bill would permit therapy that uses the actual mushroom that a government office of traditional medicine would help regulate. It also calls for scientific research on Indigenous medicine and providing compensation to Indigenous people for “patents” involving their traditions.

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The bill’s supporters say that they’re trying to protect Indigenous medicine by making sure the traditional use of magic mushrooms is enshrined into law.

But the prospect of expanding the availability of magic mushrooms has created friction within Indigenous communities that have used them for centuries. Will the spirituality associated with this traditional medicine be lost?

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Magic mushrooms have been used in Mesoamerican religious rituals since pre-Hispanic times. A mural from the ancient city of Teotihuacán, just outside Mexico City, shows the Toltec rain god Tlaloc with two figures alongside him holding mushrooms that have risen from where his raindrops fell. A Franciscan missionary documenting 16th century life in New Spain referred to the mushrooms as the “flesh of the gods.”

But it wasn’t until the 1950s that a New York banker and mushroom enthusiast named R. Gordon Wasson made Mexico’s magic mushrooms famous — perhaps too famous — in the Western world.

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On a trip to Huautla, in southern Mexico, he ate mushrooms with Indigenous Mazatec healer María Sabina and wrote about the experience in a 1957 article for Life magazine titled “ Seeking the Magic Mushroom.” The story inspired thousands to travel to Huautla — some seeking out Sabina. The Mexican press described the foreigners as addicts, and the military ultimately set up a checkpoint on the road to Huautla to try to block the outsiders.

In July 1970, Reuters reported: “Hundreds of hippies are braving imprisonment and fines to penetrate this mushroom paradise in the State of Oaxaca, where the authorities are conducting a drive against mushroom eaters.”

Wasson said he felt guilty about the crowds in a New York Times op-ed published later that year. A “humble out-of-the-way” town had been overrun by “a torrent of commercial exploitation of the vilest kind.”

“The old ways are dead,” he wrote, “and I fear that my responsibility is heavy, mine and María Sabina’s.”

In an interview toward the end of her life, Sabina described how some outsiders would take the mushrooms “at whatever time and whatever place” and “don’t use them to cure themselves of a sickness.”

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“From the moment the foreigners arrived to search for God,” she said, “the saint children lost their purity.”

In the mid-20th century, psilocybin was classified as a Schedule I substance in the U.S. — which put the kibosh on research. But interest in scientific research on mental health and psilocybin was rekindled in the 1990s.

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Psilocybin is thought to boost neuroplasticity, the brain’s ability to form new neural connections, and research indicates that it may be successful in treating depression, anxiety and substance abuse. Parts of the United States have legalized or decriminalized the substance. (Oakland decriminalized magic mushrooms in 2019.)

“That plasticity enhancement may allow people to shift how their brain is functioning into a mode that’s more helpful, more adaptive, that’s going to promote mental health,” said Greg Fonzo, who co-directs the Center for Psychedelic Research & Therapy at the Dell Medical School at the University of Texas at Austin.

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Alejandrina Pedro Castaneda has used mushrooms in her healing practice for years.

Alejandrina Pedro Castaneda, who has used mushrooms in her healing practice for years, hosts a mushroom ceremony once or twice a week.

(Alejandra Rajal / For The Times)

Some people who ingest magic mushrooms report overwhelming feelings of joy or the presence of family. Others have said they feel deeply sad or that they are having an out-of-body experience.

The risk of a lethal overdose is considered very low, Fonzo said. What’s more common is having a difficult experience or a “bad trip” due to anxiety.

Pedro Castañeda, who compares the bill with a birth certificate, supports the legislation, insisting the world must not forget that the Mazatecs, as well as other Indigenous communities, have preserved rituals with magic mushrooms for centuries.

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“The medicine is not protected now. It’s out of control,” she said. “Everyone has it in their home, like cannabis,” she said, referring to black market purchases. “What we need is a record that says the Mazatecs are the custodians, the Mazatecs are the ones that for millennia have defended the medicine.”

But other Mazatecs in Huautla are worried about appropriation and misuse, that traditions associated with Indigenous culture will be disrespected as increasing numbers of people rush to pick up their prescriptions.

In an Indigenous mushroom ceremony, the healer will use mushrooms to communicate with their spiritual world to inquire about a patient’s illness. A patient may also experience revelations.

If the bill passes, “It’ll be taken like an aspirin,” said Isaias Escudero Rodriguez, a local doctor. It will no longer have the “spirituality that it carries for us.”

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The push to legalize magic mushrooms in Mexico dates back to the early days of the pandemic. Alejandra Lagunes, 52, a senator in Mexico’s national congress, started to experience anxiety attacks that were reminiscent of the severe depression she suffered in her 20s. The depression from decades ago, she said, was resolved after she took ayahuasca — a psychoactive brew made from the Amazonian Banisteriopsis caapi vine — with an Indigenous healer.

Lagunes researched psychedelics and introduced legislation in November to increase access to magic mushrooms while recognizing the long tradition of Indigenous medicine. She hopes it opens the door for non-Indigenous Mexicans to learn from Indigenous practices.

The initiative has supporters at Mexico’s National Institute of Psychiatry, where scientists have government permission to investigate the potential therapeutic effects of magic mushrooms.

Jesús María González Mariscal, a clinical psychologist in Mexico City who has advised the senator, said much can be learned from traditional medicine, including the importance of companionship in Mazatec mushroom ceremonies. These ceremonies occur at night under the guidance of a healer with candles, flowers, incense and an altar with Catholic images. A patient’s family members may accompany them.

The result, Mariscal said, “is a space of care and protection so a person can explore their inner world in a context that’s safe, trustworthy and ethical” — and that’s what Mexico City psychotherapist Oscar O’Farrill is trying to teach his students.

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O’Farrill runs a master’s and doctoral degree program affiliated with the National School of Psychologists and Experts of Mexico where his approximately dozen students listen to Indigenous guest speakers talk about traditional medicine. He schedules group therapies in his home, a two-story house where a large container on his kitchen counter has powder from lion’s mane, a non-psychedelic mushroom, that he takes with his morning coffee. Indigenous healers have led his students through ceremonies with mushrooms, peyote and bufo, the smoked secretions of a Sonoran desert toad.

“Psychiatry in this moment can’t understand what psilocybin is if it doesn’t understand all the aspects of the customs of Indigenous people,” he said. “Like it or not, the mushrooms have a spirit.”

But Eros Quintero, a biologist who co-founded the Mexican Society of Psilocybin in 2019, said he would have preferred that Indigenous communities were not singled out in the bill, that psilocybin simply be reclassified.

Indigenous people, he said, may not view illness through the prism of Western science. In Mazatec culture, for example, people may believe that a person fell ill because they walked through a cave where spirits are thought to reside or broke a communal rule.

“They have their own traditions and their own way of seeing things, and what we see is that there are few who are interested in what we’re interested in with psilocybin,” he said.

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Huautla presents itself as a place for the mushroom-seeker.

Taxis decorated with images of small mushrooms speed up and down narrow mountain roads that are lined with tin-roofed houses. In the summer, when mushrooms are in season, locals wait by a bus terminal to offer the fungi to tourists. Prices vary, but a dozen pairs of mushrooms (they’re sold by the pair) may cost $25 and a ceremony can cost $90 or more. After mushroom season, the fungi are often preserved in jars with honey.

Several signs announce the home of the family of María Sabina — who died in poverty in 1985 but whose life has since been celebrated in Mexican culture. Her descendants, who live on the property where Sabina once resided, maintain a small museum filled with portraits of the healer and sell mushroom-themed crafts.

Anselmo García Martínez, a farmer and a great-grandson of Sabina, says he was about 6 when he tried mushrooms for the first time during a ceremony with relatives who were accompanying a sick family member. (Many other locals say they first consumed mushrooms as children.)

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Like some other residents, he said he didn’t mind if mushrooms are allowed outside Indigenous rituals because the general public already has access to them through the black market.

But he issued a reminder: “For us, for the Mazatecs, it’s something sacred.”

Lagunes said she’s invited Indigenous people to the forums she has sponsored, and last year she posted a video on the social media platform X that showed her with several healers and indigenous people in Huautla. They presented her with a baton that she said she’d carry to “bring the voice and knowledge of ancestral medicine to the place that it deserves.”

But some opponents have said that the Mazatec people haven’t been properly consulted on whether the bill should move forward, reminding supporters that, for the moment, there is no infrastructure to make it happen. Santos Martínez, one of the founders of Caracol Mazateco, a civil society group focused on preserving Mazatec culture, agrees there hasn’t been enough outreach to the Mazatecs.

Martinez said his experiences with magic mushrooms transformed his life. As a medical student working at a clinic in the state of Puebla, he fell into a depression after seeing patients suffer from inadequate care. He returned to his community in Huautla, where he participated in mushroom ceremonies, hoping they would help him find direction in his life.

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During the ceremonies he felt happy and had visions of family members, including his grandfather. “It was as if he was saying, ‘adelante, hijo,’” he said, or, “go forward, son.”

Francisco Javier Hernandez García, a Huautla healer who leads mushroom ceremonies for tourists almost daily at some points of the summer, fears that mushrooms will “lose respect” if they are legalized for therapy outside of the Indigenous context.

Like others, he spoke about mushrooms as carrying wisdom.

“They sprout because they are waiting for that person,” he said, referring to the one who will eat them. “They already know who carries problems.”

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In mid-April, O’Farrill organized a trip for six people — including himself — to visit Pedro Castañeda for the healing retreat. Two people, a man who works for a Wall Street asset management firm and a woman training to guide people during mushroom trips, had flown in from the U.S. A mother and daughter, both psychologists, and a literary editor were from Mexico.

They spent three days at the home of Pedro Castañeda, who lives with eight dogs in a house that has several floors under construction. She hosts a mushroom ceremony for locals or tourists once or twice a week and said that the “great spirit” tells her how many mushrooms to give each person.

The members of O’Farrill’s group had individual therapy sessions with Pedro Castañeda in which she asked them about their insecurities. After her guests ate mushrooms, Pedro Castañeda asked several of them to sing. At one point, the editor began to suddenly cry, and the younger psychologist said she felt pain, prompting the healer to rigorously brush her with a feather in a cleansing ritual. A few minutes later, the psychologist said she was having visions of “injustice in jail.”

The next morning, the group hiked — mostly barefoot — the Mountain of Adoration, which the Mazatecs consider sacred.

At the top of the mountain, which overlooked Huautla, the healer gave each person cacao beans to leave as an offering, giving thanks for the previous night. They placed them on a tower of rocks jutting out from the mountain, next to many little mounds of cacao left earlier by other visitors.

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Opinion: Abortion foes lost Round One on mifepristone. Here's how their fight continues

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Opinion: Abortion foes lost Round One on mifepristone. Here's how their fight continues

The Supreme Court’s mifepristone decision on June 13 put a stop to one challenge to the drug used in more than half of all abortions in the United States. But antiabortion groups are already preparing their next line of attack.

New groups of plaintiffs might try to establish that they have standing where the doctors in the Food and Drug Administration vs. Alliance for Hippocratic Medicine failed. But if Donald Trump wins the 2024 election, such lawsuits might be far less important to abortion foes: Conservatives already have detailed plans in place to use the executive branch to impose national limits on abortion.

The plaintiffs in FDA vs. Alliance made two sets of claims. First, they challenged the overall authority of the agency to approve and subsequently lift restrictions on mifepristone. The plaintiffs also argued that the FDA didn’t have the power to allow patients to receive the pills in the mail because the federal Comstock Act, a 19th century obscenity law, includes a ban on mailing and receiving abortion-related items.

In holding that the Alliance plaintiffs didn’t have standing to sue, the Supreme Court didn’t say a word about the merits of either of those claims. So it’s no surprise that other plaintiffs might try to bring them again before the justices. The leading contenders are the states of Kansas, Missouri and Idaho, which had sought to intervene in the case, a request turned away by the Supreme Court.

The states’ attorneys general have suggested that they will continue the litigation, with a new argument on standing. A preview of that claim came in the states’ petition to intervene: They argued that because their citizens could get mifepristone from doctors out of state, the states’ own interests were affected. Medicaid recipients who suffered mifepristone complications were imposing costs on state medical systems, they added, and the availability of mifepristone was making it difficult to make and enforce abortion bans.

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There may be problems with the states’ case for standing too. Patients might experience complications if they take mifepristone, which might impose costs on the states. That doesn’t sound so different from the weak hypotheticals on which the Alliance plaintiffs relied. And what about Missouri and Idaho’s supposed sovereign interest in enforcing their abortion bans when other states allow it? The answer the court gave the Alliance doctors would seem to apply: “A plaintiff’s desire to make a drug less available for others does not establish standing to sue.”

Kansas’ case for standing is even more puzzling. Abortion is legal in Kansas until 22 weeks, albeit with restrictions. Barely more than a month after Roe was overturned, Kansans expressly voted against amending their state constitution to say there was no right to abortion. How will the state make the case that it is harmed by the approval of mifepristone when its own voters chose to preserve abortion access?

Whatever the fate of the case the Alliance doctors started, abortion foes and conservatives understand that the war against mifepristone and medication abortion can’t just depend on litigation. For example, Louisiana recently passed a law categorizing mifepristone and misoprostol, another drug used in medication abortion, as controlled substances, making it easier for the state to surveil patients, doctors and pharmacies and to punish anyone in possession of the drugs without a prescription. Idaho passed a so-called trafficking law that criminalizes those who help minors travel out of state or obtain abortion pills without parental consent.

But even these kinds of strategies may be far less important if Donald Trump wins a second term. The Heritage Foundation and a coalition of more than 100 conservative groups have laid out a detailed plan — known as Project 2025 — for a second Trump administration. The plan begins with a call for the FDA to “reverse its approval of chemical abortion drugs,” including mifepristone, or at a minimum, to eliminate the telehealth option for the drug.

Thousands of abortions can take place each month in states that ban the procedure because the telehealth option allows patients to get a prescription and get the pills by mail. With a Trump appointee as secretary of Health and Human Services, and one heading the FDA , the government might approach mifepristone differently without the pressure of a lawsuit. Some legal scholars argue that structural features of the federal Food and Drug Act could even allow the HHS secretary alone to override scientists at the FDA.

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Then there is the ancient Comstock Act — moribund but still on the books. Gene Hamilton, a prominent figure in the first Trump administration, argues in the Project 2025 plan that the Department of Justice could simply dust off the 151-year-old law and start criminally prosecuting the mailing or receipt of mifepristone. If the Supreme Court buys this interpretation of the Comstock Act, despite its flaws, such an executive action would get around the thorny questions about standing raised in Alliance.

The Supreme Court deflected the Alliance case against mifepristone. We may well see it reappear in some form on the court’s docket next year. But whatever shape Alliance 2.0 takes, in the fight over a national abortion ban, it’s unlikely to be the main event.

Mary Ziegler is a law professor at UC Davis and the author of “Roe: The History of a National Obsession.”

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