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Do Christian ethics say we have a moral duty to take a Covid vaccine?

Maria Steen leads a discussion about whether or not we have a moral duty to take one of the Covid vaccines.

CW long post (original content)

More restrictive laws contribute to reduce the incidence of abortion.

A new study found that 70% of unintended pregnancies end in abortion in countries where it is broadly legal, while in countries where abortion is restricted, this happens only in 50% of the cases.

A new multi-authored study ( ) published by The Lancet medical journal investigated the occurrence of abortion in unintended pregnancies world-wide. By unintended they mean pregnancies that occurred sooner than desired or were not wanted.

The researchers developed a new statistical model that jointly estimates unintended pregnancies and abortion.

It should be highlighted that four of the eight authors of the article are from the Guttmacher Institute, historically associated to the US abortion provider Planned Parenthood. Funding was provided by pro-choice organisations such as the Bill and Melinda Gates Foundation.

Nonetheless, the study proves what pro-life groups has always claimed: more restrictive laws contribute to reduce the incidence of abortion.

The study divides all the countries in the world in two categories: where abortion is restricted and where it is “broadly legal”. By restricted they mean that it is prohibited, permitted to save the life of the woman or to preserve physical and mental health. By broadly legal is intended where abortion is available on request or on broad socioeconomic grounds.

Interestingly, Ireland is listed among those countries where abortion is available on request while the United Kingdom is among those where it is permitted on socioeconomic grounds.
( )

Two results are particularly significant: in the period 2015-19, in countries where abortion is broadly legal, the abortion rate per 1,000 women aged 15-49 was 40. The rate was 36 where abortion is restricted.

In the same period, 70% of unintended pregnancies ended in abortion in countries where it is broadly legal, while in countries where it is restricted, this happens only in 50% of the cases.

Those two results prove that where more restrictive laws are in place, both the abortion rate and the number of unintended pregnancies ending in abortion are lower, compared to countries with more liberal abortion regimes.

There is no simple cause and effect between legislation and those two rates, as they are determined by a complex number of factors (socioeconomic conditions, quality of the health system, culture, etc.), but the association is clear.

The study also divided countries into three groups, according to their income as calculated by the World Bank, and found that the annual unintended pregnancy rate is 34 per 1,000 women aged 15-39 in high-income countries, 66 in middle-income countries, and 93 in low-income countries. It is not a surprise that unintended pregnancies are inversely proportional to the country income. Nonetheless, both the abortion rate and the proportion of unintended pregnancies ending in abortion is higher in middle-income countries, than in low or high-income countries. In other words, even if in poor countries there are more unintended pregnancies, those pregnancies don’t end in abortion as much as in middle-income countries.

The limit of this world-wide studies is that they group dozens of countries that might have one element in common (abortion legislation, in this case) but too many other factors that cannot be taken into consideration.

In the study the authors make some claims that are contradicted by their own results. For instance, they say: “We found no evidence that abortion rates were lower where abortion was restricted”.

In saying this, they refer not to the figures that I have quoted above. Instead, they have to exclude India and China, so that abortion rate in countries where abortion is legal decreases from 40 per 1,000 women to 26 per 1,000 women.

But why should those countries be excluded? Because they “skew” the results and the authors of the study are not happy with that.

In a quite unreasonable explanation they say: “We found that China and India, which comprised 62% of women who were at reproductive age in countries where abortion was broadly legal, skewed the averages in countries was broadly legal. Averaging among all other countries where abortion is broadly legal, abortion rates were higher among countries where abortion was restricted.”

( )

That is quite astonishing. Of course, if you exclude 62% of the population, the results will be different but that is not a good reason to do it. Manipulating a sample to achieve a preferred result is not science.

Yes, even this new study from pro-choice researchers confirms that abortion rates are lower where abortion is more restricted, unless you want to ignore the two most populated countries in the world.

CW Long post (original content)

The purposes of medicine

Medicine has three main purposes: to prevent and cure diseases, and to take care of patients. It is not simply a science but also a practice inspired by ethical values. So, what is the difference with the other sciences? Take for instance mineralogy. It is the description of the chemical and physical properties of minerals. Medicine, instead, aims not simply at describing what a human body is but it is also based on the assumption that there is a natural order, which we call health, and the purpose of the medical practice is to keep or to restore this order. There is an intrinsic good (health) that we discover through science and we preserve and reestablish through practice.
For instance, anatomy and physiology tell us what is the proper function of the eyes, i.e. to see. This is not simply a description but it also contains a prescriptive element because the ideal eye is also the normative model that the doctor uses when she acts to keep the patient’s eyes healthy or to prevent their diseases.
This understanding of medicine doesn’t require a particular religious faith but it is nonetheless intrinsically ethical. It is inspired by a certain conception of the good (health) that we find in human nature through the correct use of reason. The principle of “do not harm”, which has guided health care since ancient times, has the form of an ethical imperative.
Not everything that happens (or might happen) in a hospital or a clinic is medicine, unless it aims at preventing and curing diseases, and also at the same time at taking care of patients. Not all interventions that alter our bodies surgically or chemically are medicine, even if a scientist (medical expert) might be involved. Getting your facial features surgically changed to look more like your music idol is not medicine. Killing the unborn because she was unplanned or is disabled is not medicine. Augmenting your muscles through drugs to win a weightlifting contest is not medicine. Removing a perfectly healthy organ to adjust your body to your perceived gender is not medicine. Facilitating suicide is not medicine.
In all these examples a certain level of scientific knowledge is necessary but they lack what makes medicine more than a science: the ethical value of health. They might involve someone who has a proper knowledge of the human body but his purpose, in these examples, is not to restore or preserve the good of the functioning body. They are instances of scientific techniques without good and true medical ethics.
There is a growing pressure by certain ideologies to transform medicine, which is necessarily led by an objective good that we call health, into the satisfying of the subjective requests and choices of the patient. If bodily autonomy (my body, my choice), rather than health, is the ultimate value then there is no reason why doctor should not amputate a healthy arm or leg, when requested, or administer a dangerous substance, for recreation or self-harm or death. Without the guiding principle of health, practitioners become simply the executors of someone else’s desires. Obviously, people can do what they want with their bodies but this is not medicine.
There is no good medicine without ethics. Hospitals don’t need to be under church or religious influence but they cannot exist without an ethos, without values. When their core value is not health – an intrinsic good indicated by human nature- they don’t serve medicine anymore but trends, ideologies, business.

CW long post

Getting the facts right about reversing effects of abortion pills

This week an article on the Irish Independent attacked Irish doctors who offer medical assistance to women who have taken abortion pills and then changed their minds before the effects were final. (1) The article contains a number of claims that need to be challenged.

A chemical abortion consists of two separate pills: the first, called mifepristone, blocks the effects of progesterone, which is the natural hormone in a pregnant mother’s body necessary for her pregnancy to thrive. The second pill, called misoprostol, is normally taken one to two days later and completes the abortion. (The author of the article, Ellen Coyne, incorrectly writes “The first is misoprostol and the second is mifepristone.”) (2)

The Abortion Pill Reversal protocol helps the women who have changed their mind within 72 hours of taking the first abortion pill and it aims at reversing the process and save their baby.

In some US states, doctors are legally required to tell about this possibility to women seeking abortions.

There is evidence that the attempts to reverse the effects of mifepristone (the first of the two pills) can be significantly successful and studies are undergoing to improve the efficacy of those protocols.

For instance, a study published in 2017 on the European Journal of Contraception and Reproductive Health Care concludes: “Women have changed their mind after commencing medical abortion. Progesterone use in early pregnancy is low risk and its application to counter the effects of mifepristone in such circumstances may be clinically beneficial in preserving her threatened pregnancy. Further research is required, however, to provide definitive evidence.” (3)

There is no scientific evidence, instead, that those protocols are dangerous, even if Ellen Coyne’s article suggests so.

Let’s analyse the article and its faults. At the end of February (Ellen Coyne incorrectly says January), a group of Irish prolife doctors organised a conference on the “Abortion Pill Reversal”, with the participations of medical experts from the US. (4)

Ellen Coyne incorrectly uses the expression “abortion reversal” but obviously abortion cannot be reversed. The medical intervention aims at reversing the effect of the first pill (mifepristone) before it is too late. So, “abortion pill reversal”, or the more technical expression “mifepristone antagonization”, is the correct one.

Dr Fiona O Hanlon was contacted by a journalist of the Irish Independent and, on request, she offered to prescribe progestosterone to stop the effect of the first abortion pill. “It’s a similar mechanism that we are used to using for a threatened miscarriage so if you have changed your mind it is worth a try”, she told the journalist.

Ellen Coyne claims that there is no medical evidence that progesterone after the first pill can reverse a termination. The 2017 article that I have mentioned earlier disproves this claim. (More evidence can be found here). (4)

Coyne reports that the Dr O Hanlon, when challenged, referred to a 2018 study which suggested progesterone could be used to treat a threatened miscarriage. Coyne comments “More recent research has contradicted this study, and the American College of Obstetricians and Gynaecologists has said using progestins for threatened miscarriages is “controversial, and conclusive evidence supporting their use is lacking”.”

It is impossible to assess the unspecified research Coyne refers to but her quote from the American College of Obstetricians and Gynaecologists refers to a 2011 study, so it can’t be used to disprove something published in 2018. Coyne also omits the next paragraph from the same document, which says that progesterone could beneficial to those who had three miscarriages. (5)

On this same topic, in January this year the UK Royal College of Obstetricians and Gynecologists announced “Progesterone could prevent 8,450 miscarriages a year, finds new research.” (6) (Remember, an abortion is effectively a deliberate miscarriage).

“Giving progesterone to women with early pregnancy bleeding and a history of miscarriage could lead to 8,450 more babies being born each year, finds new research published today.

Two new studies evidence both the scientific and economic advantages of giving a course of self-administered twice daily progesterone pessaries to women from when they first present with early pregnancy bleeding up until 16 weeks of pregnancy to prevent miscarriage. … Researchers are calling for progesterone to be offered as standard in the NHS for women with early pregnancy bleeding and a history of miscarriage, after their growing body of research has found it is both cost-effective and can increase women’s chances of having a baby.”

Perhaps Ellen Coyne should rewrite her article to take the above research into account?

Her article continues by mentioning a study about the efficacy of progesterone in stopping the effect of the first abortion pill. (7)

“Dr Mitchell Creinin, a professor of obstetrics and gynaecology at UC Davis, told the Irish Independent that the study had to be abandoned amid safety concerns. A number of women who had taken mifepristone but not followed it with misoprostol were admitted to hospital after they started to bleed.”, she writes.

The suggestion is that the use of progesterone is dangerous and this is why the study had to be interrupted. Quite the opposite. The study involved only 12 women, two of which left before the end. They were divided in two groups, one used progesterone and the other a placebo.

Of the three who were hospitalized, two were from the placebo group while the third had completed her abortion in spite of the progesterone.

The study had to be suspended not because progesterone is dangerous but because those in the placebo group were at risk.

The April 2020 issue of Obstetrics & Gynecology, published The American College of Obstetricians and Gynecologists, contains some interesting comments to the study. (8)

“The authors’ limited data show that giving progesterone after mifepristone is safe. The significant safety concerns were in the placebo arm only. Moreover, regarding the efficacy of progesterone, the limited data showed that progesterone was effective in preserving embryonic life. Four of the 5 (80%) patients who received progesterone had continued gestational cardiac activity.”, wrote Dr Michael T. Valley.

“Although too small for statistical significance, these data are consistent with previous findings of a 68% live birth rate after treatment with the same dosing for oral progesterone and 25% for embryos exposed to mifepristone only. More research is warranted assessing all outcomes of progesterone after mifepristone.”, wrote Dr George Delgado, Dr Mary Davenport, and Dr Matthew Harrison.

From the dates of the articles mentioned, it should be noted that this is an ongoing discussion in the scientific community. More studies are necessary and, contrary to what Coyne’s article says, there are good reasons to claim that this method could save lives.

Some women are conflicted about their abortion and change their minds between the first and the second pill. Some even change their mind when the two pills fail to achieve a termination, and they decide to keep the baby rather than going for a surgical procedure. (9)

Those who are pro-choice should welcome the possibility to give women one last chance.

(1) and (2)








CW long post

Religious practice reduces ‘deaths from despair’

A new study from Harvard University has found that the frequent attendance of religious services dramatically reduces so-called ‘deaths from despair’, such as suicide, and drug or alcohol abuse. This finding seems more relevant than ever given the current pandemic that has resulted in untold job losses and a very uncertain future for many people. Economic slumps are always associated with a rise in ‘deaths from despair’, so if religion acts as a protective against this, then we need to pay attention.

The study followed a large cohort of more than 100,000 health care professionals in the US, over a long period of time (1999 -2016).

The investigators started with the hypothesis that a weakening in traditional social support systems such as marriage and the family, leads to an increasing sense of hopelessness in many, leading in turn to a rise in “deaths of despair”.

One of the leading examples of such a weakened support system is the decline in religious participation, and therefore the investigators wanted to establish the link between despair and the declining attendance of religious services.

They found that nurses and physicians who attend a religious service at least weekly are less likely to die as a result of suicide or drug or alcohol abuse than their peers who do not attend.

The incidence of ‘deaths from despair’ among health professionals is more than double that of the general population, as a result of stress and trauma, but among those who attend a religious service at least once a week it drops by 68pc among women, and 33pc among men.

As the educational attainment of health professionals is higher than the average, despair in them is associated more with factors such as loss in meaning in life, rather than material deprivation.

Religion often fosters a sense of peace and positive outlook to life, it promotes social connectedness and encourages engagement in prosocial activities, such volunteering. “In the context of trauma, such resources may provide healthy stress-coping strategies and revive a sense of meaning in difficult times and thereby counteract various processes associated with despair.”, the study claims.

This is something to be pondered, particularly in the current difficult times when the general populations is experiencing unusual stress and trauma.

Even if churches are closed for public worship, people are still praying. A poll commissioned by the Iona Institute found that in Ireland 18pc said that they are praying more than they usually would.

Another new poll commissioned by Tearfund, a Christian relief and development agency and a member of the Disasters’ Emergency Committee, found that in the UK one in twenty (5pc) adults say they have started praying during the lockdown but they didn’t pray before.

Eighteen percent of UK adults have asked someone else to say a prayer for them and 19% say they have read a religious text during lockdown. Prayer is a vital part of life for the public, and among those who pray a third say that they have prayed since the COVID-19 lockdown because they believe it makes a difference.

There is a solid body of evidence highlighting the benefit of religion for mental health and the new Harvard study confirms that.

Professor Patricia Casey produced for the Iona Institute a paper called “The Psycho-Social Benefits of Religious Practice”, showing how a large number of scientific papers have established that religious practice reduces the risk of depression, suicide, marital breakdown, alcohol and drug abuse, pregnancy among teenagers. It also helps cope with bereavement effects.

Worship is, for those who believe, a source of consolation and hope, strength and motivation. A church is also a place where they can experience the support of a community and are encouraged to engage in activities that are useful to themselves and to others.

This new Harvard study shows that believers often respond better to the struggles of life, and it brings further evidence to fact that both their religious beliefs and the enhanced social connection that worshiping involves, are good for our health. This is something that secularists often forget.

"The Alleged Conflict Between Science and Faith"
Physicist and priest Dr. Andrew Pinsent exposes one of the great myths of our time, that science and faith cannot support each other.

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Ethical questions in a pandemic

The current epidemic raises a number of profound ethical questions. We are facing unprecedented events under the pressure of time and of limited resources. In the name of urgency and necessity we are experiencing exceptional restrictions of fundamental liberties, and a significant alteration of our familiar ways of living.
After the initial shock, when energies are inevitably focused on emergency measures, it is now time to address more fundamental issues that this epidemic has highlighted.
Why do we need a debate about ethics now? In the current exceptional circumstances, it seems that many decisions are not free choices, but they are rather dictated by necessity. Nonetheless, practical deliberations are always inspired by values. Either consciously or unconsciously, we all operate within a moral framework. We decide to pursue a certain course of action, rather than another, because we deem certain principles more important than others. This is obvious when we face conflictual duties – for instance, saving lives and preserving freedom – and we ultimately follow a certain road because of our deep philosophical commitments.
Strategic decisions are now led more by the assessments of the experts than the democratic mandate which legitimizes our political representatives. National and international bureaucratic structures define our common tasks in terms of measurable effectiveness to the point that we feel we are living in a tyranny of the specialists, legitimated by their scientific expertise.
Nothing should be done against science, but the problem is that science is not about ends, it is about means. Medicine tell us how to save lives but doesn’t tell us which lives should or shouldn’t be saved, and why they should be saved at all. Experts disagree, not only on purely scientific grounds – for instance, which treatment works better – but also on what we ultimately want to achieve. Different policies are expression of different values and it would be foolish to move through an epoch-defining outbreak without having a debate about what we ultimately want and why.
We need a debate about ends. What are we here for? The good life in a community, says an old tradition that goes back to our Greek philosophical roots.
What clearly emerges in front of our eyes these days is that we can’t understand ourselves as individuals. We are members of a community. My life depends on what other people around me do. My best efforts will count nothing without everybody else’s best efforts. More than ever, this epidemic requires us to think and act in solidarity, which literally means being strong together. This solidarity is necessary not only in action but firstly in the way we frame and approach our problems.
We are operating in fear and isolation, under the pressure of unprecedented events. We hear that we are forced to trade different values against each other. But to think according to an ethics of solidarity means that conflicts and tensions should be framed not in terms of opposition but as if they all together threaten to the same end, which is the common good.
It would be wrong to present our dilemmas in terms of exclusive interests: for instance, should we care for the sick or for the one who might lose his job? If we address this problem through the prism of solidarity, we will realise that it is the same person who is at risk of getting sick and losing their job, it is the same family, it is the same community.
Roles are now swiftly exchangeable – a health carer becomes a patient – and the same person often embodies many roles – someone who works from home may also be a carer or a patient. There is no family or group that is not potentially impacted. Traditional categories such as social class, gender, ethnicity, are now insignificant. We are all one and should think in solidarity.
In a competitive struggle for scarce resources, we give priority to those we consider more valuable, overlooking the rest. In a solidaristic approach, we give precedence to those who are most in need.
As every epidemic, this one is significantly impairing what constitutes a community, such as the acting physically together. Everything that is communal is currently affected, from mourning our deaths to celebrating sports, from worshipping to travelling. However, the present epidemic is different when compared with the big ones of the past, think of the Black Death, because contemporary means of communication allows us to be united in spirit with those who are distant. Even if only virtually, certain expressions of solidarity are easier to perform.
As part of a community, we have a duty to limit some of our legitimate desires and demands if they put others at risk. And risk should be understood not simply in the sense of physical health. There is a risk of cutting meaningful relationships, of compromising the education of the younger generations, of impairing mental wellbeing, of destroying business and charitable work, of neglecting those who suffer for other reasons, etc.
The wide scope of risk is what makes this epidemic difficult to manage and it is not the role of ethics to identify what is practically appropriate in each circumstance. Our task, instead, is to inquire what goods we want to achieve and what moral principles should guide us.
I will address in a separate article the moral dilemma of prioritizing access to scarce medical resources but the general principle I am proposing, inspired by an ethics of solidarity, is that everyone should be cared according to their needs, rather than ability or, more often, inability to contribute to society.
An ethics of solidarity involves sacrifice. However, the question should not be formulated in terms of who we are willing to sacrifice for the common good. It is rather, what should be sacrificed? No one should be discriminated because is less abled, has less prospect of life, or can’t pay.
Different approaches and strategies employed to tackle this pandemic reflect who we care most. In any assessment of a balance of goods we should remember the dignity of the most vulnerable. Solidarity means that it is precisely those who are weaker that we hold stronger.
Measures have to be proportionate but what is a fair proportion cannot be determined in advance. By definition, this depends on the circumstances. What, instead, can and should be discussed is what society we wish for when promoting public health.
We won’t be able to do all the good we would like to accomplish but have we established what this good is? Let’s have this conversation.

CW long post (original content)

Euthanasia is promoted under the disguise of neutrality

Last week, a spokeperson for Fianna Fáil told the Medical Independent that they would not oppose the referral of assisted suicide to a Citizens’ Assembly for further discussion. Delegating the debate to an unelected body means that neither Fianna Fáil, nor any other major party, is not actively opposing the introduction of legislation that could legalise euthanasia and assisted suicide. (1)

In 2017 the Oireachtas Joint Committee on Justice and Equality considered possible recommendations on legislating in favour of euthanasia andassisted suicide. They heard from a number of experts, and the strongest opposition to the introduction of new liberalising laws came from the representatives of the medical profession and of disability advocacy groups. (2)

Des O’Neill, professor of medical gerontology at Trinity College Dublin, said “We have to send out a message to people of disability of whatever age that our impulse is to care, to cure sometimes, to relieve often and comfort always.” (3)

Dr Regina McQuillan of the Irish Association of Palliative Care said: “Suicide is rightly considered a blight on society and there are many efforts made to reduce it. That there are some people for whom suicide is considered appropriate may suggest that there are people whose lives are not deserving of the same level of protection.” (4)

At the end of the hearings, the Committee did not achieve a clear consensus. Accordingly, they did not recommend legislative change. Instead, they urged the Houses of the Oireachtas “to consider referring the issue to the Citizens’ Assembly for deliberation”. (5)

But why should a non-representative body, with no specific expertise, discuss and recommend vicariously, when there was no majority in the Oireachtas Committee in support of the change?

Political parties cannot stay neutral and delegate to others such a critical debate. Even small changes must be opposed or they will have catastrophic effects.

We can learn from the experience of other countries that the legislation on these issues is usually introduced on some limited ground (for terminally ill patients, for instance) but, with time, it becomes more and more liberal. Once the general principle that doctors should not participate in procuring death is eroded, it is difficult to change the trend and go back.

Psychiatrist Mark Komrad has said, “Several governments, in the last two decades, have invited and permitted physicians to transgress the prohibition against killing their patients. … Originally, the class who can be voluntarily killed or helped to suicide was limited to those at the very end of life. However, principles of justice have made it very difficult to limit such procedures to that category of people. The more experience a country has with such practices, the more the horizon of eligibility has expanded far beyond extreme end-stage cases. … The so-called “choice“ that is offered to the suffering to end their lives is a pseudo-choice, filtered through a physician’s own values, and commonly forced, by having very limited choices in other domains — economics, social support, healthcare, etc. It is unjust, and therefore impossible, in a democratic society, to limit these procedures to some — like the terminally ill — but refuse it to others — like those with chronic physical and psychiatric disabilities. Yet, it signals that chronic disability and its sufferings might constitute a “life not worth living.” (6)

The pressure on doctors to support and participate in euthanasia and assisted suicide is growing everywhere.

In October 2018, at the General Assembly of the World Medical Association (WMA), representatives from Canada and the Netherlands attempted to change the WMA code of ethics, which has always condemned the participation of physicians in procuring death through direct euthanasia or providing drugs for suicide. (7)

During the debate, all sort of euthanasic practices were rejected and eventually the proposal has been withdrawn, reiterating the WMA’s long-standing opposition to procuring death.

This debate, though, continues on national level.

The Royal College of Physicians (RCP), in the UK, has recently dropped its opposition to assisted dying in a surreptitious manner that has attracted strong criticism. They are now neutral on the issue and will not officially engage in public discussions but how they have arrived at this position appears to be despicable. (8)

In 2014, 57.6% of the RCP membership opposed a change in the law that would legalise assisted suicide. In January this year, after announcing the third poll on this topic among its members since 2006, it was decreed that a 60% majority was needed to stop changing the RCP position to non-opposition. This means that even if 59,9% were against the change, it would have occurred nonetheless. Such a majority was even more difficult to achieve as three options were given (yes, no or neutral), while the previous vote was binary (yes or no).

A group of members of the RCP have challenged them in court, arguing that “the use of a ‘super-majority’ vote on such issues is without precedent in professional organisations in the UK. They have said that it appears to be a tactical move to give a strong boost to the campaign to change the law on assisted suicide. The largest euthanasia lobby group in the UK has previously identified the opposition of medical bodies as a key obstacle to changing to law. Two well-known patrons of this organisation, and active campaigners for legalising euthanasia, are on the RCP Council – the internal body driving the RCP poll.” (9)

In spite of the robust protestation, the poll was carried out in February and found that 43.4 pc were opposed adopting a pro-assisted suicide policy, 31.6 pc were in favour and 25 pc were neutral. This means that even though the majority of the voters were against, the Royal College of Physicians will now be neutral on the matter.

In this case, as with the Joint Committee referral to the Citizens’ Assembly, we see that even when there is no clear majority in support for a significant change, certain issues are considered so important by a minority that they have to be promoted, under the disguise of neutrality, until they are accepted.










In his years at Oxford, Newman studied the scriptures and the writings of the Early Church Fathers in depth, awakening in him a passion for what the Church could become, true to its foundations. He described reading them as 'music to my inward ear.'

Cos'è il genio? (cit.)

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