DealBook: For S.E.C., a Setback in Bid for More Time in Fraud Cases

The Supreme Court on Wednesday delivered a swift and decisive rejection of the Securities and Exchange Commission’s argument that it should operate under a more forgiving statute of limitations in pursuing penalties in fraud cases.

As a result of the decision, the agency will have to find a long-term solution to give itself more time to investigate cases.

In Gabelli v. Securities and Exchange Commission, Chief Justice John G. Roberts Jr. wrote in the unanimous decision rejecting the S.E.C.’s argument that a federal statute that limits the government’s authority to pursue civil penalties should commence when a fraud is discovered, not when it occurred.

The S.E.C. was hoping that the court would apply what is known as the “discovery rule.” In 2010, the Supreme Court endorsed this rule in a private securities fraud class-action suit, Merck & Co. v. Reynolds, stating “that something different was needed in the case of fraud, where a defendant’s deceptive conduct may prevent a plaintiff from even knowing that he or she has been defrauded.”

The discovery rule is an exception to the protection afforded by a statute of limitations, which puts an endpoint on potential legal liability for conduct. Unlike most cases, when fraud is involved, it may not be apparent to the victims that they were harmed because the primary goal of deceptive conduct is to keep it from being exposed.

In the Gabelli case, the S.E.C. filed fraud charges in 2008 against the mutual fund manager Marc Gabelli and a colleague, Bruce Alpert, saying they had violated the Investment Advisers Act of 1940 for permitting an investor to engage in market timing. Ten years ago, a major scandal erupted when it came to light that some advisers had permitted select investors to buy shares at favorable prices to take advantage of pricing disparities in the securities held by mutual funds.

In its complaint, the S.E.C. sought civil monetary penalties based on market timing that it claimed had taken place from 1999 to 2002, and resulted in the preferred investor purportedly reaping significant profits while ordinary investors suffered large losses. The defendants denied the charges and filed a motion to dismiss the case because it was not brought in time.

A federal statute, 28 U.S.C. § 2462, provides that “an action, suit or proceeding for the enforcement of any civil fine, penalty, or forfeiture, pecuniary or otherwise, shall not be entertained unless commenced within five years from the date when the claim first accrued.” The provision dates to 1839, and applies to any government agency.

A decision by the United States Court of Appeals for the Second Circuit in Manhattan allowed the case to proceed by applying the discovery rule to a governmental action. Coincidentally, that decision was written by Judge Jed S. Rakoff, who despite being an occasional thorn in the S.E.C.’s side, accepted the agency’s argument to avoid a strict application of the five-year statute of limitations.

The Supreme Court, however, saw things differently. This week, it issued its opinion less than two months after it heard oral argument in the case in January, a clear sign the justices found no merit in the S.E.C.’s contention that the agency should be treated the same as private plaintiffs in trying to get around the statute of limitations.

According to the Supreme Court, victims in securities fraud cases should have a longer period to file a claim – from when the fraud was discovered. “Most of us do not live in a state of constant investigation,” the court wrote. “Absent any reason to think we have been injured, we do not typically spend our days looking for evidence that we were lied to or defrauded.”

Chief Justice Roberts explained that “the S.E.C. as enforcer is a far cry from the defrauded victim the discovery rule evolved to protect.” One of the reasons the agency exists is to detect and penalize violations, with tools that the ordinary investor simply does not have, like the authority to compel testimony and the production of documents. The message is simple. When it’s your job to investigate fraud, you cannot argue that your failure to do so is a justification for not meeting a statute of limitations.

The Supreme Court’s decision puts increased pressure on the S.E.C. to pursue its investigations with greater alacrity and not let them gather dust, which can occur as a result of staff turnover or other pressing issues. The market timing case is a good example of how an investigation might get lost in the shuffle as corporate accounting frauds at large companies like Enron and WorldCom, which also came to light in 2002, strained the S.E.C.’s investigative resources.

There are a couple of options to deal with this issue in the long run, apart from a substantial increase in the agency’s budget – an unlikely prospect in the face of the looming federal budget sequestration deadline.

The S.E.C. can obtain an agreement to stop the statute of limitations, known as tolling, from those it is investigating, something it has done in the past. For example, in its insider trading and securities fraud case against Samuel E. Wyly, his now deceased brother, Charles J. Wyly Jr., and two other defendants, the S.E.C. got an agreement that let it pursue claims beyond the normal five-year limitations period.

A permanent solution would be to seek legislation from Congress that would give the S.E.C. a longer window to complete its investigations. The statute of limitations is not a constitutional protection, so Congress can amend it as it sees fit, which it has done in other areas involving fraud.

The limitations period for banking crimes, for example, was extended to 10 years during the savings and loan crisis because of the crush of cases that made it difficult to finish investigations in the five-year window to initiate criminal prosecutions. The Fraud Enforcement and Recovery Act of 2009 added mail and wire fraud affecting a financial institution to the list of crimes that get the benefit of the 10-year limitations period, again because of fear that cases would be lost because of the number of investigations taking place after the financial crisis.

The issue of the statute of limitations may even come up at the confirmation hearings of Mary Jo White, who has been nominated to be chairwoman of the S.E.C. That could be an early indicator of whether she would be willing to push for relief from the effect of the Gabelli opinion to help out the enforcement division.

In the short run, the Supreme Court’s decision will cause defendants in government enforcement actions to examine whether they might be able to take advantage of the five-year limitations period. Given how slowly the government has been known to move on occasion, it may be that some cases will fall by the wayside because of the Gabelli decision.

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The New Old Age Blog: For the Elderly, Medical Procedures to Avoid

The Choosing Wisely campaign, an initiative by the American Board of Internal Medicine Foundation in partnership with Consumer Reports, kicked off last spring. It is an attempt to alert both doctors and patients to problematic and commonly overused medical tests, procedures and treatments.

It took an elegantly simple approach: By working through professional organizations representing medical specialties, Choosing Wisely asked doctors to identify “Five Things Physicians and Patients Should Question.”

The idea was that doctors and their patients could agree on tests and treatments that are supported by evidence, that don’t duplicate what others do, that are “truly necessary” and “free from harm” — and avoid the rest.

Among the 18 new lists released last week are recommendations from geriatricians and palliative care specialists, which may be of particular interest to New Old Age readers. I’ve previously written about a number of these warnings, but it’s helpful to have them in single, strongly worded documents.

The winners — or perhaps, losers?

Both the American Geriatrics Society and the American Academy of Hospice and Palliative Medicine agreed on one major “don’t.” Topping both lists was an admonition against feeding tubes for people with advanced dementia.

“This is not news; the data’s been out for at least 15 years,” said Sei Lee, a geriatrician at the University of California, San Francisco, and a member of the working group that narrowed more than 100 recommendations down to five. Feeding tubes don’t prevent aspiration pneumonia or prolong dementia patients’ lives, the research shows, but they do exacerbate bedsores and cause such distress that people often try to pull them out and wind up in restraints. The doctors recommended hand-feeding dementia patients instead.

The geriatricians’ list goes on to warn against the routine prescribing of antipsychotic medications for dementia patients who become aggressive or disruptive. Though drugs like Haldol, Risperdal and Zyprexa remain widely used, “all of these have been shown to increase the risk of stroke and cardiovascular death,” Dr. Lee said. They should be last resorts, after behavioral interventions.

The other questionable tests and treatments:

No. 3: Prescribing medications to achieve “tight glycemic control” (defined as below 7.5 on the A1c test) in elderly diabetics, who need to control their blood sugar, but not as strictly as younger patients.

No. 4: Turning to sleeping pills as the first choice for older people who suffer from agitation, delirium or insomnia. Xanax, Ativan, Valium, Ambien, Lunesta — “they don’t magically disappear from your body when you wake up in the morning,” Dr. Lee said. They continue to slow reaction times, resulting in falls and auto accidents. Other sleep therapies are preferable.

No. 5: Prescribing antibiotics when tests indicate a urinary tract infection, but the patient has no discomfort or other symptoms. Many older people have bacteria in their bladders but don’t suffer ill effects; repeated use of antibiotics just causes drug resistance, leaving them vulnerable to more dangerous infections. “Treat the patient, not the lab test,” Dr. Lee said.

The palliative care doctors’ Five Things list cautions against delaying palliative care, which can relieve pain and control symptoms even as patients pursue treatments for their diseases.

It also urges discussion about deactivating implantable cardioverter-defibrillators, or ICDs, in patients with irreversible diseases. “Being shocked is like being kicked in the chest by a mule,” said Eric Widera, a palliative care specialist at the San Francisco V.A. Medical Center who served on the American Academy of Hospice and Palliative Medicine working group. “As someone gets close to the end of life, these ICDs can’t prolong life and they cause a lot of pain.”

Turning the devices off — an option many patients don’t realize they have — requires simple computer reprogramming or a magnet, not the surgery that installed them in the first place.

The palliative care doctors also pointed out that patients suffering pain as cancer spreads to their bones get as much relief, the evidence shows, from a single dose of radiation than from 10 daily doses that require travel to hospitals or treatment centers.

Finally, their list warned that topical gels widely used by hospice staffs to control nausea do not work because they aren’t absorbed through the skin. “We have lots of other ways to give anti-nausea drugs,” Dr. Widera said.

You can read all the Five Things lists (more are coming later this year), and the Consumer Reports publications that do a good job of translating them, on the Choosing Wisely Web site.

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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The New Old Age Blog: For the Elderly, Medical Procedures to Avoid

The Choosing Wisely campaign, an initiative by the American Board of Internal Medicine Foundation in partnership with Consumer Reports, kicked off last spring. It is an attempt to alert both doctors and patients to problematic and commonly overused medical tests, procedures and treatments.

It took an elegantly simple approach: By working through professional organizations representing medical specialties, Choosing Wisely asked doctors to identify “Five Things Physicians and Patients Should Question.”

The idea was that doctors and their patients could agree on tests and treatments that are supported by evidence, that don’t duplicate what others do, that are “truly necessary” and “free from harm” — and avoid the rest.

Among the 18 new lists released last week are recommendations from geriatricians and palliative care specialists, which may be of particular interest to New Old Age readers. I’ve previously written about a number of these warnings, but it’s helpful to have them in single, strongly worded documents.

The winners — or perhaps, losers?

Both the American Geriatrics Society and the American Academy of Hospice and Palliative Medicine agreed on one major “don’t.” Topping both lists was an admonition against feeding tubes for people with advanced dementia.

“This is not news; the data’s been out for at least 15 years,” said Sei Lee, a geriatrician at the University of California, San Francisco, and a member of the working group that narrowed more than 100 recommendations down to five. Feeding tubes don’t prevent aspiration pneumonia or prolong dementia patients’ lives, the research shows, but they do exacerbate bedsores and cause such distress that people often try to pull them out and wind up in restraints. The doctors recommended hand-feeding dementia patients instead.

The geriatricians’ list goes on to warn against the routine prescribing of antipsychotic medications for dementia patients who become aggressive or disruptive. Though drugs like Haldol, Risperdal and Zyprexa remain widely used, “all of these have been shown to increase the risk of stroke and cardiovascular death,” Dr. Lee said. They should be last resorts, after behavioral interventions.

The other questionable tests and treatments:

No. 3: Prescribing medications to achieve “tight glycemic control” (defined as below 7.5 on the A1c test) in elderly diabetics, who need to control their blood sugar, but not as strictly as younger patients.

No. 4: Turning to sleeping pills as the first choice for older people who suffer from agitation, delirium or insomnia. Xanax, Ativan, Valium, Ambien, Lunesta — “they don’t magically disappear from your body when you wake up in the morning,” Dr. Lee said. They continue to slow reaction times, resulting in falls and auto accidents. Other sleep therapies are preferable.

No. 5: Prescribing antibiotics when tests indicate a urinary tract infection, but the patient has no discomfort or other symptoms. Many older people have bacteria in their bladders but don’t suffer ill effects; repeated use of antibiotics just causes drug resistance, leaving them vulnerable to more dangerous infections. “Treat the patient, not the lab test,” Dr. Lee said.

The palliative care doctors’ Five Things list cautions against delaying palliative care, which can relieve pain and control symptoms even as patients pursue treatments for their diseases.

It also urges discussion about deactivating implantable cardioverter-defibrillators, or ICDs, in patients with irreversible diseases. “Being shocked is like being kicked in the chest by a mule,” said Eric Widera, a palliative care specialist at the San Francisco V.A. Medical Center who served on the American Academy of Hospice and Palliative Medicine working group. “As someone gets close to the end of life, these ICDs can’t prolong life and they cause a lot of pain.”

Turning the devices off — an option many patients don’t realize they have — requires simple computer reprogramming or a magnet, not the surgery that installed them in the first place.

The palliative care doctors also pointed out that patients suffering pain as cancer spreads to their bones get as much relief, the evidence shows, from a single dose of radiation than from 10 daily doses that require travel to hospitals or treatment centers.

Finally, their list warned that topical gels widely used by hospice staffs to control nausea do not work because they aren’t absorbed through the skin. “We have lots of other ways to give anti-nausea drugs,” Dr. Widera said.

You can read all the Five Things lists (more are coming later this year), and the Consumer Reports publications that do a good job of translating them, on the Choosing Wisely Web site.

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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Bits Blog: One on One: Sugata Mitra, 2013 TED Prize Winner

Are teachers keeping students from learning in the digital age? Sugata Mitra, a professor of educational technology at Newcastle University, believes so. Dr. Mitra is best known for an experiment in which he carved a hole from his research center in Delhi into an adjacent slum, placing a freely accessible computer there for children to use.

The children quickly taught themselves basic computer skills. The “hole in the wall” experiment, as it is known, led Dr. Mitra to develop the idea of learning environments in which teachers would merely be supervisors as children taught themselves by working together at computer terminals. On Tuesday Dr. Mitra was given the 2013 TED Prize, which grants him $1 million to build a learning laboratory based on this principle.

Q.

What did you learn from the original “hole in the wall” experiment?

A.

The first thing to point out is that it was done 14 years ago, at a time when few children in India had access to computers. I noticed the rich parents saying that their sons and daughters must be gifted, because they were so good with computers. And since we know that gifted kids are not born only to rich parents, why would there not be similar children in the slums? I was curious to see what would happen if I gave an Internet-connected computer to the kind of kids who never had one.

We noticed that they learned how to surf within hours. It was a bit of a surprise. Long story short, they would teach themselves whatever they had to to use the computer, such was the attraction of the machine.

Q.

What does this mean for education?

A.

In those days, the main question was what does it mean for training, because back then people were trained to use computers. So I said it looks like we don’t have to do that.

But I got curious about the fact that the children were teaching themselves a smattering of English. So I started doing a whole range of experiments, and I found that if you left them alone, working in groups, they could learn almost anything once they’ve gotten used to the fact that you can research on the Internet. This was done between 2000 and 2006.

I came to England in 2006, and the schools said, why aren’t you doing it here? So I did, and I realized that what I’ve got has nothing to do with poor children. It probably is just a new way in which children learn in this new environment. It needs two things. First, broadband. That’s fine, everybody loves that. The second thing is, it needs the teacher to stand back.

At first I thought that the children were learning in spite of the teacher not interfering. But I changed my opinion, and realized this was happening because the teacher was not interfering. At that point, I didn’t become entirely popular with teachers. But I explained to them that the job has changed. You ask the right kind of question, then you stand back and let the learning happen.

Q.

Do schools need to be radically changed to implement this, or is this a technique that fits into the current structure of schools?

A.

At the moment I pitch it as a technique that you can bring into your schools. But that’s not the real story, which is that the current schooling system is a leftover from the Victorian age of empire. In that world, there were no computers, no telegraphs and data was carried around on ships. This meant that the pillars of education were reading, writing and arithmetic. That age is gone. The system was wonderfully engineered, but we don’t need it anymore; we need something else. But you can’t just say that without saying how you do it.

What I’m doing is I’m putting my foot in the door by saying here’s a new way. Try it. If you’re happy with it, then I’ll say let’s look at the curriculum top to bottom. If we can convert the curriculum into big questions, if we can turn assessment into peer assessment, then neurophysiology tells us that learning gets enhanced. Finally, if you add admiration — what I call the grandmother’s method, where you stand behind and encourage them. Put all of this together and you get a new way to do schooling.

Q.

So it seems that you’re saying we don’t need teachers at all.

A.

We need teachers to do different things. The teacher has to ask the question, and tell the children what they have learned. She comes in at the two ends, a cap at the end and a starter at the beginning.

Teachers are not supposed to be repositories of information which they dish out. That is from an age when there were no other repositories of information, other than books or teachers, neither of which were portable. A lot of my big task is retraining these teachers. Now they have to watch as children learn.

Q.

Is there a problem with this in that it will serve the good students well, but leave those who need more coaching behind?

A.

Well, yes, to some extent. But there are some interesting things about children working in groups if those groups are self-made. Once you let children do that, the system has a self-correcting ability. Having said that, will there be good students and bad students? Of course.

Q.

Does this work for all levels of instruction?

A.

It doesn’t work the same way with adolescents, and definitely not with adults. With 8- to 12-year-olds, that’s the age where big questions turn them on.

Q.

What are your specific plans with the prize?

A.

In order to see if this sort of self-organized learning environment is suitable I need to have one in which I have some control over and can do measurements with. So I want to build one of these learning spaces somewhere.

It will be totally automatic, completely controlled from the cloud. There will be a supervisor, but that person is not going to be a computer expert or a teacher in anything. She — and it will probably be a she — will be there only for health and safety requirements.

The rest of the school, if we call it a school, is a facility that I can hand over to a mediator from the cloud. She logs in from her home, wherever her home is, and she’s able to control everything inside, the lights, the air-conditioning, you name it. Then there are four mediators who Skype in and use the pedagogical method. That’s going to take a lot of work.

The second bit is that schools all over the world have been using this method. We need to do a massive multiplication, and TED is going to help me do that. I am going to try to put that into homes; get your children and their friends together. Then, every time they do it, I’ll ask them to collect data and send it to a Web site. If I succeed, in two years I’ll have massive data from all over the world. By that time I’ll be done building the facility and I’ll be ready to build a new model.

Q.

Where do you think this school will be?

A.

I’d like to do it in India, because I’d know how to get it done. There will be less of a learning curve, I know who the contractors are, and I know how not to get cheated. So I’d like to do it there, but it’s not set in stone.

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U.S. Pledges Food, Medical Aid and $60 Million to Syrian Opposition

ROME — Secretary of State John Kerry said on Thursday that the United States would provide food rations and medical supplies to the Free Syrian Army, the military wing of the opposition that is fighting to depose Syrian President Bashar al-Assad.

The assistance represents the first time that the United States has publicly committed itself to sending nonlethal support for armed factions that are battling the Assad government in the two-year-old uprising.

But the supplies Mr. Kerry announced fell well short of the weapons and equipment Syrian rebels have requested. And it remained unclear how such modest support might change Mr. Assad’s calculations about his ability to retain power, which Mr. Kerry has repeatedly said is Mr. Assad’s goal.

In addition to the nonlethal aid, the United States is providing $60 million in assistance to help the political wing of the Syrian anti-Assad coalition improve the delivery of basic services like sanitation and education in areas it has already wrested from the government’s control.

Mr. Assad is “out of time and must be out of power,” Mr. Kerry said, after meeting with Moaz al-Khatib, the leader of the Syrian opposition coalition, during a conference in Rome of the so-called “Friends of Syria” countries that support the anti-Assad uprising in Syria.

Defending the limited program of assistance to the Free Syrian Army, Mr. Kerry said that other countries would also provide help and that the “totality” of the effort would make an impression on Mr. Assad.

“We’re doing this, but other countries are doing other things,” Mr. Kerry said. But neither he nor any diplomat here provided details about that effort.

Britain is planning to provide more substantial nonlethal aid, which could include vehicles, bulletproof vests and night vision equipment, according to an American official. British officials have been consulting with their European counterparts about what sort of nonlethal aid might be allowed under the terms of European Union decisions and plans to announce its steps soon.

There has been speculation that the Obama administration might expand its program of support to the Free Syrian Army to include nonlethal equipment if rebel fighters use the initial assistance effectively and do not allow any of it to fall into the hands of extremists.

But Mr. Kerry provided no indication that such a phased expansion of nonlethal support was being planned by the White House.

American officials declined to discuss an ongoing covert program to train rebel fighters or the extent to which it has made a difference on the battlefield.

Some members of the Syria opposition said they were disappointed by the results of the Rome session.

“It is obvious that the real support is absent,” said Dr. Walid al-Bunni, a member of the anti-Assad coalition. What the resistance needed most, he said, was weapons. “What we want is to stop the Scuds launched on Aleppo, to stop the warplanes that are bombing our town and villages.”

Mr. Khatib, for is part, delivered an emotional statement in which he urged that steps be taken to establish a humanitarian corridor to the besieged city of Homs and complained that many in the West were too quick to judge some members of the opposition as Islamic extremists because of “the length of a beard of a fighter.”

“Bashar Assad, for once in your life, behave as a human being,” Mr. Khatib said. “Bashar Assad, you have to make at least one wise decision in your life for the future of your country.”

Facing divisions within the Syrian opposition about the value of the meeting, Mr. Khatib had initially decided to boycott the conference until he was encouraged to attend in phone calls from Mr. Kerry and Vice President Joseph R. Biden, Jr.

One aim of the $60 million in assistance is to help the National Coalition of Syrian Revolution and Opposition Forces, the umbrella resistance group that the United States backs and has helped shape, build up its credibility within the country and contest the influence of extremist groups like the Al Nusra Front, an Al Qaeda affiliated organization.

American officials have become increasingly concerned that the Al Nusra Front is making inroads among the Syrian population by dispersing assistance in the areas it controls, replicating a successful strategy used by Hezbollah, the militant Lebanese Shiite organization that is a politically powerful force in Lebanon.

Reporting was contributed by Anne Barnard and Hwaida Saad from Beirut, Lebanon, Mark Landler from Washington and Christine Hauser from New York.

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BP Executive Shares Blame With Contractors

NEW ORLEANS — On the second day of testimony in the Gulf of Mexico oil spill trial, BP’s top executive for North American operations at the time of the disaster insisted that his company was not solely to blame and shared responsibility for the accident with its contractors.

Lamar McKay, the former president of BP America and current chief executive in charge of global upstream operations, faced questioning on Wednesday from lawyers from Transocean, the Deepwater Horizon rig, and Halliburton, the cement provider, who insisted that BP was ultimately responsible for the accident.

“We agreed that we are part of the responsibility for this tragic accident,” Mr. McKay said on the stand. “We were part of the cause of the accident, yes.”

Don Godwin, Halliburton’s lawyer, argued that had tests that BP had misinterpreted shown that the cement that sealed the well was defective, the cement could have been fixed and the accident would not have happened.

“We agreed there were misinterpretations,” Mr. McKay said. “That was one of the causes.” But he added that BP depends on its contractors.

On Tuesday, Mr. McKay acknowledged that a well explosion had been identified as a risk before it happened.

“There was a risk identified for a blowout,” he said. “The blowout was an identified risk, and it was a big risk, yes.”

Robert Cunningham, a lawyer for private plaintiffs, tried to pin down Mr. McKay on BP’s responsibility for the 2010 disaster that killed 11 workers and dumped millions of barrels of oil into the gulf. Mr. Cunningham suggested that the British company’s cost-cutting and risk-taking culture were at the heart of the explosion and spill. He pressed Mr. McKay on the fact that a BP report on the accident held contractors responsible, but did not cite management failures.

Mr. McKay repeatedly responded that BP was responsible for designing the well, but that the rig, cement and other contractors shared responsibility for safety on the drilling operations.

“It’s a team effort,” he said. “It’s a shared responsibility to manage the safety and risk.” There was little, if anything, in his comments that diverged from what BP executives have said in the past.

The Federal District Court trial in New Orleans combines suits brought by the Justice Department, state governments, private businesses and individual claimants against BP and several of its contractors. Decisions on culpability and damages could be a year or more away, but they are likely to have profound effects on environmental law and on the viability of BP as a major oil company with global ambitions.

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Personal Health: Too Many Pills in Pregnancy

The thalidomide disaster of the early 1960s left thousands of babies with deformed limbs because their mothers innocently took a sleeping pill thought to be safe during pregnancy,

In its well-publicized wake, countless pregnant women avoided all medications, fearing that any drug they took could jeopardize their babies’ development.

I was terrified in December 1968 when, during the first weeks of my pregnancy, I developed double pneumonia and was treated with antibiotics and codeine. Before swallowing a single dose, I called my obstetrician, who told me to take what was prescribed, “reassuring” me that if I died of pneumonia I wouldn’t have a baby at all.

In the decades that followed, pregnancy-related hazards were linked to many medicinal substances: prescription and over-the-counter drugs and herbal remedies, as well as abused drugs and even some vitamins.

Now, however, the latest findings about drug use during pregnancy have ignited new concerns among experts who monitor the effects of medications on the developing fetus and pregnancy itself.

During the last 30 years, use of prescription drugs during the first trimester of pregnancy, when fetal organs are forming, has grown by more than 60 percent.

About 90 percent of pregnant women take at least one medication, and 70 percent take at least one prescription drug, according to the Centers for Disease Control and Prevention.

Since the late 1970s, the proportion of pregnant women taking four or more medications has more than doubled.

Nearly one woman in 10 takes an herbal remedy during the first trimester.

A growing number of pregnant women, naïvely assuming safety, self-medicate with over-the-counter drugs that were once sold only by prescription.

While many commonly taken medications are considered safe for unborn babies, the Food and Drug Administration estimates that 10 percent or more of birth defects result from medications taken during pregnancy. “We seem to have forgotten as a society that drugs pose risks,” Dr. Allen A. Mitchell, professor of epidemiology and pediatrics at Boston University Schools of Public Health and Medicine, said in an interview. “Many over-the-counter drugs were grandfathered in with no studies of their possible effects during pregnancy.”

Medical progress has contributed to the rising use of medications during pregnancy, Dr. Mitchell said. Various conditions, like depression, are now recognized as diseases that warrant treatment; drugs have been developed to treat conditions for which no treatment was previously available, and some conditions, like Type 2 diabetes and hypertension, have become more prevalent.

Misled by the Web

Now a new concern has surfaced: Bypassing their doctors, more and more women are using the Internet to determine whether the medication they are taking or are about to take is safe for an unborn baby.

A study, published online last month in Pharmacoepidemiology and Drug Safety, of so-called “safe lists for medications in pregnancy” found at 25 Web sites revealed glaring inconsistencies and sometimes false reassurances or alarms based on “inadequate evidence.”

The report was prepared by Cheryl S. Broussard of the Centers for Disease Control and Prevention with co-authors from Emory, Georgia State University, the University of British Columbia and the Food and Drug Administration.

“Among medications approved for use in the U.S.A. from 2000 to 2010, over 79% had no published human data on which to assess teratogenic risk (potential to cause birth defects), and 98% had insufficient published data to characterize such risk,” the authors wrote.

But that did not stop the 25 Web sites from characterizing 245 medications as “safe” for use by pregnant women, which “might encourage use of medications during pregnancy even when they are not necessary,” the authors suggested.

Furthermore, the information found online was sometimes contradictory. “Twenty-two of the products listed as safe by one or more sites were stated not to be safe by one or more of the other sites,” the study found.

The question of timing was often ignored. A drug that could interfere with fetal organ development might be safe to take later in pregnancy. Or one (for example, ibuprofen) that is safe early in pregnancy could become a hazard later if it raises the risk of excessive bleeding or premature delivery.

Fewer than half the sites advised taking medication only when necessary, and only 13 sites encouraged pregnant women to consult their doctors before stopping or starting a medication.

Doctors, too, are often poorly informed about pregnancy-related hazards of various medications, the authors noted. One woman I know was advised to wean off an antidepressant before she became pregnant, but another was told to continue taking the same drug throughout her pregnancy.

“In many instances the best bet is for mom to stay on her medication,” said Dr. Siobhan M. Dolan, an obstetrician and geneticist at Albert Einstein College of Medicine. She said that if a woman is depressed during pregnancy, her risk of postpartum depression is greater and she may have difficulty bonding with her baby.

Dr. Dolan, who is author, with Alice Lesch Kelly, of the March of Dimes’ newest book, “Healthy Mom Healthy Baby,” emphasized the importance of weighing benefits and risks in deciding whether to take medication during pregnancy and which drugs to take.

“In anticipation of pregnancy, a woman taking more than one drug to treat her condition should try to get down to a single agent,” Dr. Dolan said in an interview. “Of the various medications available to treat a condition, is there a best choice — one least likely to cause a problem for either the baby or the mother?”

She cautioned against sharing medications prescribed for someone else and assuming that a remedy labeled “natural” or “herbal” is safe. Virtually none have been tested for safety in pregnancy.

Among medications a woman should be certain to avoid, in some cases starting three months before becoming pregnant, are isotretinoin (Accutane and others) for acne; valproic acid for seizure disorders; lithium for bipolar disorder; tetracycline for infections, and angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor antagonists for hypertension, Dr. Dolan said.

“Many medications that are not recommended during pregnancy can be replaced with low-risk alternatives,” she wrote.

Dr. Broussard, who did the “safe lists” study, said in an interview, “We’ve heard about women seeing medications on these lists and deciding on their own that it’s O.K. to take them. “Women who are pregnant or even thinking about getting pregnant should talk directly to their doctors before taking anything. They should be sure they’re taking only what’s necessary for their health condition.”

A reliable online resource for both women and their doctors, Dr. Mitchell said, are fact sheets prepared by OTIS, the Organization of Teratology Information Specialists, which are continually updated as new facts become available: http://www.otispregnancy.org.

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Gadgetwise Blog: A Wireless Speaker With a Wi-Fi Connection

When we talk wireless speakers, we still generally mean speakers that connect to players by Bluetooth.

There is nothing wrong with Bluetooth, but Wi-Fi, which can carry a lot more information, can sound a lot better. That is part of the reason we are seeing more Wi-Fi and Apple AirPlay speakers on store shelves.

Among them is the Libratone Zipp, a 10-inch tall canister with a fuzzy cover that makes it look like a small, colorful roll of carpet.

The Zipp’s Wi-Fi connection is supposed to be Apple- and Android-friendly. The connection with the iPhone was easy; in my test I set the iPhone’s Wi-Fi network to Libratone, then went to the music player, hit the AirPlay button, picked Libratone again and was connected through the play direct feature. That feature broadcasts directly from the phone to the speaker without going through your larger Wi-Fi network.

Connecting with a Android phone was did not work so easily, which is to say at all. Even with help from support and a software update, I was unable to get a Motorola RAZR Maxx to connect. Support said the problem seemed to be a faulty speaker.

The Zipp says it also supports DLNA, which should make it work with Windows, but I didn’t test that feature.

The Zipp is portable – it claims four hours of battery life when using Wi-Fi – but it isn’t exactly light weight, tipping the scales at four pounds.

The sound quality is good, thanks partially to a 4-inch woofer and a pair of 1-inch ribbon speakers, although I don’t know if it’s fair to call a monaural speaker “high fidelity,” as Libratone does.

There is one major drawback to using Wi-Fi to connect a player and speaker. Once the Wi-Fi is occupied by the Zipp, you can’t use it to connect to your Pandora, Slacker or other streaming audio account. So no streaming audio. You could get around this by connecting the device using a USB cable, which also doubles the Zipp’s battery life.

The Zipp, which comes in any of eight colors, starts at $400 list price online.

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News Analysis: Now Gathering in Rome, a Conclave of Fallible Cardinals

Dmitry Lovetsky/Associated Press

St. Peter’s Basilica on Tuesday. Roman Catholic cardinals were gathering at the Vatican amid scandal to choose a new pope.

The sudden resignation of the most senior Roman Catholic cardinal in Britain, who stepped aside on Monday in the face of accusations that he made unwanted sexual advances toward priests years ago, showed that the taint of scandal could force a cardinal from participating in the selection of a new pope.

His exit came as at least a dozen other cardinals tarnished with accusations that they had failed to remove priests accused of sexually abusing minors were among those gathering in Rome to prepare for the conclave to select a successor to Pope Benedict XVI. There was no sign that the church’s promise to confront the sexual abuse scandal had led to direct pressure on those cardinals to exempt themselves from the conclave.

Advocates for abuse victims who were in Rome on Tuesday focused particular ire on Cardinal Roger M. Mahony, the former archbishop of Los Angeles, and called for him to be excluded from the conclave. But Cardinal Mahony, who has vigorously defended his record, was already in Rome, posting on Twitter about the weather.

Even stalwart defenders of the church point out that to disqualify Cardinal Mahony would leave many more cardinals similarly vulnerable. Many of the men who will go into the Sistine Chapel to elect a pope they hope will help the church recover from the bruising scandal of sexual abuse have themselves been blemished by it.

“Among bishops and cardinals, certainly the old guys who have been involved for so long, sure they’re going to have blood on their hands,” said Thomas G. Plante, a professor of psychology at Santa Clara University, who has served on the American bishops’ national abuse advisory board and has written three books on sexual abuse. “So when Cardinal Mahony says he’s being scapegoated, in some respects I think he’s right. All the focus is on him, but what about the other guys?”

Among the many challenges facing the church, addressing the wounds caused by sexual abuse is among the top priorities, church analysts say. When Benedict was elected pope in 2005, many Catholics hoped that his previous experience at the helm of the Vatican office that dealt with abuse cases would result in substantive changes.

Benedict has repeatedly apologized to victims, and listened personally to their testimonies of pain. After the abuse scandal paralyzed the church in Europe in 2010, and began to emerge on other continents, Benedict issued new policies for bishops to follow on handling sexual abuse accusations, and he held a conference at the Vatican on the issue. But despite calls from many Catholics, he never removed prelates who, court cases and documents revealed, put children at risk by failing to report pedophiles or remove them from the priesthood.

It is not that these cardinals behaved so differently from the others, or that they do not have achievements to their names. It is just that they happened to come from pinpoints on the Catholic world map where long-hidden secrets became public because victims organized, government officials investigated, lawyers sued or the news media paid attention.

They include cardinals from Belgium, Chile and Italy. They include the dean of the College of Cardinals, Angelo Sodano, who is accused of taking large monetary gifts from a religious order, the Legion of Christ, and halting an investigation into its founder, the Rev. Marcial Maciel — who was later exposed as a pathological abuser and liar.

They also include cardinals reviled by many in their own countries, like Cardinal Sean Brady, the primate of All Ireland, who survived an uproar after government investigations uncovered endemic cover-ups of the sexual and physical abuse of minors.

“There’s so many of them,” said Justice Anne Burke, a judge in Illinois who served on the American bishops’ first advisory board 10 years ago. “They all have participated in one way or another in having actual information about criminal conduct, and not doing anything about it. What are you going to do? They’re all not going to participate in the conclave?”

Even one cardinal frequently mentioned as a leading candidate for pope has been accused of turning a blind eye toward abuse victims. A Canadian, Cardinal Marc Ouellet, issued apologies to the many victims of abuse in church boarding schools in Quebec Province, but left behind widespread resentment when he reportedly refused to meet with them.

Pascale Bonnefoy contributed reporting from Santiago, Chile; Ian Austen from Ottawa; and Gaia Pianigiani from Rome.

This article has been revised to reflect the following correction:

Correction: February 27, 2013

An earlier version of this article misstated part of the address of a Web site that tracks abuse cases. It is BishopAccountability.org, not BishopAccountability.com.

This article has been revised to reflect the following correction:

Correction: February 27, 2013

An earlier version of this article referred incorrectly to the Roman church over which Cardinal Bernard Law presides. It is a basilica, not a cathedral.

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Wall Street Sheds Morning Gains

Stocks mostly rose on Tuesday after the Federal Reserve chairman, Ben S. Bernanke, defended the Fed’s bond-buying stimulus before Congress, but warned that forced spending cuts that could be set in motion this week represented a headwind for the economy.

Gains in homebuilders and other consumer stocks, following strong economic data, kept the overall market nearly unchanged, while a 5 percent jump in Home Depot lifted the Dow industrials. The Philadelphia Stock Exchange housing sector index rose 2 percent.

Stocks hit session highs shortly after Mr. Bernanke, in testimony before the Senate Banking Committee, strongly defended the Fed’s bond-buying stimulus program that has been essential for the stock market’s recovery.

But he also urged lawmakers to avoid sharp spending cuts set to go into effect on Friday, which he warned could combine with earlier tax increases to create a “significant headwind” for the economic recovery.

“He really came down foursquare on the bearish camp with respect to the potential economic impact of these cuts,” said Michael Jones, chief investment officer of Riverfront Investment Group in Richmond, Va. “That’s a surprise, and that’s probably why the market’s a little nervous right now.”

In early afternoon trading, the Dow Jones industrial average rose 74.64 points or 0.54 percent to 13,858.81. The Standard & Poor’s 500-stock index gained 1.78 points or 0.12 percent to 1,489.63. The Nasdaq Composite dropped 5.84 points or 0.19 percent to 3,110.41.

The S.&P. 500 failed to move above 1,500, a closely watched level that was technical support until recently, but could now become a hurdle.

The cable programmer AMC Networks was the Nasdaq’s biggest percentage decliner after AMC, the home of popular shows such as “The Walking Dead” and “Mad Men,” reported a quarterly profit far below analysts’ estimates. Its stock fell 7.4 percent to $53.77.

Equities continued to be weighed by concerns about a stalemate in Italy after a general election failed to give any party a parliamentary majority, posing the threat of prolonged instability and European financial crisis.

The FTSEurofirst-300 index of top European shares unofficially closed down 1.3 percent at 1,150.58. The benchmark Italian index tumbled 4.9 percent.

Home Depot, the world’s largest home improvement chain, was the top gainer in both the Dow and the S.&P. 500 after it reported adjusted earnings and sales that beat expectations. Home Depot’s shares jumped 5.5 percent to $67.46.

Macy’s shares climbed 2.8 percent to $39.60 after the department-store chain said it expected full-year earnings to be above analysts’ forecasts because of strong holiday sales.

Economic reports that showed strength in housing and consumer confidence also supported stocks.

United States home prices rose more than expected in December, according to the S.&P./Case-Shiller index. Consumer confidence rebounded in February, rising more than expected, and new-home sales rose to their highest in four and a half years.

This article has been revised to reflect the following correction:

Correction: February 26, 2013

Because of an editing error, an earlier version of this article misidentified the Senate panel before which Ben S. Bernanke, the Federal Reserve chairman, was testifying Tuesday. It was the Banking Committee, not the Finance Committee.

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