The United States (U.S.) and Jordan launched negotiations for a free trade agreement in 2000.The US-JO FTA includes a preamble, nineteen articles, three annexes, joint statements, memorandums of understanding, and side letters. In addition to the interesting articles on labor and environment, the US-JO FTA provides the opportunity for Jordanian nationals to come to the U.S. to make investments and participate in trade. Under certain conditions, Jordanian nationals can enter the U.S. to render professional services. The purpose of this (...) article is to examine in detail article 8 of the US-JO FTA which relates to entry of nationals of one party into the territory of the other. The article starts by providing a brief background of the negotiation and conclusion of the US-JO FTA. Then, the article analyzes in detail the specific provision related to temporary entry of nationals. The article draws a comparison between US-JO FTA with the North American Free Trade Agreement (NAFTA) and the more recent trade agreements between the U.S., Oman, Bahrain, and Morocco. Finally, the article observes that although the US-JO FTA, like all US FTAs, is designed to permit temporary entry, without intent to establish permanent residence, of persons, the U.S. should have provided Jordan with special and differential treatment for entry of its nationals. Taking into account the special circumstances of Jordan as a developing country with low-income status, high unemployment rate, and lack of resources, movement of business visitors, investors, intra-company transferees, and professionals should have been dealt with leniency so that the FTA could generate effective and real market access. (shrink)

On 19 May 2011, the Lithuanian Parliament adopted the Law on Temporary Agency Employment to implement the EU Directive on temporary agency work. Up to now there has been no special regulations for the so called “personnel lease”, although Lithuanian companies have been using such service since 2003. The law basically followed the recommendations of the Directive without setting additional restrictions. Temporary agency workers will be subject to the same conditions as permanent workers of employment agency clients (...) are regarding working and leisure time regime and work safety. The Law on Temporary Agency Employment will enter into force on 1 December 2011. The purpose of this article is to analyze the EU Directive on temporary agency work transfer to the Lithuanian legal system and the peculiarities of the theoretical and practical problems associated with the new regulation. Conclusions and suggestions for the improvement of the legal provisions are presented. (shrink)

Computer-facilitated self-service technologies have become ubiquitous in today’s consumer-focused world. Yet, few human–computer interactions elicit such dramatically polarizing emotional reactions from users as those involving SSTs. ATMs, pay-at-the-pump gas stations, and self-scanning retail registers tend to produce both passionate supporters and critics. While negative comments often center on unpleasant personal user experiences, the actual “abuse” related to such systems is really much deeper and more complex. SSTs carry with them a number of potentially insidious consequences, including the exploitation of consumers (...) as uncompensated temporary workers; the sacrifice of our inherent humanity to delegate both skills and cognition to electronic helpers; and the enabling of a new type of posthuman consumer identity, where each transaction is completed by a cyborg entity constructed of the human on one side and the electronic mechanism on the other. As a result, we may ultimately lose the boundary between the human and the machine. (shrink)

Organisational restructuring involving cost-cutting, downsizing, and the acquisition and divestment of different functions is an increasingly normalised aspect of employment in both the private and public sectors. This article takes up the question of the effects of restructuring on workers through a study based on in-depth, semi-structured interviews of long-term workers in Finland’s state-owned postal service, using the concept of dignity as an analytical lens. The article distinguishes between everyday, organisational, and social dignity, using this distinction to capture how workers (...) strove to sustain dignity in a process of organisational restructuring that generated dignity threats related to occupational devaluation. The study shows how dignity in postal work has been dependent on a particular historical configuration of public service work involving the employer organisation, employment relations, and occupational values. Cost-driven restructuring has destabilised this configuration, producing a stark separation between dignity in everyday work and the organisational indignities of restructuring in postal workers’ experiences. Feeling unable to affect organisational changes in their work, postal workers have been left to sustain dignity through everyday relationality, and by drawing intra-organisational boundaries to temporary workers and upper managers based on an occupational hierarchy of commitment and competence. The study highlights the significance of organisational support for dignity at work, particularly in relation to the dignity threats generated by prolonged processes of restructuring. (shrink)

Computer-facilitated self-service technologies have become ubiquitous in today’s consumer-focused world. Yet, few human–computer interactions elicit such dramatically polarizing emotional reactions from users as those involving SSTs. ATMs, pay-at-the-pump gas stations, and self-scanning retail registers tend to produce both passionate supporters and critics. While negative comments often center on unpleasant personal user experiences, the actual “abuse” related to such systems is really much deeper and more complex. SSTs carry with them a number of potentially insidious consequences, including the exploitation of consumers (...) as uncompensated temporary workers; the sacrifice of our inherent humanity to delegate both skills and cognition to electronic helpers; and the enabling of a new type of posthuman consumer identity, where each transaction is completed by a cyborg entity constructed of the human on one side and the electronic mechanism on the other. As a result, we may ultimately lose the boundary between the human and the machine. (shrink)

Computer-facilitated self-service technologies have become ubiquitous in today’s consumer-focused world. Yet, few human–computer interactions elicit such dramatically polarizing emotional reactions from users as those involving SSTs. ATMs, pay-at-the-pump gas stations, and self-scanning retail registers tend to produce both passionate supporters and critics. While negative comments often center on unpleasant personal user experiences, the actual “abuse” related to such systems is really much deeper and more complex. SSTs carry with them a number of potentially insidious consequences, including the exploitation of consumers (...) as uncompensated temporary workers; the sacrifice of our inherent humanity to delegate both skills and cognition to electronic helpers; and the enabling of a new type of posthuman consumer identity, where each transaction is completed by a cyborg entity constructed of the human on one side and the electronic mechanism on the other. As a result, we may ultimately lose the boundary between the human and the machine. (shrink)

This study is an investigation of the views of medical students (N=15) and physicians (N=14), in Turkey, on conscientious objection through elaboration on their experiences in medical practice within the framework of conscientious objection, and evaluation of the data from an ethical perspective. The data received from in‐depth interviews were evaluated by using the thematic content analysis method. They were then divided into contexts and themes as follows: “Refusal to provide healthcare services,” “scope of conscientious objection,” and “impact of (...) conscientious objection (in case of legal entitlement).” The opinions of our research participants suggest that conscientious objection has become widespread in medical practices. It is argued that the tendency of healthcare providers and patients to find temporary resolutions to ethical dilemmas only complicates such resolutions. It is imperative, therefore, to set a rational limit on conscientious objection so as to prevent the adoption of an attitude shaped completely by the personal beliefs of the physician or the patient. (shrink)

Background Several ethical issues are associated with providing living organ transplantation services, and there is limited information on these issues faced by the teams providing service to refugees or asylum seekers. Aim To determine the challenges healthcare professionals face in organ transplant centers providing services to Syrians under temporary protection status and discern whether these difficulties align with ethical issues in living organ transplantation. Research design This study employed a qualitative design and conducted individual semi-structured, in-depth interviews (...) with 18 transplant team members in Istanbul between September and November 2022. Data analysis was based on Braun and Clarke’s thematic analysis. Participants and research context The participants comprised 18 healthcare professionals, including 6 physicians and 12 nurses working in organ transplant teams in Istanbul. Ethical considerations The University’s Ethics Committee provided approval. Participants were informed regarding confidentiality and signed an informed consent form. Results Three themes emerged from the data on ethical issues faced by organ transplantation services to Syrians: (a) beneficence or double equipoise, (b) autonomy, and (c) justice. Transplant teams experience problems related to preserving double equipoise in the provision of living donor organ transplantation because of language barriers, poor socioeconomic conditions, and cultural factors, which increases transplant teams’ individual and indirect social burden. Although problems arise from the language barrier when obtaining informed consent in the autonomy theme, institutional and national policies in preventing donor abuse have a comforting effect. Health workers had the least problems with the justice theme, wherein national health policies are determined. Conclusion Fewer issues related to autonomy and justice were reported in providing organ transplantation services to Syrians, with the most intense reported issues being maintaining double equipoise. The results revealed the need to develop institutional, national, and international policies with individual solutions to prevent difficulties healthcare professionals face in this process. (shrink)

Machine‐learning algorithms have the potential to revolutionise diagnostic and prognostic tasks in health care, yet algorithmic performance levels can be materially worse for subgroups that have been underrepresented in algorithmic training data. Given this epistemic deficit, the inclusion of underrepresented groups in algorithmic processes can result in harm. Yet delaying the deployment of algorithmic systems until more equitable results can be achieved would avoidably and foreseeably lead to a significant number of unnecessary deaths in well‐represented populations. Faced with this dilemma (...) between equity and utility, we draw on two case studies involving breast cancer and melanoma to argue for the selective deployment of diagnostic and prognostic tools for some well‐represented groups, even if this results in the temporary exclusion of underrepresented patients from algorithmic approaches. We argue that this approach is justifiable when the inclusion of underrepresented patients would cause them to be harmed. While the context of historic injustice poses a considerable challenge for the ethical acceptability of selective algorithmic deployment strategies, we argue that, at least for the case studies addressed in this article, the issue of historic injustice is better addressed through nonalgorithmic measures, including being transparent with patients about the nature of the current epistemic deficits, providing additional services to algorithmically excluded populations, and through urgent commitments to gather additional algorithmic training data from excluded populations, paving the way for universal algorithmic deployment that is accurate for all patient groups. These commitments should be supported by regulation and, where necessary, government funding to ensure that any delays for excluded groups are kept to the minimum. We offer an ethical algorithm for algorithms—showing when to ethically delay, expedite, or selectively deploy algorithmic systems in healthcare settings. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Burma’s Healthcare Under Fire: My Experience as an Exiled Medical ProfessionalP. P. KyawI used to work as a medical doctor in a less developed state than many big cities in Burma1 that experienced prolonged civil wars and current similar atrocities decades before the urban areas of the country experienced them. Before everything started, I was responsible for the medical management of the most vulnerable communities and had been struggling (...) with pandemic-related medical activities. Those were the happiest years of my life. I was with one of the best international organizations, where every effort I made was directly delivered to the patients with no unnecessary paperwork. The system was efficient, my colleagues were supportive, and I had a good work-life balance. I supported my family and whoever needed temporary financial support, played music weekly, met good friends who I hung out with every weekend, and [End Page 164] found hobbies like gardening and crocheting. I was content and happy. I even postponed my plans to get registered as a doctor in the Western world.Before moving to this beautiful ethnic state in 2019, I previously worked as a government medical doctor in Yangon, the capital. As much as I loved working in those civilian hospitals, I could not support myself with a monthly pay of $100-$150 USD. It was a hard decision to leave the service because it meant I could not pursue the medical specialty that I had always longed for and had to leave like-minded supportive colleagues. In Myanmar, unless you are a civil servant, you cannot pursue further clinical specialties. However, after leaving the government’s service to work in humanitarian medical assistance in hard-to-reach areas of Burma, I learned that life is still beautiful outside my comfort zone, until February 2021 when the coup began. Democratically elected members of the country’s ruling party were overthrown by the military, which then bestowed power in a military junta.I expected the election prior to the coup in November 2020 to be an uphill battle for Burma, but nothing more. I was still in denial when I first heard the news from one of the town’s NGO staff. The person had to travel on a motorbike to inform everyone that the junta had staged the coup. No telephone or internet was working at that time. My colleagues and I cried in our office, saying, “We are so young, and the future is still ahead. I don’t think this is going to last long. Maybe it will be over in a few days or, at most, a few weeks.” Once the peaceful protests started nationwide, my friends and I provided medical cover for the protesters, initially for minor medical problems such as low sugar, low blood pressure, injuries from accidental minor slips and falls, etc. Never in my life had I imagined that I would be taking care of bullet wounds and people injured by live rounds. While learning about gunshot wounds in forensic medicine, I thought, “Oh, this is not going to be very useful because Burma is not America, and I am not going there.” Then suddenly, it became too real and more useful than I would’ve liked it to be.I always think back to one especially bloody day when many people in the town were shot with live rounds. We assisted many patients. Usually, we would go around with the protest groups until they were over in the late afternoon. The protesters were always peaceful. There were no riots, no harmful acts, or vandalism. Only when the protesters were cruelly dispersed with tear gas, high-pressure pumps, rubber bullets, and live rounds (to the head) did they decide to defend themselves while still making their voices heard. The only defenses people had to counteract the live rounds were things like metal covers, firecrackers, and slingshots.One afternoon in March 2021, my team and I took an early break for lunch—unaware that some people would lose their lives that afternoon. We followed the local protests through Facebook Live while having lunch and started to hear firecracker sounds. A few seconds later, we knew... (shrink)

With the fast expansion of urbanization, temporary migrants have become a large demographic in Chinese cities. Therefore, in order to enhance the social integration of the migrant population, scholars and policymakers have an urgency to investigate the influencing factors of the integration progress. Prior studies regarding social integration have neglected to examine this topic from the perspective of social participation. Empirical research is conducted based on the data of 15,997 migrants across eight cities in the 2014 wave of National (...) Migrant Population Dynamic Monitoring Survey in China. Hierarchical linear models were used to test the hypotheses regarding the impacts of formal social participation and informal social participation on social integration. Community type, neighbor composition, hometown pressure, withdrawal guarantee, and constraints of hukou were examined as moderators. FSP and ISP possess different features such as operating with distinct modes, providing different services. Members within the organizations also entail different rights and responsibilities, providing them with different types of social capital and psychological perceptions. Hence, this study strived to identify the effects of social participation behaviors on social integration from a social capital perspective. The results revealed that social participation is positively linked to social integration. We also distinguished between FSP and ISP of migrants to investigate the boundary effects of different types of social participation on social integration. The findings provide both theoretical and practical implications for scholars as well as policymakers on issues regarding the social integration of migrants. (shrink)

The transmission of cholera, a highly infectious disease, is closely linked to inadequate access to clean water and sanitation facilities, with resource-poor communities, including refugees, rural communities and temporary displacement camps particularly vulnerable to outbreaks. Any disruption in water and sanitation systems or a sudden surge in community size owing to displacement can spark a humanitarian and health crisis, elevating the risk of cholera transmission and possibly triggering a regional epidemic. Recently, Hammanskraal in Gauteng, South Africa, experienced such an (...) epidemic. A multifaceted approach is essential to minimise fatalities and effectively manage healthcare services in such health emergencies. This approach includes early detection, rapid response to contain outbreaks, and the effective deployment of technical support, advocacy, resource mobilisation and partnerships at local, national, and international levels. This paper explores the responsibilities of individuals, healthcare workers, communities and governments in addressing epidemics. It also delves into the concept of collective responsibility with regard to climate change and cholera, as part of the multifaceted approach for cholera prevention and control. While economic development, equal access to safe drinking water, and adequate sanitation are necessary for cholera control, major challenges persist in achieving the fundamental right to a healthy environment in the long term. We also discuss these obstacles and conclude with practical suggestions and recommendations for future cholera prevention. (shrink)

Precarity applies to people who, in order to survive, need to work in a low-quality job, which is uncertain, temporary, low-paid, with no prospect of promotion, no security and no contract. In this sense, the precariat is a category related mostly to the secondary segment of the labour market, according to the concept of a dual labour market. It is also the universal feature of Post-Fordism and the modern working conditions in which women, more often than men, are located (...) in the ‘worst’segment of the labour market. In this context, it can be noted that since the beginning of the era of globalization, women start working particularly in those sectors that were more uncertain and unstable e.g. in services and trade. It was feminization in a double sense: there were more and more working women on the one hand, and on the other hand, the flexible jobs were undertaken usually by women. Most of these kind of jobs were precarity jobs. Precarity is combined with insecurity, which does not allow the people in this group to plan anything, and wages so low that they can’t afford a decent life. In the article I would like to prove that the threat of precariat is more probable for women than men. I present data related to precarity for Poland compared to other European countries (based on data from Eurostat and the OECD). (shrink)

This paper presents an overview of the key ethical questions of performing gene editing research on military service members. The recent technological advance in gene editing capabilities provided by CRISPR/Cas9 and their path towards first-in-human trials has reinvigorated the debate on human enhancement for non-medical purposes. Human performance optimization has long been a priority of military research in order to close the gap between the advancement of warfare and the limitations of human actors. In spite of this focus on (...) class='Hi'>temporary performance improvement, biomedical enhancement is an extension of these endeavours and the ethical issues of such research should be considered. In this paper, we explore possible applications of CRISPR to military human gene editing research and how it could be specifically applied towards protection of service members against biological or chemical weapons. We analyse three normative areas including risk–benefit analysis, informed consent, and inequality of access as it relates to CRISPR applications for military research to help inform and provide considerations for military institutional review boards and policymakers. (shrink)

Hospital admission and mortality statistics suggested that peptic ulcer reached a peak prevalence in the mid-1950s. During the Second World War, against this background of serious and common pathology, an epidemic of dyspepsia afflicted both service personnel and civilians alike. In the absence of reliable diagnostic techniques, physicians struggled to distinguish between life-threatening illness and mild, temporary disorders. This article explores the context in which non-ulcer stomach conditions flourished. At a time when fear was considered defeatist and overt psychological (...) disorder attracted stigma, both soldiers and civilians exposed to frightening events may have unconsciously translated their distress into gastrointestinal disorders. While the nature of army food was initially identified as the cause of duodenal ulcer in servicemen, the pre-war idea that conscientious and anxious individuals were at high risk gathered support and fed into post-war beliefs that this was a stress-related illness. Diet continued to be employed as a means of management at a time when the nation was preoccupied by food because of the constraints imposed by rationing. The peptic ulcer phenomenon set much of the medical agenda for the war years and conflicted with the commonly held view that the British people had never been healthier. (shrink)

This article aims to explore and make theoretical sense of a stream of tourism that blurs the boundaries between sex, romance and intimacy, and diffuses the line between affectionate and economic relations. The empirical scope is the expanding international tourism of tango dancing—meaning the increasing number of people from all over the world travelling to Buenos Aires to dance tango and engage with the local tango culture. In contrast to women's sex tourism on the beaches of Jamaica and Ghana, the (...) relationships evolving in the Argentinean dance halls only occasionally lead to sexual affairs and temporary romances, but they are still part of a sensual geography made up of a transnational skin-to-skin intimacy. In addition, the relations between local dancers and tourists rarely result in economic transactions of sex for money; however, they engage with a growing market of intimate dance services and are part of the economic injustices and exotified projections of our post-colonial time. Hence, this article seeks to shed critical light over a broader area of transnational romance. The case of tango evokes new sets of critical queries regarding the trade of bodily intimacy and affection; the consequences of economic inequality in the area of heterosexual romance; and the production of class morals and racialised gender regimes. Through an exploration of these intimate practices, discourses and sets of emotions produced in this particular context, a complex landscape of market forces and close-embrace dancing unfolds. (shrink)

There are different groups in society who may be considered vulnerable, for example those experiencing mental or physical health issues, learning disabilities, prisoners or children. There are, however, other groups in society who may also be regarded as vulnerable, such as those who are bereaved. Vulnerability in relation to the bereaved occurs as a result of experiencing a normal life event, death or a loss. In this situation vulnerability may be transient and, depending upon the management of the bereavement, generally (...) temporary. Unlike the aforementioned groups, participants required for this type of research (bereavement, death and dying) are able to consent themselves into projects, and the capacity to do so is not an issue. Undertaking research with those who may be considered vulnerable into sensitive, emotive topics such as death and dying can create difficulties for the National Research Ethics Service (NRES), making it difficult to get approval for such studies. It appears that the ethical issues are concerned with not wishing to cause distress to participants when asked for research purposes to recollect what for some may have been emotionally challenging and traumatic events. The article offers a narrative, reflective account of the above from several perspectives: being employed as a contract researcher in a university; having experience of being an active member of a National Health Service Research Ethics Committee; and later assuming the role of full-time postgraduate (PhD) student requiring ethical approval to undertake research with what may be considered a vulnerable group involving a sensitive and emotive topic. Valuable insights from participants – their views on participation in an emotive research project and good practice in research having been explored via questionnaire – are highlighted and discussed. (shrink)

In contemporary market societies, the laws do not place individuals under enforceable obligations to aid others. Perhaps the most striking exception to this broad generalization is the practice of conscription of able-bodied males into military service, particularly in time of war. Another notable exception is the legal enforcement in some contemporary societies of “Good Samaritan” obligations — obligations to provide temporary aid to victims of emergencies, such as car accident victims. The obligation applies to those who are in the (...) immediate vicinity of the emergency and who can supply aid of great value to the victim at small risk and tolerable cost to themselves. The fact that not all contemporary societies have enacted such Good Samaritan laws underscores the point that the general rule is that individuals are under no legal obligation to help others. According to some moral views, this legal situation approximately accords with the moral fact that persons who have not voluntarily incurred obligations to aid others should not be coerced into tendering such aid. Moreover, it is worth noting that these two prominent exceptions to the tendency of legal systems to eschew enforcement of positive obligations to aid others are plausibly in everyone's ex ante interest and not notably redistributive in intent. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Ästhetische Autonomie als Abnormität: Kritische Analysen zu Schopenhauers Ästhetik im Horizont seiner Willensmetaphysik by Barbara NeymeyrGünter ZöllerBarbara Neymeyr. Ästhetische Autonomie als Abnormität: Kritische Analysen zu Schopenhauers Ästhetik im Horizont seiner Willensmetaphysik. Berlin: Walter de Gruyter, 1996. Pp. x + 430. Cloth, DM 250.00.Like a latter-day Janus, Schopenhauer faces the history of philosophy in two directions. As a self-proclaimed follower of Kant and one-time student of Fichte, he partakes (...) in the development of transcendental-idealist philosophy at the beginning of the nineteenth-century. When published in 1818, Schopenhauer’s four-part system of philosophy in The World as Will and Representation, consisting of an epistemology, a philosophy of nature, an aesthetics, and an ethics, was the first philosophical system of German idealism executed in detail. Yet with his orientation toward the natural sciences, from which he sought confirmation of his metaphysics, and through the delayed reception of his work, which began only in the 1850s, Schopenhauer seems to belong to the later nineteenth century, as an immediate precursor of Nietzsche. At the systematic level, the double orientation of [End Page 475] Schopenhauer’s philosophy finds expression in the concurrence of two types of philosophical theory in his work: a transcendental philosophy based on the correlation between a nonworldly subject of cognition and its world of objects, structured according to the basic forms of the principle of sufficient reason, and a metaphysics of the will based on the ultimate reality of everything and everyone as will.The systematic instability that threatens Schopenhauer’s double philosophy of transcendental idealism and voluntaristic metaphysics has prevented his work from being included in the canonical tradition of classical German philosophy and has resulted in a reductive and selective appropriation of parts and aspects of his work, especially focussing on his philosophy of music and his ethics of pity. But recently a number of authors have begun to explore and explain the overall, systematic dimension and potential of Schopenhauer’s philosophy. Rudolf Malter has argued forcefully and in great detail for the significance of Schopenhauer as a key figure in the transcendental tradition from Kant to Heidegger, and John Atwell has laid open the systematic ambition and scope of Schopenhauer’s philosophical project of an anthropomorphic cosmology.1Barbara Neymeyr’s thorough and well-informed reading of Schopenhauer’s aesthetics continues this trend toward a systematic Schopenhauer interpretation. The specific focus of her work, a revised doctoral dissertation that had been directed by Gerold Prauss (Freiburg i. Br.), is the systematic integrity, or lack thereof, of Schopenhauer’s metaphysics of the beautiful. The study soon widens to consider the background of Schopenhauer’s aesthetics in his overall metaphysics of the will. Neymeyr argues that the aesthetic in Schopenhauer occupies a decidedly abnormal systematic position. The norm from which the aesthetic seems to deviate in a radical way is the heteronomy of the intellect in the service of the all-powerful will. Normally, in the nonaesthetic attitude, the intellect is only a tool of the will, providing cognitive illumination to the latter’s originally blind striving. Abnormally though, in the aesthetic attitude, the intellect is supposed to achieve temporary freedom from the will. (Lasting emancipation is afforded only by the ethical, understood as ascetic denial of all willing.) Yet, as Neymeyr argues, in the absence of the will’s driving force, there is no positive basis for any self-determination and intentional activity on the part of the emancipated as well as emaciated aesthetic intellect. Moreover, the role of the will as ultimate reality in Schopenhauer suggests to Neymeyr that the apparent aesthetic emancipation of the intellect from the will is still a case of the will’s ultimate, although clandestine mastery over the intellect. The liberation of the aesthetic intellect from the will is at bottom, so Neymeyr, the cosmic will’s self-liberation from its manifestation as individual will. Thus for Neymeyr, aesthetic autonomy constitutes an inadmissable abnormality in Schopenhauer’s systematic philosophy.Exhibiting great ingenuity and extensive familiarity with the entire corpus of Schopenhauer’s writings, Neymeyr tracks the various levels and forms of inconsistency that [End Page 476] plague Schopenhauer’s aesthetic... (shrink)

Hospital admission and mortality statistics suggested that peptic ulcer reached a peak prevalence in the mid-1950s. During the Second World War, against this background of serious and common pathology, an epidemic of dyspepsia afflicted both service personnel and civilians alike. In the absence of reliable diagnostic techniques, physicians struggled to distinguish between life-threatening illness and mild, temporary disorders. This article explores the context in which non-ulcer stomach conditions flourished. At a time when fear was considered defeatist and overt psychological (...) disorder attracted stigma, both soldiers and civilians exposed to frightening events may have unconsciously translated their distress into gastrointestinal disorders. While the nature of army food was initially identified as the cause of duodenal ulcer in servicemen, the pre-war idea that conscientious and anxious individuals were at high risk gathered support and fed into post-war beliefs that this was a stress-related illness. Diet continued to be employed as a means of management at a time when the nation was preoccupied by food because of the constraints imposed by rationing. The peptic ulcer phenomenon set much of the medical agenda for the war years and conflicted with the commonly held view that the British people had never been healthier. (shrink)

“Artworks are not being but a process of becoming” —Theodor W. Adorno, Aesthetic Theory In the everyday use of the concept, saying that something is grotesque rarely implies anything other than saying that something is a bit outside of the normal structure of language or meaning – that something is a peculiarity. But in its historical use the concept has often had more far reaching connotations. In different phases of history the grotesque has manifested its forms as a means of (...) subversive resistance against society’s prevailing notions of form and power. What aids this impact and distinguishes two of its basic stylistic features is the grotesque’s dissolution of form and its hyperbole. Such grotesqueries, however, soon solidify into new forms, new structures of meaning, hierarchy and practice, and in this sense the history of the grotesque is, on one hand, a continual opposition and transgression of the prevailing notions of art as well as of God and humanity, while on the other hand it offers continual resistance to its own solidifying process. As such the grotesque will not and cannot be contained in form without it losing the very thing that makes it grotesque. Even though it is somewhat easy to point out certain stylistic features of the grotesque, the sum of those features tell us very little about what is at play within it. Definitions concerned with the grotesque’s content rather than its form faces similar difficulties. Throughout history, expressions relating to the grotesque have been used in defense of a whole host of different social and cultural discourse including, for instance, Catholicism (See Erhard Schön’s Der Teufel mit der Sackpfeife , 1536), Protestantism (See Lucas Cranach’s Der Papstesel , 1523), a material folk culture (see Mikhail Bakhtin’s Rabelais and his World , 1984) and an idealistic romantic structure of meaning (see Wolfgang Kayser’s The Grotesque in Art and Literature , 1957). Thus though the grotesque cannot be reduced to the expression of certain forms or meanings, in order to examine what the grotesque is about one has to try to see how it’s relationship to flow and process and how, by maintaining this relationship, it attempts to avoid solidifying into form and meaning. The process of the grotesque alluded to here revolves around a play between periphery and center, the marginalized and the dominant. Most often this is expressed as a direct negation of the center of power. In the medieval grotesque tradition of the carnival, for example, it is expressed by its emphasis on the nether regions of the body as the center of creation of meaning. Spirit does not come from above, but from the belly, buttocks and genitals, and there is, expressed in this manner, a mockery of the predominant Christian notion of truth and meaning. Such inversions of the sites of meaning most often explicitly express an increased interest in materiality instead of ideal content which comes to the fore through the play between periphery and center. Even in early grotesque Renaissance art (for example in the works of Raphael) the depiction of the mythological or ideal reveals an exploration of the possibilities of the material. The works of art thus explore their own boundaries rather than act as vessels of the divine and in this way the grotesque explores the limits of form and materiality. This in turn brings to the fore a metaphysical dimension in the workings of the grotesque: It is an immanent exploration of its own boundaries. Materiality and metaphysics are joined together, because it is through the awareness of itself as a structuring (dis)order that it places itself in opposition to the prevailing notions of form and power. This way the grotesque expresses an awareness of the division of sign and reality and a search for this reality. It implicitly expresses the awareness that meaning is not something God-given and static, but fluctuating and man-made. In modern explorations of the history of the grotesque it is commonly seen as a form of realism that manifests a shift from the ideal towards the material, freeing art from representing some hidden higher order and instead making the work of art the very site of creation and meaning. Going even further, the grotesque actively opposes the notions of the ideal by marking a shift from an ahistorical view of the world towards the historical. However, this also makes clear why the grotesque has a tendency to solidify into new static forms of meaning, for by establishing itself as a subversive counterforce there is an idea of transgression and emancipation. That is why the grotesque often historicizes and relativizes only to repeat the mistakes of that which it negates: putting itself in the king’s chair. The exploration of the material seems to create new forms and notions of the ideal. The representation of an otherness outside the prevailing notions of meaning and truth becomes a positive manifestation of this otherness as truth itself. Thus the historical “truths” of the grotesque are superseded by history itself. When the expressions of the grotesque solidify into static form and meaning, they become mere objects like anything else in the world. Instead of being this elusive thing of process and flow, it becomes tangible to the existing hierarchy of power as well as history itself. In this way the grotesque can be expunged, included or simply revealed as yet another false notion of truth, which is precisely what has happened with the grotesque throughout the course of history. If from the beginning the expression of the grotesque has not already been in the service of some structure of meaning and truth, it has quickly been included or has quickly included itself in such a structure. But by doing so it rejects its own basis: the tension between periphery and center is replaced by the attempt to create a new center, a new structure of meaning and truth. The doubleness, ambiguity and flow of the grotesque are then rejected by the grotesque itself. THE NON-FORM OF FORM In the critical thinking of Theodor W. Adorno (1903-69) the problem of art, caught between a reductive and prevalent notion of truth and meaning and a peripheral and alienated otherness, is reexamined and reformulated. For Adorno, the instrumental rationality of Enlightenment itself reverts into a new form of mythology which is every bit as static and exclusive as the hierarchies of religion it supersedes. All is excluded that is non-identical to the instrumental mastery of the objects of the world, "For the Enlightenment, anything which cannot be resolved into numbers, and ultimately into one, is illusion; modern positivism consigns it to poetry." 1 As such the non-identical has been banished from the realm of thought and action, and banished specifically to the realm of art. But the realm of art is not able to provide a decent home for it because even modern art is not something entirely autonomous. While it is excluded from the notions of truth and meaning provided by instrumental rationality, it still originates from society. Just like instrumental rationality art is about mastery, structuring and exclusion. Therefore, the problem for art is that it cannot directly provide a space for the non-identical because its mode of operation is similar to that of instrumental rationality. Even worse, art has very few possibilities to free itself from this. If it becomes l’art pour l’art it is at the same time reduced to the very thing instrumental rationality claims it to be: a subjective judgment of taste.expressionism also stands as an example of this. Conversely, art cannot work within the framework of the identity-thinking of society, because any notion of freedom or emancipation would reproduce the exclusive practices of instrumental rationality. For example: Explicit socialist literature may establish itself in opposition to instrumental rationality while at the same time reproducing it. Its language may seem different, but in reality it merely provides a different set of reductive schematics for human life and experience. The problem for the art of the grotesque was, as I mentioned earlier, that far too often it was merely a symbolic manifestation of a notion of otherness—not otherness itself. Because of this the subversive character of the grotesque ends up shaping and containing otherness instead of providing a space for it. According to Adorno the only way to avoid this is to radicalize the grotesque. In order to avoid solidifying into form the work of art has to be an object which cannot be contained in thought or form—a non-form of form. The work of art has to work in a way that it strives for autonomy but without entirely leaving a discernible reality. In other words, it has to pull in two directions at once. Thus the work of art is a paradox. It is autonomous in the sense that it closes itself off from everything outside of the work of art, trying to shy away from the contaminating influence of the identity thinking of instrumental rationality. At the same time though the work of art is heteronomous in the sense that it originates from a specific historical context and is bound to be what society is not. Autonomy and heteronomy are inseparably intertwined. Unable to display otherness itself, but still trying to be a refuge for it, there is only one option for art: It has to turn against itself and destroy its own logic of form, thereby demonstrating how any representation of otherness is impossible. Art becomes a lamentation of the victims of the identity thinking of instrumental rationality and shows the traces of the otherness that is unable to appear. Adorno’s pessimistic theory of art and history stages art as a negative dialectical process where the work of art closes itself off and rejects everything outside, while the individual elements in the work of art destroys its very own logic of form from within: Artworks synthetize ununifiable, nonidentical elements that grind away at each other; they truly seek the identity of the identical and nonidentical processually because even their unity is only an element and not the magical formula of the whole […]. The resistance to them of otherness, on which they are nevertheless dependent compels them to articulate their own formal language, to leave not the smallest unformed particle as remnant. This reciprocity constitutes art’s dynamic; it is an irresolvable antithesis that is never brought to rest in the state of being. 2 Relative to a traditional understanding of the grotesque, Adorno radicalizes the tension between center and periphery, autonomy and heteronomy. In the traditional understanding of the grotesque, as we find it for example in the writings of Mikhail Bakhtin, the grotesque establishes the display of otherness as a new center of meaning and truth. However Adorno rejects such notions and argues instead for a modernism of the grotesque in which both center and periphery are included in a negative dialectical process and continually synthesizing and destabilizing each other’s positions. A modernism of the grotesque works on the inside of the sign or the artwork, continually outlining and questioning the boundaries between materiality and form. This moves the focus away from the relation between the sign or work of art as a conceptual manifestation on one side and the object it refers to on the other side. Instead it implicitly points to the amorphous mass from which the signs and thereby meaning have been carved, the remnants that have been left behind. Modernism of the grotesque does not imply that it is emancipatory or that it reconciles man with nature, and does not represent a new position or a new ideology. It merely remembers and insists on the double nature of man and art: to write or paint yourself or an artwork whole by inscribing meaning in life or by applying form on a canvas is at the same time both creation and destruction. The very signs we use to center meaning in our lives carry its own alienation in them. Meaning surfaces only when process and flow comes to a halt—solidifying, but at the same time excluding parts that do not fit into that particular structure of meaning. NOTHING DONE AND NOTHING UNDONE It has always been difficult for art historians to find a suitable category for the works of the Danish artist Leif Lage (b. 1933). In his paintings the sensitive figuration seems so fragile that it is on the verge of turning into abstraction. Or conversely: the figurative emerges cautiously and hesitantly out of abstraction. As an art critic once wrote, he can almost paint things away. 3 Working in some undefinable space between abstraction and figuration, the Lage’s works shy away from the realm of words, and as a result few critics have been able to write anything meaningful about his works. In fact even fewer have been able to write more than one or two pages. The Danish author and art critic Leif Hjernøe is one of those few, but even he starts off by saying how impossible it is to write about Lage, confessing that his works exist both as process and in a field of in-between which words cannot reach. He writes: Always you find yourself in a place where nothing is done and nothing left undone, and where the elements of the work of art rest in a continuous motion. Always there is the open wound, where infection rather than surgical intervention is considered as an opportunity. And the conflict between matter and antimatter makes all diagnoses uncertain and allows conditions of uncertainty to spread in a place of raw presence. 4 The art works against the diagnosis and the certainty. Words are being eaten up by what is outside the realm of words: tension, process and doubleness. An approach to an understanding of the work of Lage could be to follow his connection to Samuel Beckett (1906-89). One can note, therefore, that Lage has illustrated several of the Danish translations of Beckett’s works. Though one is an author and the other a painter both seek a place where figuration, where the word, erodes. For both this entails an attempt to question and examine and so move in behind the façade of the surface in an exploration of that something or nothing that may be behind representation. At the same time even in the vanishing point of figuration or words, the meaningless words or the disjointed lines still stand as signs of human activity—signs of movement in emptiness. With very few exceptions Lage’s artworks revolve around one motif: Man—most often “en face.” But unlike traditional portraitures Lage’s people are found within. The artworks do not sense the reality of appearances, but rather the existential dimensions within man. As a seismograph they are sensitive to the utmost subjectivity in order to display an objective, sensuous depiction of the very problem of subjectivity. Instead of a static façade of a man, Lage’s “en face” shows the process-character of man. The people in Lage’s paintings are always in process—in the midst of becoming or dissolving. I will take a closer look in the following at the ways in which Lage establishes this sense of being in constant process, of being in-between modes or categories. THE DOUBLENESS OF THE STROKE Lage’s etchings attract attention in particular for the tension conveyed there between the material and the form. The material physically opposes the violence of the needle. But instead of embracing the violence of the needle and the victory over matter—instead of making the artistic creation and figuration express a heroic mastery of the background it is made out of—Lage uses the stroke to express the very tension between stroke and material, figuration and background. In the drypoint etching Untitled from 1983, which illustrated the Danish translation of Beckett’s Ill Seen, Ill Said , the needle tears up the material in long rough lines: Together, the primarily horizontal and vertical lines form a face. Thus the force needed to etch a line in the metal-plate draws attention to itself: It is there in the absence of curves and nuances. Man emerges on the metal-plate after great exertion and in a very simplistic form. This way Lage enhances the nature of the material, as the material’s resistance is not something to overcome. On the contrary the figuration is smitten by its very resistance and as such expresses the violence of its own becoming. Even more pronounced is the fact that the lines do not just show the violence of creation—it actively erases figuration in the same process that creates it. For example the mouth consists of 8-10 horizontal strokes, of which some seem to be connected to each other as if the mouth has been quickly scratched out. The mouth speaks of the inability to speak. In the same way, the eyes are black holes due to a large amount of criss-cross cuts, which together form a dark middle. Those lines, at the same time, form the eyes of the figuration and scratch out the eyes of the figuration. The extroverted aspects of the face—connected to speech and sight—are portrayed as introverted as well. Just as the etchings down into the metal-plate makes something appear. Leif Lage, Untitled , 1983 (etching) The figuration of the etching is connected to creation. It expresses that something is wrought into existence out of nothing by sheer artistic force. However, this force is at the same time presented as a violence of creation, which makes it impossible for form to truly emerge. Herein lies one of the basic principles of Lage’s art, namely that art cannot be that nothing or something behind the realm of words or signs. Without form, art would lose its ability to express anything at all. Form is a necessity if art is to avoid becoming as devoid of expression as the reality is that we cannot reach behind the appearance of things. On the other hand, art cannot raise itself above its own material in joyous celebration of the beauty of form. This would use the material in the manner of an instrument and thus would suppress the otherness it attempts to rescue. When art becomes mere form, any traces of otherness will have dissolved. Then art would be a question of technique, in no way different from the instrumental rationality of society. Therefore art works in a particular space between form and non-form. As Hjernøe says of the works of Lage, it is in the center of the event, in the in-between where things neither are nor are not, "And everything takes place just before it changes character. As the blood just before it coagulates, as the milk just before it separates, as fried egg just before it turns white […]." 5 The precise emphasis on the in-between of Lage’s art points in particular to the work of art as both outside of and in time. The work of art is a singular point in time, but at the same time it is continually in process. In the borderland between form and non-form, between creation and destruction, it shimmers like a fata morgana . The work is done but at the same time undone. It is only there as a cry in response to the inability to come into being. Akin to the etching is the drawing, but while both, of course, use the stroke or line as their main instrument, the paper does not resist the line in the same sense as the metal-plate of the etching. As a result in Lage’s drawings the stroke frolics in a space with almost no tension at all. There is nothing there to keep the pencil stroke at bay, but at the same time this means that there is nothing there to keep it together. One of the more expressive examples of this is found in an untitled drawing from Tegninger og Text ( Drawings and Text ) from 1999. The drawing consists of one unbroken pencil stroke. It is as if the stroke is confused—it darts around on the paper making doodles on the way or gathers itself in more straight lines in the center of the paper. It is in this manner that the semblance of a body is established. A couple of small circles serve as eyes and are the reason that the rest can be read as both face and body instead of pure abstraction. In fact the unbroken stroke serves as both abstraction and figuration as on the one hand it is the stroke that seemingly outlines the shape of a figure, while on the other hand the unbroken stroke dissolves any truly recognizable figuration by continuously, without end or aim, overflowing the boundaries of the figure. Seen again here is a doubleness to the stroke and the act of creation. In the etching it was all about the tension between the resistance of the material which created the doubleness. Here it is the opposite. It is the lack of tension. The stroke is free to do anything, but has no aim: without some kind of resistance, there is nothing to hold figuration together. It threatens to dissolve into nothingness. Conversely, the drawing can also be seen as a process of becoming. Like a form of automatic writing, the pencil darts around until it finds a point of densification. But even in such an interpretation of the drawing, the figuration appears artificial—it points to itself as the result of the artistic act of creation. The stroke is primarily stroke and only secondarily figuration. With its wild movement it calls attention to itself as stroke. Thus the figuration never becomes something in its own right. It points to the basic principle of creation: Someone has drawn me, I am the result of artistic endeavors, and therefore I am not for myself but always overflowing the boundaries that contain me. It is the stroke that in the very same movement creates figuration and dissolves it. Leif Lage, Untitled , 1999 (drawing) THE LIGHTNESS OF COLOR, THE DENSITY OF PAPER Often the watercolor is used as a precursor for larger paintings, because it has an immediacy in which one can quickly paint the main lines of a composition. However, Lage’s watercolors are not temporary points in a process leading to another final painting. They are not sketches, later to be filled with details in another material. For him watercolor is an end in itself. This also implies that he doesn’t try to work against the paper’s absorption of the water color and its tendency to absorb detail. On the contrary, he examines the possibilities inherent in this blurring of the line and absorption of color. As in the previous examples, there are of course recognizable shapes in Lage’s water colors. But these shapes are rarely separable from color, line or even paper. In other words: the figurative and the abstract more or less become one. One of the reasons for this is that Lage often works on wetted paper which means that the paper hungrily absorbs color into its fabric instead of it being on top of the paper. The paper becomes line because it is the absorption of the color which, together with the brush stroke itself, separates the colors from each other. The line is also color and the color is also line, because there is no separation between the different colors other than the colors themselves. At times this results in almost complete abstraction. In such cases Lage add lines with a pencil as if he wants to hold some sort of figuration together. At other times it is the other way around: the strokes of the pencil are a being dissolved by the water color blurring out the figuration. Untitled 1 from 1999 displays various tones of green. The contour of the colors appears unusually rough. Most of all it is reminiscent of a shoreline which has found its form through the work of thousands of years between water and land. Pockets of resistance surface as islands not yet drowned in color—as paper or color not yet consumed by the dominant color. The shape of the colors does not seem created by the hand of the artist, but rather by the inner workings of the watercolor: color against color over time has resulted in this very image, as if it is all a part of a natural process of change and decay. Despite the fact that there are no strong differences in color there seems to be a struggle taking place in the watercolor. For example, inexplicable holes in the dark color, which cover most of the right side of the watercolor, appear as if the underlying color is eating away the dark color, or that the dark color is in the process of covering up the underlying color. The small pockets of resistance demonstrate a process and development that, almost as a happy accident, evokes a couple of small eyes and a large mouth. Behind the colors a few slanted lines can be discerned, but the hand of the artist has long ago disappeared behind the life of the colors. Thus the watercolor seems to be held at precisely the point in time where figuration randomly appears. The small eyes and wide mouth seemingly express the realization of the figuration’s temporality. It is just a moment in time, soon to be consumed again in the life of the colors. The nature, the background it stems from and is part of, moves on undeterred, continuing its everlasting process of creation and decay. In this sense, the watercolor provides an experience of how neither artist nor man is able to transcend the materiality they consist of. The colors of man, the materials man consists of are “becoming” and “progress” but also “decay” and “disappearance”. The artist’s pencil strokes have been eaten up long ago, and the figuration is living on borrowed time. Human or artistic activity is about creating form, transcending mere matter by shaping and applying meaning to it. But Untitled 1 shows the doubleness of such creation: the transience and fragility of human life. Should the figuration come into being, should it rise and transcend the material, which binds it to its temporal existence, it would become nothing because its very existence is conditioned by the life and work of the colors. In the same sense man cannot escape his own temporality. He too, for better or worse, must accept a life in the volatility of sensation. Leif Lage, Untitled 1 , 1999 (watercolor) In most of Lage’s watercolors there seem to be a stronger artistic control than in Untitled 1 . Most often both the arrangement of colors and the technique in which they are painted express the hand of the artist. An example of this is Untitled 2 from 1999. While figuration in Untitled 1 seemed to appear as a happy accident, the figuration is much more “created” in Untitled 2 . Here the most important parts of the figuration, the eyes, the mouth and part of the skull, are colored black and painted on top of the background’s play of colors. The background primarily consists of blue and yellow tones. Only parts of the paper are covered in color, however, which yet again stresses the act of painting: There is a surface which is being filled by color by an artist. The blue tones are concentrated in the figuration, while the yellow tones surround it. All this means that the figuration stands out more clearly in this watercolor. This is also underlined by the fact that the blue and dark tones cover part of the yellow tones as spots here and there. Thus it is not a background which is in the process of consuming figuration, but rather the emerging figuration which blots out the background. Such an understanding is even suggested by how the mouth and eyes are placed in the larger blue color field. The eyes and mouth are in the center of the watercolor, while the blue color field is placed from center out towards the left side. This gives the impression of a face turned slightly to the right and slightly upwards, which again makes the mouth appear to emerge from the paper. It also helps that the mouth cuts the center axis of the watercolor. In other words, the arrangement of the blue and black colors create some depth and perspective which gives the illusion of a figuration, seen partially in profile, emerging from the background. Seen in profile, the eyes and mouth seem extroverted—they almost seem as if they are put on top of the face. But at the same time they are painted as black holes, sucking in the gaze of the onlooker. The watercolor is even more challenging if one follows what may be the faint outline of the skull, which, on the right side of the watercolor, no longer works together with the blue color, but rather alone postulates the outline of the skull. If not the blue color field, but this line, is the outline of the skull, then all of a sudden the face is not in profile but “en face”—staring directly towards the onlooker. Outline and color seemingly work against each other and establish two different expressions. Without the slightly upward tilted expression of the profile, the eyes and mouth do not seem to emerge from the paper. On the contrary, seen “en face,” the eyes and mouth are really gaping pits of darkness. In this sense Untitled 2 is at the same time surface and depth of perspective. The line gives form but at the same time it dissolves the form created by the colors, and vice versa. Leif Lage, Untitled 2 , 1999 (watercolor) As the last example of Lage’s artistic method, I have chosen another untitled work (as indeed nearly all of Lage’s artworks are)—this time from 2000. This is perhaps one of the most figurative watercolors Lage has created, though that doesn’t tell us too much. The painting depicts a human face in blue and green tones on a yellow toned background. The colors create a clear demarcation between the figure and the background, which compensate for the watercolor’s lack of outline. Beneath the face darker tones imply the beginning of the torso, and nuances of color even hint at something which could be a collar. The hair is in even darker tones and its structure is emphasized using pencil strokes on top of the water color. One eye is marked by a brown spot with a darker spot in the middle, while the other eye is added by pencil. The mouth is a round, red dot. In Untitled from 2000 the work between abstraction and figuration is much less pronounced than in the previous examples cited here. Nonetheless the watercolor has a delicacy to it which almost makes the figuration disappear, even as it appears. This has something to do with the fact that all the individual brush strokes have dissolved. The only outlines are those created by the clash of colors. Even the red mouth seems to be more paint than mouth—unable to be formed truly as anything other than a speck of color with some small semblance to a mouth. In contrast to the other watercolors, there is no movement, no progress or decay, just a vibrating standstill. The figure is not emerging or disappearing but embedded in and as surface, and as such it makes the figure seem stuck in its condition rather than freed by the act of giving form: mouth open as a wound. Pencil strokes add detail and life to the hair as an attempt to help the figure emerge. But all this does is create two levels in the watercolor: The pencil strokes are put on top of the figuration rather than being part of it. Thus they end up highlighting the endless distance between the movement and form-giving of the pencil strokes and the static and stuck figure behind these strokes. Leif Lage, Untitled , 2000 (watercolor) MAN AND THE VIEW OF THE ONLOOKER Lage’s works seem at the same time to be an examination of tensions between form and material in art and a display of an image of man full of the same tensions. This is because the people who are emerging in Lage’s images are not just in his works, They are his works. This means that man is not something emerging from a background but is part of this background and vice versa. The art of Lage inscribes man in its surroundings and background. Man is not the ruler of nature. Man does not rise above matter; there is no truly transcendent position for man to occupy in the art of Lage. Instead man is a part of the very matter, it, at the same time, tries to distance itself from in order to distinguish itself from its surroundings. Man emerges in an attempt not to be line, stroke, color. In an attempt to free itself of matter. Should it succeed in this, however, it would turn into nothing. On the other hand, if man fully accepted itself as mere matter it would disappear in it—in instincts, urges and lack of reflection. The appearance of man is thus subject to a state of being in-between. Only in the tension between material and its negation can the outlines of man be traced. However this also means that in the art of Lage man is never something in itself but always in process—on the way to its freedom and its loss. However, Lage’s art is not just about showing the tensions inherent in man but also about showing such tension on the verge of breaking point. In the moment before everything is done, or when nothing yet has been done, the delicate tension between form and material has been stretched to its utmost in such a way that man’s character of process emerges and is contained on the paper or canvas. Therefore, Lage’s art contain traces of human life. Not only is it an autonomous unity of tensions where man is stretched out between its singularity and the surroundings it is a part of. It is also this pulsation between figuration and material which brings about the traces of human endeavor and activity. Even when man almost seems to have disappeared into the material, strokes and lines are still there as a reminder of human activity and potential creative power—as a reminder that hope is still possible and that man is still there. The view of the onlooker seeks out forms and meaning. It seeks outlines and edges. But first and foremost it is the eyes in Lage’s works of art that allow the onlooker to decode the figuration at play. This creates a distinctive relationship between the onlooker and the artwork. The onlooker tries to wrest the enigma from the artwork, tries to reduce it to solid, meaningful form. But the very same moment that hints at such a possibility sees the view of the onlooker confronted with a gaze of its own. The eyes of the figure in the work of art are most often dark pits, as if they were an illustration of the violence committed against the eyes of the onlookers and their search for meaning. Or as if they were a dark reflection of the onlooker’s failed attempts to delineate the traces of life in the artwork to a solid meaningful form. Therefore, the gaze of the figuration speaks not only of its own powerlessness but also of the powerlessness of the onlooker. When the view or sight has trouble finding solid meaningful forms, it has something to do with the fact that the precondition for sight, light, no longer stems from something transcendent. In Lage’s art there is nothing outside the works of art, nothing outside of human life, and as such nothing to shed light on the works of art or human life and reveal solid meaningful forms. All light comes from within. In a western context, light as a medium for sight is central to the understanding of meaning. People speak of the clarity of thought, while knowledge is tied together with enlightenment, and so forth. But the light no longer originates from a divine point of view. It originates from man, who has created himself in the image of God. The problem with this is that light always covers up its own base. Light illuminates something but at the same time it hides itself. 6 While it was previously God who was unknowable, now it is man. It is also problematic that sight and the medium of sight stem from the same place. Following this thought one can posit two final problems. Firstly, the immediacy and presence established by light by making forms and objects accessible to sight is fake. Light is not some independent entity which present things in a neutral manner for the onlooker. It is inextricably tied together with the gaze’s desire after meaning. In other words: Light perverts the appearance of things because it doesn’t originate from some objective entity which allows them to appear as they are. Instead light is based upon and originates from the subject and its conquering gaze, seeking out meaning and form constantly. Secondly, the joining of sight and light makes introspection within human life impossible. Everything can be illuminated by its use value for the subject but only as long as it is separated from the subject, as long as it is an object. But the subject itself cannot be illuminated. Lage’s art tears down such a dividing line between subject and matter, but it does so without reestablishing a divine position from where the light emanates. Therefore, the light in Lage’s art may not illuminate very well. It may not have the certainty presented by modern science or the religions of yesterday. But it does show what such light tries to hide, namely, the subject as it is in its material reality—inscribed in time and death, which are the basic conditions of materiality, but at the same time also full of life in its joy and will to create. For the onlooker the meeting of the gaze in Lage’s works of art is thus also a destruction of the view of the onlooker. The ability to see is challenged in a radical way. Those outlines will not solidify into static form, as if the light was too dim to see. Just as in Lage’s figurations, the view of the onlooker turns to black: turns towards the onlooker in recognition and becoming—or disappearance. NOTES Max Horkheimer and Theodor W. Adorno. Dialectic of Enlightenment . (Palo Alto: Stanford University Press, 2002): 4-5. Theodor W. Adorno. Aesthetic Theory . (London & New York, 2002): 176. Carsten Bach-Nielsen. “Mere glæde end gru.” Kristeligt Dagblad . September 24, 2002. Leif Hjernøe. “Den yderliggående inderlighed.” LEIF LAGE—Retrospektiv udstilling 1983 . (Copenhagen: Brøndum, 1983): 18. Ibid. Maurice Blanchot. The Infinite Conversation . (Minneapolis: University of Minnesota Press, 1993): 162-163. (shrink)

In this article, it is argued that it is problematic to construe the debate around the process labelled ‘surrogacy’ as a form for infertility treatment. Firstly, this way of defining what happens opens up a new form of medical desire where a growing number of people wish to have children through ‘surrogacy’. This medicalizes childlessness and creates pressure within health services to respond to the desires of an ever-growing group of patients. Secondly, this labels the woman who carries the (...) child as a ‘surrogate’ and defines her as a core element in a ‘treatment method’. This way of phrasing and defining what happens puts the woman carrying the child in an unacceptable moral position within the health system. Thirdly, by viewing the woman carrying the child as a ‘substitute’ for a mother or as a ‘temporary custodian’ ignores the unique relationship between the foetus and the pregnant woman. To keep the ethical issues in focus in the ‘surrogacy’ process, it is necessary for health professionals to always... (shrink)

The author considers James’ (1910) essay The Moral Equivalent of War and applies some of its ideas to another pressing problem of our times, which for short is called greed, but can be described more precisely as the working out of the possessive market society under the conditions of neoliberalism and great technological power. James considered that pacifists had the best arguments, but failed to persuade mainstream society. The same can be said today of the critics of neoliberalism. There is (...) need for radical change away from an unjust and dysfunctional economic system, but mainstream society is unwilling to try new ideas. The present author adapts James’ idea and considers benign and malign forms of greed. What we all desire, more than huge monetary assets, is self-respect and social respect. There are already many rewards that are not primarily monetary. In a radically different culture, which rejected the principles of unlimited accumulation and almost unlimited convertibility, benign rewards would motivate constructive activity. The moral equivalents of greed briefly discussed here are—Honours and prizes for merit (administered justly); Celebrity (important in society); Luck (gambling, with certain constraints, could be benign); Power (rewarding in itself, so large monetary gain need not go with it); Services (people making important contributions to society could concentrate their commitment); Temporary custody of public treasures (a privilege prized by some). The essay ends by linking James’ idea, the Faustian bargain myth, and the necessity of hope. (shrink)

Guiding questions in this dissertation: Does indeterminacy of interpretation imply no standards and limits of meaning? Is Nietzsche "modern" or "postmodern" in his approach to this and other problems? What is Nietzsche's "affirmative" message? What are the implications for the identity and future of philosophy? ;If Nietzsche has freed the signifier from any transcendental signified, how do we know when the free play of reading has utterly departed from the text? How do we recognize that one reading of a text (...) or one account of the world is better than another? ;Nietzsche said, "What was at stake in all philosophizing hitherto was not at all 'truth' but something else--let us say, health, future, growth, power, life." Truth in the service of life: Truth understood as transitory boundaries or limits without which life is impossible. As esteemers, we always impose limits, constraints. Hence, limits are absolutely necessary, never absent, though never fixed and absolute. Temporary fixity is ensured and so is truth in this sense. Conflict is resolved not by "truth," but by the demands of life, in response to which "truth" has its meaning. It is through Nietzsche's interplay of philological rigor and interpretive play that we can avoid the result in which "the text disappears under the interpretation." ;Nietzsche said, "My style, which is affirmative ... deals with contradiction and criticism only as a means." It is a means for something not easily captured in language, and certainly not in any set of logical inferences: A transformation of the attitude of resentment toward the challenge and struggle of life, and overcoming the desperate desire for salvation from suffering, insecurity, uncertainty, i.e., salvation from oneself and life through "truth." The overcoming of such motives is troped in the myth of the ubermensch and in the transforming ideas of eternal recurrence and amor fati. These are signifiers of a possible type of consciousness, a way of living in which we have a radically different relationship to our beliefs, and are no longer trapped by our "truths" in our unceasing attempt to say the unsayable, to interpret the enigma that is life. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"To make a difference...":Narrative Desire in Global MedicineByron J. Good and Mary-Jo DelVecchio GoodIf, as Arthur Frank (2002) writes, "moral life, for better and worse, takes place in storytelling," this collection of narratives written by physicians working in field settings in global medicine gives us a glimpse of some aspects of moral experience, practice, and dilemmas in settings of poverty and low health care resources. These essays are written (...) from the midst of practice, in diverse settings in Africa, South Asia, Latin America, the Caribbean, and the United States. The majority of the writers are practitioners of contemporary 'global medicine'—physicians from North America or Europe who spend part of their lives flying into settings of poverty or special need to practice medicine and work with on-going collaborative clinical and public health systems—while a smaller number are working in the societies in which they were born. Although a few work for classic humanitarian organizations or have developed their own local NGO's, the great majority are engaged in the 'hybrid life' described by Robert Riviello and noted by Renée Fox, moving between academic medical centers and distant health care systems that are supported by local governments, major international organizations and funding agencies, and international NGO's like Partners in Health. These diverse forms of practice have become a common model for contemporary clinicians engaged in what has emerged as a new discipline of global health or global medicine, and these narratives give us a glimpse of some of the enduring, as well as newly emerging, forms of moral practice and ethical dilemmas characteristic of today's global medicine.Many of these stories are filled with the tension and pathos that makes clinical narratives powerful to read. Physicians are forced to make unfathomable decisions about whether to resuscitate and keep a baby alive, using all means available, or to let the infant die, whether to carry out a procedure that will save an infant in birth but would put the mother at risk, about how to deal with a cancer found in a very advanced state. However, virtually all of the stories transcend these classical stories of the decisions physicians are forced to make by being placed in settings of great scarcity of resources, which stand in particular contrast to the academic medical settings in North America or Europe where many of these global medicine specialists have trained and many continue to practice. The unspeakable inequality of resources emerges throughout these narratives as a kind of master theme, as the underlying moral, as opposed to plot, which gives meaning and sense to the stories. For those who practice medicine in such settings, global inequalities and scarcity of medical resources are deeply felt. They produce the rage that Jeffrey Deal describes. ("I learned to despise American churches during that time, a time when my world encompassed a dying newborn in Sudan, as well as the air conditioned padded seats [End Page 121] of our affluent suburban church.") They produce the distinctive experiences of helplessness and pain felt by clinicians who cannot separate how they would be able to treat such a patient at home from how they have to practice in these settings. For those clinicians working in their own societies, scarcity of resources often produces deep anger at the corrupt governments that fail to support basic human services for the great majority of their population. ("We were temporary actors performing in the cynical play of scarcity on permanent display in Port-au-Prince," writes Haitian physician Paul Pierre about his experience prior to joining Partners in Health.)But for those who regularly travel back and forth across the divide between rich and poor, whether across national boundaries or within their own society, the challenge to live a moral life is unendingly complicated. While becoming a part of a struggle for global justice with colleagues and advocates from both sides of the divide, few of the narrators can avoid personal feelings of ambivalence and guilt at being able to easily move from one side of that divide to the other back home. Many fantasize about giving up their lives in the north to devote themselves... (shrink)

Matthew Goldspan was faced with a series of coincidental personnel issues that tested both his fairness and integrity. He had been a branch manager of a financial services operation for three years, where he oversaw thirty five employees. In one instance, a clerical employee protested salary differences she discovered; in another, his affirmative action record, as well as his right to make hiring decisions, was in question; and thirdly, he had to decide how to respond to theft by a (...) temporary employee who happened to be the son of a prized member of his staff. In each case, employees were looking for Matt to demonstrate appropriate leadership and sound judgment. (shrink)

Military reproductive health policies affect large numbers of women. In 2006 servicewomen numbered nearly 350,000 and comprised 14.5% of active-duty forces and 17.4% of the reserve force. In addition, approximately 165,000 female dependents of active duty military personnel and 157,000 female dependents of reserve duty personnel are between the ages of 12 and 22 and are eligible for military health care services. Dependents of military personnel are eligible for military health care coverage until age 21, or up to the (...) age of 23 if considered a full-time student.About 10% of active duty female servicemembers become pregnant each year. Pregnant servicewomen are considered non-deployable and are usually not assigned to overseas commands. Pregnant women in the Army, the service branch with the greatest number of women on active duty, can choose to remain on active duty, request temporary leave from service, or request separation from service. Separation options include either discharge, honorable or uncharacterized depending on rank, or transfer to individual ready reserve. (shrink)

This doctoral thesis within applied ethics consists of four articles together with a cover essay. All articles concern the ethics of skilled health worker emigration from under-served and resourcepoor regions, often referred to as ‘medical brain drain’. Methodologically, the thesis utilizes normative ethical theory to analyse the justifiability of temporary or long-term emigration restrictions, such as compulsory health service programmes, that are employed by developing countries with the aim of safeguarding their needs for health care provision. Such programmes restrict (...) the mobility of individual health workers and give rise to conflicts between different types of rights and interests. -/- The ethics of skilled worker emigration warrants an exploration of the ethical implications of such restrictive programmes for different stakeholders, such as the under-served countries and health workers; and a clarification of the rights and duties of the concerned parties. This thesis provides a thorough analysis and clarification of such rights restrictions and offers theoretically and empirically grounded recommendations as to how they ought to be managed. Rights theory and accounts of individual responsibilities are employed to assess the acceptability of restrictive health service programmes. -/- In brief, the thesis (a) discusses the conditions under which individual health workers may have responsibilities to attend to the basic health needs of a population, (b) explicates the rights at stake such as the freedom of movement and the right to exit, (c) offers insight into what it means to restrict one’s right and its implications and (d) suggests ways for conflicting rights and interests to be balanced and resolved. Taken together, the thesis presents a nuanced approach towards individual responsibilities in under-served contexts and an improved understanding of the right to exit as well as the implications of restricting the right. The thesis also contributes to the ethics of skilled worker emigration with a discussion on the responsibilities of skilled workers when the other parties do not fulfil their fair share of responsibilities. (shrink)

Since the start of the occupation of Palestinian territories in 1967, Israel's domination of the Palestinians has deprived an entire population of any political status or protection. But even decades on, most people speak of this rule—both in everyday political discussion and in legal and academic debates—as temporary, as a state of affairs incidental and external to the Israeli regime. In _The One-State Condition_, Ariella Azoulay and Adi Ophir directly challenge this belief. Looking closely at the history and contemporary (...) formation of the ruling apparatus—the technologies and operations of the Israeli army, the General Security Services, and the legal system imposed in the Occupied Territories—Azoulay and Ophir outline the one-state condition of Israel/Palestine: the grounding principle of Israeli governance is the perpetuation of differential rule over populations of differing status. Israeli citizenship is shaped through the active denial of Palestinian citizenship and civil rights. Though many Israelis, on both political right and left, agree that the occupation constitutes a problem for Israeli democracy, few ultimately admit that Israel is no democracy or question the very structure of the Israeli regime itself. Too frequently ignored are the lasting effects of the deceptive denial of the events of 1948 and 1967, and the ways in which the resulting occupation has reinforced the sweeping militarization and recent racialization of Israeli society. Azoulay and Ophir show that acknowledgment of the one-state _condition_ is not only a prerequisite for considering a one- or two-state _solution_; it is a prerequisite for advancing new ideas to move beyond the trap of this false dilemma. (shrink)

Law can greatly facilitate responses to public health emergencies, including naturally-occurring infectious disease outbreaks and intentional or accidental exposures to chemical, biological, radiological, or nuclear agents. At the federal level, the Secretary of the Department of Health and Human Services, as the lead for federal public health and medical responses to public health emergencies and incidents, has a range of authorities to support federal, state, tribal, local, and territorial responses. For example, under the Public Health Service Act, the Secretary (...) may provide temporary assistance to States to meet health emergency needs or deploy medicine and supplies from the Strategic National Stockpile. The Secretary also may determine that a disease or disorder presents a public health emergency, which may be the first step in triggering other critical legal authorities for response.Since the 2001 anthrax attacks, one focus of public health preparedness has been on developing, distributing, and rapidly dispensing medical countermeasures for CBRN emergencies and pandemics. (shrink)

In 1992, the United States Supreme Court, in Planned Parenthood of Southeastern Pennsylvania v. Casey, upheld the ruling in Roe v. Wade, namely that women have a right “to choose to have an abortion before viability and to obtain it without undue interference from the State.”1 However, since this ruling, some states have imposed regulations that greatly limit this right by restricting access. Texas is a recent example of this. Two proposed restrictions in House Bill 2, which will be discussed (...) in detail below, will force all but eight clinics that are located in metropolitan areas to shut down. The U.S. Supreme Court put the proposed restrictions on hold in October 2014, allowing several clinics to remain open while the restrictions are being appealed in the U.S. Court of Appeals for the Fifth Circuit. If the restrictions are passed, however, those clinics will be forced to shut down and, as a result, many women in Texas will be required to travel more than 100 miles in order to access a safe and legal abortion. Much of the focus of these restrictions has been on women and rightly so. However, I want to turn the attention to physicians. The requirements exacerbate unfair treatment of abortion providers compared with other physicians. Abortion providers face threats from the public—some of which turn into violent attacks—and they are often ostracized by their fellow medical practitioners. There are so few abortion providers to begin with and the proposed requirements limit these physicians’ opportunities to practice the branch of medicine of their choosing. Although the HB 2 requirements may not result in an unconstitutional undue burden on physicians, the challenges created by the bill limit physicians’ abilities to provide abortions. As a result of these limits, HB 2 creates an unconstitutional undue burden for women seeking abortions by creating barriers directed at abortion providers and clinic staff who are willing and able to provide abortions. The first of the two controversial HB 2 requirements is the admitting privileges requirement: “A physician performing or inducing an abortion must, on the date the abortion is performed or induced, have active admitting privileges at a hospital that is located not further than 30 miles from the location at which the abortion is performed or induced.”2 The second requirement is the ambulatory surgical center requirement: “The minimum standards for an abortion facility must be equivalent to the minimum standards adopted under [Texas Health & Safety Code] [...] for ambulatory surgical centres.”3 In order to meet these state-mandated obligations, some abortion clinics would have to spend more than $1 million in upgrades if they wish to remain open. The District Court decided that the ambulatory surgical center requirement places an unconstitutional undue burden on women, and that the two requirements together place an undue burden on women in Texas and especially in the Rio Grande Valley where the nearest clinic is a couple hundred miles away.4 Later, the U.S. Court of Appeals for the Fifth Circuit reversed the District Court’s decision and argued, “the admitting privileges requirement is constitutional on its face.”5 While the regulations are being appealed, the Supreme Court granted a stay of injunction, allowing about twelve abortion clinics to reopen until a final decision regarding the regulations is made. The District Court ruled that the purpose of the two regulations was to create a substantial obstacle for women seeking abortions in Texas. While the defendants argued that the regulations were designed to make abortions safer and reduce risk, the Court decided that this was not the case. An abortion, especially a first-term abortion, is a very safe procedure and is safer than many other routine surgical procedures. As stated in Planned Parenthood v. Casey, “Unnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right.”6 The undue burden in this case is imposed, not through restricting women’s access directly, but by restricting physicians’ freedom to perform abortions. The admitting privileges requirement has reduced the number of physicians who can perform abortions and the ambulatory surgical center requirement has reduced the number of clinics where abortions can be performed. The American Medical Association states, “[t]he Principles of Medical Ethics of the AMA do not prohibit a physician from performing an abortion in accordance with good medical practice and under circumstances that do not violate the law.”7 This means that physicians are not required to perform abortions, except in emergency situations, but can as long as the procedure is done safely and does not violate the law. The new Texas regulations, however, are so restrictive that few abortion providers, limited to only four urban areas, can legally perform abortions. Physicians do not have an absolute right to perform abortions as opposed to women who have an absolute right to have access to an abortion. Physicians do face many challenges that other professionals face in terms of obtaining qualifications and finding work. Abortion providers, however, face challenges that most other physicians do not. The restrictions imposed by these regulations exacerbate unfair treatment toward abortion providers and place further obstacles in their path in terms of providing the service they want and are qualified to provide. Both abortion clinics and abortion providers are being treated differently from other medical clinics and physicians. For instance, “grandfathering of existing facilities and the granting of waivers from specific requirements is prohibited for abortion providers, although other types of ambulatory surgical facilities are frequently granted waivers or are grandfathered.”8 Many abortion clinics cannot afford the necessary upgrades. Furthermore, it is extremely expensive to open a brand new clinic that complies with the ambulatory surgical center requirements. Being grandfathered in would be the only option available to abortion clinics that cannot afford the upgrade. However, unfair treatment of abortion clinics and providers is preventing those clinics from being grandfathered into the new system. As a result, many abortion clinics may be forced to close. Admitting privileges are proving difficult or impossible for physicians both to obtain and, for those who have already been granted privileges, to keep. Dr. Sherwood Lynn, an obstetrician-gynecologist who has performed abortions for decades, describes the process of obtaining admitting privileges and the difficulties abortion providers face. After sending in an application a physician must wait for the hospital to send them the required materials, “but if the address of the practice on the application is of an abortion provider or clinic, [the hospital] won’t send [them] the package of materials required. [They] simply can’t apply.”9 Dr. Lynn and several other physicians have surmised that hospitals are only withholding privileges from qualified physicians who perform abortions and that other physicians do not face this discriminatory treatment. Hospitals have also revoked privileges granted to physicians after learning that the physicians perform abortions. For instance, in Texas two doctors, “received notices [...] informing them that their admitting privileges to the University General Hospital of Dallas have been revoked, with the hospital’s CEO claiming the hospital was unaware they were providing abortion care and that the hospital believed such care would damage its reputation.”10 What is curious about this revocation is that, “federal and state laws [...] forbid hospitals from discriminating against doctors who perform abortions,” and yet hospitals are clearly doing just that.11 Dr. Pamela Richter, another abortion provider in Texas, had her temporary admitting privileges revoked with no explanation and because of this, the clinic where she performed abortions, Reproductive Services, can no longer provide abortions at all.12 As the hospital gave no reason for the revocation, it not clear Dr. Richter’s privileges were revoked because she performs abortions. Dr. Richter, however, has performed over 17,000 abortions and her privileges were revoked soon after HB 2 was introduced.13 According to the Texas Hospital Association, giving admitting privileges to doctors who do not work for the hospital is expensive and time-consuming but this does not account for the fact that hospitals are revoking previously granted privileges from physicians whom they learn are providing abortion services.14 As mentioned previously, the District Court found that the admitting privileges requirement and the ambulatory surgical center requirement do not further ensure the health and safety of women undergoing an abortion. Several physicians have testified to this fact. Dr. Lynn stated in an interview: The admitting privileges requirements are [...] absolutely unnecessary. If you have a number of patients waiting for procedures, and something happens and a patient needs to be transferred to a hospital, you’re not going to leave everyone else and go to the hospital. That makes no sense. You’re going to refer that person to a gynecologist at the hospital. There is no safety issue involved here. If a patient shows up with an emergency, every hospital is required to admit that patient. They have to by law.15 It is rare that complications will arise from an abortion performed in a clinic. Dr. Richter, for example, has performed more than 17,000 abortions and not once had to send a patient to a hospital because of complications resulting from the procedure. According to Dr. Lynn even if abortion providers were granted privileges to hospitals, it is unlikely that they will exercise them. In essence, having admitting privileges at a hospital does nothing to further ensure the safety of an already safe procedure. The only result of the admitting privileges requirement is to limit certain physicians’ ability to perform legal abortions. Not only do the HB 2 requirements fail to further ensure the health and safety of women, the HB 2 requirements may actually create more health risks to women who cannot access the eight remaining clinics. The first risk is that the remaining clinics would have an influx of patients that they may not be able to handle, forcing women to wait longer for an appointment. As stated by the District Court, “[e]ven assuming every woman in Texas who wants an abortion [...] could travel to one of the four metropolitan areas where abortions will still be available, the cumulative results of HB 2 are that, at most, eight providers would have to handle the abortion demand of the entire state.”16 Furthermore, “[t]hat the State suggests that these seven or eight providers could meet the demand of the entire state stretches credulity.”17 Abortion is a time sensitive procedure. It is safest when performed early in a pregnancy. The increase in patients to these remaining clinics, assuming all women in Texas can access them, will increase wait times and may force women to have abortions later in pregnancy. In the worst-case scenario, a woman would not see an abortion provider at all before viability. Such instances may be rare, but they are possible. In such cases, women’s access to legal abortions becomes impossible and thereby violate the ruling in Roe. Clinics may be able to avoid the aforementioned problems if they hire more physicians. However, there are two barriers to hiring more physicians. First, as mentioned previously, admitting privileges to Texas hospitals are difficult, if not impossible, for abortion providers to obtain. Second, given the negative treatment of abortion providers by anti-abortion groups, many physicians are not willing to perform abortions. The harassment abortion providers face is unique to those physicians and many physicians will not perform abortions for that reason. In an article published in the Austin Chronicle, anti- abortion activist Abby Johnson, “discusses how her group investigated appraisal district records to find the new location of where an Austin abortion physician plans to work.”18 Johnson states, “These abortionists are feeling the pressure from the pro-life movement in Texas. I think they feel like they’re on the run. And that’s how we want to keep it.”19 If the HB 2 requirements are passed and there remain at most eight abortion providers in Texas, these activists will concentrate on those clinics and, “the dangerous impact of their intimidation tactics will be exacerbated.”20 Even if the number of physicians needed to meet the demand in Texas can obtain admitting privileges and work at one of the remaining clinics, they may choose not to do such work because they are putting themselves at risk. The harm abortion providers face from such anti-abortion groups is not unique to Texas. There are stories from all over the country and from other countries where abortion is legal of physicians receiving death threats. Dr. George Tiller, an abortion provider in Kansas, was killed outside his church and had received numerous death threats prior to this. The HB 2 requirements are making it so that abortion providers either cannot provide their services any longer or will face increased threats and increased danger to themselves. Physicians are allowed to conscientiously object to providing medical interventions in certain circumstances for moral and religious reasons. However, there are limits on this right. According to the American Congress of Obstetricians and Gynecologists, “[w]hen conscientious refusals conflict with moral obligations that are central to the ethical practice of medicine, ethical care requires that the physician provide care despite reservations or that there be resources in place to allow the patient to gain access to care in the presence of conscientious refusal.”21 I would argue fear for one’s safety in the face of immediate threats is perhaps a stronger ground on which to refuse to provide care than a personal belief that abortion is immoral or against one’s religion. ACOG also states, “[p]roviders with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place so that patients have access to the service that the physician does not wish to provide.”22 This responsibility has been largely disputed by the medical community but in cases of rape, incest, and health risks to women, referrals must be made without exception. However, under the requirements of HB 2, working in proximity to an abortion provider may not be possible because they are so geographically limited. Referrals are supposed to be made within reason. Some areas of Texas, such as the Rio Grande Valley, are up to 200 miles away from the nearest clinic that would remain open if HB 2 is passed. Referrals may simply not be feasible given the geographical distances and the decreasing number of available physicians. As mentioned above, there are two risks to the health and safety of women as a result of HB 2. The second of these is that if a woman cannot access one of the remaining clinics, she may seek out a more convenient but illegal and unsafe abortion, which is far more likely to result in a dangerous complication. Dr. Lynn states, “[b]ecause of the restrictions lawmakers impose, women will seek abortions illegally, and we’re going to see a rise in septic abortions.”23 Some areas of Texas might effectively revert back to a pre-Roe era where abortions were performed in unsanitary conditions by unqualified people resulting in dangerous medical complications far more often than legal abortion procedures do now. Physicians like Dr. Lynn who want to prevent this from happening generally cannot do so without facing legal sanction. Physicians have a duty to provide safe medical care and if they cannot obtain admitting privileges, they cannot exercise this duty. ACOG released a statement expressing their objections to the new requirements. They state that HB 2 is, “plainly intended to restrict the reproductive rights of women in Texas through a series of requirements that improperly regulate medical practice and interfere with the patient-physician relationship.”24 Executive Vice-President of ACOG, Hal C. Lawrence III stated: The Texas bills set a dangerous precedent of a legislature telling doctors how to practice medicine and how to care for individual patients. ACOG opposes legislative interference, and strongly believes that decisions about medical care must be based on scientific evidence and made by licensed medical professionals, not the state or federal government.25 Abortion is one of only a few areas of medicine where the legislature imposes so many regulations restricting particular physicians’ ability to practice medicine. Not only are abortions providers being regulated by the state, they are also facing clear discrimination from others within the medical community. The state is closing down clinics that do not meet the ambulatory surgical center requirements and hospitals are denying physicians admitting privileges because they perform abortions. In summary, abortion providers are being discriminated against both by the legislature and other members of the medical community. Other physicians who do not perform abortions are not denied admitting privileges on discriminatory grounds. Clinics that cannot afford upgrades to become an ambulatory surgical center are being grandfathered in, while abortion clinics are being forced to close down. Ob-Gyns who conscientiously object to performing abortions and who are not located in close proximity to at least one abortion provider cannot effectively fulfill their duty to refer patients. Lastly, given the barriers these regulations will create, there will likely be a rise in complications resulting from abortions provided under grossly unsafe conditions. Physicians, whose duty it is to provide safe and effective medical care, are being denied the right to exercise this duty. While this denial may not be unconstitutional, it is certainly unjust and discriminatory and creates obstacles that other physicians do not face. Most importantly, these obstacles are creating an undue burden for women. The HB 2 requirements do not increase the health and safety of abortions; all they do is create substantial obstacles for women. In light of these observations, the requirements seem to me to be in clear violation of Casey, in which it was decided that, “[u]nnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on that right.”26 These regulations do just what Casey was meant to prohibit and this is accomplished through limiting physicians’ ability to practice safe abortions across the state of Texas. Therefore, the HB 2 requirements may not impose an undue burden on doctors but they do impose an undue burden on women. PDF available: Rachel Hill, "Texas HB 2," Voices in Bioethics. References: 1 Planned Parenthood of Southeastern Pennsylvania v. Casey, pg. 2. 2 Whole Women’s Health v. Lakey, pg. 2. 3 Ibid. 4 Ibid., 4. 5 Ibid., 2. 6 Planned Parenthood v. Casey, pg. 16 7 AMA Code of Medical Ethics, “Opinion 2.01 – Abortion,” American Medical Association. 8 Whole Women’s Health v. Lakey, pg. 10. 9 Dr. Sherwood Lynn, “A Texas Ob-Gyn Details the Horrific Consequences of Abortion Restrictions,” Cosmopolitan. 10 Feminist Newswire, “Texas Hospitals Revoke Admitting Privileges to Abortion Providers,” Feminist Majority Foundation Blog. 11 Ibid. 12 Ibid. 13 Ibid. 14 Glenn Hegar, “Texas Hospital Association’s Statement of Opposition to Section 2 of the Committee Substitute for Senate Bill 5,” Texas Hospital Association. 15 Dr. Lynn, “A Texas Ob-Gyn.” 16 Whole Women’s Health v. Lakey, pg. 10. 17 Ibid. 18 Mary Tuma, “Undercover Audio Reveals Anti-Abortion Tactics: Anti-abortion activists monitor and track providers, patients,” Austin Chronicle. 19 Ibid. 20 Ibid. 21 Committee on Ethics, “The Limits of Conscientious Refusal in Reproductive Medicine,” The American Congress of Obstetricians and Gynecologists. 22 Ibid. 23 Dr. Lynn, “A Texas Ob-Gyn.” 24 “Ob-Gyns Denounce Texas Abortion Legislation: Senate Bill 1 and House Bill 2 Set Dangerous Precedent,” The American Congress of Obstetricians and Gynecologists. 25 Ibid. 26 Planned Parenthood v. Casey, pg. 16. (shrink)

Thinking about Consciousness is a wonderfully clear and vigorous commen- tary on the nature of consciousness and its relationship to brain processes. It advances the contemporary discussion of a number of important issues, but it also introduces several quite valuable ideas that are independent of the con- temporary literature. Papineau has performed an important service by writing it.

A methodical study of the primitive cultures of the hunting-gathering peoples which focuses on their social structures and economic relations.

Chapter on The Australian class system previously published as Sociocentre relationship terms and the Australian class system qv. for annotation.

New Blackfriars, Volume 103, Issue 1103, Page 159-161, January 2022.

ABSTRACT Global biodiversity declines are increasingly recognized as profound ecological and social crises. In areas subject to colonialization, these declines have advanced in lockstep with settler colonialism and imposition of centralized resource management by settler states. Many have suggested that resurgent Indigenous-led governance systems could help arrest these trends while advancing effective and socially just approaches to environmental interactions that benefit people and places alike. However, how dominant management and conservation approaches might be decolonized (i.e., how their underlying colonial structure (...) might be addressed, transformed, and replaced) is not always clear. Here, we describe a ‘Decolonial Model of Environmental Management and Conservation’ as an alternative paradigm to dominant approaches of conservation and management. The tenets of the model describe characteristics that might be expected of decolonized management, contrasted with those of dominant state-led approaches such as those embedded in the North American Model of Wildlife Conservation. The model does not prescribe how Indigenous governments or communities ought to govern their own territories, but instead offers insights into how external management and conservation agencies and practitioners might support (or stop impeding) Indigenous-led governance. We illustrate the model with a conservation ‘bright spot’: grizzly bear stewardship in the area now referred to as the Great Bear Rainforest in British Columbia, Canada, with a focus on work led by or in collaboration with, and within the territories of, the Haíɫzaqv, Kitasoo/xai’xais, Nuxalk, and Wuikinuxv First Nations. While acknowledging the important context-specific variability among place-based management and conservation applications, we also discuss the model’s broader applicability. (shrink)

Previous studies of verbal short-term memory indicate that STM for serial order may be linked to language development and developmental language disorder. To clarify whether a domain-general mechanism is impaired in DLD, we studied the relations between age, non-verbal serial STM, and language competence. We hypothesized that non-verbal serial STM differences between groups of children with DLD and typically developing children are linked to their language acquisition differences. Fifty-one children with DLD and sixty-six TD children participated as part of the (...) HelSLI project in this cross-sectional study. The children were 4–6-year-old monolingual native Finnish speakers. They completed several tests of language and cognitive functioning, as well as new game-like tests of visual and auditory non-verbal serial STM. We used regression analyses to examine how serial STM moderates the effect of age on language. A non-verbal composite measure of serial visual and auditory STM moderated cross-sectional development of receptive language in the children with DLD. This moderation was not observed in the TD children. However, we found more rapid cross-sectional development of non-verbal serial STM in the TD children than in the children with DLD. The results suggest that children with DLD may be more likely to have compromised general serial STM processing and that superior non-verbal serial STM may be associated with better language acquisition in children with DLD. (shrink)

BackgroundInformed consent forms for clinical research are several and variable at international, national and local levels. According to the literature, they are often unclear and poorly understood by participants. Within the H2020 project CORBEL—Coordinated Research Infrastructures Building Enduring Life-science Services—clinical researchers, researchers in ethical, social, and legal issues, experts in planning and management of clinical studies, clinicians, researchers in citizen involvement and public engagement worked together to provide a minimum set of requirements for informed consent in clinical studies.MethodsThe template (...) was based on a literature review including systematic reviews and guidelines searched on PubMed, Embase, Cochrane Library, NICE, SIGN, GIN, and Clearinghouse databases, and on comparison of templates gathered through an extensive search on the websites of research institutes, national and international agencies, and international initiatives. We discussed the draft versions step-by-step and then we referred to it as the “matrix” to underline its modular character and indicate that it allows adaptation to the context in which it will be used. The matrix was revised by representatives of two international patient groups.ResultsThe matrix covers the process of ensuring that the appropriate information, context and setting are provided so that the participant can give truly informed consent. It addresses the key topics and proposes wording on how to clarify the meaning of placebo and of non-inferiority studies, the importance of individual participants’ data sharing, and the impossibility of knowing in advance how the data might be used in future studies. Finally, it presents general suggestions on wording, format, and length of the information sheet.ConclusionsThe matrix underlines the importance of improving the process of communication, its proper conditions (space, time, setting), and addresses the participants’ lack of knowledge on how clinical research is conducted. It can be easily applied to a specific setting and could be a useful tool to identify the appropriate informed consent format for any study. The matrix is mainly intended to support multicentre interventional randomized clinical studies, but several suggestions also apply to non-interventional research. (shrink)

The study of corporate social responsibility has been the object of much research in recent decades, although there is a need to continue investigating its benefits as a marketing tool. In the current work we adopt a multi-dimensional perspective of social responsibility, and we carry out market research to determine the perceptions of users of mobile telephone services about economic, legal, ethical and social aspects of their operating companies. With these data we determine the structure and components of the (...) concept of social responsibility. Subsequently, this is related with the overall evaluation of the service and loyalty by means of a model of structural equations, in order to determine the influence of corporate social responsibility on these concepts, and hence its benefits as a commercial tool. (shrink)