Journal articles on the topic 'Harvard University. Department of Afro-American Studies'

Scholars who have assessed Roman Jakobson’s legacy have concentrated on his contributions to various scientific disciplines, while those who knew him, who had been his students or his colleagues, have written about his rhetorical virtuosity, his impact as a lecturer. The present article focuses on a little-studied aspect of his professional biography: the ways in which, during the period mid-1940s to mid-1950s, the émigré scholar carried out an ambitious project to develop Slavic studies (Slavistics, slavistika) as a discipline in the United States. Jakobson’s institution-building activities, conceptualized while he was teaching at Columbia University, were implemented following his move in 1949 to the new Slavic Department at Harvard University. A private group, the Committee for Advanced Slavic Cultural Studies, with which he was closely connected, played a significant role in supporting the Harvard program, and, more broadly, helping develop American Slavistics as a discipline.

John W. O’Malley, a member of the Society of Jesus, is currently a university professor in the Theology Department of Georgetown University, Washington, DC. He holds a PhD in history from Harvard University. His specialty is the religious culture of early modern Europe. O’Malley has written and edited a number of books, eight of which have won best-book awards. The First Jesuits (Cambridge, MA: Harvard University Press, 1993), perhaps his best-known work, received both the Jacques Barzun Prize for Cultural History from the American Philosophical Society and the Philip Schaff Prize from the American Society for Church History. It has been translated into twelve languages and its publication opened a new era in the study of the Society. Since then, the Jesuits have attracted greater attention from scholars of all disciplines on an international basis. O’Malley has continued to write about early Jesuits and the subsequent history of the Jesuits: his main essays on Jesuit history are now collected in the first volume of Brill’s Jesuit Studies series, Saints or Devils Incarnate?: Studies in Jesuit History (Leiden, 2013). In the last few years, O’Malley published with Harvard University Press a trilogy on the three last councils in the history of the Catholic Church: What Happened at Vatican ii (2008), Trent: What Happened at the Council (2012), and Vatican I: The Council and the Making of the Ultramontane Church (2018). A comparative view of the three councils is offered now in his most recent book, When Bishops Meet: An Essay Comparing Trent, Vatican I, and Vatican ii (2019). O’Malley has lectured widely around the world to both professional and general audiences. He is past president of the Renaissance Society of America and the American Catholic Historical Association. He holds the Johannes Quasten Medal from The Catholic University of America for distinguished service in religious studies. In 1995, he was elected to the American Academy of Arts and Sciences; in 1997, to the American Philosophical Society; and in 2001, to the Accademia Ambrosiana, Milan. He holds lifetime achievement awards from the Society for Italian Historical Studies, the Renaissance Society of America, and the American Catholic Historical Association. At the origin of the following interview there are three conversations Emanuele Colombo had with O’Malley in Chicago, in 2017 and 2018, as a follow-up of a lecture he gave on his life, “My Life of Learning,” now published in The Catholic Historical Review. 1

The author is Professor Emeritus of Planning, Regional Development and Public Policy at the University of Arizona, Tucson, Arizona, USA and Biarritz, France. He was formerly Professor and Chairman of the Department of City and Regional Planning at Harvard and before that held a similar position at Rutgers University. He has been a visiting professor at five different Latin American universities. He was for ten years the Review Editor of the Journal of the American Institute of Planners and was the initial compiling editor of Ekistics magazine. Professor Mann was national Chairman of the American Institute of Certified Planners, and was elected Fellow of the Institute in 2003. His research into Basque Planning has involved several months of field-work in the Basque region every year since 1999. The paper that follows is based on a presentation that he gave at the international symposion on 'The Natural City," Toronto, 23-25 June, 2004, sponsored by the University of Toronto's Division of the Environment, Institute for Environmental Studies, and the World Society for Ekistics.

The author, a cultural anthropologist, Professor Emeritus, Social Research Center, American University in Cairo, and a member of UNESCO's International Bioethics Committee and Egypt's National Bioethics Committee, after completing her Ph. D studies at Cornell University, has been for 25 years Professor and Director of the Social Research Center, American University in Cairo, while also acting as Senior Fellow, Population Center, Harvard University; Senior Visiting Associate, Population Program, California Institute of Technology; Research Project Director, United Nations Research Institute for Social Development, Geneva. Parallel to the above, she has been consultant for, and member of numerous international evaluation missions and expert committees of the UN Economic and Social Department, the UN Population Division, UNFPA, UNESCO, UNICEF, WHO and FAO. She has also been Secretary General of the Organization for the Promotion of Social Sciences in the Middle East; member of the Smithsonian Center for the Study of Man and of the Board of the International Union for Ethnological and Anthropological Sciences; member of the World Society for Ekistics (WSE),of which she was Vice-President for four years. The various distinctions awarded to Dr El-Hamamsy for her overall scientific achievements include the Distinguished Alumni Award of the American University in Cairo and the President Award of the American Anthropological Association. The text that follows is a slightly edited and revised version of a paper presented at the WSE Symposion "Defining Success of the City in the 21st Century," Berlin, 24-28 October, 2001.

For political scientists, and particularly scholars and students of Africa, Crawford Young needs litde introduction. However, as he has now achieved an emeritus status at the University of Wisconsin, Madison, it is time to present his intimate understanding of African politics in the last forty years.Born in Philadelphia in November 1931, Young received his B.A, from the University of Michigan in 1953. He studied at the Institute of Historical Research at the University of London from 1955 to 1956 and at die Institut d'Etudes Politiques, University of Paris, from 1956 to 1957. He dien entered graduate school at Harvard University, completing his doctorate degree in political science in 1964. In 1963 Young was offered an assistant professor position by the Department of Political Science at die University of Wisconsin–Madison. He remained tiiere for his entire career, retiring in January 2001. He has held visiting professorships at Makerere University in Kampala, Uganda (1965–66), and at the University of Dakar in Senegal (1987–88). He also served as dean of the Faculty of Social Science at the Université Nationale du Zaire from 1973 to 1975. Among his publications are twelve monographs, over one hundred articles, and chapters in numerous books. Several of Young's works have been translated into different languages.Young's professional career includes extended field research in Congo-Kinshasa, Senegal, and Uganda. He has received many prestigious awards such as the Herskovits Prize (African Studies Association) and the Ralph Bunche Award (American Political Science Association) for The Politics of Cultural Pluralism (Wisconsin, 1976), and the Gregory Luebbert Prize (APSA) for The African Colonial State in Comparative Perspective (Yale, 1994).

Dr. Matthew Burke is a Cognitive Neurologist in the Neuropsychiatry Program and Department of Psychiatry at Sunnybrook Health Sciences Center. He is currently the Director of Sunnybrook’s Traumatic Brain Injury Clinic and he also sees patients with functional neurological disorders, headache disorders, and other neuropsychiatric conditions. Before starting at Sunnybrook, Dr. Burke completed medical school and his neurology residency training at the University of Toronto, where he was the Chief Neurology Resident in his last year of training. He then completed a two-year Sidney R. Baer, Jr. Foundation fellowship in Cognitive Neurology and Neuropsychiatry at Beth Israel Deaconess Medical Center and Harvard Medical School.Dr. Burke’s clinical research fellowship provided specialized training in non-invasive brain stimulation and brain network mapping. His research applies these novel techniques to investigate the complex and poorly understood brain disorders at the interface between neurology and psychiatry. He also has research interests in the neurobiology of placebo effects and is an active collaborator with the Harvard Program in Placebo Studies. Finally, concurrent with his fellowship, Dr. Burke completed the Harvard Catalyst Clinical Translational Research Academy. This is a NIH-funded program that provides advanced training in methods of clinical investigation.Dr. Burke’s research to date has resulted in multiple peer-reviewed publications, media attention on platforms such as CNN and BBC, and recent recognition with the American Neuropsychiatric Association’s 2019 Young Investigator Award and the American Headache Society’s 2018 Frontiers in Headache Research Award.AbstractPlacebo effects are the beneficial therapeutic effects derived from the context surrounding the administration of a treatment rather than the treatment itself. Recent research has shifted our understanding of placebo effects from a mystical unempirical entity to a biologically-based phenomenon capable of meaningfully modulating brain regions and neurotransmitter systems. In this presentation, Dr. Burke will begin by summarizing the evidence underlying the principles and neurobiology of placebo effects. He will then discuss clinical factors that contribute to placebo effects and how placebo effects could be harnessed in the management of neuropsychiatric disorders. Finally, Dr. Burke will interrogate how our evolving understanding of placebo effects may impact the way we design, appraise and interpret research studies in neuropsychiatry and across medicine.

The article discusses the life and work of the outstanding Sovietologist Richard Pipes, who was born in a Polonized Jewish family in Polish Cieszyn. After an adventurous trip to the United States in 1939 and 1940, he graduated in history from Harvard University and devoted himself to scientific work. For the next half a century, Pipes dealt with the historical and contemporary aspects of Russia. In his numerous publications, including more than 20 monographs, he emphasised that the Soviet Union continued rather than broke with the political practice of tsarist Russia. In his professional work, he thus contested views prevailing among American researchers and society. From the 1960s, Pipes was involved in political activities. He was sceptical about détente, advocating more decisive actions towards the Soviet Union. Between 1981 and 1983, he was the director of the Department of Eastern Europe and the Soviet Union in the National Security Council in the administration of President Ronald Reagan. Although retiring in 1996, he did not give up his scientific activity. Pipes died on 17 May 2018; according to his last will, his private book collection of 3,500 volumes has been donated to the Institute of Political Studies of the Polish Academy of Sciences.

“Race,” Writing, and Difference first appeared in 1986. That Fall, I entered graduate school at Yale University; I still associate the book with those intellectually heady times. Henry Louis Gates, Jr., left the university before my arrival, but his influence was still felt, and we graduate students followed his every move. We also read and debated the essays of his volume with great excitement. The collection legitimated our intellectual concerns and delineated a set of questions that we would pursue throughout our graduate school careers. The volume set the bar high and helped prepare us for the task ahead. These were the days when we anticipated and greeted the appearance of works by Gates, Houston Baker, Jr., Hortense Spillers, Sylvia Wynter, and Cornel West with almost as much excitement that years earlier accompanied the release of recordings by Stevie Wonder and Earth, Wind, and Fire. Many of us came to Jacques Derrida, Michel Foucault, Jacques Lacan, and Paul de Man through these brilliant theorists of African American literature and culture. Those were intellectually exciting times: the period also produced Black Literature and Literary Theory; the painful exchange between Gates, Baker, and Joyce Ann Joyce on the pages of New Literary History; Hazel Carby's Reconstructing Womanhood, and Spillers's “Mama's Baby, Papa's Maybe: An American Grammar Book.” Furthermore, through his books Black Literature and Literary Theory, Figures in Black, and The Signifying Monkey, Gates not only provided a theoretical framework for the study of African American literature, he also set forth an intellectual agenda that he would institutionalize in a number of projects, especially The Norton Anthology of African American Literature and the Department of African and African American Studies at Harvard. In fact, Gates's PBS series African American Lives might be seen as part of this larger project as well in that it demonstrates the fiction of race through scientific evidence without denying its power to determine the lived experience of those identified as black in the United States. Despite the appearance of texts such as Richard J. Herrnstein and Charles Murray's The Bell Curve (and other arguments for the biological basis of race that rear their heads every so often), few people would disagree with the fundamental premise of “Race,” Writing, and Difference: that race was not fixed or naturalized but instead socially and historically constructed and institutionalized.

Temple University’s Department of Africology and African American Studies is celebrating its 30th year of operation as a PhD program. Since its inception in l988, the doctoral program at Temple has attracted and produced world-class scholars in the discipline of Africology. Initially started by students at San Francisco State University in l968 as Black Studies, the field has been called by many names, including Afro-American Studies, African American Studies, African World Studies, Africana Studies, Pan African Studies, and Africology. As this modern-day field of study marks its 50th anniversary, it is important that we examine the impact of the 30-year history of the establishment of the first PhD program in Black Studies in the nation, founded at Temple University in the City of Philadelphia. This article offers a preliminary assessment of the far-reaching impact of Temple’s academic leadership in establishing a fundamental base for innovative scholarship and the maturing of the discipline of Africology. More specifically, it focuses on Molefi Kete Asante’s influence, his vision for the discipline, and his extraordinary impact on the field of Africology.

-Stanley L. Engerman, B.W. Higman, Slave populations of the British Caribbean, 1807-1834. Baltimore: The Johns Hopkins University Press, Johns Hopkins Studies in Atlantic History and Culture, 1984. xxxiii + 781 pp.-Susan Lowes, Gad J. Heuman, Between black and white: race, politics, and the free coloureds in Jamaica, 1792-1865. Westport CT: Greenwood Press, Contributions in Comparative Colonial Studies No. 5, 1981. 20 + 321 pp.-Anthony Payne, Lester D. Langley, The banana wars: an inner history of American empire, 1900-1934. Lexington KY: University Press of Kentucky, 1983. VIII + 255 pp.-Roger N. Buckley, David Geggus, Slavery, war and revolution: the British occupation of Saint Domingue, 1793-1798. New York: The Clarendon Press, Oxford University Press, 1982. xli + 492 pp.-Gabriel Debien, George Breathett, The Catholic Church in Haiti (1704-1785): selected letters, memoirs and documents. Chapel Hill NC: Documentary Publications, 1983. xii + 202 pp.-Alex Stepick, Michel S. Laguerre, American Odyssey: Haitians in New York City. Ithaca and London: Cornell University Press, 1984. 198 pp-Andres Serbin, H. Michael Erisman, The Caribbean challenge: U.S. policy in a volatile region. Boulder CO: Westview Press, 1984. xiii + 208 pp.-Andres Serbin, Ransford W. Palmer, Problems of development in beautiful countries: perspectives on the Caribbean. Lanham MD: The North-South Publishing Company, 1984. xvii + 91 pp.-Carl Stone, Anthony Payne, The politics of the Caribbean community 1961-79: regional integration among new states. Oxford: Manchester University Press, 1980. xi + 299 pp.-Evelyne Huber Stephens, Michael Manley, Jamaica: struggle in the periphery. London: Third World Media, in association with Writers and Readers Publishing Cooperative Society, 1982. xi + 259 pp.-Rhoda Reddock, Epica Task Force, Grenada: the peaceful revolution. Washington D.C., 1982. 132 pp.-Rhoda Reddock, W. Richard Jacobs ,Grenada: the route to revolution. Havana: Casa de Las Americas, 1979. 157 pp., Ian Jacobs (eds)-Jacqueline Anne Braveboy-Wagner, Andres Serbin, Geopolitica de las relaciones de Venezuela con el Caribe. Caracas: Fundación Fondo Editorial Acta Cientifica Venezolana, 1983.-Idsa E. Alegria-Ortega, Jorge Heine, Time for decision: the United States and Puerto Rico. Lanham MD: North-South Publishing Co., 1983. xi + 303 pp.-Richard Hart, Edward A. Alpers ,Walter Rodney, revolutionary and scholar: a tribute. Los Angeles: Center for Afro-American Studies and African Studies Center, University of California, 1982. xi + 187 pp., Pierre-Michel Fontaine (eds)-Paul Sutton, Patrick Solomon, Solomon: an autobiography. Trinidad: Inprint Caribbean, 1981. x + 253 pp.-Paul Sutton, Selwyn R. Cudjoe, Movement of the people: essays on independence. Ithaca NY: Calaloux Publications, 1983. xii + 217 pp.-David Barry Gaspar, Richard Price, To slay the Hydra: Dutch colonial perspectives on the Saramaka wars. Ann Arbor MI: Karoma Publishers, 1983. 249 pp.-Gary Brana-Shute, R. van Lier, Bonuman: een studie van zeven religieuze specialisten in Suriname. Leiden: Institute of Cultural and Social Studies, ICA Publication no. 60, 1983. iii + 132 pp.-W. van Wetering, Charles J. Wooding, Evolving culture: a cross-cultural study of Suriname, West Africa and the Caribbean. Washington: University Press of America 1981. 343 pp.-Humphrey E. Lamur, Sergio Diaz-Briquets, The health revolution in Cuba. Austin: University of Texas Press, 1983. xvii + 227 pp.-Forrest D. Colburn, Ramesh F. Ramsaran, The monetary and financial system of the Bahamas: growth, structure and operation. Mona, Jamaica: Institute of Social and Economic Research, University of the West Indies, 1984. xiii + 409 pp.-Wim Statius Muller, A.M.G. Rutten, Leven en werken van de dichter-musicus J.S. Corsen. Assen, The Netherlands: Van Gorcum, 1983. xiv + 340 pp.-Louis Allaire, Ricardo E. Alegria, Ball courts and ceremonial plazas in the West Indies. New Haven: Department of Anthropology of Yale University, Yale University Publications in Anthropology No. 79, 1983. lx + 185 pp.-Kenneth Ramchand, Sandra Paquet, The Novels of George Lamming. London: Heinemann, 1982. 132 pp.

-John F. Szwed, Richard Price, First-Time: the historical vision of an Afro-American people. Baltimore and London: The Johns Hopkins University Press, Johns Hopkins Studies in Atlantic History and Culture, 1983, 191 pp.-Thomas J. Spinner Jr., Reynold Burrowes, The Wild Coast: an account of politics in Guyana. Cambridge MA: Schenkman Publishing Company, 1984. xx + 348 pp.-Gad Heuman, Edward L. Cox, Free Coloreds in the slave societies of St. Kitts and Grenada, 1763-1833. Knoxville: University of Tennessee Press, 1984. xiii + 197 pp.-H. Michael Erisman, Anthony Payne, The international crisis in the Caribbean. Baltimore: The Johns Hopkins University Press, 1984. 177 p.-Lester D. Langley, Richard Newfarmer, From gunboats to diplomacy: new U.S. policies for Latin America. Baltimore and London: The Johns Hopkins University Press, 1984. xxii + 254 pp.-Trevor W. Purcell, Diane J. Austin, Urban life in Kingston, Jamaica: the culture and class ideology of two neighbourhoods. New York: Gordon and Breach Science Publishers, Caribbean Studies Vol. 3, 1984. XXV + 282 PP.-Robert A. Myers, Richard B. Sheridan, Doctors and slaves: a medical and demographic history of slavery in the British West Indies, 1680-1834. Cambridge, Cambridge University Press, 1985. xxii + 420 pp.-Michéle Baj Strobel, Christiane Bougerol, La médecine populaire á la Guadeloupe. Paris: Editions Karthala, 1983. 175 pp.-R. Parry Scott, Annette D. Ramirez de Arellano ,Colonialism, Catholicism, and contraception: a history of birth control in Puerto Rico. Chapel Hill, NC: University of North Carolina Press, 1983. xii + 219 pp., Conrad Seipp (eds)-Gervasio Luis García, Francis A. Scarano, Sugar and slavery in Puerto Rico: the plantation economy of Ponce, 1800-1850. Madison WI and London: The University of Wisconsin Press, 1984. xxv + 242 pp.-Fernando Picó, Edgardo Diaz Hernandez, Castãner: una hacienda cafetalera en Puerto Rico (1868-1930). Rio Piedras, Puerto Rico: Editorial Edil, 1983. 139 pp.-John V. Lombardi, Laird W. Bergad, Coffee and the growth of agrarian capitalism in nineteenth-century Puerto Rico. Princeton NJ: Princeton University Press, 1983. xxvii + 242 pp.-Robert A. Myers, Anthony Layng, The Carib Reserve: identity and security in the West Indies. Washington, D.C.: University Press of America, 1983. xxii + 177 pp.-Lise Winer, Raymond Quevedo, Atilla's Kaiso: a short history of Trinidad calypso. St. Augustine, Trinidad: Department of Extra-Mural Studies, University of the West Indies, 1983. ix + 205 pp.-Luiz R.B. Mott, B.R. Burg, Sodomy and the pirate tradition: English sea rovers in the seventeenth-century Caribbean. New York: New York University Press, 1983, xxiii + 215 pp.-Humphrey E. Lamur, Willem Koot ,De Antillianen. Muiderberg, The Netherlands: Dick Coutihno, Migranten in de Nederlandse Samenleving nr. 1, 1984. 175 pp., Anco Ringeling (eds)-Gary Brana-Shute, Paul van Gelder, Werken onder de boom: dynamiek en informale sektor: de situatie in Groot-Paramaribo, Suriname. Dordrecht, The Netherlands: Foris, 1985, xi + 313 pp.-George L. Huttar, Eddy Charry ,De Talen van Suriname: achtergronden en ontwikkelingen. With the assistance of Sita Kishna. Muiderberg, The Netherlands: Dick Coutinho, 1983. 225 pp., Geert Koefoed, Pieter Muysken (eds)-Peter Fodale, Nelly Prins-Winkel ,Papiamentu: problems and possibilities. (authors include also Luis H. Daal, Roger W. Andersen, Raúl Römer). Zutphen. The Netherlands: De Walburg Pers, 1983, 96 pp., M.C. Valeriano Salazar, Enrique Muller (eds)-Jeffrey Wiliams, Lawrence D. Carrington, Studies in Caribbean language. In collaboration with Dennis Craig & Ramon Todd Dandaré. St. Augustine, Trinidad: Society for Caribbean Linguistics, University of the West Indies, 1983. xi + 338 pp.

-Charles V. Carnegie, W. Jeffrey Bolster, Black Jacks: African American Seamen in the age of sail. Cambridge MA: Harvard University Press, 1997. xiv + 310 pp.-Stanley L. Engerman, Wim Klooster, Illicit Riches: Dutch trade in the Caribbean, 1648-1795. Leiden: KITLV Press, 1998. xiv + 283 pp.-Luis Martínez-Fernández, Emma Aurora Dávila Cox, Este inmenso comercio: Las relaciones mercantiles entre Puerto Rico y Gran Bretaña 1844-1898. San Juan: Editorial de la Universidad de Puerto Rico, 1996. xxi + 364 pp.-Félix V. Matos Rodríguez, Arturo Morales Carrión, Puerto Rico y la lucha por la hegomonía en el Caribe: Colonialismo y contrabando, siglos XVI-XVIII. San Juan: Editorial de la Universidad de Puerto Rico y Centro de Investigaciones Históricas, 1995. ix + 244 pp.-Herbert S. Klein, Patrick Manning, Slave trades, 1500-1800: Globalization of forced labour. Hampshire, U.K.: Variorum, 1996. xxxiv + 361 pp.-Jay R. Mandle, Kari Levitt ,The critical tradition of Caribbean political economy: The legacy of George Beckford. Kingston: Ian Randle, 1996. xxvi + 288., Michael Witter (eds)-Kevin Birth, Belal Ahmed ,The political economy of food and agriculture in the Caribbean. Kingston: Ian Randle; London: James Currey, 1996. xxi + 276 pp., Sultana Afroz (eds)-Sarah J. Mahler, Alejandro Portes ,The urban Caribbean: Transition to the new global economy. Baltimore: John Hopkins University Press, 1997. xvii + 260 pp., Carlos Dore-Cabral, Patricia Landolt (eds)-O. Nigel Bolland, Ray Kiely, The politics of labour and development in Trinidad. Barbados, Jamaica, Trinidad and Tobago: The Press University of the West Indies, 1996. iii + 218 pp.-Lynn M. Morgan, Aviva Chomsky, West Indian workers and the United Fruit Company in Costa Rica, 1870-1940. Baton Rouge: Louisiana State University Press, 1996. xiii + 302 pp.-Eileen J. Findlay, Maria del Carmen Baerga, Genero y trabajo: La industria de la aguja en Puerto Rico y el Caribe hispánico. San Juan: Editorial de la Universidad de Puerto Rico, 1993. xxvi + 321 pp.-Andrés Serbin, Jorge Rodríguez Beruff ,Security problems and policies in the post-cold war Caribbean. London: :Macmillan; New York: St. Martin's, 1996. 249 pp., Humberto García Muñiz (eds)-Alex Dupuy, Irwin P. Stotzky, Silencing the guns in Haiti: The promise of deliberative democracy. Chicago: University of Chicago Press, 1997. xvi + 294 pp.-Carrol F. Coates, Myriam J.A. Chancy, Framing silence: Revolutionary novels by Haitian women. New Brunswick NJ: Rutgers University Press, 1997. ix + 200 pp.-Havidán Rodríguez, Walter Díaz, Francisco L. Rivera-Batiz ,Island paradox: Puerto Rico in the 1990's. New York: Russel Sage Foundation, 1996. xi + 198 pp., Carlos E. Santiago (eds)-Ramona Hernández, Alan Cambeira, Quisqueya la Bella: The Dominican Republic in historical and cultural perspective. Armonk NY: M.E. Sharpe, 1996. xi + 272 pp.-Ramona Hernández, Emilio Betances ,The Dominican Republic today: Realities and perspectives. New York: Bildner Center for Western Hemisphere studies, CUNY, 1996. 205 pp., Hobart A. Spalding, Jr. (eds)-Bonham C. Richardson, Eberhard Bolay, The Dominican Republic: A country between rain forest and desert. Wekersheim, FRG: Margraf Verlag, 1997. 456 pp.-Virginia R. Dominguez, Patricia R. Pessar, A visa for a dream: Dominicans in the United States. Boston: Allyn and Bacon, 1995. xvi + 98 pp.-Diane Austin-Broos, Nicole Rodriguez Toulis, Believing identity: Pentecostalism and the mediation of Jamaican ethnicity and gender in England. Oxford NY: Berg, 1997. xv + 304 p.-Mary Chamberlain, Trevor A. Carmichael, Barbados: Thirty years of independence. Kingston: Ian Randle Publishers, 1996. xxxv + 294 pp.-Paul van Gelder, Gert Oostindie, Het paradijs overzee: De 'Nederlandse' Caraïben en Nederland. Amsterdam: Bert Bakker, 1997. 385 pp.-Roger D. Abrahams, Richard D.E. Burton, Afro-Creole: Power, Opposition, and Play in the Caribbean. Ithaca NY: Cornell University Press, 1997. x + 297 pp.-Roger D. Abrahams, Joseph Roach, Cities of the dead: Circum-Atlantic performance. New York NY: Columbia University Press, 1996. xiii + 328 pp.-George Mentore, Peter A. Roberts, From oral to literate culture: Colonial experience in the English West Indies. Kingston, Jamaica: The Press University of the West Indies, 1997. xii + 301 pp.-Emily A. Vogt, Howard Johnson ,The white minority in the Caribbean. Princeton NJ: Markus Wiener, 1998. xvi + 179 pp., Karl Watson (eds)-Virginia Heyer Young, Sheryl L. Lutjens, The state, bureaucracy, and the Cuban schools: Power and participation. Boulder CO: Westview Press, 1996. xiii + 239 pp.

-Selwyn R. Cudjoe, John Thieme, The web of tradition: uses of allusion in V.S. Naipaul's fiction,-A. James Arnold, Josaphat B. Kubayanda, The poet's Africa: Africanness in the poetry of Nicolás Guillèn and Aimé Césaire. Westport CT: Greenwood, 1990. xiv + 176 pp.-Peter Mason, Robin F.A. Fabel, Shipwreck and adventures of Monsieur Pierre Viaud, translated by Robin F.A. Fabel. Pensacola: University of West Florida Press, 1990. viii + 141 pp.-Alma H. Young, Robert B. Potter, Urbanization, planning and development in the Caribbean, London: Mansell Publishing, 1989. vi + 327 pp.-Hymie Rubinstein, Raymond T. Smith, Kinship and class in the West Indies: a genealogical study of Jamaica and Guyana, Cambridge: Cambridge University Press, 1988. xiv + 205 pp.-Shepard Krech III, Richard Price, Alabi's world, Baltimore and London: Johns Hopkins University Press, 1990. xx + 445 pp.-Graham Hodges, Sandra T. Barnes, Africa's Ogun: Old world and new, Bloomington & Indianapolis: Indiana University Press, 1989. xi + 274 pp.-Pamela Wright, Philippe I. Bourgois, Ethnicity at work: divided labor on a Central American banana plantation, Baltimore MD: John Hopkins University Press, 1989. xviii + 311 pp.-Idsa E. Alegría-Ortega, Andrés Serbin, El Caribe zona de paz? geopolítica, integración, y seguridad, Caracas: Editorial Nueva Sociedad, 1989. 188 pp. (Paper n.p.) [Editor's note. This book is also available in English: Caribbean geopolitics: towards security through peace? Boulder CO: Lynne Rienner, 1990.-Gary R. Mormino, C. Neale Ronning, José Martí and the émigré colony in Key West: leadership and state formation, New York; Praeger, 1990. 175 pp.-Gary R. Mormino, Gerald E. Poyo, 'With all, and for the good of all': the emergence of popular nationalism in the Cuban communities of the United States, 1848-1898, Durham NC: Duke University Press, 1989. xvii + 182 pp.-Fernando Picó, Raul Gomez Treto, The church and socialism in Cuba, translated from the Spanish by Phillip Berryman. Maryknoll NY: Orbis, 1988. xii + 151 pp.-Fernando Picó, John M. Kirk, Between God and the party: religion and politics in revolutionary Cuba. Tampa FL: University of South Florida Press, 1989. xxi + 231 pp.-Andrés Serbin, Carmen Gautier Mayoral ,Puerto Rico en la economía política del Caribe, Río Piedras PR; Ediciones Huracán, 1990. 204 pp., Angel I. Rivera Ortiz, Idsa E. Alegría Ortega (eds)-Andrés Serbin, Carmen Gautier Mayoral ,Puerto Rico en las relaciones internacionales del Caribe, Río Piedras PR: Ediciones Huracán, 1990. 195 pp., Angel I. Rivera Ortiz, Idsa E. Alegría Ortega (eds)-Jay R. Mandle, Jorge Heine, A revolution aborted : the lessons of Grenada, Pittsburgh: University of Pittsburgh Press, 1990. x + 351 pp.-Douglas Midgett, Rhoda Reddock, Elma Francois: the NWCSA and the workers' struggle for change in the Caribbean in the 1930's, London: New Beacon Books, 1988. vii + 60 pp.-Douglas Midgett, Susan Craig, Smiles and blood: the ruling class response to the workers' rebellion of 1937 in Trinidad and Tobago, London: New Beacon Books, 1988. vii + 70 pp.-Ken Post, Carlene J. Edie, Democracy by default: dependency and clientelism in Jamaica, Kingston, Jamaica: Ian Randle Publishers, and Boulder CO: Lynne Rienner Publishers, 1991. xiv + 170 pp.-Ken Post, Trevor Munroe, Jamaican politics: a Marxist perspective in transition, Kingston, Jamaica: Heinemann Publishers (Caribbean) and Boulder CO: Lynne Rienner Publishers, 1991. 322 pp.-Wendell Bell, Darrell E. Levi, Michael Manley: the making of a leader, Athens GA: University of Georgia Press, 1990, 349 pp.-Wim Hoogbergen, Mavis C. Campbell, The Maroons of Jamaica, 1655-1796: a history of resistance, collaboration and betrayal, Granby MA Bergin & Garvey, 1988. vi + 296 pp.-Kenneth M. Bilby, Rebekah Michele Mulvaney, Rastafari and reggae: a dictionary and sourcebook, Westport CT: Greenwood, 1990. xvi + 253 pp.-Robert Dirks, Jerome S. Handler ,Searching for a slave cemetery in Barbados, West Indies: a bioarcheological and ethnohistorical investigation, Carbondale IL: Center for archaeological investigations, Southern Illinois University, 1989. xviii + 125 pp., Michael D. Conner, Keith P. Jacobi (eds)-Gert Oostindie, Cornelis Ch. Goslinga, The Dutch in the Caribbean and in Surinam 1791/1942, Assen, Maastricht: Van Gorcum, 1990. xii + 812 pp.-Rosemarijn Hoefte, Alfons Martinus Gerardus Rutten, Apothekers en chirurgijns: gezondheidszorg op de Benedenwindse eilanden van de Nederlandse Antillen in de negentiende eeuw, Assen/Maastricht: Van Gorcum, 1989. xx + 330 pp.-Rene A. Römer, Luc Alofs ,Ken ta Arubiano? sociale integratie en natievorming op Aruba, Leiden: Department of Caribbean studies, Royal Institute of Linguistics and Anthropology, 1990. xi + 232 pp., Leontine Merkies (eds)-Michiel van Kempen, Benny Ooft et al., De nacht op de Courage - Caraïbische vertellingen, Vreeland, the Netherlands: Basispers, 1990.-M. Stevens, F.E.R. Derveld ,Winti-religie: een Afro-Surinaamse godsdienst in Nederland, Amersfoort, the Netherlands: Academische Uitgeverij Amersfoort, 1988. 188 pp., H. Noordegraaf (eds)-Dirk H. van der Elst, H.U.E. Thoden van Velzen ,The great Father and the danger: religious cults, material forces, and collective fantasies in the world of the Surinamese Maroons, Dordrecht, the Netherlands and Providence RI: Foris Publications, 1988. xiv + 451 pp. [Second printing, Leiden: KITLV Press, 1991], W. van Wetering (eds)-Johannes M. Postma, Gert Oostindie, Roosenburg en Mon Bijou: twee Surinaamse plantages, 1720-1870, Dordrecht, Netherlands: Foris Publications, 1989. x + 548 pp.-Elizabeth Ann Schneider, John W. Nunley ,Caribbean festival arts: each and every bit of difference, Seattle/St. Louis: University of Washington Press / Saint Louis Art Museum, 1989. 217 pp., Judith Bettelheim (eds)-Bridget Brereton, Howard S. Pactor, Colonial British Caribbean newspapers: a bibliography and directory, Westport CT: Greenwood, 1990. xiii + 144 pp.-Marian Goslinga, Annotated bibliography of Puerto Rican bibliographies, compiled by Fay Fowlie-Flores. Westport CT: Greenwood Press, 1990. xxvi + 167 pp.

In the magical late 1960s, an amazing young scholar came, armed with a Harvard doctorate, to his first tenure-stream job at the Ontario Institute for Studies in Education (OISE), then in its second year as a new independent research and teaching centre affiliated with the University of Toronto. Our paths crossed; fortuitously, it was the summer of 1967, which coincided with the beginning of my Ph.D in U of T's history department. In one of those accidents that determine one's fate, my advisor Maurice Careless suggested that, since the focus of my research was to be the history of education, I should wander up to “that new place on Bloor Street” (OISE) to see about a course on the subject. There, the chair of the History & Philosophy of Education Department (H & P) steered me to Michael's new offering on the history of American education. Participation in this brilliant seminar was life changing. Embedded in intellectual, religious, cultural and social frameworks, and interpreting educational history to be more than the history of schools, his course led students to more questions than answers. I found both the course meetings and the readings riveting.

Wendy Hui Kyong Chun is Simon Fraser University’s Canada 150 Research Chair in New Media in the School of Communication. She has studied both systems design engineering and English literature, which she combines and mutates in her current work on digital media. She is author of Control and Freedom: Power and Paranoia in the Age of Fiber Optics (Chun, 2006), Programmed Visions: Software and Memory (MIT, 2011), Updating to Remain the Same: Habitual New Media (Chun, 2016), and co-author of Pattern Discrimination (Apprich, Chun, Cramer, & Steyerl, 2018). She has been Professor and Chair of the Department of Modern Culture and Media at Brown University, where she worked for almost two decades and where she is currently a Visiting Professor. She has also been a Visiting Scholar at the Annenberg School at the University of Pennsylvania, a member of the Institute for Advanced Study (Princeton), and she has held fellowships from the Guggenheim, ACLS, the American Academy of Berlin, and the Radcliffe Institute for Advanced Study at Harvard. She has been a Visiting Professor at AI Now at New York University, the Velux Visiting Professor of Management, Politics and Philosophy at the Copenhagen Business School, the Wayne Morse Chair for Law and Politics at the University of Oregon, Visiting Professor at Leuphana University (Luneburg, Germany), and a Visiting Associate Professor in the History of Science Department at Harvard, where she is an Associate.

In a recent "Arts & Leisure" feature in a national Canadian newspaper, The Globe and Mail (5 June 1999), music critic Robert Everett-Green muses on the invention by the pop music industry of Andrea Bocelli as an opera singer: "call him an airborne virus or a gift from God ... . He is the voice you are most likely to hear while waiting for a double latte." The pop sentimentality industry fast-tracked Bocelli (a pop singer who "sounds" operatic) and created a global entertainment product. In a masterful stroke of high pop spectacle, the holy trinity of musical melodrama joined together -- Bocelli and Céline Dion gush out David Foster's "The Prayer", the theme for the movie Quest for Camelot -- to create an exquisite pop moment. The massive reach of the mainstream; the resonant power of vocal turgidity and excess; the pop diva who never met a song she couldn't oversing -- this is the pop often neglected in critical forays into the nature of the popular that search for the active and the participatory dimensions of popular culture. Yet pop both plunders and perpetuates popular culture; it contains and dramatises the social possibilities of popular culture, and at the same time, spreads out like a great theme park of trivia. Let's pick through the trash. If nothing else, the contemplation of the "question" of pop is an enterprise which often begins with the issue of redemption for popular culture. Even the cultural populist wrestles with the anxiety that much of what we understand as "pop" in culture constitutes the detritus, the ephemera, a repository of the trivialities of society in all of its contemporary moments. The best critical insights into the nature and substance of popular culture (studies in cultural geography and perspectives on history and collective memory, for examples), recognise that what they are considering, describing, and analysing in the spaces and experiences of the popular is at the very least deeply and irrevocably contradictory. The cool, renegade, and enormously creative cultural excursions and general messing about of turntablism and drum'n'bass, for examples, are democratic, active, even "heroic" by some critical discourses, where, say, the maudlin "pop diva" is forgettable at best, and unworthy of an analytical encounter at worst. There is a haziness to the concept of "pop", and more broadly, "popular", and the definitional defiance among the numerous and varied theorists of this energetic practice and/or genre of cultural form and production produces a rather decentred, if not indeterminate object of study. Bill Readings's critique of Cultural Studies offers the relevance of analogy here. Readings notes the "second moment" in the progress of Cultural Studies (around 1990), and the publication of a number of works at the time "that seem to mark the acquisition of professional disciplinarity of Cultural Studies". His excavation of these works reveals a characteristic theoretical element or two -- the suspicion of "the exclusionary force of certain boundaries: female/male, north/south, center/margin, high culture/low culture, western/other, heterosexual/homosexual" (97) -- and some of the authoritative antecedents of these theories against exclusion (Williams, Foucault, Gramsci, Hall, and others). Yet he notes that the striking characteristic of Cultural Studies is the thinness or even absence of theoretical definition or specificity -- "how little it needs to determine its object. Which does not mean that a lot of theorising doesn't go on in its name, only that such efforts are not undertaken in a way that secures the relation of an observer to a determinate set of phenomena or an autonomous object" (97). There is then, a frustration in providing an account of what it means to "do" Cultural Studies, or, more glaringly, what exactly the promised political interventions of Cultural Studies are in the context of hazy objects, floating themes, and sketchy "projects", all of which are products of the declared refusal by Cultural Studies to submit to definitional constraints. Pop suffers from a similar indeterminacy in its object of study, but interestingly because its tends to be over-defined rather than under-defined. Figuring out the object of study in pop is not unlike attempting to parse the object(s) of study in Cultural Studies -- a frustration ultimately, but for very different reasons. Pop is a universe of "anything and everything", and incomprehensible not because it is conceptually challenging (like a universe), but because its geography stretches across so much cultural space. In critiques, pop takes on the torque of the critic, a necessary strategy to somehow delimit its space, and make it graspable, if not meaningful. Encounters with pop (as in "pop art" and "PoMo pop") mine for signs of life among the trash, and have come up with a heartbeat or two on occasion. This geography of trash is in need of some attention. For conceptual guidance in this task, or at least for some respite from the arguments about the "projects" and "interventions" of pop and popular culture, I turn to Don DeLillo's seminal critique of media, consumerism, and the bizarre dislocations and bewildering drift of contemporary social life in his 1985 novel, White Noise (a book that should be required reading for undergraduate courses in media and communication). Murray Jay Suskind, an ex-sports writer and émigré from New York City has come to University-on-the-Hill in Blacksmith, somewhere in middle America, and has assumed his position as visiting lecturer in the Department of American Environments. He becomes a kind of participant-observer and quasi-family member in the household of Jack Gladney, the narrator of the novel and Chairman of the Department of Hitler Studies at the university -- a field he invented in 1968. Murray expresses his desire to establish an "Elvis Presley power base in the department of American Environments", to "do for Elvis" what Jack has "done for Hitler". Murray is engaged in a debate with his students on the true substance and significance of television, and the media-saturated Gladney household serves as a laboratory. Murray argues that the medium is a "primal force in the American home ... a myth being born right there in our living room". Murray elaborates in a conversation with Jack: You have to learn to look. You have to open yourself to the data. TV offers incredible amounts of psychic data. It opens up ancient memories of world birth, its welcomes us into the grid, the network of little buzzing dots that make up the picture pattern. There is light, there is sound. I ask my students, "What more do you want? Look at the wealth of data concealed in the grid, in the bright packaging, the jingles, the slice-of-life commercials, the products hurtling out of the darkness, the coded messages and endless repetitions, like chants, like mantras. 'Coke is it, Coke is it, Coke is it.' The medium practically overflows with sacred formulas if we can remember how to respond innocently and get past our irritation, weariness and disgust. (51) His students disagree -- television for them is "worse than junk mail", it is "the death throes of human consciousness". Murray, however, finds vindication in the Gladney home where the children live lives of total consumer/television immersion to the extent that they eat, think, speak, and dream according to all things televisual and all things commercial. Jack and his wife Babette are fearful of TV, its "narcotic undertow and eerie diseased brain-sucking power", and Babette has developed a strategy to "de-glamorise" television for the good of the family by instituting a family ritual of watching television en masse every Friday night. Mostly numbed or bored, the family occasionally engages in the strangely pleasurable and thoroughly grotesque activity of watching catastrophes: "we were otherwise silent, watching houses slide into the ocean, whole villages crackle and ignite in a mass of advance lava". The family found itself wishing for more with each disaster on the screen, something more sensational, "something bigger, grander, more sweeping" (64). The popular life as depicted by DeLillo is gripping in its familiarity. It is a life that unfolds around and within the television screen; a life that unfolds beside chemical dump sites and industrial waste zones, where toxic fallout produces glorious sunsets as well as fruit that is bright and burnished and always appears to be in season; a life that unfolds in supermarkets and malls where shopping is automatic, somnambulant, and strangely comforting; a life grounded in, structured by, and rationalised within consumerism, media, and omnipresent technological forces that produce everything from dark and insidious pharmaceuticals to an airborne toxic cloud; a life in which families are fragmented and destroyed by the very institutions and pastimes (Disney World and shopping) that declare and promote the support of families and their "values". There is a refrain that emerges like some unconscious ritual chant in the novel, a refrain that has no context or exposition, and that moves through and around the dialogue and the text like a persistent advertising jingle that refuses to quit one's head: Dacron, Orlon, Lycra, Spandex Mastercard, Visa, American Express Leaded, Unleaded, Superunleaded And when children dream, they dream in the consumer-unconscious. Jack hears his child mumbling something in her sleep, and leans closer to hear. She says, "Toyota Celica". The utterance transports Jack, an utterance that was "beautiful and mysterious, gold-shot with looming wonder. It was like the name of an ancient power in the sky, tablet-carved in cuneiform" (155). The brand name has come to have sacred resonance, supreme, transcendent, the stuff of dreams. This is a fiction about suffocating distractedly under the sheer weighty banality of popular trash. It offers a portrait of all of us deep in the commercial media swamp, flailing about in the flotsam and jetsam of all things commercial and popular. DeLillo's narrative moves towards its dark conclusion as the malevolent force of the toxic cloud brings the certainty of death in uncertain ways. The apocalyptic moment is evidenced by the sudden rearrangement of goods on the supermarket shelves. "Older shoppers" panic: "they walk in a fragmented trance, stop and go, clusters of well-dressed figures frozen in the aisles, trying to figure out the pattern, discern the underlying logic, trying to remember where they'd seen the Cream of Wheat" (325). DeLillo's version of life as we know offers some compelling signposts. Mainstream trash -- much of pop, if you will -- is toxic at many turns, and if not a great cloud, then infinitely more than a mere inflection. We desire that which we despise, and herein is the power of pop as a concept, a way of offering a critical trajectory. In a reflection on Pop Art, Roy Lichtenstein once remarked that "What characterises Pop is mainly its use of what is despised" (qtd. in Barthes 22). The pop impulse in art has always suggested a useful ambivalence for addressing the contradictions of life in the maelstrom -- the artist as interventionist/renegade and as commercial hack/celebrity; artful plundering and artless reproduction; the simultaneity of the provocation and the tedium of art in the pop mode; the knowable faux finish of the commercial good look of things and falseness as the raw material of cultural production; bad taste and cool cultural assaults. Pop in art has been accused of constituting a kind of slick cultural finish over cheap particle board. Still, there is a modicum of subversive power in the reversal of values in Pop Art (and in its precursors and its legacies) -- the common, the vulgar, the garish, the boring, the mass produced, the consumable, the pure commodity, all reworked to reveal their common, vulgar, garish, boring, massified, consumable, commodity nature. There have been impressive pop stylistic aggressions carried out against the constipation of high tastes, immutable standards, seriousness, and the ideologies of artistic and cultural legitimacy. Yet at times pop has been blunted by its very self-conscious edge as it engaged in self-congratulations for its irony, pith, and hipness. For some critics, pop in art suffers the malady of most style statements in the postmodern plague -- statements with no convictions since such statements are served up in quotation marks; and a life in quotation marks is no life at all. Pop declares that it is the progeny of commercial technique, marketplaces, advertising, and the commodity environments of junk; and if it didn't exactly spring from the mall, it has come to reside there now between the fountain and the food fair. At its worst, pop appears to be a vaporescent activity, but this perspective neglects some fine and very active pop moments. Pop excursions are important because they can open up creative and critical responses to popular culture. There is pop practice that rises well above empty irony and the business of oversinging (as in some current and brilliant cut-ups and constructed sounds in performance that not only have emotional substance, but are also danceable). Sometimes, out of the trash heap of pop, there are spaces in which popular culture is regenerated. And it is only in this relationship to popular culture that pop matters. References Barthes, Roland. "That Old Thing Called Art." Post-Pop Art. Ed. Paul Taylor. Cambridge: Harvard UP, 1989. DeLillo, Don. White Noise. New York: Viking, 1985. Readings, Bill. The University in Ruins Cambridge: Harvard UP, 1996. Citation reference for this article MLA style: Martin Laba. "Picking through the Trash." M/C: A Journal of Media and Culture 2.4 (1999). [your date of access] <http://www.uq.edu.au/mc/9906/trash.php>. Chicago style: Martin Laba, "Picking through the Trash," M/C: A Journal of Media and Culture 2, no. 4 (1999), <http://www.uq.edu.au/mc/9906/trash.php> ([your date of access]). APA style: Martin Laba. (1999) Picking through the trash. M/C: A Journal of Media and Culture 2(4). <http://www.uq.edu.au/mc/9906/trash.php> ([your date of access]).

IntroductionThis paper explores the different meanings that individuals from diverse ethnic backgrounds associate with being authentic. It builds on previous research (Menendez 11) that found quantitative differences in terms of the meanings individuals from Eastern and Western backgrounds tend to associate with being authentic. Using qualitative analysis, it describes in more detail how individuals from these two backgrounds construct their different meanings of authenticity.Authenticity has become an overriding moral principle in contemporary Western societies and has only recently started to be contested (Feldman). From cultural products to individuals’ discourses, authenticity pervades Western culture (Lindholm; Potter; Vannini and Williams). On an individual level, the ideal of authenticity is reflected in the maxim “be true to yourself.” The social value of authenticity has a relatively recent history in the Western world of approximately 200 years (Trilling). It started to develop alongside the notion of individuality during modernity (Taylor, Sources; Trilling). The Romantic movement consolidated its cultural influence (Taylor, Sources). In the 1960s, the Hippy movement revived authenticity as a countercultural discourse, although it has progressively become mainstream through consumer culture and therapeutic discourses (Binkley).Most of the studies in the literature on authenticity as a cultural phenomenon are theoretical, conducted from a philosophical perspective (Ferrara; Guignon; Taylor, Ethics), but few of them are empirical, mostly from sociology (Erickson; Franzese, Thine; Turner, Quest; Vannini, Authenticity). Part of this dearth of empirical research on authenticity is due to the difficulties that researchers encounter in attempting to define what it means to be authentic (Franzese, Authenticity 87). Sociologists study the phenomenological experience of being true to oneself, but are less attentive to the metaphysical notion of being a “true self” (Vannini, Dead 236–37). Trying to preserve this open approach, without judging individuals on how “authentic” they are, is what makes defining authenticity difficult. For this reason, sociologists have defined being authentic in a broad sense as “an individual’s subjective sense that their behaviour, appearance, self, reflects their sense of core being. One’s sense of core being is composed of their values, beliefs, feelings, identities, self-meanings, etc.” (Franzese, Authenticity 87); this is the definition of authenticity that I use here. Besides being scarce, the sociological empirical studies on authenticity have been conducted with individuals from Western backgrounds and, thus, have privileged authenticity as a Western cultural construct. This paper tries to contribute to this field of research by: (1) contributing more empirical investigation and (2) providing cross-cultural comparison between individuals from Eastern and Western backgrounds.The literature on cross-cultural values associates Eastern societies with collective (Hofstede, Hofstede and Mirkov 95–97; 112–17) and material or survival (Inglehart and Welzel 51–57; 61–65) values, while Western societies tend to be linked to the opposite kind of values: individual, post-material or self-expression (WVS). For example, societies that score high in survival values are likely to be African (e.g., Zimbabwe) Middle Eastern (e.g., Morocco and Jordan) or Asian (e.g., Bangladesh) countries, while societies that score high in self-expression values tend to be European (e.g., Sweden) or English speaking (e.g., Australia) countries. Nevertheless, there are some exceptions, the case of Japan, for example, which tends to score high in self-expression values despite being an “Eastern” society (WVS). These differences also tend to be reflected among Eastern minorities living in Western countries (Chua and Rubenfeld). Collective values emphasise harmony in relations and prioritise the needs of the group over the individual; on the other hand, individual values emphasise self-expression. Material or survival values accentuate the satisfaction of “basic” needs, in Abraham Maslow’s terms (21), such as physiological or security needs, and imply practising thrift and delaying immediate gratification; by contrast, post-material or self-expression values stress the satisfaction of “higher” needs, such as freedom of speech, equality, or aesthetic needs.The sociologist Ralph Turner (Real) created a theoretical framework to organize individuals’ discourses around authenticity: the “impulsive” and “institutional” categories. One of Turner’s assumptions is particularly important in understanding the differences between these two categories: individuals tend to consider the self as an objective entity that, despite only existing in their minds, feels “real” to them. This can have consequences for the meanings they ascribe to certain internal subjective states, such as cognitions or emotions, which can be interpreted as indicators of their authentic selves (990–91).The institutional and impulsive categories are two different ways of understanding authenticity that present several differences (991–95). Two among them are most relevant to understand the differences that I discuss in this paper. The first one has to do with the individual’s locus of the self, whether the self is conceptualized as located “outside” or “inside” the individual. Impulsive interpretations of authenticity have an internal sense of authenticity as “being,” while institutional conceptualizations have an external sense of authenticity as “becoming.” For “impulsives,” the authentic self is something that must be searched for. Impulsives look within to discover their “true self,” which is often in opposition to society’s roles and its expectations of the individual. On the other hand, for “institutionals” authentic is achieved through external effort (Turner, Quest 155); it is something that individuals achieve through regular practice, often aligned with society’s roles and their expectations of the individual (Turner, Real 992).The second difference has to do with the management of emotions. For an institutional understanding of authenticity, individuals are true to their own authentic selves when they are in full control of their capacities and emotions. By contrast, from an impulsive point of view, individuals are true to themselves when they are spontaneous, accepting and freely expressing their emotions, often by breaking the internal or external controls that society imposes on them (Turner, Real 993).Although individuals can experience both types of authenticity, previous research on this topic (Menendez) has shown that institutional experiences tend to happen more frequently among Easterners, and impulsive experiences tend to occur more frequently among Westerners. In this paper, I show how Easterners and Westerners construct institutional and impulsive meanings of authenticity respectively; what kind of authenticity work individuals from these two backgrounds do when they conceptualize their authentic selves; how they interpret internal subjective states as expressions of who they are; and what stories they tell themselves about who they are.I suggest that these stories, although they may look purely individual, can also be social. Individuals from Western backgrounds tend to interpret impulsive experiences of authenticity as expressing their authentic selves, as they are informed by the individual and post-material values of Western societies. In contrast, individuals from Eastern backgrounds tend to interpret institutional experiences of authenticity as expressing their authentic selves, as they have been socialized in the more collective and material values of Eastern societies.Finally, and before I proceed to the analysis, I would like to acknowledge a limitation of this study. The dichotomies that I use to explain my argument, such as the Western and Eastern or the impulsive and institutional categories, can constitute a limitation for this paper because they cannot reflect nuances. They can be easily contested. For example, the division between Eastern and Western societies is often seen as ideological and Turner’s distinction between institutional and impulsive experiences of authenticity can create artificial separations between the notions of self and society or reason and passion (Solomon 173). However, these concepts have not been used for ideological or simplifying purposes, but to help explain distinguishable cultural orientations towards authenticity in the data.MethodologyI completed 20 interviews (from 50 minutes to 2 hours in length) with 20 students at La Trobe University (Australia), between September 2012 and April 2013. The 20 interviewees (9 females and 11 males), ranged from 18 to 58 years old (the median age was 24 years old). The sample was theoretically designed to cover as many diverse cultural backgrounds as possible. I asked the interviewees questions about: moments they had experienced that felt either authentic and inauthentic, what constitutes a life worth-living, and the impact their cultural backgrounds might have had on their conceptions of their true selves.The 20 interviewees were born in 13 different countries. According to the extensive dataset on cultural values, the World Values Survey (WVS), these 13 countries have different percentages of post-materialists—individuals who choose post-material instead of material values (Inglehart and Welzel 54–56). Table 1 shows the percentages of post-materialists in each of the interviewees’ countries of birth. Table 1: Percentages of post-materialists in the interviewees’ countries of birth Country % of post-materialists WVS Wave United Kingdom 22.8 2005 – 2009 Australia 20.5 2010 – 2014 United States 16.7 2010 – 2014 Israel 11.6 2000 – 2004 Finland 11.3 2005 – 2009 Greece (Turkey) 10.7 2010 – 2014 South Africa 7.7 2005 – 2009 Malaysia 5.6 2010 – 2014 Ghana 4.2 2010 – 2014 India 4 2005 – 2009 China 2.5 2010 – 2014 Egypt 1.1 2010 – 2014 Note: These data are based on the 4-item post-materialism index question (Y002) of World Values Survey (WVS). I use three different waves of data (2000–2004, 2005–2009, and 2010–2014). Greece did not have any data in World Values Survey, so its data have been estimated considering the results from Turkey, which is the most similar country in geographical and cultural terms that had data available.In my model, I consider “Western” societies as those that have more than 10% post-materialists, while “Eastern” societies have less than 10% post-materialists. As shown in Table 1 and mentioned earlier, Western countries (English speaking or European) tend to have higher percentages of post-materialists than Eastern societies (African, Asian and Middle Eastern).Thus, as Table 2 shows, the interviewees who were born in a Western society are ascribed to one group, while individuals born in an Eastern society are ascribed to another group. Although many overseas-born interviewees have lived in Australia for periods that range from 6 months to 10 years, they were ascribed to the “East” and “West” groups solely based on their country of birth. Even though these individuals may have had experiences of socialization in Australia, I assume that they have been primarily socialized in the values of their ethnic backgrounds and the countries where they were born, via their parents’ educational values or through direct experience, during the time that they lived in their countries of birth. According to my definition of authenticity, individuals’ values inform their understanding of authenticity, therefore, the values from their ethnic backgrounds can also influence their understanding of authenticity.In the first phase of the analysis, I used Grounded Theory (Charmaz), with categories directly emerging from the data, to analyse my interviewees’ stories. In the second stage, I reviewed these categories in combination with Turner’s categories of impulsive and institutional, applying them to classify the stories.Table 2: Distribution of participants between “East” and “West” West (n=11) East (n=9) Australia (n=5) China (n=2) United Kingdom (n=2) India (n=2) United States (n=1) South Korea (n=1) Greece (n=1) South Africa (n=1) Finland (n=1) Egypt (n=1) Israel (n=1) Ghana (n=1) Malaysia (n=1) ResultsAlthough I interviewed 20 participants, due to space-constraints, I illustrate my argument with only 4 interview extracts from 4 of the interviewees: 2 interviewees from Western backgrounds and 2 from Eastern backgrounds. However, these stories are representative of the trends found for the whole sample. I show how Easterners and Westerners construct their authentic selves in institutional and impulsive senses respectively through the two key characteristics that I presented in the introduction: locus of the self and management of emotions.In the first instance, Rachel (from Australia, 24 years old), a Western respondent, shows an impulsive locus of the self as “being.” Authenticity is discovered through self-acceptance of an uncomfortable emotion, like a “bad mood:”I think the times when I want to say, ‘oh, I wasn’t myself’, I usually was. My bad moods are more ‘me’. My bad moods are almost always the ‘real me’. [So you consider that your authentic self is something that is there, inside you, that you have to discover, or it is something outside yourself, that you can achieve?] I think it is something that you have to discover for yourself. I think it is different for everyone. [But would you say that it is something that is there already or it is something that you become?] No, I think it is something that is there already.On the other hand, Rani (from China, 24 years old), an Eastern respondent, interprets authenticity as “becoming;” authenticity does not pre-exist—as in the case of Rachel—but is something “external” to her idea of self. Rani becomes herself by convincing herself that she conforms to society’s ideals of physical beauty. Unlike the process of self-acceptance that Rachel described, Rani develops authentic selfhood by “lying” to herself or, as she says, “through some lies”:I have heard this sentence, like ‘you have to be yourself to others’, but I think it is really hard to do this. I think people still need some ‘acting’ things in their life. You need to act, not to say to act as another person, but sometimes like let’s say to be polite or make other people like you, you need acting. And sometimes if you are doing the ‘acting things’ a lot, you are going to believe this is true (she laughs). [Like others will believe that you are something that you are not?] I think at the beginning, maybe that’s not, but… because some people wake up every morning and say to the mirror, ‘you are very beautiful, you are the most beautiful girl in the world’, then, you will be happy and you will actually become beautiful. I think it is not like lie to yourself, but it is just being confident. Maybe at the beginning you are not going to believe that you are beautiful… like, what is this sentence? ‘Being true to yourself’, but actually doing this everyday, then that’s true, you will become, you will be confident. [So that means you can be yourself also through…] Through some lies. [So you don’t think that there is something inside you that you have to kind of discover?] No.Eastern and Western respondents also tend to interpret emotions differently. Westerners are more likely to interpret them in more impulsive terms than Easterners, who interpret them in a more institutional light. As we can see in the following extract, Sean, a Western respondent (born in Australia, but raised in England, 41 years old), feels inauthentic because he could not express his dislike of a co-worker he did not get along with:In a six months job I had before I came to Australia, I was an occupational therapist in a community. There was a girl in the administration department who was so rude. I wanted to say: ‘look darling you are so rude. It is really unpleasant talking to you. Can you just be nice? It would be just so much better and you will get more done and you will get more from me’. That’s what I should have said, but I didn’t say it. I didn’t, why? Maybe it is that sort of culture of not saying things or maybe it is me not being assertive enough. I don’t think I was being myself. Because my real self wanted to say: ‘look darling, you are not helping matters by being a complete bitch’. But I didn’t say that. I wasn’t assertive enough.In a similar type of incident, Ben, an Eastern respondent (from Ghana, 32 years old), describes an outburst he had with a co-worker who was annoying him. Unlike Sean, Ben expressed his anger to the co-worker, but he does not consider this to be a manifestation of his authentic self. For Ben, to act authentically one must control their emotions and try help others:I don’t know if that is myself or if that is not myself, but sometimes I get angry, I get upset, and I am the open type. I am the type that I can’t keep something in me, so sometimes when you make me annoyed, I just response. There is this time about this woman, in a class, that I was in Ghana. She was an older woman, a respected woman, she kept annoying me and there was one day that I couldn’t take it any longer, so I just burst up and I just… I don’t know what I said, I just… said a lot of bad things to her. The woman, she was shocked. I also felt shocked because I thought I could control myself, so that’s me… I don’t want to hide my feelings, I just want to come out with what I think when you make me annoyed, but those times, when I come out, I don’t like them, because I think it contradicts who I really am, someone who is supposed to help or care. I don’t like that aspect. You know somebody could be bossy, so he or she enjoys shouting everybody. I don’t enjoy that, but sometimes it is something that I cannot even control. Someone pushes me to the limit, and I just can’t keep that anger, and it comes out. I won’t say that is ‘me,’ I wouldn’t say that that is me. I don’t think that is a ‘true me’. [Why?] Because the true me would enjoy that experience the way I enjoy helping people instead.Unlike the two accounts from Rachel and Rani, these two last passages from Sean and Ben describe experiences of inauthenticity, where the authentic self cannot be expressed. What is important in these two passages is not their behaviour, but how they attribute their own emotions to their sense of authentic selfhood. Sean identifies his authentic self with the “impulsive” self who expresses his emotions, while Ben identifies his authentic self with the “institutional” self who is in control of his emotions. Sean feels inauthentic because he could not express his angry feelings to the co-worker, whereas Ben feels inauthentic because he could not control his outburst. Ben still hesitates about which side of himself can be attributed to his authentic self, for example, he says that he is “the open type” or that he does not want to “hide [his] feelings”, but he eventually identifies his authentic self with his institutional self.The choices that Sean and Ben make about the emotions that they attribute to their authentic selves could be motivated by their respective ethnic backgrounds. Like Rachel, Sean identifies his authentic self with a socially unacceptable emotion: anger. Consistent with his Western background, Sean’s sense of authenticity emphasizes the needs of the individual over the group and sees suppression of emotions as repressive. On the other hand, Ben reasons that since he does not enjoy being angry as much as he enjoys helping others, expressing anger is not a manifestation of authenticity. His authentic self is linked to his institutional self. Ben’s values are infused with altruism, which reflects the collective values that tend to be associated with his Eastern background. For him, suppression of emotions might not mean repression, but can foster authenticity instead.DiscussionBoth ways of interpreting authenticity, impulsive and institutional, look for self-consistency and the need to tell a coherent story to ourselves about who we are. The results section of this paper showed how Easterners and Westerners conceptualize authenticity. Easterners understand authenticity differently to Western discourses of the authentic. These alternative understandings offer viable solutions to the self-consistency problem. They present external, rather than internal, ways of conceiving the authentic self, and regulative, rather than expressive, approaches to emotions. As I mentioned earlier, Eastern societies are associated with collective and material values, while Western ones are related to individual and post-material values. These divisions in terms of values are reflected in individuals’ self-constructs. Individuals in Western societies tend to have a more independent idea of the self, whereas individuals in Eastern societies are more likely to have an interdependent one (Kitayama). An interdependent idea of the self values connectedness and conceptualizes the self in relation to others, so it can generate an institutional approach to authenticity, where the idea of the authentic self is not something that individuals search for inside themselves, but something that individuals become through their participation in social roles. This was evident in the example of Rani, whose idea of being authentic as “becoming” seemed to be an extension of her more interdependent self-construct and the need to fit in society.A regulative approach to emotions has also been associated with Easterners (Cheung and Park), on the basis of their collective values and interdependent self-constructs. For individuals from a Western background, with a more independent sense of self, as in the case of Sean, suppressing emotions tends to be seen negatively as being inauthentic, a form of repression. However, for individuals with interdependent self-constructs, this can be not only less harmful (feeling less inauthentic), but can even be beneficial because they tend to prioritize the needs of others (Le and Impett). This is evident in the example of Ben, for whom suppressing aanger does not make him feel inauthentic because he identifies his authentic self with the self that is in control of his emotions and helps others. This understanding of authenticity is aligned with the collective values of his ethnic background.In sum, ideas of authenticity seem to vary culturally according to the repertoires and values systems that inform them. Thus, even what we think might be our most intimate or individual experiences, like our experiences of authenticity and ideas of who we are, can also be socially constructed. This paper has tried to demonstrate the importance of sociology for the study of authenticity as a cultural phenomenon.ReferencesBinkley, Sam. Getting Loose: Lifestyle Consumption in the 1970s. Durham: Duke UP, 2007.Charmaz, Kathy. Constructing Grounded Theory. London: Sage, 2013.Cheung, Rebecca and Irene Park. “Anger Supression, Interdependent Self-Construal, and Depression among Asian American and European American College Students”. Cultural Diversity and Ethnic Minority Psychology 16.4 (2010): 517–25.Chua, Amy, and Jed Rubenfeld. The Triple Package: How Three Unlikely Traits Explain the Rise and Fall of Cultural Groups in America. New York: The Penguin P, 2014.Erickson, Rebecca J. When Emotion Is the Product: Self, Society, and (In)Authenticity in a Postmodern World. Ph.D. Thesis, Washington: Whasington State U, 1991.Feldman, Simon. Against Authenticity: Why You Shouldn't Be Yourself. Kentucky: Lexington Books, 2014.Ferrara, Alessandro. Reflective Authenticity Rethinking the Project of Modernity. London: Routledge, 2002.Franzese, Alexis D. To Thine Own Self Be True? An Exploration of Authenticity. Ph.D. Thesis, Durham: Duke University, 2007.———. “Authenticity: Perspectives and Experiences.” Authenticity in Culture, Self, and Society. Eds. Phillip Vannini and J. Patrick Williams. Farnham: Ashgate, 2009. 87–101.Guignon, Charles B. On Being Authentic. London: Routledge, 2004.Hofstede, Geert, and Michael Minkov. Cultures and Organizations: Software of the Mind. USA: McGraw Hill, 2010.Inglehart, Ronald, and Christian Welzel. Modernization, Cultural Change and Democracy: The Human Development Sequence. New York: Cambridge UP, 2005.Kitayama, Shinobu, and Hazel R. Markus. “Culture and the Self: Implications for Cognition, Emotion, and Motivation.” Psychological Review 98.2 (1991): 224–53.Le, Bonnie M., and Emily A. Impett. “When Holding Back Helps: Supressing Negative Emotions during Sacrifice Feels Authentic and Is Beneficial for Highly Interdependent People”. Pscyhological Science 24.9 (2013): 1809–15.Lindholm, Charles. Culture and Authenticity. Malden: Blackwell, 2008.Maslow, Abraham H. Toward a Psychology of Being. Princeton: Van Nostrand, 1968.Menendez, Ramon. “The Culture of Authenticity: An Empirical Study of La Trobe University Students from Diverse Cultural Backgrounds.” Proceedings of The Australian Sociological Association (TASA) Conference, 25-28 November. Melbourne: Monash U, 2013.Potter, Andrew. The Authenticity Hoax How We Get Lost Finding Ourselves. Carlton North: Scribe, 2010.Solomon, Robert C. “Notes on Emotion, ‘East and West.’” Philosophy East and West 45.2 (1995): 171–202.Taylor, Charles. Sources of the Self: The Making of the Modern Identity. Cambridge: Cambridge UP, 1989.———. The Ethics of Authenticity. Cambridge: Harvard UP, 1991.Trilling, Lionel. Sincerity and Authenticity. Cambridge: Harvard UP, 1972.Turner, Ralph. “Is There a Quest for Identity?” The Sociological Quarterly 16.2 (1975): 148–61.———. “The Real Self: From Institution to Impulse.” The American Journal of Sociology 81.5 (1976): 989–1016.Vannini, Phillip. Authenticity and Power in the Academic Profession. Ph.D. Thesis, Whasington: Whashington State U, 2004.———. “Dead Poet’s Society: Teaching, Publish-or-Perish, and Professors’ Experiences of Authenticity.” Symbolic Interaction 29.2 (2006): 235–57.———, and J. Patrick Williams. Authenticity in Culture, Self, and Society. Farnham: Ashgate, 2009.WVS. World Values Survey. World Values Survey Association. 18 Feb. 2015 ‹http://www.worldvaluessurvey.org/wvs.jsp›.

Donald Olding Hebb’s lasting influence in psychology and neuroscience stemslargely from his influential book, The Organization of Behavior (Hebb 1949a) in which he introduced the concepts of synaptic change and cell assemblies to explain the neural events underlying behaviour. Hebb’s work revolutionized psychology by establishing a biological basis for psychological phenomena and expounding a neuropsychological theory which provided the structure for the development of the fields of cognitive and behavioural neuroscience. His ultimate fame could not have been predicted from his performance at Dalhousie University nor from his early career as a teacher. His career as a psychologist began as a night school student in psychology at McGill University in 1928. After completing his MA in psychology at McGill in 1932, he studied with Karl Lashley at the University of Chicago completing his PhD with Lashley at Harvard in 1936. For the next two years he conducted neuropsychological tests on the patientsof Dr. Wilder Penfield at the Montreal Neurological Institute and from 1939 to 1942 was a professor at Queen’s University in Kingston, Ontario. He spent the next five years studying emotionality in chimpanzees at the Yerkes Primate Center in Florida where he began to write The Organization of Behavior. Hebb became a professor of Psychology at McGill University in 1947 and head of his department in 1948 where he completed his book and directed an internationally recognized graduate program in physiological psychology. Elected President of the Canadian Psychological Association in 1952 and the American Psychological Association in 1960 he also became a Fellow of the Royal Societies of Canada and England. Late in his career, he was Vice Dean of Biological Sciences (1964-66) and then Chancellor of McGill University (1970-74). Upon retirement from McGill, he moved back to Nova Scotia and became a professor emeritus at Dalhousie University from 1978 until his death in 1985. During this time he wrote his last book, Essay on Mind (Hebb 1980a). He was inducted into the CanadianMedical Hall of Fame in October 2003.L’influence durable de Donald Olding Hebb dans les domaines de la psychologieet de la neuroscience est en grande partie le résultat de son ouvrage prestigieux The Organization of Behavior (1949) dans lequel il présente les concepts de modification synaptique et de réseau neuronal pour expliquer les phénomènes neuronaux qui sous‑tendent le comportement. M. Hebb a révolutionné le domaine de la psychologie en établissant une base biologique pour des phénomènes psychologiques et en expliquant une théorie neuropsychologique qui a fourni la structure nécessaire au développement des domaines de la neuroscience cognitive et comportementale. Sa renommée n’aurait pu être prédite à partir de sa performance à l’Université Dalhousie ou de son poste d’enseignant au début de sa carrière. Sa carrière dans le domaine de la psychologie a débuté lorsqu’il a commencé à suivre des cours du soir dans le domaine à l’Université McGill en 1928. Après avoir obtenu une maîtrise en psychologie à l’Université McGill en 1932, il a étudié aux côtés de Karl Lashley à l’Université de Chicago pour finalement obtenir un doctorat avec M. Lashley à l’Université Harvard en 1936. Au cours des deux années suivantes, il a effectué des tests neuropsychologiques sur les patients du docteur Wilder Penfield à l’Institut neurologique de Montréal. De 1939 à 1942, il a été professeur à l’Université Queen’s, à Kingston en Ontario. Il a passé les cinq années suivantes à étudier les émotions chez le chimpanzé au Yerkes Primate Center en Floride. C’estau cours de cette période qu’il a commencé à rédiger The Organization of Behavior. M. Hebb a ensuite occupé un poste de professeur de psychologie à l’Université McGill en 1947 et il a été nommé chef du département de psychologie en 1948, poste dans le cadre duquel il a dirigé un programme d’études supérieures de renommée internationale en psychophysiologie. C’est à cette période qu’il a terminé son ouvrage prestigieux. Élu président de la Société canadienne de psychologie en 1952 et de l’American Psychological Association en 1960, il a également été un Membre de la Société royale du Canada et un membre de la Royal Society of England. Vers la fin de sa carrière, il a occupé le poste de vice-doyen des sciences biologiques à l’Université McGill (de 1964 à 1966) puis de chancelier de cette même université (de 1970 à 1974). Au moment de sa retraite de l’Université McGill, M. Hebb est retourné en Nouvelle‑Écosse. Il a été professeur émérite à l’Université Dalhousie de 1978 jusqu’à sa mort en 1985, période durant laquelle il a rédigé son dernier ouvrage Essay on Mind (1980a). Il a été intronisé au Temple de la renommée médicale canadienne en octobre 2003.

Introduction: Google Autocomplete Algorithms Despite recent attention to the impact of social media platforms on political discourse and public opinion, most people locate their news on search engines (Robertson et al.). When a user conducts a search, millions of outputs, in the form of videos, images, articles, and Websites are sorted to present the most relevant search predictions. Google, the most dominant search engine in the world, expanded its search index in 2009 to include the autocomplete function, which provides suggestions for query inputs (Dörr and Stephan). Google’s autocomplete function also allows users to “search smarter” by reducing typing time by 25 percent (Baker and Potts 189). Google’s complex algorithm is impacted upon by factors like search history, location, and keyword searches (Karapapa and Borghi), and there are policies to ensure the autocomplete function does not contain harmful content. In 2017, Google implemented a feedback tool to allow human evaluators to assess the quality of search results; however, the algorithm still provides misleading results that frame far-right actors as neutral. In this article, we use reverse engineering to understand the nature of these algorithms in relation to the descriptive outcome, to illustrate how autocomplete subtitles label conspiracists in three countries. According to Google, these “subtitles are generated automatically”, further stating that the “systems might determine that someone could be called an actor, director, or writer. Only one of these can appear as the subtitle” and that Google “cannot accept or create custom subtitles” (Google). We focused our attention on well-known conspiracy theorists because of their influence and audience outreach. In this article we argue that these subtitles are problematic because they can mislead the public and amplify extremist views. Google’s autocomplete feature is misleading because it does not highlight what is publicly known about these actors. The labels are neutral or positive but never negative, reflecting primary jobs and/or the actor’s preferred descriptions. This is harmful to the public because Google’s search rankings can influence a user’s knowledge and information preferences through the search engine manipulation effect (Epstein and Robertson). Users’ preferences and understanding of information can be manipulated based upon their trust in Google search results, thus allowing these labels to be widely accepted instead of providing a full picture of the harm their ideologies and belief cause. Algorithms That Mainstream Conspiracies Search engines establish order and visibility to Web pages that operationalise and stabilise meaning to particular queries (Gillespie). Google’s subtitles and blackbox operate as a complex algorithm for its search index and offer a mediated visibility to aspects of social and political life (Gillespie). Algorithms are designed to perform computational tasks through an operational sequence that computer systems must follow (Broussard), but they are also “invisible infrastructures” that Internet users consciously or unconsciously follow (Gran et al. 1779). The way algorithms rank, classify, sort, predict, and process data is political because it presents the world through a predetermined lens (Bucher 3) decided by proprietary knowledge – a “secret sauce” (O’Neil 29) – that is not disclosed to the general public (Christin). Technology titans, like Google, Facebook, and Amazon (Webb), rigorously protect and defend intellectual property for these algorithms, which are worth billions of dollars (O’Neil). As a result, algorithms are commonly defined as opaque, secret “black boxes” that conceal the decisions that are already made “behind corporate walls and layers of code” (Pasquale 899). The opacity of algorithms is related to layers of intentional secrecy, technical illiteracy, the size of algorithmic systems, and the ability of machine learning algorithms to evolve and become unintelligible to humans, even to those trained in programming languages (Christin 898-899). The opaque nature of algorithms alongside the perceived neutrality of algorithmic systems is problematic. Search engines are increasingly normalised and this leads to a socialisation where suppositions are made that “these artifacts are credible and provide accurate information that is fundamentally depoliticized and neutral” (Noble 25). Google’s autocomplete and PageRank algorithms exist outside of the veil of neutrality. In 2015, Google’s photos app, which uses machine learning techniques to help users collect, search, and categorise images, labelled two black people as ‘gorillas’ (O’Neil). Safiya Noble illustrates how media and technology are rooted in systems of white supremacy, and how these long-standing social biases surface in algorithms, illustrating how racial and gendered inequities embed into algorithmic systems. Google actively fixes algorithmic biases with band-aid-like solutions, which means the errors remain inevitable constituents within the algorithms. Rising levels of automation correspond to a rising level of errors, which can lead to confusion and misdirection of the algorithms that people use to manage their lives (O’Neil). As a result, software, code, machine learning algorithms, and facial/voice recognition technologies are scrutinised for producing and reproducing prejudices (Gray) and promoting conspiracies – often described as algorithmic bias (Bucher). Algorithmic bias occurs because algorithms are trained by historical data already embedded with social biases (O’Neil), and if that is not problematic enough, algorithms like Google’s search engine also learn and replicate the behaviours of Internet users (Benjamin 93), including conspiracy theorists and their followers. Technological errors, algorithmic bias, and increasing automation are further complicated by the fact that Google’s Internet service uses “2 billion lines of code” – a magnitude that is difficult to keep track of, including for “the programmers who designed the algorithm” (Christin 899). Understanding this level of code is not critical to understanding algorithmic logics, but we must be aware of the inscriptions such algorithms afford (Krasmann). As algorithms become more ubiquitous it is urgent to “demand that systems that hold algorithms accountable become ubiquitous as well” (O’Neil 231). This is particularly important because algorithms play a critical role in “providing the conditions for participation in public life”; however, the majority of the public has a modest to nonexistent awareness of algorithms (Gran et al. 1791). Given the heavy reliance of Internet users on Google’s search engine, it is necessary for research to provide a glimpse into the black boxes that people use to extract information especially when it comes to searching for information about conspiracy theorists. Our study fills a major gap in research as it examines a sub-category of Google’s autocomplete algorithm that has not been empirically explored before. Unlike the standard autocomplete feature that is primarily programmed according to popular searches, we examine the subtitle feature that operates as a fixed label for popular conspiracists within Google’s algorithm. Our initial foray into our research revealed that this is not only an issue with conspiracists, but also occurs with terrorists, extremists, and mass murderers. Method Using a reverse engineering approach (Bucher) from September to October 2021, we explored how Google’s autocomplete feature assigns subtitles to widely known conspiracists. The conspiracists were not geographically limited, and we searched for those who reside in the United States, Canada, United Kingdom, and various countries in Europe. Reverse engineering stems from Ashby’s canonical text on cybernetics, in which he argues that black boxes are not a problem; the problem or challenge is related to the way one can discern their contents. As Google’s algorithms are not disclosed to the general public (Christin), we use this method as an extraction tool to understand the nature of how these algorithms (Eilam) apply subtitles. To systematically document the search results, we took screenshots for every conspiracist we searched in an attempt to archive the Google autocomplete algorithm. By relying on previous literature, reports, and the figures’ public statements, we identified and searched Google for 37 Western-based and influencial conspiracy theorists. We initially experimented with other problematic figures, including terrorists, extremists, and mass murderers to see whether Google applied a subtitle or not. Additionally, we examined whether subtitles were positive, neutral, or negative, and compared this valence to personality descriptions for each figure. Using the standard procedures of content analysis (Krippendorff), we focus on the manifest or explicit meaning of text to inform subtitle valence in terms of their positive, negative, or neutral connotations. These manifest features refer to the “elements that are physically present and countable” (Gray and Densten 420) or what is known as the dictionary definitions of items. Using a manual query, we searched Google for subtitles ascribed to conspiracy theorists, and found the results were consistent across different countries. Searches were conducted on Firefox and Chrome and tested on an Android phone. Regardless of language input or the country location established by a Virtual Private Network (VPN), the search terms remained stable, regardless of who conducted the search. The conspiracy theorists in our dataset cover a wide range of conspiracies, including historical figures like Nesta Webster and John Robison, who were foundational in Illuminati lore, as well as contemporary conspiracists such as Marjorie Taylor Greene and Alex Jones. Each individual’s name was searched on Google with a VPN set to three countries. Results and Discussion This study examines Google’s autocomplete feature associated with subtitles of conspiratorial actors. We first tested Google’s subtitling system with known terrorists, convicted mass shooters, and controversial cult leaders like David Koresh. Garry et al. (154) argue that “while conspiracy theories may not have mass radicalising effects, they are extremely effective at leading to increased polarization within societies”. We believe that the impact of neutral subtitling of conspiracists reflects the integral role conspiracies plays in contemporary politics and right-wing extremism. The sample includes contemporary and historical conspiracists to establish consistency in labelling. For historical figures, the labels are less consequential and simply reflect the reality that Google’s subtitles are primarily neutral. Of the 37 conspiracy theorists we searched (see Table 1 in the Appendix), seven (18.9%) do not have an associated subtitle, and the other 30 (81%) have distinctive subtitles, but none of them reflects the public knowledge of the individuals’ harmful role in disseminating conspiracy theories. In the list, 16 (43.2%) are noted for their contribution to the arts, 4 are labelled as activists, 7 are associated with their professional affiliation or original jobs, 2 to the journalism industry, one is linked to his sports career, another one as a researcher, and 7 have no subtitle. The problem here is that when white nationalists or conspiracy theorists are not acknowledged as such in their subtitles, search engine users could possibly encounter content that may sway their understanding of society, politics, and culture. For example, a conspiracist like Alex Jones is labeled as an “American Radio Host” (see Figure 1), despite losing two defamation lawsuits for declaring that the shooting at Sandy Hook Elementary School in Newtown, Connecticut, was a ‘false flag’ event. Jones’s actions on his InfoWars media platforms led to parents of shooting victims being stalked and threatened. Another conspiracy theorist, Gavin McInnes, the creator of the far-right, neo-fascist Proud Boys organisation, a known terrorist entity in Canada and hate group in the United States, is listed simply as a “Canadian writer” (see Figure 1). Fig. 1: Screenshots of Google’s subtitles for Alex Jones and Gavin McInnes. Although subtitles under an individual’s name are not audio, video, or image content, the algorithms that create these subtitles are an invisible infrastructure that could cause harm through their uninterrogated status and pervasive presence. This could then be a potential conduit to media which could cause harm and develop distrust in electoral and civic processes, or all institutions. Examples from our list include Brittany Pettibone, whose subtitle states that she is an “American writer” despite being one of the main propagators of the Pizzagate conspiracy which led to Edgar Maddison Welch (whose subtitle is “Screenwriter”) travelling from North Carolina to Washington D.C. to violently threaten and confront those who worked at Comet Ping Pong Pizzeria. The same misleading label can be found via searching for James O’Keefe of Project Veritas, who is positively labelled as “American activist”. Veritas is known for releasing audio and video recordings that contain false information designed to discredit academic, political, and service organisations. In one instance, a 2020 video released by O’Keefe accused Democrat Ilhan Omar’s campaign of illegally collecting ballots. The same dissembling of distrust applies to Mike Lindell, whose Google subtitle is “CEO of My Pillow”, as well as Sidney Powell, who is listed as an “American lawyer”; both are propagators of conspiracy theories relating to the 2020 presidential election. The subtitles attributed to conspiracists on Google do not acknowledge the widescale public awareness of the negative role these individuals play in spreading conspiracy theories or causing harm to others. Some of the selected conspiracists are well known white nationalists, including Stefan Molyneux who has been banned from social media platforms like Twitter, Twitch, Facebook, and YouTube for the promotion of scientific racism and eugenics; however, he is neutrally listed on Google as a “Canadian podcaster”. In addition, Laura Loomer, who describes herself as a “proud Islamophobe,” is listed by Google as an “Author”. These subtitles can pose a threat by normalising individuals who spread conspiracy theories, sow dissension and distrust in institutions, and cause harm to minority groups and vulnerable individuals. Once clicking on the selected person, the results, although influenced by the algorithm, did not provide information that aligned with the associated subtitle. The search results are skewed to the actual conspiratorial nature of the individuals and associated news articles. In essence, the subtitles do not reflect the subsequent search results, and provide a counter-labelling to the reality of the resulting information provided to the user. Another significant example is Jerad Miller, who is listed as “American performer”, despite the fact that he is the Las Vegas shooter who posted anti-government and white nationalist 3 Percenters memes on his social media (SunStaff), even though the majority of search results connect him to the mass shooting he orchestrated in 2014. The subtitle “performer” is certainly not the common characteristic that should be associated with Jerad Miller. Table 1 in the Appendix shows that individuals who are not within the contemporary milieux of conspiracists, but have had a significant impact, such as Nesta Webster, Robert Welch Junior, and John Robison, were listed by their original profession or sometimes without a subtitle. David Icke, infamous for his lizard people conspiracies, has a subtitle reflecting his past football career. In all cases, Google’s subtitle was never consistent with the actor’s conspiratorial behaviour. Indeed, the neutral subtitles applied to conspiracists in our research may reflect some aspect of the individuals’ previous careers but are not an accurate reflection of the individuals’ publicly known role in propagating hate, which we argue is misleading to the public. For example, David Icke may be a former footballer, but the 4.7 million search results predominantly focus on his conspiracies, his public fora, and his status of being deplatformed by mainstream social media sites. The subtitles are not only neutral, but they are not based on the actual search results, and so are misleading in what the searcher will discover; most importantly, they do not provide a warning about the misinformation contained in the autocomplete subtitle. To conclude, algorithms automate the search engines that people use in the functions of everyday life, but are also entangled in technological errors, algorithmic bias, and have the capacity to mislead the public. Through a process of reverse engineering (Ashby; Bucher), we searched 37 conspiracy theorists to decode the Google autocomplete algorithms. We identified how the subtitles attributed to conspiracy theorists are neutral, positive, but never negative, which does not accurately reflect the widely known public conspiratorial discourse these individuals propagate on the Web. This is problematic because the algorithms that determine these subtitles are invisible infrastructures acting to misinform the public and to mainstream conspiracies within larger social, cultural, and political structures. This study highlights the urgent need for Google to review the subtitles attributed to conspiracy theorists, terrorists, and mass murderers, to better inform the public about the negative nature of these actors, rather than always labelling them in neutral or positive ways. Funding Acknowledgement This project has been made possible in part by the Canadian Department of Heritage – the Digital Citizen Contribution program – under grant no. R529384. 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The Black Box Society. Harvard UP, 2015. Robertson, Ronald E., David Lazer, and Christo Wilson. "Auditing the Personalization and Composition of Politically-Related Search Engine Results Pages." Proceedings of the 2018 World Wide Web Conference. 2018. Staff, Sun. “A Look inside the Lives of Shooters Jerad Miller, Amanda Miller.” Las Vegas Sun 9 June 2014. <https://lasvegassun.com/news/2014/jun/09/look/>. Webb, Amy. The Big Nine: How the Tech Titans and Their Thinking Machines Could Warp Humanity. Hachette UK, 2019. Appendix Table 1: The subtitles of conspiracy theorists on Google autocomplete Conspiracy Theorist Google Autocomplete Subtitle Character Description Alex Jones American radio host InfoWars founder, American far-right radio show host and conspiracy theorist. The SPLC describes Alex Jones as "the most prolific conspiracy theorist in contemporary America." Barry Zwicker Canadian journalist Filmmaker who made a documentary that claimed fear was used to control the public after 9/11. Bart Sibrel American producer Writer, producer, and director of work to falsely claim the Apollo moon landings between 1969 and 1972 were staged by NASA. Ben Garrison American cartoonist Alt-right and QAnon political cartoonist Brittany Pettibone American writer Far-right, political vlogger on YouTube and propagator of #pizzagate. Cathy O’Brien American author Cathy O’Brien claims she was a victim of a government mind control project called Project Monarch. Dan Bongino American radio host Stakeholder in Parler, Radio Host, Ex-Spy, Conspiracist (Spygate, MAGA election fraud, etc.). David Icke Former footballer Reptilian humanoid conspiracist. David Wynn Miller (No subtitle) Conspiracist, far-right tax protester, and founder of the Sovereign Citizens Movement. Jack Posobiec American activist Alt-right, alt-lite political activist, conspiracy theorist, and Internet troll. Editor of Human Events Daily. James O’Keefe American activist Founder of Project Veritas, a far-right company that propagates disinformation and conspiracy theories. John Robison Foundational Illuminati conspiracist. Kevin Annett Canadian writer Former minister and writer, who wrote a book exposing the atrocities to Indigenous Communities, and now is a conspiracist and vlogger. Laura Loomer Author Far-right, anti-Muslim, conspiracy theorist, and Internet personality. Republican nominee in Florida's 21st congressional district in 2020. Marjorie Taylor Greene United States Representative Conspiracist, QAnon adherent, and U.S. representative for Georgia's 14th congressional district. Mark Dice American YouTuber Right-wing conservative pundit and conspiracy theorist. Mark Taylor (No subtitle) QAnon minister and self-proclaimed prophet of Donald Trump, the 45th U.S. President. Michael Chossudovsky Canadian economist Professor emeritus at the University of Ottawa, founder of the Centre for Research on Globalization, and conspiracist. Michael Cremo(Drutakarmā dāsa) American researcher Self-described Vedic creationist whose book, Forbidden Archeology, argues humans have lived on earth for millions of years. Mike Lindell CEO of My Pillow Business owner and conspiracist. Neil Patel English entrepreneur Founded The Daily Caller with Tucker Carlson. Nesta Helen Webster English author Foundational Illuminati conspiracist. Naomi Wolf American author Feminist turned conspiracist (ISIS, COVID-19, etc.). Owen Benjamin American comedian Former actor/comedian now conspiracist (Beartopia), who is banned from mainstream social media for using hate speech. Pamela Geller American activist Conspiracist, Anti-Islam, Blogger, Host. Paul Joseph Watson British YouTuber InfoWars co-host and host of the YouTube show PrisonPlanetLive. QAnon Shaman (Jake Angeli) American activist Conspiracy theorist who participated in the 2021 attack on Capitol Hil. Richard B. Spencer (No subtitle) American neo-Nazi, antisemitic conspiracy theorist, and white supremacist. Rick Wiles (No subtitle) Minister, Founded conspiracy site, TruNews. Robert W. Welch Jr. American businessman Founded the John Birch Society. Ronald Watkins (No subtitle) Founder of 8kun. Serge Monast Journalist Creator of Project Blue Beam conspiracy. Sidney Powell (No subtitle) One of former President Trump’s Lawyers, and renowned conspiracist regarding the 2020 Presidential election. Stanton T. Friedman Nuclear physicist Original civilian researcher of the 1947 Roswell UFO incident. Stefan Molyneux Canadian podcaster Irish-born, Canadian far-right white nationalist, podcaster, blogger, and banned YouTuber, who promotes conspiracy theories, scientific racism, eugenics, and racist views Tim LaHaye American author Founded the Council for National Policy, leader in the Moral Majority movement, and co-author of the Left Behind book series. Viva Frei (No subtitle) YouTuber/ Canadian Influencer, on the Far-Right and Covid conspiracy proponent. William Guy Carr Canadian author Illuminati/III World War Conspiracist Google searches conducted as of 9 October 2021.

BackgroundIn the past twenty years the discourse of the weight-centred health paradigm (WCHP) has attained almost complete dominance in the sphere of public health policy throughout the developed English speaking world. The national governments of Australia and many countries around the world have responded to what is perceived as an ‘epidemic of obesity’ with public health policies and programs explicitly focused on reducing and preventing obesity through so called ‘lifestyle’ behaviour change. Weight-related public health initiatives have been subjected to extensive critique based on ideological, ethical and empirical grounds (Solovay; Oliver; Gaesser; Gard; Monaghan, Colls and Evans; Wright; Rothblum and Solovay; Saguy; Rich, Monaghan and Aphramor; Bacon and Aphramor; Brown). Many scholars have raised concerns about the stigmatising and harmful effects of the WCHP (Aphramor; Bacon and Aphramor; O'Dea; Tylka et al.), and in particular the inequitable distribution of such negative impacts on women, people who are poor, and people of colour (Campos). Weight-based stigma is now well recognised as a pervasive and insidious form of stigma (Puhl and Heuer). Weight-based discrimination (a direct result of stigma) in the USA has a similar prevalence rate to race-based discrimination, and discrimination for fatter and younger people in particular is even higher (Puhl, Andreyeva and Brownell). Numerous scholars have highlighted the stigmatising discourse evident in obesity prevention programs and policies (O'Reilly and Sixsmith; Pederson et al.; Nuffield Council on Bioethics; ten Have et al.; MacLean et al.; Carter, Klinner, et al.; Fry; O'Dea; Rich, Monaghan and Aphramor). The ‘war on obesity’ can therefore be regarded as a social determinant of poor health (O'Hara and Gregg). Focusing on overweight and obese people is not only damaging to people’s health, but is ineffective in addressing the broader social and economic issues that create health and wellbeing (Cohen, Perales and Steadman; MacLean et al.; Walls et al.). Analyses of the discourses used in weight-related public health initiatives have highlighted oppressive, stigmatizing and discriminatory discourses that position body weight as pathological (O'Reilly; Pederson et al.), anti-social and a threat to the viable future of society (White). There has been limited analysis of discourses in Australian social marketing campaigns focused on body weight (Lupton; Carter, Rychetnik, et al.).Social Marketing CampaignsIn 2006 the Australian, State and Territory Governments funded the Measure Up social marketing campaign (Australian Government Department of Health and Ageing "Measure Up"). As the name suggests Measure Up focuses on the measurement of health through body weight and waist circumference. Campaign resources include brochures, posters, a tape measure, a 12 week planner, a community guide and a television advertisement. Campaign slogans are ‘The more you gain, the more you have to lose’ and ‘How do you measure up?’Tomorrow People is the component of Measure Up designed for Indigenous Australians (Australian Government Department of Health and Ageing "Tomorrow People"). Tomorrow People resources focus on healthy eating and physical activity and include a microsite on the Measure Up website, booklet, posters, print and radio advertisements. The campaign slogan is ‘Tomorrow People starts today. Do it for our kids. Do it for our culture.’ In 2011, phase two of the Measure Up campaign was launched (Australian Government Department of Health and Ageing "Swap It, Don't Stop It"). The central premise of Swap It, Don’t Stop It is that you ‘can lose your belly without losing all the things you love’ by making ‘simple’ swaps of behaviours related to eating and physical activity. The campaign’s central character Eric is made from a balloon, as are all of the other characters and visual items used in the campaign. Eric claims thatover the years my belly has ballooned and ballooned. It’s come time to do something about it — the last thing I want is to end up with some cancers, type 2 diabetes and heart disease. That’s why I’ve become a Swapper! What’s a swapper? It’s simple really. It just means swapping some of the things I’m doing now for healthier choices. That way I can lose my belly, without losing all the things I love. It’s easy! The campaign has produced around 30 branded resource items including brochures, posters, cards, fact sheets, recipes, and print, radio, television and online advertisements. All resources include references to Eric and most also include the image of the tape measure used in the Measure Up campaign. The Swap It, Don’t Stop It campaign also includes resources specifically directed at Indigenous Australians including two posters from the generic campaign with a dot painting motif added to the background. MethodologyThe epistemological position in this project was constructivist (Crotty) and the theoretical perspective was critical theory (Crotty). Multimedia critical discourse analysis (Machin and Mayr) was the methodology used to examine the social marketing campaigns and identify the discourses within them. Critical discourse analysis (CDA) focuses on critiquing text for evidence of power and ideology. CDA is used to reveal the ideas, absences and assumptions, and therefore the power interests buried within texts, in order to bring about social change. As a method, CDA has a structured three dimensional approach involving textual practice analysis (for lexicon) at the core, within the context of discursive practice analysis (for rhetorical and lexical strategies particularly with respect to claims-making), which falls within the context of social practice analysis (Jacobs). Social practice analysis explores the role played by power and ideology in supporting or disturbing the discourse (Jacobs; Machin and Mayr). Multimodal CDA (MCDA) uses a broad definition of text to include words, pictures, symbols, ideas, themes or any message that can be communicated (Machin and Mayr). Analysis of the social marketing campaigns involved examining the vocabulary, grammar, sentence structure, visuals and overall structure of the text for textual, discursive and social practices.Results and DiscussionIndividual ResponsibilityThe discourse of individual responsibility is strongly evident in the campaigns. In this discourse, it is ultimately the individual who is held responsible for their body weight and their health. The individual responsibility discourse is signified by the discursive practice of using epistemic (related to the truth or certainty) and deontic (compelling or instructing) modality words, particularly modal verbs and modal adverbs. High modality epistemic words are used to convince the reader of the certainty of statements and to portray the statement-maker as authoritative. High modality deontic words are used to instil power and authority in the instructions.The extensive use of high modality epistemic and deontic words is demonstrated in the following paragraph assembled from various campaign materials: Ultimately (epistemic modality adverb) individuals must take responsibility (deontic modality verb) for their own health, including their and weight. Obesity is caused (epistemic modality verb) by an imbalance in energy intake (from diet) (epistemic modality verb) and expenditure (from activity) (epistemic modality verb). Individually (epistemic modality adverb) we make decisions (epistemic modality verb) about how much we eat (epistemic modality verb) and how much activity we undertake (epistemic modality verb). Each of us can control (epistemic modality) our own weight by controlling (deontic modality) what we eat (deontic modality verb) and how much we exercise (deontic modality verb). To correct (deontic modality verb) the energy imbalance, individuals need to develop (deontic modality verb) a healthy lifestyle by making changes (deontic modality verb) to correct (deontic modality verb) their dietary habits and increase (deontic modality verb) their activity levels. The verbs must, control, correct, develop, change, increase, eat and exercise are deontic modality verbs designed to instruct or compel the reader.These discursive practices result in the clear message that individuals can and must control, correct and change their eating and physical activity, and thereby control their weight and health. The implication of the individualist discourse is that individuals, irrespective of their genes, life-course, social position or environment, are charged with the responsibility of being more self-surveying, self-policing, self-disciplined and self-controlled, and therefore healthier. This is consistent with the individualist orientation of neoliberal ideology, and has been identified in various critiques of obesity prevention public health programs that centralise the self-responsible subject (Murray; Rich, Monaghan and Aphramor) and the concept of ‘healthism’, the moral obligation to pursue health through healthy behaviours or healthy lifestyles (Aphramor and Gingras; Mansfield and Rich). The hegemonic Western-centric individualist discourse has also been critiqued for its role in subordinating or silencing other models of health and wellbeing including Aboriginal or indigenous models, that do not place the individual in the centre (McPhail-Bell, Fredericks and Brough).Obesity Causes DiseaseEpistemic modality verbs are used as a discursive practice to portray the certainty or probability of the relationship between obesity and chronic disease. The strength of the epistemic modality verbs is generally moderate, with terms such as ‘linked’, ‘associated’, ‘connected’, ‘related’ and ‘contributes to’ most commonly used to describe the relationship. The use of such verbs may suggest recognition of uncertainty or at least lack of causality in the relationship. However this lowered modality is counterbalanced by the use of verbs with higher epistemic modality such as ‘causes’, ‘leads to’, and ‘is responsible for’. For example:The other type is intra-abdominal fat. This is the fat that coats our organs and causes the most concern. Even though we don’t yet fully understand what links intra-abdominal fat with chronic disease, we do know that even a small deposit of this fat increases the risk of serious health problems’. (Swap It, Don’t Stop It Website; italics added)Thus the prevailing impression is that there is an objective, definitive, causal relationship between obesity and a range of chronic diseases. The obesity-chronic disease discourse is reified through the discursive practice of claims-making, whereby statements related to the problem of obesity and its relationship with chronic disease are attributed to authoritative experts or expert organisations. The textual practice of presupposition is evident with the implied causal relationship between obesity and chronic disease being taken for granted and uncontested. Through the textual practice of lexical absence, there is a complete lack of alternative views about body weight and health. Likewise there is an absence of acknowledgement of the potential harms arising from focusing on body weight, such as increased body dissatisfaction, disordered eating, and, paradoxically, weight gain.Shame and BlameBoth Measure Up and Swap It, Don’t Stop It include a combination of written/verbal text and visual images that create a sense of shame and blame. In Measure Up, the central character starts out as young, slim man, and as he ages his waist circumference grows. When he learns that his expanding waistline is associated with an increased risk of chronic disease, his facial expression and body language convey that he is sad, dejected and fearful. In the still images, this character and a female character are positioned looking down at the tape measure as they measure their ‘too large’ waists. This position and the looks on their faces suggest hanging their heads in shame. The male characters in both campaigns specifically express shame about “letting themselves go” by unthinkingly practicing ‘unhealthy’ behaviours. The characters’ clothing also contribute to a sense of shame. Both male and female characters in Measure Up appear in their underwear, which suggests that they are being publicly shamed. The clothing of the Measure Up characters is similar to that worn by contestants in the television program The Biggest Loser, which explicitly uses shame to ‘motivate’ contestants to lose weight. Part of the public shaming of contestants involves their appearance in revealing exercise clothing for weigh-ins, which displays their fatness for all to see (Thomas, Hyde and Komesaroff). The stigmatising effects of this and other aspects of the Biggest Loser television program are well documented (Berry et al.; Domoff et al.; Sender and Sullivan; Thomas, Hyde and Komesaroff; Yoo). The appearance of the Measure Up characters in their underwear combined with their head position and facial expressions conveys a strong, consistent message that the characters both feel shame and are deserving of shame due to their self-inflicted ‘unhealthy’ behaviours. The focus on ‘healthy’ and ‘unhealthy’ behaviours contributes to accepted and contested health identities (Fry). The ‘accepted health identity’ is represented as responsible and aspiring to and pursuing good health. The ‘contested health identity’ is represented as unhealthy, consuming too much food, and taking health risks, and this identity is stigmatised by public health programs (Fry). The ‘contested health identity’ represents the application to public health of Goffman’s ‘spoiled identity’ on which much stigmatisation theorising and research has been based (Goffman). As a result of both lexical and visual textual practices, the social marketing campaigns contribute to the construction of the ‘accepted health identity’ through discourses of individual responsibility, choice and healthy lifestyle. Furthermore, they contribute to the construction of the spoiled or ‘contested health identity’ through discourses that people are naturally unhealthy and need to be frightened, guilted and shamed into stopping ‘unhealthy’ behaviours and adopting ‘healthy’ behaviours. The ‘contested health identity’ constructed through these discourses is in turn stigmatised by such discourses. Thus the campaigns not only risk perpetuating stigmatisation through the reinforcement of the health identities, but possibly extend it further by legitimising the stigma associated with such identities. Given that these campaigns are conducted by the Australian Government, the already deeply stigmatising social belief system receives a significant boost in legitimacy by being positioned as a public health belief system perpetrated by the Government. Fear and AlarmIn the Measure Up television advertisement the main male character’s daughter, who has run into the frame, abruptly stops and looks fearful when she hears about his increased risk of disease. Using the discursive practice of claims-making, the authoritative external source informs the man that the more he gains (in terms of his waist circumference), the more he has to lose. The clear implication is that he needs to be fearful of losing his health, his family and even his life if he doesn’t reduce his waist circumference. The visual metaphor of a balloon is used as the central semiotic trope in Swap It, Don’t Stop It. The characters and other items featuring in the visuals are all made from twisting balloons. Balloons themselves may not create fear or alarm, unless one is unfortunate to be afflicted with globophobia (Freed), but the visual metaphor of the balloon in the social marketing campaign had a range of alarmist meanings. At the population level, rates and/or costs of obesity have been described in news items as ‘ballooning’ (Body Ecology; Stipp; AFP; Thien and Begawan) with accompanying visual images of extremely well-rounded bodies or ‘headless fatties’ (Cooper). Rapid or significant weight gain is referred to in everyday language as ‘ballooning weight’. The use of the balloon metaphor as a visual device in Swap It, Don’t Stop It serves to reinforce and extend these alarmist messages. Further, there is no attempt in the campaigns to reduce alarm by including positive or neutral photographs or images of fat people. This visual semiotic absence – a form of cultural imperialism (Young) – contributes to the invisibilisation of ‘real life’ fat people who are not ashamed of themselves. Habermas suggests that society evolves and operationalises through rational communication which includes the capacity to question the validity of claims made within communicative action (Habermas The Structural Transformation of the Public Sphere; Habermas The Theory of Communicative Action: Reason and the Rationalisation of Society). However the communicative action taken by the social marketing campaigns analysed in this study presents claims as uncontested facts and is therefore directorial about the expectations of individuals to take more responsibility for themselves, adopt certain behaviours and reduce or prevent obesity. Habermas argues that the lack or distortion of rational communication erodes relationships at the individual and societal levels (Habermas The Theory of Communicative Action: Reason and the Rationalisation of Society; Habermas The Structural Transformation of the Public Sphere). The communicative actions represented by the social marketing campaigns represents a distortion of rational communication and therefore erodes the wellbeing of individuals (for example through internalised stigma, shame, guilt, body dissatisfaction, weight preoccupation, disordered eating and avoidance of health care), relationships between individuals (for example through increased blame, coercion, stigma, bias, prejudice and discrimination) and society (for example through stigmatisation of groups in the population on the basis of their body size and increased social and health inequity). Habermas proposes that power differentials work to distort rational communication, and that it is these distortions in communication that need to be the focal point for change (Habermas The Theory of Communicative Action: Reason and the Rationalisation of Society; Habermas The Theory of Communicative Action: The Critique of Functionalist Reason; Habermas The Structural Transformation of the Public Sphere). Through critical analysis of the discourses used in the social marketing campaigns, we identified that they rely on the power, authority and status of experts to present uncontested representations of body weight and ‘appropriate’ health responses to it. In identifying the discourses present in the social marketing campaigns, we hope to focus attention on and thereby disrupt the distortions in the practical knowledge of the weight-centred health paradigm in order to contribute to systemic reorientation and change.ConclusionThrough the use of textual, discursive and social practices, the social marketing campaigns analysed in this study perpetuate the following concepts: everyone should be alarmed about growing waistlines and ‘ballooning’ rates of ‘obesity’; individuals are to blame for excess body weight, due to ignorance and the practice of ‘unhealthy behaviours’; individuals have a moral, parental, familial and cultural responsibility to monitor their weight and adopt ‘healthy’ eating and physical activity behaviours; such behaviour changes are easy to make and will result in weight loss, which will reduce risk of disease. These paternalistic campaigns evoke feelings of personal and parental guilt and shame, resulting in coercion to ‘take action’. They simultaneously stigmatise fat people yet serve to invisibilise them. Public health agencies must consider the harmful consequences of social marketing campaigns focused on body weight.ReferencesAFP. "A Ballooning Health Issue around the World." Gulfnews.com 29 May 2013. 17 Sep. 2013 ‹http://gulfnews.com/news/world/other-world/a-ballooning-health-issue-around-the-world-1.1189899›.Aphramor, Lucy. "The Impact of a Weight-Centred Treatment Approach on Women's Health and Health-Seeking Behaviours." Journal of Critical Dietetics 1.2 (2012): 3-12.Aphramor, Lucy, and Jacqui Gingras. "That Remains to Be Said: Disappeared Feminist Discourses on Fat in Dietetic Theory and Practice." The Fat Studies Reader, eds. Esther Rothblum and Sondra Solovay. New York: New York University Press, 2009. 97-105. Australian Government Department of Health and Ageing. 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Discussions of the economic theory of planned obsolescence—the purposeful embedding of redundancy into the functionality or other aspect of a product—in the 1980s and 1990s often focused on the impact of such a design strategy on manufacturers, consumers, the market, and, ultimately, profits (see, for example, Bulow; Lee and Lee; Waldman). More recently, assessments of such shortened product life cycles have included calculations of the environmental and other costs of such waste (Claudio; Kondoh; Unruh). Commonly utilised examples are consumer products such as cars, whitegoods and small appliances, fashion clothing and accessories, and, more recently, new technologies and their constituent components. This discourse has been adopted by those who configure workers as human resources, and who speak both of skills (Janßen and Backes-Gellner) and human capital itself (Chauhan and Chauhan) being made obsolete by market forces in both predictable and unplanned ways. This includes debate over whether formal education can assist in developing the skills that make their possessors less liable to become obsolete in the workforce (Dubin; Holtmann; Borghans and de Grip; Gould, Moav and Weinberg). However, aside from periodic expressions of disciplinary angst (as in questions such as whether the Liberal Arts and other disciplines are becoming obsolete) are rarely found in discussions regarding higher education. Yet, higher education has been subsumed into a culture of commercial service provision as driven by markets and profit as the industries that design and deliver consumer goods. McKelvey and Holmén characterise this as a shift “from social institution to knowledge business” in the subtitle of their 2009 volume on European universities, and the recent decade has seen many higher educational institutions openly striving to be entrepreneurial. Despite some debate over the functioning of market or market-like mechanisms in higher education (see, for instance, Texeira et al), the corporatisation of higher education has led inevitably to market segmentation in the products the sector delivers. Such market segmentation results in what are called over-differentiated products, seemingly endless variations in the same product to attempt to increase consumption and attendant sales. Milk is a commonly cited example, with supermarkets today stocking full cream, semi-skimmed, skimmed, lactose-free, soy, rice, goat, GM-free and ‘smart’ (enriched with various vitamins, minerals and proteins) varieties; and many of these available in fresh, UHT, dehydrated and/or organic versions. In the education market, this practice has resulted in a large number of often minutely differentiated, but differently named, degrees and other programs. Where there were once a small number of undergraduate degrees with discipline variety within them (including the Bachelor of Arts and Bachelor of Science awards), students can now graduate with a named qualification in a myriad of discipline and professional areas. The attempt to secure a larger percentage of the potential client pool (who are themselves often seeking to update their own skills and knowledges to avoid workforce obsolescence) has also resulted in a significant increase in the number of postgraduate coursework certificates, diplomas and other qualifications across the sector. The Masters degree has fractured from a research program into a range of coursework, coursework plus research, and research only programs. Such proliferation has also affected one of the foundations of the quality and integrity of the higher education system, and one of the last bastions of conventional practice, the doctoral degree. The PhD as ‘Gold-Standard’ Market Leader? The Doctor of Philosophy (PhD) is usually understood as a largely independent discipline-based research project that results in a substantial piece of reporting, the thesis, that makes a “substantial original contribution to knowledge in the form of new knowledge or significant and original adaptation, application and interpretation of existing knowledge” (AQF). As the highest level of degree conferred by most universities, the PhD is commonly understood as indicating the height of formal educational attainment, and has, until relatively recently, been above reproach and alteration. Yet, whereas universities internationally once offered a single doctorate named the PhD, many now offer a number of doctoral level degrees. In Australia, for example, candidates can also complete PhDs by Publication and by Project, as well as practice-led doctorates in, and named Doctorates of/in, Creative Arts, Creative Industries, Laws, Performance and other ‘new’ discipline areas. The Professional Doctorate, introduced into Australia in the early 1990s, has achieved such longevity that it now has it’s own “first generation” incarnations in (and about) disciplines such as Education, Business, Psychology and Journalism, as well as a contemporary “second generation” version which features professionally-practice-led Mode 2 knowledge production (Maxwell; also discussed in Lee, Brennan and Green 281). The uniquely Australian PhD by Project in the disciplines of architecture, design, business, engineering and education also includes coursework, and is practice and particularly workplace (or community) focused, but unlike the above, does not have to include a research element—although this is not precluded (Usher). A significant number of Australian universities also currently offer a PhD by Publication, known also as the PhD by Published Papers and PhD by Published Works. Introduced in the 1960s in the UK, the PhD by Publication there is today almost exclusively undertaken by academic staff at their own institutions, and usually consists of published work(s), a critical appraisal of that work within the research context, and an oral examination. The named degree is rare in the USA, although the practice of granting PhDs on the basis of prior publications is not unknown. In Australia, an examination of a number of universities that offer the degree reveals no consistency in terms of the framing policies except for the generic Australian Qualifications Framework accreditation statement (AQF), entry requirements and conditions of candidature, or resulting form and examination guidelines. Some Australian universities, for instance, require all externally peer-refereed publications, while others will count works that are self-published. Some require actual publications or works in press, but others count works that are still at submission stage. The UK PhD by Publication shows similar variation, with no consensus on purpose, length or format of this degree (Draper). Across Australia and the UK, some institutions accept previously published work and require little or no campus participation, while others have a significant minimum enrolment period and count only work generated during candidature (see Brien for more detail). Despite the plethora of named degrees at doctoral level, many academics continue to support the PhD’s claim to rigor and intellectual attainment. Most often, however, these arguments cite tradition rather than any real assessment of quality. The archaic trappings of conferral—the caps, gowns and various other instruments of distinction—emphasise a narrative in which it is often noted that doctorates were first conferred by the University of Paris in the 12th century and then elsewhere in medieval Europe. However, challenges to this account note that today’s largely independently researched thesis is a relatively recent arrival to educational history, being only introduced into Germany in the early nineteenth century (Bourner, Bowden and Laing; Park 4), the USA in a modified form in the mid-nineteenth century and the UK in 1917 (Jolley 227). The Australian PhD is even more recent, with the first only awarded in 1948 and still relatively rare until the 1970s (Nelson 3; Valadkhani and Ville). Additionally, PhDs in the USA, Canada and Denmark today almost always incorporate a significant taught coursework element (Noble). This is unlike the ‘traditional’ PhD in the UK and Australia, although the UK also currently offers a number of what are known there as ‘taught doctorates’. Somewhat confusingly, while these do incorporate coursework, they still include a significant research component (UKCGE). However, the UK is also adopting what has been identified as an American-inflected model which consists mostly, or largely, of coursework, and which is becoming known as the ‘New Route British PhD’ (Jolley 228). It could be posited that, within such a competitive market environment, which appears to be driven by both a drive for novelty and a desire to meet consumer demand, obsolescence therefore, and necessarily, threatens the very existence of the ‘traditional’ PhD. This obsolescence could be seen as especially likely as, alongside the existence of the above mentioned ‘new’ degrees, the ‘traditional’ research-based PhD at some universities in Australia and the UK in particular is, itself, also in the process of becoming ‘professionalised’, with some (still traditionally-framed) programs nevertheless incorporating workplace-oriented frameworks and/or experiences (Jolley 229; Kroll and Brien) to meet professionally-focused objectives that it is acknowledged cannot be met by producing a research thesis alone. While this emphasis can be seen as operating at the expense of specific disciplinary knowledge (Pole 107; Ball; Laing and Brabazon 265), and criticised for that, this workplace focus has arisen, internationally, as an institutional response to requests from both governments and industry for training in generic skills in university programs at all levels (Manathunga and Wissler). At the same time, the acknowledged unpredictability of the future workplace is driving a cognate move from discipline specific knowledge to what have been described as “problem solving and knowledge management approaches” across all disciplines (Gilbert; Valadkhani and Ville 2). While few query a link between university-level learning and the needs of the workplace, or the motivating belief that the overarching role of higher education is the provision of professional training for its client-students (see Laing and Brabazon for an exception), it also should be noted that a lack of relevance is one of the contributors to dysfunction, and thence to obsolescence. The PhD as Dysfunctional Degree? Perhaps, however, it is not competition that threatens the traditional PhD but, rather, its own design flaws. A report in The New York Times in 2007 alerted readers to what many supervisors, candidates, and researchers internationally have recognised for some time: that the PhD may be dysfunctional (Berger). In Australia and elsewhere, attention has focused on the uneven quality of doctoral-level degrees across institutions, especially in relation to their content, rigor, entry and assessment standards, and this has not precluded questions regarding the PhD (AVCC; Carey, Webb, Brien; Neumann; Jolley; McWilliam et al., "Silly"). It should be noted that this important examination of standards has, however, been accompanied by an increase in the awarding of Honorary Doctorates. This practice ranges from the most reputable universities’ recognising individuals’ significant contributions to knowledge, culture and/or society, to wholly disreputable institutions offering such qualifications in return for payment (Starrs). While generally contested in terms of their status, Honorary Doctorates granted to sports, show business and political figures are the most controversial and include an award conferred on puppet Kermit the Frog in 1996 (Jeffries), and some leading institutions including MIT, Cornell University and the London School of Economics and Political Science are distinctive in not awarding Honorary Doctorates. However, while distracting, the Honorary Doctorate itself does not answer all the questions regarding the quality of doctoral programs in general, or the Doctor of Philosophy in particular. The PhD also has high attrition rates: 50 per cent or more across Australia, the USA and Canada (Halse 322; Lovitts and Nelson). For those who remain in the programs, lengthy completion times (known internationally as ‘time-to-degree’) are common in many countries, with averages of 10.5 years to completion in Canada, and from 8.2 to more than 13 years (depending on discipline) in the USA (Berger). The current government performance-based funding model for Australian research higher degrees focuses attention on timely completion, and there is no doubt that, under this system—where universities only receive funding for a minimum period of candidature when those candidates have completed their degrees—more candidates are completing within the required time periods (Cuthbert). Yet, such a focus has distracted from assessment of the quality and outcomes of such programs of study. A detailed survey, based on the theses lodged in Australian libraries, has estimated that at least 51,000 PhD theses were completed in Australia to 2003 (Evans et al. 7). However, little attention has been paid to the consequences of this work, that is, the effects that the generation of these theses has had on either candidates or the nation. There has been no assessment, for instance, of the impact on candidates of undertaking and completing a doctorate on such facets of their lives as their employment opportunities, professional choices and salary levels, nor any effect on their personal happiness or levels of creativity. Nor has there been any real evaluation of the effect of these degrees on GDP, rates of the commercialisation of research, the generation of intellectual property, meeting national agendas in areas such as innovation, productivity or creativity, and/or the quality of the Australian creative and performing arts. Government-funded and other Australian studies have, however, noted for at least a decade both that the high numbers of graduates are mismatched to a lack of market demand for doctoral qualifications outside of academia (Kemp), and that an oversupply of doctorally qualified job seekers is driving wages down in some sectors (Jones 26). Even academia is demanding more than a PhD. Within the USA, doctoral graduates of some disciplines (English is an often-cited example) are undertaking second PhDs in their quest to secure an academic position. In Australia, entry-level academic positions increasingly require a scholarly publishing history alongside a doctoral-level qualification and, in common with other quantitative exercises in the UK and in New Zealand, the current Excellence in Research for Australia research evaluation exercise values scholarly publications more than higher degree qualifications. Concluding Remarks: The PhD as Obsolete or Retro-Chic? Disciplines and fields are reacting to this situation in various ways, but the trend appears to be towards increased market segmentation. Despite these charges of PhD dysfunction, there are also dangers in the over-differentiation of higher degrees as a practice. If universities do not adequately resource the professional development and other support for supervisors and all those involved in the delivery of all these degrees, those institutions may find that they have spread the existing skills, knowledge and other institutional assets too thinly to sustain some or even any of these degrees. This could lead to the diminishing quality (and an attendant diminishing perception of the value) of all the higher degrees available in those institutions as well as the reputation of the hosting country’s entire higher education system. As works in progress, the various ‘new’ doctoral degrees can also promote a sense of working on unstable ground for both candidates and supervisors (McWilliam et al., Research Training), and higher degree examiners will necessarily be unfamiliar with expected standards. Candidates are attempting to discern the advantages and disadvantages of each form in order to choose the degree that they believe is right for them (see, for example, Robins and Kanowski), but such assessment is difficult without the benefit of hindsight. Furthermore, not every form may fit the unpredictable future aspirations of candidates or the volatile future needs of the workplace. The rate with which everything once new descends from stylish popularity through stages of unfashionableness to become outdated and, eventually, discarded is increasing. This escalation may result in the discipline-based research PhD becoming seen as archaic and, eventually, obsolete. Perhaps, alternatively, it will lead to newer and more fashionable forms of doctoral study being discarded instead. 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Connecting I’ve moved house on the weekend, closer to the centre of an Australian capital city. I had recently signed up for broadband, with a major Australian Internet company (my first contact, cf. Turner). Now I am the proud owner of a larger modem than I have ever owned: a white cable modem. I gaze out into our new street: two thick black cables cosseted in silver wire. I am relieved. My new home is located in one of those streets, double-cabled by Telstra and Optus in the data-rush of the mid-1990s. Otherwise, I’d be moth-balling the cable modem, and the thrill of my data percolating down coaxial cable. And it would be off to the computer supermarket to buy an ASDL modem, then to pick a provider, to squeeze some twenty-first century connectivity out of old copper (the phone network our grandparents and great-grandparents built). If I still lived in the country, or the outskirts of the city, or anywhere else more than four kilometres from the phone exchange, and somewhere that cable pay TV will never reach, it would be a dish for me — satellite. Our digital lives are premised upon infrastructure, the networks through which we shape what we do, fashion the meanings of our customs and practices, and exchange signs with others. Infrastructure is not simply the material or the technical (Lamberton), but it is the dense, fibrous knotting together of social visions, cultural resources, individual desires, and connections. No more can one easily discern between ‘society’ and ‘technology’, ‘carriage’ and ‘content’, ‘base’ and ‘superstructure’, or ‘infrastructure’ and ‘applications’ (or ‘services’ or ‘content’). To understand telecommunications in action, or the vectors of fibre, we need to consider the long and heterogeneous list of links among different human and non-human actors — the long networks, to take Bruno Latour’s evocative concept, that confect our broadband networks (Latour). The co-ordinates of our infrastructure still build on a century-long history of telecommunications networks, on the nineteenth-century centrality of telegraphy preceding this, and on the histories of the public and private so inscribed. Yet we are in the midst of a long, slow dismantling of the posts-telegraph-telephone (PTT) model of the monopoly carrier for each nation that dominated the twentieth century, with its deep colonial foundations. Instead our New World Information and Communication Order is not the decolonising UNESCO vision of the late 1970s and early 1980s (MacBride, Maitland). Rather it is the neoliberal, free trade, market access model, its symbol the 1984 US judicial decision to require the break-up of AT&T and the UK legislation in the same year that underpinned the Thatcherite twin move to privatize British Telecom and introduce telecommunications competition. Between 1984 and 1999, 110 telecommunications companies were privatized, and the ‘acquisition of privatized PTOs [public telecommunications operators] by European and American operators does follow colonial lines’ (Winseck 396; see also Mody, Bauer & Straubhaar). The competitive market has now been uneasily installed as the paradigm for convergent communications networks, not least with the World Trade Organisation’s 1994 General Agreement on Trade in Services and Annex on Telecommunications. As the citizen is recast as consumer and customer (Goggin, ‘Citizens and Beyond’), we rethink our cultural and political axioms as well as the axes that orient our understandings in this area. Information might travel close to the speed of light, and we might fantasise about optical fibre to the home (or pillow), but our terrain, our band where the struggle lies today, is narrower than we wish. Begging for broadband, it seems, is a long way from warchalking for WiFi. Policy Circuits The dreary everyday business of getting connected plugs the individual netizen into a tangled mess of policy circuits, as much as tricky network negotiations. Broadband in mid-2003 in Australia is a curious chimera, welded together from a patchwork of technologies, old and newer communications industries, emerging economies and patterns of use. Broadband conjures up grander visions, however, of communication and cultural cornucopia. Broadband is high-speed, high-bandwidth, ‘always-on’, networked communications. People can send and receive video, engage in multimedia exchanges of all sorts, make the most of online education, realise the vision of home-based work and trading, have access to telemedicine, and entertainment. Broadband really entered the lexicon with the mass takeup of the Internet in the early to mid-1990s, and with the debates about something called the ‘information superhighway’. The rise of the Internet, the deregulation of telecommunications, and the involuted convergence of communications and media technologies saw broadband positioned at the centre of policy debates nearly a decade ago. In 1993-1994, Australia had its Broadband Services Expert Group (BSEG), established by the then Labor government. The BSEG was charged with inquiring into ‘issues relating to the delivery of broadband services to homes, schools and businesses’. Stung by criticisms of elite composition (a narrow membership, with only one woman among its twelve members, and no consumer or citizen group representation), the BSEG was prompted into wider public discussion and consultation (Goggin & Newell). The then Bureau of Transport and Communications Economics (BTCE), since transmogrified into the Communications Research Unit of the Department of Communications, Information Technology and the Arts (DCITA), conducted its large-scale Communications Futures Project (BTCE and Luck). The BSEG Final report posed the question starkly: As a society we have choices to make. If we ignore the opportunities we run the risk of being left behind as other countries introduce new services and make themselves more competitive: we will become consumers of other countries’ content, culture and technologies rather than our own. Or we could adopt new technologies at any cost…This report puts forward a different approach, one based on developing a new, user-oriented strategy for communications. The emphasis will be on communication among people... (BSEG v) The BSEG proposed a ‘National Strategy for New Communications Networks’ based on three aspects: education and community access, industry development, and the role of government (BSEG x). Ironically, while the nation, or at least its policy elites, pondered the weighty question of broadband, Australia’s two largest telcos were doing it. The commercial decision of Telstra/Foxtel and Optus Vision, and their various television partners, was to nail their colours (black) to the mast, or rather telegraph pole, and to lay cable in the major capital cities. In fact, they duplicated the infrastructure in cities such as Sydney and Melbourne, then deciding it would not be profitable to cable up even regional centres, let alone small country towns or settlements. As Terry Flew and Christina Spurgeon observe: This wasteful duplication contrasted with many other parts of the country that would never have access to this infrastructure, or to the social and economic benefits that it was perceived to deliver. (Flew & Spurgeon 72) The implications of this decision for Australia’s telecommunications and television were profound, but there was little, if any, public input into this. Then Minister Michael Lee was very proud of his anti-siphoning list of programs, such as national sporting events, that would remain on free-to-air television rather than screen on pay, but was unwilling, or unable, to develop policy on broadband and pay TV cable infrastructure (on the ironies of Australia’s television history, see Given’s masterly account). During this period also, it may be remembered, Australia’s Internet was being passed into private hands, with the tendering out of AARNET (see Spurgeon for discussion). No such national strategy on broadband really emerged in the intervening years, nor has the market provided integrated, accessible broadband services. In 1997, landmark telecommunications legislation was enacted that provided a comprehensive framework for competition in telecommunications, as well as consolidating and extending consumer protection, universal service, customer service standards, and other reforms (CLC). Carrier and reseller competition had commenced in 1991, and the 1997 legislation gave it further impetus. Effective competition is now well established in long distance telephone markets, and in mobiles. Rivalrous competition exists in the market for local-call services, though viable alternatives to Telstra’s dominance are still few (Fels). Broadband too is an area where there is symbolic rivalry rather than effective competition. This is most visible in advertised ADSL offerings in large cities, yet most of the infrastructure for these services is comprised by Telstra’s copper, fixed-line network. Facilities-based duopoly competition exists principally where Telstra/Foxtel and Optus cable networks have been laid, though there are quite a number of ventures underway by regional telcos, power companies, and, most substantial perhaps, the ACT government’s TransACT broadband network. Policymakers and industry have been greatly concerned about what they see as slow takeup of broadband, compared to other countries, and by barriers to broadband competition and access to ‘bottleneck’ facilities (such as Telstra or Optus’s networks) by potential competitors. The government has alternated between trying to talk up broadband benefits and rates of take up and recognising the real difficulties Australia faces as a large country with a relative small and dispersed population. In March 2003, Minister Alston directed the ACCC to implement new monitoring and reporting arrangements on competition in the broadband industry. A key site for discussion of these matters has been the competition policy institution, the Australian Competition and Consumer Commission, and its various inquiries, reports, and considerations (consult ACCC’s telecommunications homepage at http://www.accc.gov.au/telco/fs-telecom.htm). Another key site has been the Productivity Commission (http://www.pc.gov.au), while a third is the National Office on the Information Economy (NOIE - http://www.noie.gov.au/projects/access/access/broadband1.htm). Others have questioned whether even the most perfectly competitive market in broadband will actually provide access to citizens and consumers. A great deal of work on this issue has been undertaken by DCITA, NOIE, the regulators, and industry bodies, not to mention consumer and public interest groups. Since 1997, there have been a number of governmental inquiries undertaken or in progress concerning the takeup of broadband and networked new media (for example, a House of Representatives Wireless Broadband Inquiry), as well as important inquiries into the still most strategically important of Australia’s companies in this area, Telstra. Much of this effort on an ersatz broadband policy has been piecemeal and fragmented. There are fundamental difficulties with the large size of the Australian continent and its harsh terrain, the small size of the Australian market, the number of providers, and the dominant position effectively still held by Telstra, as well as Singtel Optus (Optus’s previous overseas investors included Cable & Wireless and Bell South), and the larger telecommunications and Internet companies (such as Ozemail). Many consumers living in metropolitan Australia still face real difficulties in realising the slogan ‘bandwidth for all’, but the situation in parts of rural Australia is far worse. Satellite ‘broadband’ solutions are available, through Telstra Countrywide or other providers, but these offer limited two-way interactivity. Data can be received at reasonable speeds (though at far lower data rates than how ‘broadband’ used to be defined), but can only be sent at far slower rates (Goggin, Rural Communities Online). The cultural implications of these digital constraints may well be considerable. Computer gamers, for instance, are frustrated by slow return paths. In this light, the final report of the January 2003 Broadband Advisory Group (BAG) is very timely. The BAG report opens with a broadband rhapsody: Broadband communications technologies can deliver substantial economic and social benefits to Australia…As well as producing productivity gains in traditional and new industries, advanced connectivity can enrich community life, particularly in rural and regional areas. It provides the basis for integration of remote communities into national economic, cultural and social life. (BAG 1, 7) Its prescriptions include: Australia will be a world leader in the availability and effective use of broadband...and to capture the economic and social benefits of broadband connectivity...Broadband should be available to all Australians at fair and reasonable prices…Market arrangements should be pro-competitive and encourage investment...The Government should adopt a National Broadband Strategy (BAG 1) And, like its predecessor nine years earlier, the BAG report does make reference to a national broadband strategy aiming to maximise “choice in work and recreation activities available to all Australians independent of location, background, age or interests” (17). However, the idea of a national broadband strategy is not something the BAG really comes to grips with. The final report is keen on encouraging broadband adoption, but not explicit on how barriers to broadband can be addressed. Perhaps this is not surprising given that the membership of the BAG, dominated by representatives of large corporations and senior bureaucrats was even less representative than its BSEG predecessor. Some months after the BAG report, the Federal government did declare a broadband strategy. It did so, intriguingly enough, under the rubric of its response to the Regional Telecommunications Inquiry report (Estens), the second inquiry responsible for reassuring citizens nervous about the full-privatisation of Telstra (the first inquiry being Besley). The government’s grand $142.8 million National Broadband Strategy focusses on the ‘broadband needs of regional Australians, in partnership with all levels of government’ (Alston, ‘National Broadband Strategy’). Among other things, the government claims that the Strategy will result in “improved outcomes in terms of services and prices for regional broadband access; [and] the development of national broadband infrastructure assets.” (Alston, ‘National Broadband Strategy’) At the same time, the government announced an overall response to the Estens Inquiry, with specific safeguards for Telstra’s role in regional communications — a preliminary to the full Telstra sale (Alston, ‘Future Proofing’). Less publicised was the government’s further initiative in indigenous telecommunications, complementing its Telecommunications Action Plan for Remote Indigenous Communities (DCITA). Indigenous people, it can be argued, were never really contemplated as citizens with the ken of the universal service policy taken to underpin the twentieth-century government monopoly PTT project. In Australia during the deregulatory and re-regulatory 1990s, there was a great reluctance on the part of Labor and Coalition Federal governments, Telstra and other industry participants, even to research issues of access to and use of telecommunications by indigenous communicators. Telstra, and to a lesser extent Optus (who had purchased AUSSAT as part of their licence arrangements), shrouded the issue of indigenous communications in mystery that policymakers were very reluctant to uncover, let alone systematically address. Then regulator, the Australian Telecommunications Authority (AUSTEL), had raised grave concerns about indigenous telecommunications access in its 1991 Rural Communications inquiry. However, there was no government consideration of, nor research upon, these issues until Alston commissioned a study in 2001 — the basis for the TAPRIC strategy (DCITA). The elision of indigenous telecommunications from mainstream industry and government policy is all the more puzzling, if one considers the extraordinarily varied and significant experiments by indigenous Australians in telecommunications and Internet (not least in the early work of the Tanami community, made famous in media and cultural studies by the writings of anthropologist Eric Michaels). While the government’s mid-2003 moves on a ‘National Broadband Strategy’ attend to some details of the broadband predicament, they fall well short of an integrated framework that grasps the shortcomings of the neoliberal communications model. The funding offered is a token amount. The view from the seat of government is a glance from the rear-view mirror: taking a snapshot of rural communications in the years 2000-2002 and projecting this tableau into a safety-net ‘future proofing’ for the inevitable turning away of a fully-privately-owned Telstra from its previously universal, ‘carrier of last resort’ responsibilities. In this aetiolated, residualist policy gaze, citizens remain constructed as consumers in a very narrow sense in this incremental, quietist version of state securing of market arrangements. What is missing is any more expansive notion of citizens, their varied needs, expectations, uses, and cultural imaginings of ‘always on’ broadband networks. Hybrid Networks “Most people on earth will eventually have access to networks that are all switched, interactive, and broadband”, wrote Frances Cairncross in 1998. ‘Eventually’ is a very appropriate word to describe the parlous state of broadband technology implementation. Broadband is in a slow state of evolution and invention. The story of broadband so far underscores the predicament for Australian access to bandwidth, when we lack any comprehensive, integrated, effective, and fair policy in communications and information technology. We have only begun to experiment with broadband technologies and understand their evolving uses, cultural forms, and the sense in which they rework us as subjects. Our communications networks are not superhighways, to invoke an enduring artefact from an older technology. Nor any longer are they a single ‘public’ switched telecommunications network, like those presided over by the post-telegraph-telephone monopolies of old. Like roads themselves, or the nascent postal system of the sixteenth century, broadband is a patchwork quilt. The ‘fibre’ of our communications networks is hybrid. To be sure, powerful corporations dominate, like the Tassis or Taxis who served as postmasters to the Habsburg emperors (Briggs & Burke 25). Activating broadband today provides a perspective on the path dependency of technology history, and how we can open up new threads of a communications fabric. Our options for transforming our multitudinous networked lives emerge as much from everyday tactics and strategies as they do from grander schemes and unifying policies. We may care to reflect on the waning potential for nation-building technology, in the wake of globalisation. We no longer gather our imagined community around a Community Telephone Plan as it was called in 1960 (Barr, Moyal, and PMG). Yet we do require national and international strategies to get and stay connected (Barr), ideas and funding that concretely address the wider dimensions of access and use. We do need to debate the respective roles of Telstra, the state, community initiatives, and industry competition in fair telecommunications futures. Networks have global reach and require global and national integration. Here vision, co-ordination, and resources are urgently required for our commonweal and moral fibre. To feel the width of the band we desire, we need to plug into and activate the policy circuits. Thanks to Grayson Cooke, Patrick Lichty, Ned Rossiter, John Pace, and an anonymous reviewer for helpful comments. Works Cited Alston, Richard. ‘ “Future Proofing” Regional Communications.’ Department of Communications, Information Technology and the Arts, Canberra, 2003. 17 July 2003 <http://www.dcita.gov.au/Article/0,,0_1-2_3-4_115485,00.php> —. ‘A National Broadband Strategy.’ Department of Communications, Information Technology and the Arts, Canberra, 2003. 17 July 2003 <http://www.dcita.gov.au/Article/0,,0_1-2_3-4_115486,00.php>. Australian Competition and Consumer Commission (ACCC). Broadband Services Report March 2003. Canberra: ACCC, 2003. 17 July 2003 <http://www.accc.gov.au/telco/fs-telecom.htm>. —. Emerging Market Structures in the Communications Sector. Canberra: ACCC, 2003. 15 July 2003 <http://www.accc.gov.au/pubs/publications/utilities/telecommu... ...nications/Emerg_mar_struc.doc>. Barr, Trevor. new media.com: The Changing Face of Australia’s Media and Telecommunications. Sydney: Allen & Unwin, 2000. Besley, Tim (Telecommunications Service Inquiry). Connecting Australia: Telecommunications Service Inquiry. Canberra: Department of Information, Communications and the Arts, 2000. 17 July 2003 <http://www.telinquiry.gov.au/final_report.php>. Briggs, Asa, and Burke, Peter. A Social History of the Internet: From Gutenberg to the Internet. Cambridge: Polity, 2002. Broadband Advisory Group. Australia’s Broadband Connectivity: The Broadband Advisory Group’s Report to Government. Melbourne: National Office on the Information Economy, 2003. 15 July 2003 <http://www.noie.gov.au/publications/NOIE/BAG/report/index.htm>. Broadband Services Expert Group. Networking Australia’s Future: Final Report. Canberra: Australian Government Publishing Service (AGPS), 1994. Bureau of Transport and Communications Economics (BTCE). Communications Futures Final Project. Canberra: AGPS, 1994. Cairncross, Frances. The Death of Distance: How the Communications Revolution Will Change Our Lives. London: Orion Business Books, 1997. Communications Law Centre (CLC). Australian Telecommunications Regulation: The Communications Law Centre Guide. 2nd edition. Sydney: Communications Law Centre, University of NSW, 2001. Department of Communications, Information Technology and the Arts (DCITA). Telecommunications Action Plan for Remote Indigenous Communities: Report on the Strategic Study for Improving Telecommunications in Remote Indigenous Communities. Canberra: DCITA, 2002. Estens, D. Connecting Regional Australia: The Report of the Regional Telecommunications Inquiry. Canberra: DCITA, 2002. <http://www.telinquiry.gov.au/rti-report.php>, accessed 17 July 2003. Fels, Alan. ‘Competition in Telecommunications’, speech to Australian Telecommunications Users Group 19th Annual Conference. 6 March, 2003, Sydney. <http://www.accc.gov.au/speeches/2003/Fels_ATUG_6March03.doc>, accessed 15 July 2003. Flew, Terry, and Spurgeon, Christina. ‘Television After Broadcasting’. In The Australian TV Book. Ed. Graeme Turner and Stuart Cunningham. Allen & Unwin, Sydney. 69-85. 2000. Given, Jock. Turning Off the Television. Sydney: UNSW Press, 2003. Goggin, Gerard. ‘Citizens and Beyond: Universal service in the Twilight of the Nation-State.’ In All Connected?: Universal Service in Telecommunications, ed. Bruce Langtry. Melbourne: University of Melbourne Press, 1998. 49-77 —. Rural Communities Online: Networking to link Consumers to Providers. Melbourne: Telstra Consumer Consultative Council, 2003. Goggin, Gerard, and Newell, Christopher. Digital Disability: The Social Construction of Disability in New Media. Lanham, MD: Rowman & Littlefield, 2003. House of Representatives Standing Committee on Communications, Information Technology and the Arts (HoR). Connecting Australia!: Wireless Broadband. Report of Inquiry into Wireless Broadband Technologies. Canberra: Parliament House, 2002. <http://www.aph.gov.au/house/committee/cita/Wbt/report.htm>, accessed 17 July 2003. Lamberton, Don. ‘A Telecommunications Infrastructure is Not an Information Infrastructure’. Prometheus: Journal of Issues in Technological Change, Innovation, Information Economics, Communication and Science Policy 14 (1996): 31-38. Latour, Bruno. Science in Action: How to Follow Scientists and Engineers Through Society. Cambridge, MA: Harvard University Press, 1987. Luck, David. ‘Revisiting the Future: Assessing the 1994 BTCE communications futures project.’ Media International Australia 96 (2000): 109-119. MacBride, Sean (Chair of International Commission for the Study of Communication Problems). Many Voices, One World: Towards a New More Just and More Efficient World Information and Communication Order. Paris: Kegan Page, London. UNESCO, 1980. Maitland Commission (Independent Commission on Worldwide Telecommunications Development). The Missing Link. Geneva: International Telecommunications Union, 1985. Michaels, Eric. Bad Aboriginal Art: Tradition, Media, and Technological Horizons. Sydney: Allen & Unwin, 1994. Mody, Bella, Bauer, Johannes M., and Straubhaar, Joseph D., eds. Telecommunications Politics: Ownership and Control of the Information Highway in Developing Countries. Mahwah, NJ: Erlbaum, 1995. Moyal, Ann. Clear Across Australia: A History of Telecommunications. Melbourne: Thomas Nelson, 1984. Post-Master General’s Department (PMG). Community Telephone Plan for Australia. Melbourne: PMG, 1960. Productivity Commission (PC). Telecommunications Competition Regulation: Inquiry Report. Report No. 16. Melbourne: Productivity Commission, 2001. <http://www.pc.gov.au/inquiry/telecommunications/finalreport/>, accessed 17 July 2003. Spurgeon, Christina. ‘National Culture, Communications and the Information Economy.’ Media International Australia 87 (1998): 23-34. Turner, Graeme. ‘First Contact: coming to terms with the cable guy.’ UTS Review 3 (1997): 109-21. Winseck, Dwayne. ‘Wired Cities and Transnational Communications: New Forms of Governance for Telecommunications and the New Media’. In The Handbook of New Media: Social Shaping and Consequences of ICTs, ed. Leah A. Lievrouw and Sonia Livingstone. London: Sage, 2002. 393-409. World Trade Organisation. General Agreement on Trade in Services: Annex on Telecommunications. Geneva: World Trade Organisation, 1994. 17 July 2003 <http://www.wto.org/english/tratop_e/serv_e/12-tel_e.htm>. —. Fourth protocol to the General Agreement on Trade in Services. Geneva: World Trade Organisation. 17 July 2003 <http://www.wto.org/english/tratop_e/serv_e/4prote_e.htm>. Links http://www.accc.gov.au/pubs/publications/utilities/telecommunications/Emerg_mar_struc.doc http://www.accc.gov.au/speeches/2003/Fels_ATUG_6March03.doc http://www.accc.gov.au/telco/fs-telecom.htm http://www.aph.gov.au/house/committee/cita/Wbt/report.htm http://www.dcita.gov.au/Article/0,,0_1-2_3-4_115485,00.html http://www.dcita.gov.au/Article/0,,0_1-2_3-4_115486,00.html http://www.noie.gov.au/projects/access/access/broadband1.htm http://www.noie.gov.au/publications/NOIE/BAG/report/index.htm http://www.pc.gov.au http://www.pc.gov.au/inquiry/telecommunications/finalreport/ http://www.telinquiry.gov.au/final_report.html http://www.telinquiry.gov.au/rti-report.html http://www.wto.org/english/tratop_e/serv_e/12-tel_e.htm http://www.wto.org/english/tratop_e/serv_e/4prote_e.htm Citation reference for this article Substitute your date of access for Dn Month Year etc... MLA Style Goggin, Gerard. "Broadband" M/C: A Journal of Media and Culture< http://www.media-culture.org.au/0308/02-featurebroadband.php>. APA Style Goggin, G. (2003, Aug 26). Broadband. M/C: A Journal of Media and Culture, 6,< http://www.media-culture.org.au/0308/02-featurebroadband.php>

Photo by Waranont (Joe) on Unsplash INTRODUCTION The age-adjusted COVID-19 mortality rate among Black Americans is twice as high as White Americans.[1] This shocking evidence of health disparities, coincident to a public reckoning with the history of racism in the US, highlights the inverse relationship between race and health. Public sentiment may now favor addressing these pressing public health issues, but the sprawling healthcare system largely focuses on clinical care; it lacks tools to influence the social determinants of health at the point of the healthcare institution. Reinvigorating organizational ethics, sometimes called institutional ethics, may provide such a tool. BACKGROUND Organizational ethics became part of the healthcare system during the upheavals in financing and organization of health care in the 1990s. Yet organizational ethics in a medical setting must be more than simple business ethics.[2] Just as health care professionals are granted special privileges in society in exchange for adherence to a code of medical ethics and duties, healthcare organizations and systems also must now adhere to ethical requirements in exchange for their privileged position that includes the right to provide, and be reimbursed for, health care.[3] In the 1990s, ethicists began to discuss how clinical ethics committees might develop an understanding of business ethics in order to provide comprehensive organizational ethics reviews.[4] Some bioethicists even believed that the challenges of integrating business and medical care would compel ethics committees to look outward, engaging in public advocacy around ethical issues in health care.[5] To fulfill the mission of maintaining organizational ethics standards within the healthcare system, ethics committees would need to advocate for patients in the public sphere. Ethics committees might even take positions at odds with those of the healthcare institutions in which they work. Organizational ethics committees might have served as watchdogs, ensuring that healthcare organizations fulfill their fiduciary duties to their patients and communities. Bioethicists soon realized that the vision of a robust ethics committee involving administrators, bioethicists, and medical staff advising multiple divisions of large organizations and policy makers would fall short.[6] The two ethical systems remained separate: most organizations developed a combination of a clinical ethics committee adjunct to the medical staff with a compliance department to oversee organizational ethics. However, organizational ethics really goes beyond compliance; it “cannot be addressed by focusing narrowly on business matters or by quasi-legal mechanisms to assure that behavior conforms to pre-established codes or rules.”[7] As a result, there is no centralized entity with power in each healthcare institution that can treat healthcare inequities as an institutional ethical failure that must be addressed. Current research on specific inequitable outcomes due to bias in clinical care includes specialties such as maternal care,[8]cardiac care,[9] pain management, and technology.[10] Implicit bias and racist clinical interactions, once identified, may be addressed through staff training and other interventions. Yet the ethics of clinical care requires little attention to the social determinants of health such as high levels of police surveillance in the community which may cause increased rates of hypertension,[11] pre-term birth,[12] and may affect mental health. Leaving these problems to the public health realm disconnects health practitioners and institutions from the ability to remedy some of the causes of health problems in their patients. Simply treating the effects of racism in the practice of medicine is not curative – it is really palliative care.[13] ANALYSIS The term “organizational ethics” is too limited to encompass the scope of change needed to address structural racism and the social determinants of health in today’s healthcare institutions. Structural Justice Ethics[14] better describes a plan and a process that requires the healthcare system and professionals to look both inward and outward to take on the structural causes of racism and health disparities. Building on organizational and clinical ethics, Structural Justice Ethics could amplify the research on systemic issues such as the effects of social determinants of health, racism in clinical care, and necessary advocacy with the local community. To be effective and complete, organizations should recognize duties to patients that arrive at their doorstep, damaged by generations of subordination and racism. To ethically treat patients who have experienced racism, the system and health practitioners must acknowledge and work to reduce the inequities in society that cause harm to their health in the clinical setting. Accreditation companies such as The Joint Commission could amend their standards to require top-rated healthcare organizations to form new Structural Justice Ethics committees in their organizations, taking affirmative steps to acknowledge the ethical implications of racism and the social determinants of health. Many bioethicists have already called for the field of bioethics to address racism as an ethical issue in healthcare, some even calling for a new Black Bioethics.[15] This frustration with the profession of bioethics has developed in other areas, such as disability ethics and feminist ethics, and reflects a belief that mainstream bioethics is a rigidly principlist endeavor. The education of new bioethicists is grounded in practical philosophy graduate programs, entwined with academia’s history of exclusivity. As a relatively young academic subject, bioethics has the potential to expand and grow into a more practical and justice-oriented tool, learning how to counter the overly individualistic bioethics that has roots in our racist and Protestant-dominant history.[16] Expanding organizational ethics into Structural Justice Ethics in health care could bring Black bioethicists into the center of healthcare ethics and provide the tools to implement changes needed to address racism in health care. Healthcare organizations should not expect Black healthcare practitioners to take on these Structural Justice Ethics roles as “extra” work. Too often, people of color are expected to bear the burden of explaining racism and working to eradicate it.[17]The Structural Justice Ethics committee should be a new model, centered in ethics and policy, with professional-level staffing that reflects the racial and ethnic makeup of the community it serves. Calling on bioethicists as moral agents in the world, and particularly within the medical system, to act as social justice advocates against systemic injustice in a system where they have privilege and power seems logical and surprisingly necessary. “Going forward, bioethics needs to engage with the nuances of race with the same vigor that it has approached discussions of moral theories and biotechnologies.”[18] Graduate-level bioethics programs have expanded significantly in recent years, with 45 current master’s level programs,[19] and there should be a wealth of professionals ready to oversee the role of encouraging and monitoring justice in the system. These programs focus primarily if not exclusively on the dominant paradigm of bioethics, yet as ethics programs, they should be able to course-correct and embrace greater diversity in people and thought. Structural Justice Ethicists can guide healthcare organizations to become learning institutions open to the idea that bias and inequity are ethical harms that they can and should address. Some may question whether such close attention to Black health care needs amounts to reparations or “reverse” discrimination, a controversial topic in our political discussions. However, when posed as an ethical duty of health care, there is no option to continue to treat Black people unethically. Of course, healthcare systems will have to balance competing budgetary interests; even with unlimited funding, disparities in health care would not disappear overnight.[20] In a fair process where decisionmakers must weigh the demands of stakeholders, the ethical obligation to address the social determinants of health must have an advocate. Moreover, setting high ethical standards is not the same as government spending to make reparations for past harms. In fact, Structural Justice Ethics does not look to the past at all but looks to the needs of subordinated communities of patients as they exist today. Any community that is harmed by structural injustice in health care can be the focus of a Structural Justice Ethics review. The Joint Commission and other accrediting organizations can require healthcare organizations to meet the challenges of health inequities by adopting new Structural Justice Ethics committees, just as The Joint Commission added organizational ethics to its requirements in 1995. Admittedly, Structural Justice Ethics is an amorphous concept and its role within healthcare institutions needs to be refined and assigned specific tasks. However, there is substantial research on the social determinants of health; the challenge for the Structural Justice Ethics is to recommend systemic changes from within, rather than beginning this research anew. The Joint Commission’s Center for Transforming Healthcare, as a data-driven and process-oriented patient safety organization, is well-primed to take on this task. The Center can collaborate with existing academic and governmental health equity researchers to set short- and long-term goals for Structural Justice Ethics committees. To begin with, a Structural Justice Ethics committee can pose the question of “how is racism operating here” and: a. connect with current research on specific inequitable outcomes due to bias in medicine and bring best practices to the attention of medical staff. b. work with human resources and medical staff to support and increase diverse populations in the workforce. c. ensure that implicit bias and other trainings are properly provided to all staff, as well as expanding the scope of such trainings to address developing areas such as epistemic harm, or the harm of one’s own physical experience being discounted by medical professionals.[21] The health care workforce should also be trained in Title VI law.[22] d. evaluate research data on the organization’s own potential disparate outcomes due to race, to determine areas for improvement both within and outside of the organization. e. invite the local community to come in for listening and learning sessions, to better understand the community’s concerns and perspective on health equity. f. improve advocacy on behalf of community members to state and local authorities, effectively taking a stand for health care equity for local stakeholders. Dr. Camara P. Jones describes a collaborative endeavor like this as critical to anti-racist work and likens it to adopting a community health center model where the health facility takes responsibility for the health and well-being of the local community.[23] AMA policy already encourages this type of effort in opinion 8.11 of the AMA Code, which states that, alongside diagnosis and treatment, “physicians also have a professional commitment to prevent disease and promote health and well-being for their patients and the community.”[24] A theoretical framework and concrete plan for radical improvement in the ethics of the healthcare system will help all healthcare professionals. Some healthcare practitioners may not recognize their own biases and need training to meet best practices standards in light of health inequities. Other healthcare practitioners may feel disillusioned because they know they face individual patients suffering the effects of structural racism, yet they can treat only the illness.[25] The scope of the problem may overwhelm practitioners, and without a belief that the system is committed to improvement, practitioners may become numb to the suffering, a trauma reaction that affects both the practitioners and their patients. Unfortunately, when current medical students ask the question, “what can I do to fight systemic racism?” the answer is usually “call it out.” But putting the onus on newly minted individual practitioners to call out racism in an established structure is unrealistic, unfair, and destined to be unsuccessful. Just as we should not expect subordinated individuals to “overcome” their social determinants of health, we should not expect health professionals to make this change individually. Addressing injustices in the institution and adjusting medical ethics accordingly can alleviate the burden of these ethical dilemmas. CONCLUSION Structural Justice Ethics must be woven into the ethics committees at the institutional level. Organizational ethics committees can evaluate healthcare organizations by their integrity, i.e., how well their actions fulfill the moral obligations they have undertaken.[26] Our healthcare system has avoided the moral obligation to address racism and the social determinants of health by focusing on clinical ethics, leaving public health to academics and the government. Expanding organizational ethics to take on the issues of structural injustice within each healthcare institution will help organizations better measure, change, and ultimately fulfill their moral obligations to their patients and communities. [1] “Color of Coronavirus: COVID-19 Deaths Analyzed by Race and Ethnicity,” APM Research Lab, accessed June 1, 2021, https://www.apmresearchlab.org/covid/deaths-by-race. [2] M. Constantinescu, “Seeing the Forest beyond the Trees: A Holistic Approach to Health-Care Organizational Ethics,” in Contemporary Debates in Bioethics: European Perspectives, 2018, 86–96, https://doi.org/10.2478/9783110571219-009. [3] See Norman Daniels, Just Health: Meeting Health Needs Fairly (Cambridge: Cambridge University Press, 2008) at 219. [4] Elizabeth Heitman and Ruth Ellen Bulger, “The Healthcare Ethics Committee in the Structural Transformation of Health Care: Administrative and Organizational Ethics in Changing Times,” HEC Forum 10, no. 2 (June 1, 1998): 152–76, 162, https://doi.org/10.1023/A:1008865603499. [5] Cohen, Cynthia B. "Ethics Committees as Corporate and Public Policy Advocates." The Hastings Center Report 20, no. 5 (1990): 36+. Gale Academic OneFile (accessed May 6, 2021). https://link.gale.com/apps/doc/A8998890/AONE?u=nysl_oweb&sid=AONE&xid=84a1cade. [6] Linda L. Emanuel, “Ethics and the Structures of Healthcare Special Section: Issues in Organization Ethics and Healthcare,” Cambridge Quarterly of Healthcare Ethics 9, no. 2 (2000): 151–68, 166. [7] George Khushf and Rosemarie Tong, “Setting Organizational Ethics within a Broader Social and Legal Context,” HEC Forum 14, no. 2 (June 2002): 77–85, 78. [8] Olivia Pham, Usha Ranji Published: Nov 10, and 2020, “Racial Disparities in Maternal and Infant Health: An Overview - Issue Brief,” KFF (blog), November 10, 2020, https://www.kff.org/report-section/racial-disparities-in-maternal-and-infant-health-an-overview-issue-brief/. [9] Eberly Lauren A. et al., “Identification of Racial Inequities in Access to Specialized Inpatient Heart Failure Care at an Academic Medical Center,” Circulation: Heart Failure 12, no. 11 (November 1, 2019): e006214, https://doi.org/10.1161/CIRCHEARTFAILURE.119.006214. [10] Michael W. Sjoding et al., “Racial Bias in Pulse Oximetry Measurement,” New England Journal of Medicine 383, no. 25 (December 17, 2020): 2477–78, https://doi.org/10.1056/NEJMc2029240. [11] Alyasah Ali Sewell et al., “Illness Spillovers of Lethal Police Violence: The Significance of Gendered Marginalization,” Ethnic and Racial Studies 44, no. 7 (July 22, 2020): 1–26, https://doi.org/10.1080/01419870.2020.1781913. [12] Brad N. Greenwood et al., “Physician–Patient Racial Concordance and Disparities in Birthing Mortality for Newborns,” Proceedings of the National Academy of Sciences 117, no. 35 (September 1, 2020): 21194–200, https://doi.org/10.1073/pnas.1913405117. [13] The term “palliative care” as applied to patients suffering from the social determinants of health was used by Dr. Michelle Morse at a webinar entitled “Medical Stereotypes: Confronting Racism and Disparities in US Health Care: A Health Policy and Bioethics Consortium” presented by the Harvard Petrie-Flom Center on February 12, 2021. [14] Linda L. Emanuel coined the term “Structural Ethics” in 2000. This term did not seem to generate much interest from the bioethics community at the time. Her explanation of this term is consistent with my thinking, although I expand it to address the health system as an entity, and focus on improving health equity. [15] Keisha Shantel Ray, “Black Bioethics and How the Failures of the Profession Paved the Way for Its Existence | Bioethics.Net,” www.bioethics.net, August 6, 2020, http://www.bioethics.net/2020/08/black-bioethics-and-how-the-failures-of-the-profession-paved-the-way-for-its-existence/; Yolonda Y. Wilson, “Racial Injustice and Meaning Well: A Challenge for Bioethics,” The American Journal of Bioethics 21, no. 2 (February 1, 2021): 1–3, https://doi.org/10.1080/15265161.2020.1866875. [16] See Catherine Myser, “Differences from Somewhere: The Normativity of Whiteness in Bioethics in the United States,” The American Journal of Bioethics 3, no. 2 (May 2003): 1–11, https://doi.org/10.1162/152651603766436072. [17] Ushe Blackstock, “Why Black Doctors like Me Are Leaving Academic Medicine,” STAT (blog), January 16, 2020, https://www.statnews.com/2020/01/16/black-doctors-leaving-faculty-positions-academic-medical-centers/. [18] Zamina Mithani, Jane Cooper, and Boyd J. Wesley, “Race, Power, and COVID-19: A Call for Advocacy within Bioethics,” The American Journal of Bioethics21, no. 2 (2021): 11–18, 13 https://doi.org/10.1080/15265161.2020.1851810. [19] “Graduate Programs,” The Hastings Center, accessed 2 June, 2021, https://www.thehastingscenter.org/publications-resources/bioethics-careers-education/graduate-programs-2/. [20] Norman Daniels, Just Health: Meeting Health Needs Fairly, at 299. [21] Ian James Kidd and Havi Carel, “Epistemic Injustice and Illness,” Journal of Applied Philosophy 34, no. 2 (2017): 172–90, https://doi.org/10.1111/japp.12172. [22] Ruqaiijah Yearby, “Sick and Tired of Being Sick and Tired: Putting an End to Separate and Unequal Health Care in the United States 50 Years after the Civil Rights Act of 1964,” Health Matrix 25, no. 1 (January 1, 2015): 1–33, at 11. [23] Jones CP, Maybank A, Nolen L, Fields N, Ogunwole M, Onuoha C, Williams J, Tsai J, Paul D, Essien UR, Khazanchi, R. “Episode 5: Racism, Power, and Policy: Building the Antiracist Health Systems of the Future.” The Clinical Problem Solvers Podcast. https://clinicalproblemsolving.com/episodes. January 19, 2021. [24] Sienna Moriarty, “AMA Policies and Code of Medical Ethics’ Opinions Related to Health Promotion and Community Development,” AMA Journal of Ethics 21, no. 3 (March 1, 2019): 259–61, https://doi.org/10.1001/amajethics.2019.259. [25] Constantinescu, “Seeing the Forest beyond the Trees,” at 92. [26] Ana Smith Iltis, “Organizational Ethics: Moral Obligation and Integrity,” in Institutional Integrity in Health Care, ed. Ana Smith Iltis, Philosophy and Medicine (Dordrecht: Springer Netherlands, 2003), 175–82, https://doi.org/10.1007/978-94-017-0153-2_10.

IntroductionContemporary theorisations of family often present change in marriage as an icon of deinstitutionalisation (Cherlin). This idea, widely discussed in sociology, has been deepened and extended by Giddens, Beck and Beck-Gernsheim, Beck-Gernsheim and Bauman, considered to be the main architects of the individualisation, detraditionalisation and risk theses (Brannen and Nielsen). According to these authors, contemporary family is an ephemeral, fluid, and fragilereality, and weakening as a traditional institution. At the same time, and partly as a result of the changes to this institution, there has been a rise in the individual’s capacity to reflect on and choose their own life, to the point that living a life of their own becomes the individual’s defining injunction. Based on an in-depth and detailed analysis of a number of young Portuguese people’s accounts of their entry into conjugality, this paper seeks to unveil some of the hidden constraints which persist despite this claim to individualisation. Whilst individuals incorporate a personalised narrative in their construction of that “special day” – stressing the performance of the wedding they wanted, in the way they chose – these data show the continuing influence of the family on individual decisions (e.g. to marry or not to marry, and how to marry). These empirical findings thus contribute to the recent body of literature complexifying the individualisation and detraditionalisation theses (Smart and Shipman, Gross, Smart, Eldén).Using Sociology to Unveil Individualisation’s Hidden ConstraintsThis discussion of contemporary marriages is driven by empirical data from a sociological qualitative study based on episodic interviews (Flick, An Introduction to Qualitative Research and The Episodic Interview). This research (Costa) was developed in 2009 and aimed at an in-depth understanding of family practices (Morgan, Risk and Family Practices, Family Connections and Rethinking Family Practices), specifically family rituals (Bossard and Boll, Imber-Black and Roberts, Wolin and Bennett). Using a theoretical sampling (Glaser and Strauss), accounts were collected from 30 middle-class individuals, both men and women, living in an urban medium-sized city (Évora) in the south of Portugal (southern Europe), and with at least one small child between the age of 3 and 14 years old. Confidentiality and anonymity were maintained, and all names used in this paper are pseudonyms. For the purposes of this paper, I focus only on the women’s accounts. On the one hand, particularly for them, socialisation and media culture helped to consolidate a social representation around the wedding (Gillis, Marriages of the Mind); on the other hand, their more exhaustive descriptions of the wedding day allow better for examining the hidden constraints to individualisation. Data were coded and analysed through a thematic and structural content analysis (Bardin). The analysis of emerging themes and issues regarding the diverse ways of entering into conjugality was primarily assisted by qualitative software (NVivo, QSR International) and then presented in the form of contextualised narratives. Using a sociological perspective, the themes presented below illustrate the major conclusions of this study. Big Decisions: To Marry or Not to Marry? How to Marry?At the core of the decision of whether “to marry or not to marry?” and “how to marry?,” one can find multiple and complex arguments, which go beyond simplistic justifications based exclusively on the couple’s decision (Chesser; Maillochnon and Castrén). Women in particular display an awareness of the ways in which their decisions regarding marriage are crossed by the will, desires or preferences of the parents or in-laws. This was the case of Maria dos Anjos, married at the age of 26:It was a choice of the two of us [to marry]. Not an imposition. I didn’t care whether we were married by church or not… and there were times when I even put forward the possibility of a simple civil marriage. However, my parents really liked that I got married by the church. I'm not sure if this is due to tradition, if… and... they talked about it… and I also thought it was beautiful... it was a beautiful party... the dress, all that fantasy... and I really loved marrying in the church... so it became a strong possibility when we began to think about it [to get marry]… The argument that two people might marry because of or also to please the parents or in-laws explains, at least partially, a certain pressure that the fiancées feel before marriage to marry “in a certain way.” Filipa, who dated for ten years, lived the wedding day like “the realisation of a childhood’s dream.” The satisfaction she obtained was shared with her parents and in-laws:To marry in the church, with the wedding dress, and everything else... My mother in-law is a religious person too, right? So we felt that we both like it, the two of us, my mother, my mother-in-law, they would also like it, so we decided to marry in the church. To do the parents’ will is to meet the expectations around a “beautiful” wedding, but sometimes also to fulfil the marriage that the parents did not have. Lurdes is an only daughter, married at the age of 29. She argues that “marriage should be primarily significant for those who actually marry, not the parents or in-laws”. Yet, that was not her case: For us, maybe it was not so important; the paper signed, the ceremony in the church… maybe the two of us made it for our parents. It doesn’t mean that we didn’t have fun [...] and I don’t mean by this that it was a sacrifice, or a hardship […] My mother had no more daughters, and had a great will to marry her only daughter in the church. My mother was not married by the church, but was only married by civil registry. She never managed to convince my dad to get married by the church. And perhaps it was a bit... to project on me what she had not done! Despite her having the will to do but did not achieve it. And maybe I made her wish come true; I realise that she had that desire, a great desire that her daughter would marry in the church. For me, it was not a problem. So, we finally did agree and married in the church. The family of origin thus clearly has a great influence over some of the big decisions associated with marriage, such as whether to get married at all, and whether to involve the church in the process.Small decisions: It Is All about Details! The intrusion of the family of origin is also felt on the apparently more individual decisions as the choice of the dress or several other details concerning the organisation of the ceremony and the party (Chesser, Leeds-Hurwitz). The wedding dress is a good example of how women in particular perceive a certain pressure for conformity and subjection to buy it or choose it “in a certain way.” Silvia, who married at age 23, remembers: I married with a traditional wedding dress, even though I did not want to. I took a long veil, yet I did not want it... because at the time... I wanted to take a short dress... my mum thought I should not... because my mother did not marry in a wedding dress, did not marry in the church, she was already pregnant at the time and so on [downgrade of the tone] so she made pressure so that I was dressed properly.Precisely in order to run away from these impositions, some women admit having bought the dress alone, almost secretly. Maria dos Anjos, for example, chose and bought the wedding dress alone so that she did not have to give in to pressure from anyone: I really enjoyed it! I took a wedding dress... I was the one who chose it; I went to buy it myself, with my own money. I said to myself ‘the wedding dress, I will choose it; I will not be constrained by... I will not take my godmother and then think’... oh... I knew that if I did it, I would have to submit a little to her likes and dislikes… no! So I went to choose the dress alone. The girl who was in the shop was an acquaintance of mine, I tried a lot of them, and when I tried that one, I said to myself ‘this is it!’ and so it was the one!The position of the spouses in the sibling group also has an effect on numerous decisions that fiancées must make in the lead-up to the wedding. Raquel, who felt this pressure before marriage, attributed it to a large extent to the fact that her husband is an only child: Pressure in the sense that João [her husband]... he is an only child, right? So… his parents were always very concerned with certain things. And... everybody... even little things that had no importance, they wanted to decide on that! […] There are a lot of things that have to be decided, a lot of detail and… what I really think is that it is a really unique day, and it's all very important and all that but... but... then each one gives his/her opinion... And ‘I want this,’ ‘I want that,’ ‘I want the other’… it's too much; it's a lot of pressure... to manage... on one side, on the other side… because to try not to hurt vulnerabilities ends up being... crazy. Completely! Those fifteen days before... I think they are... they are a little crazy!Seemingly unimportant details (such as the fact that the mother did not marry in a wedding dress) end up becoming major arguments behind the suggestions or impositions made by both parents and in-laws in relation to decisions surrounding their children’s weddings.(Un)important Decisions: The Guest List The parents of the couple are often heavily involved in the planning of the wedding partly because, although the day is officially about the bride and groom, it is also the way that the parents share this important milestone with their family and friends (Pleck, Kalmijn, Maillochnon and Castrén). Interviewees say it is “easy” to decide on the guest list, since, at first glance arguments behind the most significant family relatives and friends to be present on the wedding day have to do with proximity, relationality and pleasure or happiness in sharing the moment. Nevertheless, it can be a hard task for couples to implement the criteria of proximity in the selection of guests as initially planned. In cases where the family is larger and there are economic constraints, it is common for fiancées to feel some unpleasantness from those relatives who would like to have been invited and were not. In other cases, parents, closer to the extended family, are the ones who produce this tension. On the one hand, they feel the need to justify to some relatives the choices of their adult children who did not include them in the guest list; on the other hand, they are forced to accept the fact that that decision lies with the couple. When planning the marriage of Dora, her mother at one point said something like “[…] ‘but my aunt invited us to her wedding and now...’” Dora understood the suspension of the sentence as a subtle pressure from her mother, although, for her, the question was indeed a very simple one: I give a lot of importance to the people who are with me on a day-to-day basis and that really are with me in good and bad times. [...] It happened. It was easy. For me, it was [laughs]. To my way of thinking it was. It cost my parents. However, not to me [laughs]. It cost me nothing! When the family is larger – but when there are no economic constraints which limit the number of guests – it is more common that weddings are bigger. In these circumstances, it is also more common to have a certain meddling from the families of origin encouraging couples to include the guests of the parents. Teresa admits this is precisely what happened with her: It was not so difficult because we were not also so limited. […] We left everything to the satisfaction of all. […] there were many people who were distant relatives, whom I was not close to. It didn’t really matter to me whether those people were present or not. It had more to do with the will of my parents. And usually we were also invited to those people’s weddings, so maybe it was also because of that… In some other cases there is a kind of agreement between parents and adult children, which allows both to invite “whoever they want”. This is the case of Marina, who had 194 guests “on her side,” against around 70 invited by her husband: I invited more people than him. Why? Well... I could count on my parents, right? And what my parents told me was: ‘you invite whoever you want!’. So, I invited my friends, and some other people I was not as close to, but who my parents wanted me to invite, right? […] but ok, they made a point of inviting them, and since they did not impose any financial limits, instead, they said to me ‘invite whoever you want to’, and we invited... For me, it was a ‘deal.’ I was indifferent about it [laughs]. Marina admits that she made a “deal” with her parents. By letting them pay the costs, she gave tacit consent that they could invite those who they wanted, even if it was the case those guests “didn’t relate to [her] at all.” At the wedding of Raquel, the fact that “there is family that [only her] parents were keen on inviting” was one of the main points of contention between her parents and the couple. The indignation was greater since it was “your [their own, not the parent’s] wedding” and they were being pressed to include people who they “hardly knew,” and with whom they “had no connection”: There were people who came who I did not know even who they were! Never seen them anywhere... but ok, my parents were keen on inviting some people, because they know them and all that... and then... it went into widening, extending and then... it ended up with more than one hundred guests […] we wanted it to be more intimate, more... with closer people… but it was not! The engaged couple thus recognises the importance of the parents’ guests. As one of the interviewees points out, the question is not so much the imposition of the will of the parents, rather the recognition of the importance of certain guests because “they are important to the parents.” Thus, the importance of these guests is not directly measured by the couple, but indirectly by being part of the importance that parents give them.Counter-Decisions: Narratives from the Inside Out Joana, a first daughter, “felt in her skin” the “punishment” for not having succumbed to the pressure she felt over her decision to marry. She told us she had her teenage dreams; however, as she grew older she identified herself less and less with the wedding ceremony. Moreover, with the death of her grandmother, who was especially meaningful to her, “it no longer made sense” to arrange that kind of ceremony since it would always be “incomplete” without her presence. Her boyfriend also did not urge that they marry, instead preferring to live in a de facto union. Joana felt strongly the pressure to take on a role that her parents and in-laws wanted: on the one hand, because she was “a girl, and the oldest daughter;” on the other hand, because her mother-in-law insisted since she had not saw her other daughter to get marry in church, as she was only civilly married. In fact, Joana could marry in church because she had been educated in the Catholic religion and met all the formal requirements to perform a religious marriage: I was the person who was prepared to move forward with this. And I did not! I'm not sorry. I don’t regret it at all! Although not regretted, Joana felt “very deeply” the gap between the expectations of her parents and the direction that she decided to give to her life when she told her parents she did not wanted to marry. She had the same boyfriend since adolescence, whom she moved in with on a New Year's Day at the age of 27. On that evening she organised a small party in the house they had rented and furnished, and stayed there for good. The mother “never forgave her.” The following year, when her sister got married, Joana “had the punishment” of, in the eyes of the mother, “not having done the right thing”: one thing I would have loved to have was a nightshirt [old piece of clothing, handmade] of my grandmother [...] But my mother kept the nightshirt and gave it to my sister on the day she married! My sister also loved my grandmother..., but she didn’t have the same emotional bond that I had with her! So, I got hurt. Honestly, I got! And the day of my sister's wedding for me it was full of surprises... This episode is particularly revealing of how Joana experienced the disappointment that caused to her parents for not having married: I did not have the faintest idea that she [her mother] was going to do that... Yet she kept it [the nightshirt]! [...] She kept it, and then she gave it to my sister! [...] It was my grandmother’s! And then I said, ‘but I was the first to get married!’ And it was I who had a closer relationship with my grandmother. I found it very unfair! [...] Joana sees this wedding gift as “a prize”: It was... she [her sister] was awarded because ‘you did the right thing,’ ‘you got married,’ ‘you had done it with all the pomp ... so take this [the nightshirt], that was of your grandmother!’ The day of her sister's wedding would still hold another surprise for Joana, that one coming from her father. She remembers always seeing at home a bottle of aged whiskey that her father “kept for the first daughter who gets to marry.” I did not get married, right? And... and it was sad to see that day and get the bottle open, the bottle that was proudly kept untouched for many years until the first daughter to marry... Whilst most women admit to have given in to pressure from parents and in-laws, Joana’s example demonstrates another side – emotionally painful – of those who did not conform to marry or to marry in a certain way.Conclusion Based on empirical research on marriages as a family ritual, I have argued that behind representations and discourses of a wedding “of our own,” quite often individuals grant the importance, of, and sometimes they are even pressured by, their families of origin (e.g. parents and in-laws). At the crossroad of tradition and modernity, this pressure is pervasive from the most important to the most apparently trivial decisions or details concerning the mise en scène of the ritual elements chosen to give a symbolic meaning to the ceremony and party (Chesser, Leeds-Hurwitz).Empirical findings and data discussion thus confirm and reinforce the high symbolic value that, despite all the changes weddings, still assume in contemporary society (Berger and Kellner, Segalen and Gillis, A World of their Own Making, Our Virtual Families and Marriages of the Mind). The power and influence of the size and density of the families of origin is not a part of history left behind by the processes of individualization and detraditionalization; rather, families continue to play a central role in structuring the actual options behind the anticipation, planning, and organisation of the wedding. This demonstrates that the reality of contemporary relationality is vastly more textured (Smart) than the normative generalisations of the individualisation and detraditionalisation theses imply, and suggests that in contemplating contemporary marriage conventions, the overt claims to individual choice and autonomy should be be contextualised by the variety of relationships the bride and groom participate in. References Bardin, Laurence. L’Analyse de Contenu. Paris: PUF, 1977. Bauman, Zygmunt. Liquid Love: On the Frailty of Human Bonds. Cambridge: Polity, 2003. Beck, Ulrich, and Beck-Gernsheim, Elisabeth. The Normal Chaos of Love. Cambridge: Polity, 1995. Beck-Gernsheim, Elisabeth. Reinventing the Family: In search of New Lifestyles. Cambridge: Polity, 2002. Berger, Peter, and Kellner, Hansfried. “Marriage and the constitution of reality.” Diogenes 46 (1964): 1–24. Bossard, James, and Boll, Eleanor. Ritual in Family Living – A Contemporary Study. Philadelphia: U Pennsylvania P, 1950. Brannen, Julia, and Nielsen, Ann. “Individualisation, Choice and Structure: a Discussion of Current Trends in Sociological Analysis.” The Sociological Review 53.3 (2005): 412–28. Cherlin, Andrew. “The Deinstitutionalization of American Marriage.” Journal of Marriage and Family 66 (2004): 848–861. Chesser, Barbara Jo. “Analysis of Wedding Rituals: An Attempt to Make Weddings More Meaningful.” Family Relations 29.2 1980): 204—09. Costa, Rosalina. Pequenos e Grandes Dias: os Rituais na Construção da Família Contemporânea [Small and Big Days. The Rituals Constructing Contemporay Families]. PhD Thesis in Social Sciences – specialization ‘General Sociology’. University of Lisbon: Institute of Social Sciences of the University of Lisbon (ICS-UL), 2011 ‹http://hdl.handle.net/10451/4770›. Eldén, Sara. “Scripts for the ‘Good Couple’: Individualization and the Reproduction of Gender Inequality.” Acta Sociologica 55.1 (2012): 3–18. Flick, Uwe. An Introduction to Qualitative Research. 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Photo ID 158378414 © Eduard Muzhevskyi | Dreamstime.com ABSTRACT There is a debate about the ethical implications of using human embryos in stem cell research, which can be influenced by cultural, moral, and social values. This paper argues for an adaptable framework to accommodate diverse cultural and religious perspectives. By using an adaptive ethics model, research protections can reflect various populations and foster growth in stem cell research possibilities. INTRODUCTION Stem cell research combines biology, medicine, and technology, promising to alter health care and the understanding of human development. Yet, ethical contention exists because of individuals’ perceptions of using human embryos based on their various cultural, moral, and social values. While these disagreements concerning policy, use, and general acceptance have prompted the development of an international ethics policy, such a uniform approach can overlook the nuanced ethical landscapes between cultures. With diverse viewpoints in public health, a single global policy, especially one reflecting Western ethics or the ethics prevalent in high-income countries, is impractical. This paper argues for a culturally sensitive, adaptable framework for the use of embryonic stem cells. Stem cell policy should accommodate varying ethical viewpoints and promote an effective global dialogue. With an extension of an ethics model that can adapt to various cultures, we recommend localized guidelines that reflect the moral views of the people those guidelines serve. BACKGROUND Stem cells, characterized by their unique ability to differentiate into various cell types, enable the repair or replacement of damaged tissues. Two primary types of stem cells are somatic stem cells (adult stem cells) and embryonic stem cells. Adult stem cells exist in developed tissues and maintain the body’s repair processes.[1] Embryonic stem cells (ESC) are remarkably pluripotent or versatile, making them valuable in research.[2] However, the use of ESCs has sparked ethics debates. Considering the potential of embryonic stem cells, research guidelines are essential. The International Society for Stem Cell Research (ISSCR) provides international stem cell research guidelines. They call for “public conversations touching on the scientific significance as well as the societal and ethical issues raised by ESC research.”[3] The ISSCR also publishes updates about culturing human embryos 14 days post fertilization, suggesting local policies and regulations should continue to evolve as ESC research develops.[4] Like the ISSCR, which calls for local law and policy to adapt to developing stem cell research given cultural acceptance, this paper highlights the importance of local social factors such as religion and culture. I. Global Cultural Perspective of Embryonic Stem Cells Views on ESCs vary throughout the world. Some countries readily embrace stem cell research and therapies, while others have stricter regulations due to ethical concerns surrounding embryonic stem cells and when an embryo becomes entitled to moral consideration. The philosophical issue of when the “someone” begins to be a human after fertilization, in the morally relevant sense,[5] impacts when an embryo becomes not just worthy of protection but morally entitled to it. The process of creating embryonic stem cell lines involves the destruction of the embryos for research.[6] Consequently, global engagement in ESC research depends on social-cultural acceptability. a. US and Rights-Based Cultures In the United States, attitudes toward stem cell therapies are diverse. The ethics and social approaches, which value individualism,[7] trigger debates regarding the destruction of human embryos, creating a complex regulatory environment. For example, the 1996 Dickey-Wicker Amendment prohibited federal funding for the creation of embryos for research and the destruction of embryos for “more than allowed for research on fetuses in utero.”[8] Following suit, in 2001, the Bush Administration heavily restricted stem cell lines for research. However, the Stem Cell Research Enhancement Act of 2005 was proposed to help develop ESC research but was ultimately vetoed.[9] Under the Obama administration, in 2009, an executive order lifted restrictions allowing for more development in this field.[10] The flux of research capacity and funding parallels the different cultural perceptions of human dignity of the embryo and how it is socially presented within the country’s research culture.[11] b. Ubuntu and Collective Cultures African bioethics differs from Western individualism because of the different traditions and values. African traditions, as described by individuals from South Africa and supported by some studies in other African countries, including Ghana and Kenya, follow the African moral philosophies of Ubuntu or Botho and Ukama, which “advocates for a form of wholeness that comes through one’s relationship and connectedness with other people in the society,”[12] making autonomy a socially collective concept. In this context, for the community to act autonomously, individuals would come together to decide what is best for the collective. Thus, stem cell research would require examining the value of the research to society as a whole and the use of the embryos as a collective societal resource. If society views the source as part of the collective whole, and opposes using stem cells, compromising the cultural values to pursue research may cause social detachment and stunt research growth.[13] Based on local culture and moral philosophy, the permissibility of stem cell research depends on how embryo, stem cell, and cell line therapies relate to the community as a whole. Ubuntu is the expression of humanness, with the person’s identity drawn from the “’I am because we are’” value.[14] The decision in a collectivistic culture becomes one born of cultural context, and individual decisions give deference to others in the society. Consent differs in cultures where thought and moral philosophy are based on a collective paradigm. So, applying Western bioethical concepts is unrealistic. For one, Africa is a diverse continent with many countries with different belief systems, access to health care, and reliance on traditional or Western medicines. Where traditional medicine is the primary treatment, the “’restrictive focus on biomedically-related bioethics’” [is] problematic in African contexts because it neglects bioethical issues raised by traditional systems.”[15] No single approach applies in all areas or contexts. Rather than evaluating the permissibility of ESC research according to Western concepts such as the four principles approach, different ethics approaches should prevail. Another consideration is the socio-economic standing of countries. In parts of South Africa, researchers have not focused heavily on contributing to the stem cell discourse, either because it is not considered health care or a health science priority or because resources are unavailable.[16] Each country’s priorities differ given different social, political, and economic factors. In South Africa, for instance, areas such as maternal mortality, non-communicable diseases, telemedicine, and the strength of health systems need improvement and require more focus[17] Stem cell research could benefit the population, but it also could divert resources from basic medical care. Researchers in South Africa adhere to the National Health Act and Medicines Control Act in South Africa and international guidelines; however, the Act is not strictly enforced, and there is no clear legislation for research conduct or ethical guidelines.[18] Some parts of Africa condemn stem cell research. For example, 98.2 percent of the Tunisian population is Muslim.[19] Tunisia does not permit stem cell research because of moral conflict with a Fatwa. Religion heavily saturates the regulation and direction of research.[20] Stem cell use became permissible for reproductive purposes only recently, with tight restrictions preventing cells from being used in any research other than procedures concerning ART/IVF. Their use is conditioned on consent, and available only to married couples.[21] The community's receptiveness to stem cell research depends on including communitarian African ethics. c. Asia Some Asian countries also have a collective model of ethics and decision making.[22] In China, the ethics model promotes a sincere respect for life or human dignity,[23] based on protective medicine. This model, influenced by Traditional Chinese Medicine (TCM), [24] recognizes Qi as the vital energy delivered via the meridians of the body; it connects illness to body systems, the body’s entire constitution, and the universe for a holistic bond of nature, health, and quality of life.[25] Following a protective ethics model, and traditional customs of wholeness, investment in stem cell research is heavily desired for its applications in regenerative therapies, disease modeling, and protective medicines. In a survey of medical students and healthcare practitioners, 30.8 percent considered stem cell research morally unacceptable while 63.5 percent accepted medical research using human embryonic stem cells. Of these individuals, 89.9 percent supported increased funding for stem cell research.[26] The scientific community might not reflect the overall population. From 1997 to 2019, China spent a total of $576 million (USD) on stem cell research at 8,050 stem cell programs, increased published presence from 0.6 percent to 14.01 percent of total global stem cell publications as of 2014, and made significant strides in cell-based therapies for various medical conditions.[27] However, while China has made substantial investments in stem cell research and achieved notable progress in clinical applications, concerns linger regarding ethical oversight and transparency.[28] For example, the China Biosecurity Law, promoted by the National Health Commission and China Hospital Association, attempted to mitigate risks by introducing an institutional review board (IRB) in the regulatory bodies. 5800 IRBs registered with the Chinese Clinical Trial Registry since 2021.[29] However, issues still need to be addressed in implementing effective IRB review and approval procedures. The substantial government funding and focus on scientific advancement have sometimes overshadowed considerations of regional cultures, ethnic minorities, and individual perspectives, particularly evident during the one-child policy era. As government policy adapts to promote public stability, such as the change from the one-child to the two-child policy,[30] research ethics should also adapt to ensure respect for the values of its represented peoples. Japan is also relatively supportive of stem cell research and therapies. Japan has a more transparent regulatory framework, allowing for faster approval of regenerative medicine products, which has led to several advanced clinical trials and therapies.[31] South Korea is also actively engaged in stem cell research and has a history of breakthroughs in cloning and embryonic stem cells.[32] However, the field is controversial, and there are issues of scientific integrity. For example, the Korean FDA fast-tracked products for approval,[33] and in another instance, the oocyte source was unclear and possibly violated ethical standards.[34] Trust is important in research, as it builds collaborative foundations between colleagues, trial participant comfort, open-mindedness for complicated and sensitive discussions, and supports regulatory procedures for stakeholders. There is a need to respect the culture’s interest, engagement, and for research and clinical trials to be transparent and have ethical oversight to promote global research discourse and trust. d. Middle East Countries in the Middle East have varying degrees of acceptance of or restrictions to policies related to using embryonic stem cells due to cultural and religious influences. Saudi Arabia has made significant contributions to stem cell research, and conducts research based on international guidelines for ethical conduct and under strict adherence to guidelines in accordance with Islamic principles. Specifically, the Saudi government and people require ESC research to adhere to Sharia law. In addition to umbilical and placental stem cells,[35] Saudi Arabia permits the use of embryonic stem cells as long as they come from miscarriages, therapeutic abortions permissible by Sharia law, or are left over from in vitro fertilization and donated to research.[36] Laws and ethical guidelines for stem cell research allow the development of research institutions such as the King Abdullah International Medical Research Center, which has a cord blood bank and a stem cell registry with nearly 10,000 donors.[37] Such volume and acceptance are due to the ethical ‘permissibility’ of the donor sources, which do not conflict with religious pillars. However, some researchers err on the side of caution, choosing not to use embryos or fetal tissue as they feel it is unethical to do so.[38] Jordan has a positive research ethics culture.[39] However, there is a significant issue of lack of trust in researchers, with 45.23 percent (38.66 percent agreeing and 6.57 percent strongly agreeing) of Jordanians holding a low level of trust in researchers, compared to 81.34 percent of Jordanians agreeing that they feel safe to participate in a research trial.[40] Safety testifies to the feeling of confidence that adequate measures are in place to protect participants from harm, whereas trust in researchers could represent the confidence in researchers to act in the participants’ best interests, adhere to ethical guidelines, provide accurate information, and respect participants’ rights and dignity. One method to improve trust would be to address communication issues relevant to ESC. Legislation surrounding stem cell research has adopted specific language, especially concerning clarification “between ‘stem cells’ and ‘embryonic stem cells’” in translation.[41] Furthermore, legislation “mandates the creation of a national committee… laying out specific regulations for stem-cell banking in accordance with international standards.”[42] This broad regulation opens the door for future global engagement and maintains transparency. However, these regulations may also constrain the influence of research direction, pace, and accessibility of research outcomes. e. Europe In the European Union (EU), ethics is also principle-based, but the principles of autonomy, dignity, integrity, and vulnerability are interconnected.[43] As such, the opportunity for cohesion and concessions between individuals’ thoughts and ideals allows for a more adaptable ethics model due to the flexible principles that relate to the human experience The EU has put forth a framework in its Convention for the Protection of Human Rights and Dignity of the Human Being allowing member states to take different approaches. Each European state applies these principles to its specific conventions, leading to or reflecting different acceptance levels of stem cell research. [44] For example, in Germany, Lebenzusammenhang, or the coherence of life, references integrity in the unity of human culture. Namely, the personal sphere “should not be subject to external intervention.”[45] Stem cell interventions could affect this concept of bodily completeness, leading to heavy restrictions. Under the Grundgesetz, human dignity and the right to life with physical integrity are paramount.[46] The Embryo Protection Act of 1991 made producing cell lines illegal. Cell lines can be imported if approved by the Central Ethics Commission for Stem Cell Research only if they were derived before May 2007.[47] Stem cell research respects the integrity of life for the embryo with heavy specifications and intense oversight. This is vastly different in Finland, where the regulatory bodies find research more permissible in IVF excess, but only up to 14 days after fertilization.[48] Spain’s approach differs still, with a comprehensive regulatory framework.[49] Thus, research regulation can be culture-specific due to variations in applied principles. Diverse cultures call for various approaches to ethical permissibility.[50] Only an adaptive-deliberative model can address the cultural constructions of self and achieve positive, culturally sensitive stem cell research practices.[51] II. Religious Perspectives on ESC Embryonic stem cell sources are the main consideration within religious contexts. While individuals may not regard their own religious texts as authoritative or factual, religion can shape their foundations or perspectives. The Qur'an states: “And indeed We created man from a quintessence of clay. Then We placed within him a small quantity of nutfa (sperm to fertilize) in a safe place. Then We have fashioned the nutfa into an ‘alaqa (clinging clot or cell cluster), then We developed the ‘alaqa into mudgha (a lump of flesh), and We made mudgha into bones, and clothed the bones with flesh, then We brought it into being as a new creation. So Blessed is Allah, the Best of Creators.”[52] Many scholars of Islam estimate the time of soul installment, marked by the angel breathing in the soul to bring the individual into creation, as 120 days from conception.[53] Personhood begins at this point, and the value of life would prohibit research or experimentation that could harm the individual. If the fetus is more than 120 days old, the time ensoulment is interpreted to occur according to Islamic law, abortion is no longer permissible.[54] There are a few opposing opinions about early embryos in Islamic traditions. According to some Islamic theologians, there is no ensoulment of the early embryo, which is the source of stem cells for ESC research.[55] In Buddhism, the stance on stem cell research is not settled. The main tenets, the prohibition against harming or destroying others (ahimsa) and the pursuit of knowledge (prajña) and compassion (karuna), leave Buddhist scholars and communities divided.[56] Some scholars argue stem cell research is in accordance with the Buddhist tenet of seeking knowledge and ending human suffering. Others feel it violates the principle of not harming others. Finding the balance between these two points relies on the karmic burden of Buddhist morality. In trying to prevent ahimsa towards the embryo, Buddhist scholars suggest that to comply with Buddhist tenets, research cannot be done as the embryo has personhood at the moment of conception and would reincarnate immediately, harming the individual's ability to build their karmic burden.[57] On the other hand, the Bodhisattvas, those considered to be on the path to enlightenment or Nirvana, have given organs and flesh to others to help alleviate grieving and to benefit all.[58] Acceptance varies on applied beliefs and interpretations. Catholicism does not support embryonic stem cell research, as it entails creation or destruction of human embryos. This destruction conflicts with the belief in the sanctity of life. For example, in the Old Testament, Genesis describes humanity as being created in God’s image and multiplying on the Earth, referencing the sacred rights to human conception and the purpose of development and life. In the Ten Commandments, the tenet that one should not kill has numerous interpretations where killing could mean murder or shedding of the sanctity of life, demonstrating the high value of human personhood. In other books, the theological conception of when life begins is interpreted as in utero,[59] highlighting the inviolability of life and its formation in vivo to make a religious point for accepting such research as relatively limited, if at all.[60] The Vatican has released ethical directives to help apply a theological basis to modern-day conflicts. The Magisterium of the Church states that “unless there is a moral certainty of not causing harm,” experimentation on fetuses, fertilized cells, stem cells, or embryos constitutes a crime.[61] Such procedures would not respect the human person who exists at these stages, according to Catholicism. Damages to the embryo are considered gravely immoral and illicit.[62] Although the Catholic Church officially opposes abortion, surveys demonstrate that many Catholic people hold pro-choice views, whether due to the context of conception, stage of pregnancy, threat to the mother’s life, or for other reasons, demonstrating that practicing members can also accept some but not all tenets.[63] Some major Jewish denominations, such as the Reform, Conservative, and Reconstructionist movements, are open to supporting ESC use or research as long as it is for saving a life.[64] Within Judaism, the Talmud, or study, gives personhood to the child at birth and emphasizes that life does not begin at conception:[65] “If she is found pregnant, until the fortieth day it is mere fluid,”[66] Whereas most religions prioritize the status of human embryos, the Halakah (Jewish religious law) states that to save one life, most other religious laws can be ignored because it is in pursuit of preservation.[67] Stem cell research is accepted due to application of these religious laws. We recognize that all religions contain subsets and sects. The variety of environmental and cultural differences within religious groups requires further analysis to respect the flexibility of religious thoughts and practices. We make no presumptions that all cultures require notions of autonomy or morality as under the common morality theory, which asserts a set of universal moral norms that all individuals share provides moral reasoning and guides ethical decisions.[68] We only wish to show that the interaction with morality varies between cultures and countries. III. A Flexible Ethical Approach The plurality of different moral approaches described above demonstrates that there can be no universally acceptable uniform law for ESC on a global scale. Instead of developing one standard, flexible ethical applications must be continued. We recommend local guidelines that incorporate important cultural and ethical priorities. While the Declaration of Helsinki is more relevant to people in clinical trials receiving ESC products, in keeping with the tradition of protections for research subjects, consent of the donor is an ethical requirement for ESC donation in many jurisdictions including the US, Canada, and Europe.[69] The Declaration of Helsinki provides a reference point for regulatory standards and could potentially be used as a universal baseline for obtaining consent prior to gamete or embryo donation. For instance, in Columbia University’s egg donor program for stem cell research, donors followed standard screening protocols and “underwent counseling sessions that included information as to the purpose of oocyte donation for research, what the oocytes would be used for, the risks and benefits of donation, and process of oocyte stimulation” to ensure transparency for consent.[70] The program helped advance stem cell research and provided clear and safe research methods with paid participants. Though paid participation or covering costs of incidental expenses may not be socially acceptable in every culture or context,[71] and creating embryos for ESC research is illegal in many jurisdictions, Columbia’s program was effective because of the clear and honest communications with donors, IRBs, and related stakeholders. This example demonstrates that cultural acceptance of scientific research and of the idea that an egg or embryo does not have personhood is likely behind societal acceptance of donating eggs for ESC research. As noted, many countries do not permit the creation of embryos for research. Proper communication and education regarding the process and purpose of stem cell research may bolster comprehension and garner more acceptance. “Given the sensitive subject material, a complete consent process can support voluntary participation through trust, understanding, and ethical norms from the cultures and morals participants value. This can be hard for researchers entering countries of different socioeconomic stability, with different languages and different societal values.[72] An adequate moral foundation in medical ethics is derived from the cultural and religious basis that informs knowledge and actions.[73] Understanding local cultural and religious values and their impact on research could help researchers develop humility and promote inclusion. IV. Concerns Some may argue that if researchers all adhere to one ethics standard, protection will be satisfied across all borders, and the global public will trust researchers. However, defining what needs to be protected and how to define such research standards is very specific to the people to which standards are applied. We suggest that applying one uniform guide cannot accurately protect each individual because we all possess our own perceptions and interpretations of social values.[74] Therefore, the issue of not adjusting to the moral pluralism between peoples in applying one standard of ethics can be resolved by building out ethics models that can be adapted to different cultures and religions. Other concerns include medical tourism, which may promote health inequities.[75] Some countries may develop and approve products derived from ESC research before others, compromising research ethics or drug approval processes. There are also concerns about the sale of unauthorized stem cell treatments, for example, those without FDA approval in the United States. Countries with robust research infrastructures may be tempted to attract medical tourists, and some customers will have false hopes based on aggressive publicity of unproven treatments.[76] For example, in China, stem cell clinics can market to foreign clients who are not protected under the regulatory regimes. Companies employ a marketing strategy of “ethically friendly” therapies. Specifically, in the case of Beike, China’s leading stem cell tourism company and sprouting network, ethical oversight of administrators or health bureaus at one site has “the unintended consequence of shifting questionable activities to another node in Beike's diffuse network.”[77] In contrast, Jordan is aware of stem cell research’s potential abuse and its own status as a “health-care hub.” Jordan’s expanded regulations include preserving the interests of individuals in clinical trials and banning private companies from ESC research to preserve transparency and the integrity of research practices.[78] The social priorities of the community are also a concern. The ISSCR explicitly states that guidelines “should be periodically revised to accommodate scientific advances, new challenges, and evolving social priorities.”[79] The adaptable ethics model extends this consideration further by addressing whether research is warranted given the varying degrees of socioeconomic conditions, political stability, and healthcare accessibilities and limitations. An ethical approach would require discussion about resource allocation and appropriate distribution of funds.[80] CONCLUSION While some religions emphasize the sanctity of life from conception, which may lead to public opposition to ESC research, others encourage ESC research due to its potential for healing and alleviating human pain. Many countries have special regulations that balance local views on embryonic personhood, the benefits of research as individual or societal goods, and the protection of human research subjects. To foster understanding and constructive dialogue, global policy frameworks should prioritize the protection of universal human rights, transparency, and informed consent. In addition to these foundational global policies, we recommend tailoring local guidelines to reflect the diverse cultural and religious perspectives of the populations they govern. Ethics models should be adapted to local populations to effectively establish research protections, growth, and possibilities of stem cell research. For example, in countries with strong beliefs in the moral sanctity of embryos or heavy religious restrictions, an adaptive model can allow for discussion instead of immediate rejection. In countries with limited individual rights and voice in science policy, an adaptive model ensures cultural, moral, and religious views are taken into consideration, thereby building social inclusion. While this ethical consideration by the government may not give a complete voice to every individual, it will help balance policies and maintain the diverse perspectives of those it affects. Embracing an adaptive ethics model of ESC research promotes open-minded dialogue and respect for the importance of human belief and tradition. By actively engaging with cultural and religious values, researchers can better handle disagreements and promote ethical research practices that benefit each society. This brief exploration of the religious and cultural differences that impact ESC research reveals the nuances of relative ethics and highlights a need for local policymakers to apply a more intense adaptive model. - [1] Poliwoda, S., Noor, N., Downs, E., Schaaf, A., Cantwell, A., Ganti, L., Kaye, A. D., Mosel, L. I., Carroll, C. B., Viswanath, O., & Urits, I. (2022). Stem cells: a comprehensive review of origins and emerging clinical roles in medical practice. 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In Recent Advances in Theories and Practice of Chinese Medicine (p. 79). InTech. [26] Luo, D., Xu, Z., Wang, Z., & Ran, W. (2021). China's Stem Cell Research and Knowledge Levels of Medical Practitioners and Students. Stem cells international, 2021, 6667743. https://doi.org/10.1155/2021/6667743 [27] Luo, D., Xu, Z., Wang, Z., & Ran, W. (2021). China's Stem Cell Research and Knowledge Levels of Medical Practitioners and Students. Stem cells international, 2021, 6667743. https://doi.org/10.1155/2021/6667743 [28] Zhang, J. Y. (2017). Lost in translation? accountability and governance of Clinical Stem Cell Research in China. Regenerative Medicine, 12(6), 647–656. https://doi.org/10.2217/rme-2017-0035 [29] Wang, L., Wang, F., & Zhang, W. (2021). Bioethics in China’s biosecurity law: Forms, effects, and unsettled issues. Journal of law and the biosciences, 8(1). https://doi.org/10.1093/jlb/lsab019 https://academic.oup.com/jlb/article/8/1/lsab019/6299199 [30] Chen, H., Wei, T., Wang, H. et al. Association of China’s two-child policy with changes in number of births and birth defects rate, 2008–2017. BMC Public Health 22, 434 (2022). https://doi.org/10.1186/s12889-022-12839-0 [31] Azuma, K. Regulatory Landscape of Regenerative Medicine in Japan. Curr Stem Cell Rep 1, 118–128 (2015). https://doi.org/10.1007/s40778-015-0012-6 [32] Harris, R. (2005, May 19). Researchers Report Advance in Stem Cell Production. NPR. https://www.npr.org/2005/05/19/4658967/researchers-report-advance-in-stem-cell-production [33] Park, S. (2012). South Korea steps up stem-cell work. Nature. https://doi.org/10.1038/nature.2012.10565 [34] Resnik, D. B., Shamoo, A. E., & Krimsky, S. (2006). Fraudulent human embryonic stem cell research in South Korea: lessons learned. Accountability in research, 13(1), 101–109. https://doi.org/10.1080/08989620600634193. [35] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6 [36]Association for the Advancement of Blood and Biotherapies. https://www.aabb.org/regulatory-and-advocacy/regulatory-affairs/regulatory-for-cellular-therapies/international-competent-authorities/saudi-arabia [37] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: Interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6 [38] Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: Interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6 Culturally, autonomy practices follow a relational autonomy approach based on a paternalistic deontological health care model. The adherence to strict international research policies and religious pillars within the regulatory environment is a great foundation for research ethics. However, there is a need to develop locally targeted ethics approaches for research (as called for in Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6), this decision-making approach may help advise a research decision model. For more on the clinical cultural autonomy approaches, see: Alabdullah, Y. Y., Alzaid, E., Alsaad, S., Alamri, T., Alolayan, S. W., Bah, S., & Aljoudi, A. S. (2022). Autonomy and paternalism in Shared decision‐making in a Saudi Arabian tertiary hospital: A cross‐sectional study. Developing World Bioethics, 23(3), 260–268. https://doi.org/10.1111/dewb.12355; Bukhari, A. A. (2017). Universal Principles of Bioethics and Patient Rights in Saudi Arabia (Doctoral dissertation, Duquesne University). https://dsc.duq.edu/etd/124; Ladha, S., Nakshawani, S. A., Alzaidy, A., & Tarab, B. (2023, October 26). Islam and Bioethics: What We All Need to Know. Columbia University School of Professional Studies. https://sps.columbia.edu/events/islam-and-bioethics-what-we-all-need-know [39] Ababneh, M. A., Al-Azzam, S. I., Alzoubi, K., Rababa’h, A., & Al Demour, S. (2021). Understanding and attitudes of the Jordanian public about clinical research ethics. Research Ethics, 17(2), 228-241. https://doi.org/10.1177/1747016120966779 [40] Ababneh, M. A., Al-Azzam, S. I., Alzoubi, K., Rababa’h, A., & Al Demour, S. (2021). Understanding and attitudes of the Jordanian public about clinical research ethics. Research Ethics, 17(2), 228-241. https://doi.org/10.1177/1747016120966779 [41] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East. Nature 510, 189. https://doi.org/10.1038/510189a [42] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East. Nature 510, 189. https://doi.org/10.1038/510189a [43] The EU’s definition of autonomy relates to the capacity for creating ideas, moral insight, decisions, and actions without constraint, personal responsibility, and informed consent. However, the EU views autonomy as not completely able to protect individuals and depends on other principles, such as dignity, which “expresses the intrinsic worth and fundamental equality of all human beings.” Rendtorff, J.D., Kemp, P. (2019). Four Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity and Vulnerability. In: Valdés, E., Lecaros, J. (eds) Biolaw and Policy in the Twenty-First Century. International Library of Ethics, Law, and the New Medicine, vol 78. Springer, Cham. https://doi.org/10.1007/978-3-030-05903-3_3 [44] Council of Europe. Convention for the protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (ETS No. 164) https://www.coe.int/en/web/conventions/full-list?module=treaty-detail&treatynum=164 (forbidding the creation of embryos for research purposes only, and suggests embryos in vitro have protections.); Also see Drabiak-Syed B. K. (2013). New President, New Human Embryonic Stem Cell Research Policy: Comparative International Perspectives and Embryonic Stem Cell Research Laws in France. Biotechnology Law Report, 32(6), 349–356. https://doi.org/10.1089/blr.2013.9865 [45] Rendtorff, J.D., Kemp, P. (2019). Four Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity and Vulnerability. In: Valdés, E., Lecaros, J. (eds) Biolaw and Policy in the Twenty-First Century. International Library of Ethics, Law, and the New Medicine, vol 78. Springer, Cham. https://doi.org/10.1007/978-3-030-05903-3_3 [46] Tomuschat, C., Currie, D. P., Kommers, D. P., & Kerr, R. (Trans.). (1949, May 23). Basic law for the Federal Republic of Germany. https://www.btg-bestellservice.de/pdf/80201000.pdf [47] Regulation of Stem Cell Research in Germany. Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-germany [48] Regulation of Stem Cell Research in Finland. Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-finland [49] Regulation of Stem Cell Research in Spain. Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-spain [50] Some sources to consider regarding ethics models or regulatory oversights of other cultures not covered: Kara MA. Applicability of the principle of respect for autonomy: the perspective of Turkey. J Med Ethics. 2007 Nov;33(11):627-30. doi: 10.1136/jme.2006.017400. PMID: 17971462; PMCID: PMC2598110. Ugarte, O. N., & Acioly, M. A. (2014). The principle of autonomy in Brazil: one needs to discuss it ... Revista do Colegio Brasileiro de Cirurgioes, 41(5), 374–377. https://doi.org/10.1590/0100-69912014005013 Bharadwaj, A., & Glasner, P. E. (2012). Local cells, global science: The rise of embryonic stem cell research in India. Routledge. For further research on specific European countries regarding ethical and regulatory framework, we recommend this database: Regulation of Stem Cell Research in Europe. Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-europe [51] Klitzman, R. (2006). Complications of culture in obtaining informed consent. The American Journal of Bioethics, 6(1), 20–21. https://doi.org/10.1080/15265160500394671 see also: Ekmekci, P. E., & Arda, B. (2017). Interculturalism and Informed Consent: Respecting Cultural Differences without Breaching Human Rights. Cultura (Iasi, Romania), 14(2), 159–172.; For why trust is important in research, see also: Gray, B., Hilder, J., Macdonald, L., Tester, R., Dowell, A., & Stubbe, M. (2017). Are research ethics guidelines culturally competent? Research Ethics, 13(1), 23-41. https://doi.org/10.1177/1747016116650235 [52] The Qur'an (M. Khattab, Trans.). (1965). Al-Mu’minun, 23: 12-14. https://quran.com/23 [53] Lenfest, Y. (2017, December 8). Islam and the beginning of human life. Bill of Health. https://blog.petrieflom.law.harvard.edu/2017/12/08/islam-and-the-beginning-of-human-life/ [54] Aksoy, S. (2005). Making regulations and drawing up legislation in Islamic countries under conditions of uncertainty, with special reference to embryonic stem cell research. Journal of Medical Ethics, 31:399-403.; see also: Mahmoud, Azza. "Islamic Bioethics: National Regulations and Guidelines of Human Stem Cell Research in the Muslim World." Master's thesis, Chapman University, 2022. https://doi.org/10.36837/ chapman.000386 [55] Rashid, R. (2022). When does Ensoulment occur in the Human Foetus. Journal of the British Islamic Medical Association, 12(4). ISSN 2634 8071. https://www.jbima.com/wp-content/uploads/2023/01/2-Ethics-3_-Ensoulment_Rafaqat.pdf. [56] Sivaraman, M. & Noor, S. (2017). Ethics of embryonic stem cell research according to Buddhist, Hindu, Catholic, and Islamic religions: perspective from Malaysia. Asian Biomedicine,8(1) 43-52. https://doi.org/10.5372/1905-7415.0801.260 [57] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.), Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues (pp. 79-94). Berkeley: University of California Press. https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005 [58] Lecso, P. A. (1991). The Bodhisattva Ideal and Organ Transplantation. Journal of Religion and Health, 30(1), 35–41. http://www.jstor.org/stable/27510629; Bodhisattva, S. (n.d.). The Key of Becoming a Bodhisattva. A Guide to the Bodhisattva Way of Life. http://www.buddhism.org/Sutras/2/BodhisattvaWay.htm [59] There is no explicit religious reference to when life begins or how to conduct research that interacts with the concept of life. However, these are relevant verses pertaining to how the fetus is viewed. ((King James Bible. (1999). Oxford University Press. (original work published 1769)) Jerimiah 1: 5 “Before I formed thee in the belly I knew thee; and before thou camest forth out of the womb I sanctified thee…” In prophet Jerimiah’s insight, God set him apart as a person known before childbirth, a theme carried within the Psalm of David. Psalm 139: 13-14 “…Thou hast covered me in my mother's womb. I will praise thee; for I am fearfully and wonderfully made…” These verses demonstrate David’s respect for God as an entity that would know of all man’s thoughts and doings even before birth. [60] It should be noted that abortion is not supported as well. [61] The Vatican. (1987, February 22). Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation Replies to Certain Questions of the Day. Congregation For the Doctrine of the Faith. https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html [62] The Vatican. (2000, August 25). Declaration On the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells. Pontifical Academy for Life. https://www.vatican.va/roman_curia/pontifical_academies/acdlife/documents/rc_pa_acdlife_doc_20000824_cellule-staminali_en.html; Ohara, N. (2003). Ethical Consideration of Experimentation Using Living Human Embryos: The Catholic Church’s Position on Human Embryonic Stem Cell Research and Human Cloning. Department of Obstetrics and Gynecology. Retrieved from https://article.imrpress.com/journal/CEOG/30/2-3/pii/2003018/77-81.pdf. [63] Smith, G. A. (2022, May 23). Like Americans overall, Catholics vary in their abortion views, with regular mass attenders most opposed. Pew Research Center. https://www.pewresearch.org/short-reads/2022/05/23/like-americans-overall-catholics-vary-in-their-abortion-views-with-regular-mass-attenders-most-opposed/ [64] Rosner, F., & Reichman, E. (2002). Embryonic stem cell research in Jewish law. Journal of halacha and contemporary society, (43), 49–68.; Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.), Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues (pp. 79-94). Berkeley: University of California Press. https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005 [65] Schenker J. G. (2008). The beginning of human life: status of embryo. Perspectives in Halakha (Jewish Religious Law). Journal of assisted reproduction and genetics, 25(6), 271–276. https://doi.org/10.1007/s10815-008-9221-6 [66] Ruttenberg, D. (2020, May 5). The Torah of Abortion Justice (annotated source sheet). Sefaria. https://www.sefaria.org/sheets/234926.7?lang=bi&with=all&lang2=en [67] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.), Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues (pp. 79-94). Berkeley: University of California Press. https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005 [68] Gert, B. (2007). Common morality: Deciding what to do. Oxford Univ. Press. [69] World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 Declaration of Helsinki – WMA – The World Medical Association.; see also: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. U.S. Department of Health and Human Services. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html [70] Zakarin Safier, L., Gumer, A., Kline, M., Egli, D., & Sauer, M. V. (2018). Compensating human subjects providing oocytes for stem cell research: 9-year experience and outcomes. Journal of assisted reproduction and genetics, 35(7), 1219–1225. https://doi.org/10.1007/s10815-018-1171-z https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063839/ see also: Riordan, N. H., & Paz Rodríguez, J. (2021). Addressing concerns regarding associated costs, transparency, and integrity of research in recent stem cell trial. Stem Cells Translational Medicine, 10(12), 1715–1716. https://doi.org/10.1002/sctm.21-0234 [71] Klitzman, R., & Sauer, M. V. (2009). Payment of egg donors in stem cell research in the USA. Reproductive biomedicine online, 18(5), 603–608. https://doi.org/10.1016/s1472-6483(10)60002-8 [72] Krosin, M. T., Klitzman, R., Levin, B., Cheng, J., & Ranney, M. L. (2006). Problems in comprehension of informed consent in rural and peri-urban Mali, West Africa. Clinical trials (London, England), 3(3), 306–313. https://doi.org/10.1191/1740774506cn150oa [73] Veatch, Robert M. Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict. Georgetown University Press, 2012. [74] Msoroka, M. S., & Amundsen, D. (2018). One size fits not quite all: Universal research ethics with diversity. Research Ethics, 14(3), 1-17. https://doi.org/10.1177/1747016117739939 [75] Pirzada, N. (2022). The Expansion of Turkey’s Medical Tourism Industry. Voices in Bioethics, 8. https://doi.org/10.52214/vib.v8i.9894 [76] Stem Cell Tourism: False Hope for Real Money. Harvard Stem Cell Institute (HSCI). (2023). https://hsci.harvard.edu/stem-cell-tourism, See also: Bissassar, M. (2017). Transnational Stem Cell Tourism: An ethical analysis. Voices in Bioethics, 3. https://doi.org/10.7916/vib.v3i.6027 [77]Song, P. (2011) The proliferation of stem cell therapies in post-Mao China: problematizing ethical regulation, New Genetics and Society, 30:2, 141-153, DOI: 10.1080/14636778.2011.574375 [78] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East. Nature 510, 189. https://doi.org/10.1038/510189a [79] International Society for Stem Cell Research. (2024). Standards in stem cell research. International Society for Stem Cell Research. https://www.isscr.org/guidelines/5-standards-in-stem-cell-research [80] Benjamin, R. (2013). People’s science bodies and rights on the Stem Cell Frontier. Stanford University Press.

Photo by National Cancer Institute on Unsplash INTRODUCTION Gift-giving by patients or their families to physicians has happened since there were patients and physicians, and in many places, it’s still quite common. It’s also potentially problematic, and the why and how of it offer important insight into the physician-patient relationship and human relationships more broadly. Yet ethicists, regulators, and the public have not paid much systematic attention. In the United States, no federal or state legislation directly addresses it. Only in the past two decades did the American Medical Association (AMA) release guidance to physicians about it. That guidance, which permits physicians to accept certain gifts by certain patients under certain circumstances, namely, when it will not influence their medical judgment or cause hardship to the gift-giver, is vague and incomplete – indeed, it’s all of 200 words.[1] Other physician professional organizations have little to add.[2] A few academics and opinion columnists have studied or reflected on the psychology of gift-giving and -receiving and recommended everything from categorical rejection of patient gifts[3] to erring on the side of accepting them, provided they are of modest value, and the motivation behind them can be discerned.[4] However, insufficient attention has been paid to the when and where of those gifts or the significance of clinic-, hospital- or other systems-level ethical safeguards. ANALYSIS When deciding whether they will accept a gift from a patient or their family, physicians must balance the possibility that the gift could cloud medical judgment, lead to favoritism, exploitation, and slippery slopes, or pressure other patients to give, and perhaps even debase the meaning of medical treatment, against the prospect that gift-giving could increase patient trust and satisfaction, as well as empower patients and respect their autonomy and culture.[5] Performing this harm-benefit calculation case by case is challenging and time-consuming. Unsurprisingly, many physicians opt simply to tell would-be gift-giving patients that they appreciate the sentiment, but, as a rule, they accept no gifts. I submit many physicians do this also because they are unaware of how meaningful giving a gift can be for patients or anyone in a disadvantaged position with respect to the gift recipient. They may also not know that there are simple accountability mechanisms they can institute that may prevent many of the possible adverse consequences of gift-giving and -receiving in the context of the physician-patient or physician-patient-family relationship. Unfortunately, many instances in which accepting a gift would have led to net benefit are foregone. It is my belief a consensus could quickly be formed about which types of gifts would clearly be wrong to accept. Few would defend the physician who agrees to use a patient’s villa in the Bahamas or welcomes expensive jewelry or lewd photos. The timing and intent of a gift also matter. Few would forgive the physician who accepted even a modestly valuable voucher to eat at a patient’s restaurant while their eligibility for transplant was being debated or after they had run out of opioid painkillers and were denied a prescription renewal. On the other hand, I doubt even Charles Weijer or the College of Physicians and Surgeons of Prince Edward Island, which views accepting gifts from patients as “boundary crossing,”[6] would demand an orthopedic surgeon turn down the happy picture a pediatric patient drew after recovering from a hip injury and resuming sports. They are also unlikely to criticize an oncology team that graciously receives a fruitcake baked by the sister of an elderly cancer patient after the decision was made and agreed to, around Christmastime, not to initiate another round of chemotherapy. These unlikely refusals may be because rejecting those gifts, all things considered, would seem cruel. But it might also be because there is disagreement about what constitutes a gift: whether it must be a tangible object (are heartfelt thank-yous and hugs not also “gifts”?) or whether it must be something that requires the physician actively do something, e.g., get on a plane. These disagreements about definitions may also partially underlie disagreements about practice. Suppose a patient in a sparsely populated, heavily wooded part of Maine takes it upon himself to offer a sack of apples from his orchard to his internist, who regularly waives fees for those who cannot pay them or will make a house call at any time of the night. In that case, the internist may not consider the apples a gift. He may not think of them as payment or re-payment either. They may exist in some in-between category, much like the knitted slippers brought in by a patient in whose culture “thank you” is seldom said. But clearly, some things are widely perceived as gifts or to have substantial gift-like character. Should they, at least, be rejected? I don’t think so. The act of gift-giving and -receiving can be a sort of ritual and gradually lead to trust and closeness.[7] Perhaps a shy patient whose wife previously sent chocolates to his physician around Christmastime will come to see the physician as a part of his extended family. Perhaps he needs to do so to feel comfortable talking about his erectile dysfunction. Gifts can be expressions of caring.[8] Perhaps an elderly Texan patient imagines her younger physician, whom she has known for thirty years and often sees at the grocery store, as her son and asks to prepare a homecoming mum (traditionally a chrysanthemum flower corsage) for his children’s school dance. Perhaps doing so will give her purpose, make her feel useful, as all her own children have moved away. Giving gifts may also provide patients with a sense of control and help them feel as if less of a power imbalance exists between them and their physician. Perhaps a young judge, who is not used to not being in control, and was previously misdiagnosed with rheumatoid arthritis, is now struggling to come to terms with his Lupus. Perhaps giving the physician who made the correct diagnosis a moderately-priced bottle of scotch restores his confidence or sense of pride to. Gifts are also undoubtedly important to the recipient. When medical providers receive a gift, they may interpret it as a sign that they are valued. While it would be wrong to practice medicine to receive gifts or expect them, there are times, like when ERs and ICUs are overwhelmed because of a viral pandemic,[9] which threatens the will to continue working, and most anything (within reason) that bolsters resolve can be considered good. There is also no obvious distinction between the satisfaction physicians normally receive on seeing their patients recover or being thanked or smiled at and what they feel when they receive a small or “token” gift, like a plate of homemade cookies. The point is that the physician-patient relationship is a human one. Many advocate it should be personal, that physicians should be emotionally invested in their patients, care about and have compassion for them in ways that professional oaths do not fully capture.[10] This dynamic is particularly important in primary care or when the physician-patient relationship continues for long periods. According to one Israeli study, many patients even wish for a relationship with their physician akin to friendship. Those who felt they had such a relationship were more satisfied with their care than those who believed the relationship was business-like.[11] The precedent for this “friendship between unequals” goes back at least to the time of Erasmus, some five hundred years ago.[12] There may be good reasons for physicians to draw the line before friendship, but if accepting certain gifts builds intimacy, and that intimacy does not cross over into an inappropriate relationship, e.g., a sexual or romantic relationship, and if it has the chance to improve healthcare outcomes through improved mood or early disclosure of problems, I think it should be done. Physicians have a prima facie duty to do good for their patients.[13] Most physicians want to do good for their patients and respect their traditions and preferences. I suspect that accepting the gifts from the patients in the examples above would do a lot of good, or at least that rejecting them could do significant harm, including making them or their families feel estranged from the medical community, impeding future care. Physicians might be more comfortable accepting gifts if receiving gifts would not subject them to scrutiny or penalty. They also may feel better if they knew that receiving gifts would not harm their patients and that rejecting gifts might. They should document all gifts they receive.[14] This will enable them to detect if gifts from a particular patient are increasing in frequency or lavishness or changing markedly in character, which could warrant attention. I maintain this “Gift Log” should be maintained in common with everyone at the clinic or in the relevant hospital department and potentially made available to hospital administration for audit. Investigation might be necessary if a gift is given (and accepted) with no explicable context, e.g., not near holiday season or after a treatment milestone is achieved. When possible, gifts should be shared communally, such as placing fruit baskets or chocolates in the staff room. Other gifts, like artwork, can be displayed on the walls. Others should be encouraged to hold physicians accountable if they feel patients who have given gifts receive preferential treatment, including something as seemingly small as priority for appointment bookings. Appearances matter and even the appearance of impropriety can affect the public’s trust in medicine. The culture of medicine has already changed such that nurses now reproach physicians they feel violate the standard of care,[15] and this would be an extension of that trend. Depending on the set-up of the practice, a staff member can be designated for receiving gifts and politely declining those that ought to be declined. Staff members should tell patients, who give gifts in full view of other patients, that they cannot do so in the future. Physicians can politely rebuff patients who wish to give inappropriate gifts, or gifts at inappropriate times and suggest they donate to charity instead. Medical practices and hospitals should develop a gift policy in consultation with staff and patients to avoid needlessly rejecting gifts that benefit both doctor and patient and to avoid pressuring patients into giving gifts. The policy should be flexible to account for the crucial human element in any provider-patient relationship and the cultural nuances of any practice setting. Psychiatrists, who work with particularly vulnerable patients, may need to be more vigilant when accepting gifts.[16] CONCLUSION Though we tend to think health innovation occurs in urban medical centers and spreads outward, there may be something big-city physicians can learn from their rural colleagues about personalized patient-physician relationships. The value of gifts is only one example. Normalizing the acceptance of patient gifts in appropriate restricted circumstances has the added benefit of shining a spotlight on the acceptance of patient gifts in dubious ones. By bringing an already fairly common practice into the open and talking about it, we can create policies that respect patients as persons, prevent abuse, and deconstruct the stereotype of the austere and detached physician. While there is no reason to think that gift-giving would get out of control if appropriate safeguards are put in place, the medical community can always re-evaluate after a period, or an individual medical practice can re-evaluate based on the circumstances of their practice environment. Gift-giving, especially when gifts are of small monetary value, should be recognized as a culturally appropriate gesture with meaning far beyond that monetary value. It is best governed by reasonable gift-giving policies, not banned altogether. - [1] Council on Ethical and Judicial Affairs. “Ethics of Patient-Physician Relationships.” In AMA Code of Medical Ethics, 11. Chicago: American Medical Association, 2021. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/code-of-medical-ethics-chapter-1.pdf. [2] Sulmasy, Lois Snyder, and Thomas A. Bledsoe. “American College of Physicians Ethics Manual.” Annals of Internal Medicine 170, no. 2_Supplement (January 15, 2019): S1–32. https://doi.org/10.7326/M18-2160; Committee on Bioethics. “Pediatrician-Family-Patient Relationships: Managing the Boundaries.” Pediatrics 124, no. 6 (December 1, 2009): 1685–88. https://doi.org/10.1542/peds.2009-2147. [3] Weijer, Charles. “No: Gifts Debase the True Value of Care.” Western Journal of Medicine 175, no. 2 (August 2001): 77. [4] Lyckholm, Laurie J. “Should Physicians Accept Gifts From Patients?” JAMA 280, no. 22 (December 9, 1998): 1944–46. https://doi.org/10.1001/jama.280.22.1944; Spence, Sean A. “Patients Bearing Gifts: Are There Strings Attached?” BMJ 331, no. 7531 (December 22, 2005): 1527–29. https://doi.org/10.1136/bmj.331.7531.1527; Gaufberg, Elizabeth. “Should Physicians Accept Gifts from Patients?” American Family Physician 76, no. 3 (August 1, 2007): 437; Caddell, Andrew, and Lara Hazelton. “Accepting Gifts from Patients.” Canadian Family Physician 59, no. 12 (December 2013): 1259–60. [5] See above commentators and Drew, Jennifer, John D. Stoeckle, and J. Andrew Billings. “Tips, Status and Sacrifice: Gift Giving in the Doctor-Patient Relationship.” Social Science & Medicine 17, no. 7 (January 1, 1983): 399–404. https://doi.org/10.1016/0277-9536(83)90343-X. [6] College of Physicians and Surgeons of Prince Edward Island. “Respecting Boundaries.” Accessed April 4, 2021. https://cpspei.ca/respecting-boundaries/. [7] The Atlantic’s Marketing Team. “What Gifting Rituals from Around the Globe Reveal About Human Nature.” The Atlantic, 2018. https://www.theatlantic.com/sponsored/hennessy-2018/what-gifting-rituals-around-globe-reveal-about-human-nature/2044/. [8] Parker-Pope, Tara. “A Gift That Gives Right Back? The Giving Itself.” The New York Times, December 11, 2007, sec. Health. https://www.nytimes.com/2007/12/11/health/11well.html. [9] Harlan, Chico, and Stefano Pitrelli. “As Coronavirus Cases Grow, Hospitals in Northern Italy Are Running out of Beds.” Washington Post. Accessed April 4, 2021. https://www.washingtonpost.com/world/europe/italy-coronavirus-patients-lombardy-hospitals/2020/03/12/36041dc6-63ce-11ea-8a8e-5c5336b32760_story.html. [10] Frankel, Richard M. “Emotion and the Physician-Patient Relationship.” Motivation and Emotion 19, no. 3 (September 1, 1995): 163–73. https://doi.org/10.1007/BF02250509. [11] Magnezi, Racheli, Lisa Carroll Bergman, and Sara Urowitz. “Would Your Patient Prefer to Be Considered Your Friend? Patient Preferences in Physician Relationships.” Health Education & Behavior 42, no. 2 (April 1, 2015): 210–19. https://doi.org/10.1177/1090198114547814. [12] Albury, W. R., and G. M. Weisz. “The Medical Ethics of Erasmus and the Physician-Patient Relationship.” Medical Humanities 27, no. 1 (June 2001): 35–41. https://doi.org/10.1136/mh.27.1.35. [13] Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. 7th edition. New York: Oxford University Press, 2012. [14] Caddell and Hazelton, 2013. [15] See, e.g. Peplau, Hildegard E. “A Glance Back in Time: Nurse-Doctor Relationships.” Nursing Forum 34, no. 3 (1999): 31–35. https://doi.org/10.1111/j.1744-6198.1999.tb00991.x and Ahmad, Ahmir. “The Doctor-Nurse Relationship: Time for Change?” British Journal of Hospital Medicine (2005), September 27, 2013. https://doi.org/10.12968/hmed.2009.70.Sup4.41642. [16] Hundert, Edward M. “Looking a Gift Horse in the Mouth: The Ethics of Gift-Giving in Psychiatry.” Harvard Review of Psychiatry 6, no. 2 (January 1, 1998): 114–17. https://doi.org/10.3109/10673229809000319.

This paper argues that artist Dope Saint Jude is transforming South African hip-hop by queering a genre that has predominantly been male and heteronormative. Specifically, I analyse the opening skit of her music video “Keep in Touch” in order to unpack the ways which she revives Gayle, a gay language that adopted double-coded forms of speech during the apartheid era—a context in which homosexuals were criminalised. The use of Gayle and spaces close to the city centre of Cape Town (such as Salt River and Woodstock) speaks to the city as it was before it was transformed by the decline of industries due to the country’s adoption of neoliberal economics and, more recently, by the gentrification of these spaces. Dope Saint Jude therefore reclaims these city spaces through her use of gay modes of speech that have a long history in Cape Town and by positioning her work as hip-hop, which has been popular in the city for well over two decades. Her inclusion of transgender MC and DJ Angel Ho pushes the boundaries of hegemonic and binary conceptions of gender identity even further. In essence, Dope Saint Jude is transforming local hip-hop in a context that is shaped significantly by US cultural imperialism. The artist is also transforming our perspective of spaces that have been altered by neoliberal economics.Setting the SceneDope Saint Jude (DSJ) is a queer MC from Elsies River, a working class township located on Cape Town's Cape Flats in South Africa. Elsies River was defined as a “coloured” neighbourhood under the apartheid state's Group Areas Act, which segregated South Africans racially. With the aid of the Population Registration Act, citizens were classified, not merely along the lines of white, Asian, or black—black subjects were also divided into further categories. The apartheid state also distinguished between black and “coloured” subjects. Michael MacDonald contends that segregation “ordained blacks to be inferior to whites; apartheid cast them to be indelibly different” (11). Apartheid declared “African claims in South Africa to be inferior to white claims” and effectively claimed that black subjects “belonged elsewhere, in societies of their own, because their race was different” (ibid). The term “coloured” defined people as “mixed race” to separate communities that might otherwise have identified as black in the broad and inclusive sense (Erasmus 16). Racial categorisation was used to create a racial hierarchy with white subjects at the top of that hierarchy and those classified as black receiving the least resources and benefits. This frustrated attempts to establish broad alliances of black struggles against apartheid. It is in this sense that race is socially and politically constructed and continues to have currency, despite the fact that biologically essentialist understandings of race have been discredited (Yudell 13–14). Thanks to apartheid town planning and resource allocation, many townships on the Cape Flats were poverty-stricken and plagued by gang violence (Salo 363). This continues to be the case because post-apartheid South Africa's embrace of neoliberal economics failed to address racialised class inequalities significantly (Haupt, Static 6–8). This is the '90s context in which socially conscious hip-hop crews, such as Prophets of da City or Black Noise, came together. They drew inspiration from Black Consciousness philosophy via their exposure to US hip-hop crews such as Public Enemy in order to challenge apartheid policies, including their racial interpellation as “coloured” as distinct from the more inclusive category, black (Haupt, “Black Thing” 178). Prophets of da City—whose co-founding member, Shaheen Ariefdien, also lived in Elsies River—was the first South African hip-hop outfit to record an album. Whilst much of their work was performed in English, they quickly transformed the genre by rapping in non-standard varieties of Afrikaans and by including MCs who rap in African languages (ibid). They therefore succeeded in addressing key issues related to race, language, and class disparities in relation to South Africa's transition to democracy (Haupt, “Black Thing”; Haupt, Stealing Empire). However, as is the case with mainstream US hip-hop, specifically gangsta rap (Clay 149), South African hip-hop has been largely dominated by heterosexual men. This includes the more commercial hip-hop scene, which is largely perceived to be located in Johannesburg, where male MCs like AKA and Cassper Nyovest became celebrities. However, certain female MCs have claimed the genre, notably EJ von Lyrik and Burni Aman who are formerly of Godessa, the first female hip-hop crew to record and perform locally and internationally (Haupt, Stealing Empire 166; Haupt, “Can a Woman in Hip-Hop”). DSJ therefore presents the exception to a largely heteronormative and male-dominated South African music industry and hip-hop scene as she transforms it with her queer politics. While queer hip-hop is not new in the US (Pabón and Smalls), this is new territory for South Africa. Writing about the US MC Jean Grae in the context of a “male-dominated music industry and genre,” Shanté Paradigm Smalls contends,Heteronormativity blocks the materiality of the experiences of Black people. Yet, many Black people strive for a heteronormative effect if not “reality”. In hip hop, there is a particular emphasis on maintaining the rigidity of categories, even if those categories fail [sic]. (87) DSJ challenges these rigid categories. Keep in TouchDSJ's most visible entry onto the media landscape to date has been her appearance in an H&M recycling campaign with British Sri Lankan artist MIA (H&M), some fashion shoots, her new EP—Reimagine (Dope Saint Jude)—and recent Finnish, US and French tours as well as her YouTube channel, which features her music videos. As the characters’ theatrical costumes suggest, “Keep in Touch” is possibly the most camp and playful music video she has produced. It commences somewhat comically with Dope Saint Jude walking down Salt River main road to a public telephone, where she and a young woman in pig tails exchange dirty looks. Salt River is located at the foot of Devil's Peak not far from Cape Town's CBD. Many factories were located there, but the area is also surrounded by low-income housing, which was designated a “coloured” area under apartheid. After apartheid, neighbourhoods such as Salt River, Woodstock, and the Bo-Kaap became increasingly gentrified and, instead of becoming more inclusive, many parts of Cape Town continued to be influenced by policies that enable racialised inequalities. Dope Saint Jude calls Angel Ho: DSJ: Awêh, Angie! Yoh, you must check this kak sturvy girl here by the pay phone. [Turns to the girl, who walks away as she bursts a chewing gum bubble.] Ja, you better keep in touch. Anyway, listen here, what are you wys?Angel Ho: Ah, just at the salon getting my hair did. What's good? DSJ: Wanna catch on kak today?Angel Ho: Yes, honey. But, first, let me Gayle you this. By the jol by the art gallery, this Wendy, nuh. This Wendy tapped me on the shoulder and wys me, “This is a place of decorum.”DSJ: What did she wys?Angel Ho: De-corum. She basically told me this is not your house. DSJ: I know you told that girl to keep in touch!Angel Ho: Yes, Mama! I'm Paula, I told that bitch, “Keep in touch!” [Points index finger in the air.](Saint Jude, Dope, “Keep in Touch”)Angel Ho's name is a play on the male name Angelo and refers to the trope of the ho (whore) in gangsta rap lyrics and in music videos that present objectified women as secondary to male, heterosexual narratives (Sharpley-Whiting 23; Collins 27). The queering of Angelo, along with Angel Ho’s non-binary styling in terms of hair, make-up, and attire, appropriates a heterosexist, sexualised stereotype of women in order to create room for a gender identity that operates beyond heteronormative male-female binaries. Angel Ho’s location in a hair salon also speaks to stereotypical associations of salons with women and gay subjects. In a discussion of gender stereotypes about hair salons, Kristen Barber argues that beauty work has traditionally been “associated with women and with gay men” and that “the body beautiful has been tightly linked to the concept of femininity” (455–56). During the telephonic exchange, Angel Ho and Dope Saint Jude code-switch between standard and non-standard varieties of English and Afrikaans, as the opening appellation, “Awêh,” suggests. In this context, the term is a friendly greeting, which intimates solidarity. “Sturvy” means pretentious, whilst “kak” means shit, but here it is used to qualify “sturvy” and means that the girl at the pay phone is very pretentious or “full of airs.” To be “wys” means to be wise, but it can also mean that you are showing someone something or educating them. The meanings of these terms shift, depending on the context. The language practices in this skit are in line with the work of earlier hip-hop crews, such as Prophets of da City and Brasse vannie Kaap, to validate black, multilingual forms of speech and expression that challenge the linguistic imperialism of standard English and Afrikaans in South Africa, which has eleven official languages (Haupt, “Black Thing”; Haupt, Stealing Empire; Williams). Henry Louis Gates’s research on African American speech varieties and literary practices emerging from the repressive context of slavery is essential to understanding hip-hop’s language politics. Hip-hop artists' multilingual wordplay creates parallel discursive universes that operate both on the syntagmatic axis of meaning-making and the paradigmatic axis (Gates 49; Haupt, “Stealing Empire” 76–77). Historically, these discursive universes were those of the slave masters and the slaves, respectively. While white hegemonic meanings are produced on the syntagmatic axis (which is ordered and linear), black modes of speech as seen in hip-hop word play operate on the paradigmatic axis, which is connotative and non-linear (ibid). Distinguishing between Signifyin(g) / Signification (upper case, meaning black expression) and signification (lower case, meaning white dominant expression), he argues that “the signifier ‘Signification’ has remained identical in spelling to its white counterpart to demonstrate [. . .] that a simultaneous, but negated, parallel discursive (ontological, political) universe exists within the larger white discursive universe” (Gates 49). The meanings of terms and expressions can change, depending on the context and manner in which they are used. It is therefore the shared experiences of speech communities (such as slavery or racist/sexist oppression) that determine the negotiated meanings of certain forms of expression. Gayle as a Parallel Discursive UniverseDSJ and Angel Ho's performance of Gayle takes these linguistic practices further. Viewers are offered points of entry into Gayle via the music video’s subtitles. We learn that Wendy is code for a white person and that to keep in touch means exactly the opposite. Saint Jude explains that Gayle is a very fun queer language that was used to kind of mask what people were saying [. . .] It hides meanings and it makes use of women's names [. . . .] But the thing about Gayle is it's constantly changing [. . .] So everywhere you go, you kind of have to pick it up according to the context that you're in. (Ovens, Saint Jude and Haupt)According to Kathryn Luyt, “Gayle originated as Moffietaal [gay language] in the coloured gay drag culture of the Western Cape as a form of slang amongst Afrikaans-speakers which over time, grew into a stylect used by gay English and Afrikaans-speakers across South Africa” (Luyt 8; Cage 4). Given that the apartheid state criminalised homosexuals, Gayle was coded to evade detection and to seek out other members of this speech community (Luyt 8). Luyt qualifies the term “language” by arguing, “The term ‘language’ here, is used not as a constructed language with its own grammar, syntax, morphology and phonology, but in the same way as linguists would discuss women’s language, as a way of speaking, a kind of sociolect” (Luyt 8; Cage 1). However, the double-coded nature of Gayle allows one to think of it as creating a parallel discursive universe as Gates describes it (49). Whereas African American and Cape Flats discursive practices function parallel to white, hegemonic discourses, gay modes of speech run parallel to heteronormative communication. Exclusion and MicroaggressionsThe skit brings both discursive practices into play by creating room for one to consider that DSJ queers a male-dominated genre that is shaped by US cultural imperialism (Haupt, Stealing Empire 166) as a way of speaking back to intersectional forms of marginalisation (Crenshaw 1244), which are created by “white supremacist capitalist patriarchy” (hooks 116). This is significant in South Africa where “curative rape” of lesbians and other forms of homophobic violence are prominent (cf. Gqola; Hames; Msibi). Angel Ho's anecdote conveys a sense of the extent to which black individuals are subject to scrutiny. Ho's interpretation of the claim that the gallery “is a place of decorum” is correct: it is not Ho's house. Black queer subjects are not meant to feel at home or feel a sense of ownership. This functions as a racial microaggression: “subtle insults (verbal, nonverbal, and/or visual) directed toward people of color, often automatically or unconsciously” (Solorzano, Ceja, and Yosso 60). This speaks to DSJ's use of Salt River, Woodstock, and Bo-Kaap for the music video, which features black queer bodies in performance—all of these spaces are being gentrified, effectively pushing working class people of colour out of the city (cf. Didier, Morange, and Peyroux; Lemanski). Gustav Visser explains that gentrification has come to mean a unit-by-unit acquisition of housing which replaces low-income residents with high-income residents, and which occurs independent of the structural condition, architecture, tenure or original cost level of the housing (although it is usually renovated for or by the new occupiers). (81–82) In South Africa this inequity plays out along racial lines because its neoliberal economic policies created a small black elite without improving the lives of the black working class. Instead, the “new African bourgeoisie, because it shares racial identities with the bulk of the poor and class interests with white economic elites, is in position to mediate the reinforcing cleavages between rich whites and poor blacks without having to make more radical changes” (MacDonald 158). In a news article about a working class Salt River family of colour’s battle against an eviction, Christine Hogg explains, “Gentrification often means the poor are displaced as the rich move in or buildings are upgraded by new businesses. In Woodstock and Salt River both are happening at a pace.” Angel Ho’s anecdote, as told from a Woodstock hair salon, conveys a sense of what Woodstock’s transformation from a coloured, working class Group Area to an upmarket, trendy, and arty space would mean for people of colour, including black, queer subjects. One could argue that this reading of the video is undermined by DSJ’s work with global brand H&M. Was she was snared by neoliberal economics? Perhaps, but one response is that the seeds of any subculture’s commercial co-option lie in the fact it speaks through commodities (for example clothing, make-up, CDs, vinyl, or iTunes / mp3 downloads (Hebdige 95; Haupt, Stealing Empire 144–45). Subcultures have a window period in which to challenge hegemonic ideologies before they are delegitimated or commercially co-opted. Hardt and Negri contend that the means that extend the reach of corporate globalisation could be used to challenge it from within it (44–46; Haupt, Stealing Empire 26). DSJ utilises her H&M work, social media, the hip-hop genre, and international networks to exploit that window period to help mainstream black queer identity politics.ConclusionDSJ speaks back to processes of exclusion from the city, which was transformed by apartheid and, more recently, gentrification, by claiming it as a creative and playful space for queer subjects of colour. She uses Gayle to lay claim to the city as it has a long history in Cape Town. In fact, she says that she is not reviving Gayle, but is simply “putting it on a bigger platform” (Ovens, Saint Jude, and Haupt). The use of subtitles in the video suggests that she wants to mainstream queer identity politics. Saint Jude also transforms hip-hop heteronormativity by queering the genre and by locating her work within the history of Cape hip-hop’s multilingual wordplay. ReferencesBarber, Kristin. “The Well-Coiffed Man: Class, Race, and Heterosexual Masculinity in the Hair Salon.” Gender and Society 22.4 (2008): 455–76.Cage, Ken. “An Investigation into the Form and Function of Language Used by Gay Men in South Africa.” Rand Afrikaans University: MA thesis, 1999.Clay, Andreana. “‘I Used to Be Scared of the Dick’: Queer Women of Color and Hip-Hop Masculinity.” Home Girls Make Some Noise: Hip Hop Feminism Anthology. Ed. Gwendolyn D. Pough, Elain Richardson, Aisha Durham, and Rachel Raimist. California: Sojourns, 2007.Collins, Patricia Hill. Black Sexual Politics: African Americans, Gender, and the New Racism. New York: Routledge, 2005. Crenshaw, Kimberle. “Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color”. Stanford Law Review 43.6 (1991): 1241–299.Didier, Sophie, Marianne Morange, and Elisabeth Peyroux. “The Adaptative Nature of Neoliberalism at the Local Scale: Fifteen Years of City Improvement Districts in Cape Town and Johannesburg.” Antipode 45.1 (2012): 121–39.Erasmus, Zimitri. “Introduction.” Coloured by History, Shaped by Place. Ed. Zimitri Erasmus. Cape Town: Kwela Books & SA History Online, 2001. Gates, Henry Louis. The Signifying Monkey: A Theory of Afro-American Literary Criticism. Oxford: Oxford UP, 1988.Gqola, Pumla Dineo. Rape: A South African Nightmare. Johannesburg: Jacana, 2015.Hames, Mary. “Violence against Black Lesbians: Minding Our Language.” Agenda 25.4 (2011): 87–91.Hardt, Michael, and Antonio Negri. Empire. London: Harvard UP, 2000.Haupt, Adam. “Can a Woman in Hip Hop Speak on Her Own Terms?” Africa Is a Country. 23 Mar. 2015. <http://africasacountry.com/2015/03/the-double-consciousness-of-burni-aman-can-a-woman-in-hip-hop-speak-on-her-own-terms/>.Haupt, Adam. Static: Race & Representation in Post-Apartheid Music, Media & Film. Cape Town: HSRC Press, 2012. Haupt, Adam. Stealing Empire: P2P, Intellectual Property and Hip-Hop Subversion. Cape Town: HSRC Press, 2008. Haupt, Adam. “Black Thing: Hip-Hop Nationalism, ‘Race’ and Gender in Prophets of da City and Brasse vannie Kaap.” Coloured by History, Shaped by Place. Ed. Zimitri Erasmus. Cape Town: Kwela Books & SA History Online, 2001. Hebdige, Dick. Subculture: The Meaning of Style. London: Routledge, 1979.Hogg, Christine. “In Salt River Gentrification Often Means Eviction: Family Set to Lose Their Home of 11 Years.” Ground Up. 15 June 2016. <http://www.groundup.org.za/article/salt-river-gentrification-often-means-eviction/>.hooks, bell. Outlaw: Culture: Resisting Representations. New York: Routledge, 1994.Lemanski, Charlotte. “Hybrid Gentrification in South Africa: Theorising across Southern and Northern Cities.” Urban Studies 51.14 (2014): 2943–60.Luyt, Kathryn. “Gay Language in Cape Town: A Study of Gayle – Attitudes, History and Usage.” University of Cape Town: MA thesis, 2014.MacDonald, Michael. Why Race Matters in South Africa. University of Kwazulu-Natal Press: Scottsville, 2006.Msibi, Thabo. “Not Crossing the Line: Masculinities and Homophobic Violence in South Africa”. Agenda. 23.80 (2009): 50–54.Pabón, Jessica N., and Shanté Paradigm Smalls. “Critical Intimacies: Hip Hop as Queer Feminist Pedagogy.” Women & Performance: A Journal of Feminist Theory (2014): 1–7.Salo, Elaine. “Negotiating Gender and Personhood in the New South Africa: Adolescent Women and Gangsters in Manenberg Township on the Cape Flats.” Journal of European Cultural Studies 6.3 (2003): 345–65.Solórzano, Daniel, Miguel Ceja, and Tara Yosso. “Critical Race Theory, Racial Microaggressions, and Campus Racial Climate: The Experiences of African American College Students.” Journal of Negro Education 69.1/2 (2000): 60–73.Sharpley-Whiting, T. Denean. Pimps Up, Ho’s Down: Hip Hop’s Hold on Young Black Women. New York: New York UP, 2007.Smalls, Shanté Paradigm. “‘The Rain Comes Down’: Jean Grae and Hip Hop Heteronormativity.” American Behavioral Scientist 55.1 (2011): 86–95.Visser, Gustav. “Gentrification: Prospects for Urban South African Society?” Acta Academica Supplementum 1 (2003): 79–104.Williams, Quentin E. “Youth Multilingualism in South Africa’s Hip-Hop Culture: a Metapragmatic Analysis.” Sociolinguistic Studies 10.1 (2016): 109–33.Yudell, Michael. “A Short History of the Race Concept.” Race and the Genetic Revolution: Science, Myth, and Culture. Ed. Sheldon Krimsky and Kathleen Sloan. New York: Columbia UP, 2011.InterviewsOvens, Neil, Dope Saint Jude, and Adam Haupt. One FM Radio interview. Cape Town. 21 Apr. 2016.VideosSaint Jude, Dope. “Keep in Touch.” YouTube. 23 Feb. 2015. <https://www.youtube.com/watch?v=w2ux9R839lE>. H&M. “H&M World Recycle Week Featuring M.I.A.” YouTube. 11 Apr. 2016. <https://www.youtube.com/watch?v=f7MskKkn2Jg>. MusicSaint Jude, Dope. Reimagine. 15 June 2016. <https://dopesaintjude.bandcamp.com/album/reimagine>.

IntroductionThe common origin of the adjective “corporeal” and the noun “corpse” in the Latin root corpus points to the value of mortuary practices for investigating how the human body is objectified. In post-mortem rituals, the body—formerly the manipulator of objects—becomes itself the object that is manipulated. Thus, these funerary rituals provide a type of double reflexivity, where the object and subject of manipulation can be used to reciprocally illuminate one another. To this extent, any consideration of corporeality can only benefit from a discussion of how the body is objectified through mortuary practices. This paper offers just such a discussion with respect to a selection of two contrasting mortuary practices, in the context of the prehistoric past and the Classical Era respectively. At the most general level, we are motivated by the same intellectual impulse that has stimulated expositions on corporeality, materiality, and incarnation in areas like phenomenology (Merleau-Ponty 77–234), Marxism (Adorno 112–119), gender studies (Grosz vii–xvi), history (Laqueur 193–244), and theology (Henry 33–53). That is to say, our goal is to show that the body, far from being a transparent frame through which we encounter the world, is in fact a locus where historical, social, cultural, and psychological forces intersect. On this view, “the body vanishes as a biological entity and becomes an infinitely malleable and highly unstable culturally constructed product” (Shilling 78). However, for all that the cited paradigms offer culturally situated appreciations of corporeality; our particular intellectual framework will be provided by cognitive science. Two reasons impel us towards this methodological choice.In the first instance, the study of ritual has, after several decades of stagnation, been rewarded—even revolutionised—by the application of insights from the new sciences of the mind (Whitehouse 1–12; McCauley and Lawson 1–37). Thus, there are good reasons to think that ritual treatments of the body will refract historical and social forces through empirically attested tendencies in human cognition. In the present connection, this means that knowledge of these tendencies will reward any attempt to theorise the objectification of the body in mortuary rituals.In the second instance, because beliefs concerning the afterlife can never be definitively judged to be true or false, they give free expression to tendencies in cognition that are otherwise constrained by the need to reflect external realities accurately. To this extent, they grant direct access to the intuitive ideas and biases that shape how we think about the world. Already, this idea has been exploited to good effect in areas like the cognitive anthropology of religion, which explores how counterfactual beings like ghosts, spirits, and gods conform to (and deviate from) pre-reflective cognitive patterns (Atran 83–112; Barrett and Keil 219–224; Barrett and Reed 252–255; Boyer 876–886). Necessarily, this implies that targeting post-mortem treatments of the body will offer unmediated access to some of the conceptual schemes that inform thinking about human corporeality.At a more detailed level, the specific methodology we propose to use will be provided by conceptual blending theory—a framework developed by Gilles Fauconnier, Mark Turner, and others to describe how structures from different areas of experience are creatively blended to form a new conceptual frame. In this system, a generic space provides the ground for coordinating two or more input spaces into a blended space that synthesises them into a single output. Here this would entail using natural or technological processes to structure mortuary practices in a way that satisfies various psychological needs.Take, for instance, W.B. Yeats’s famous claim that “Too long a sacrifice / Can make a stone of the heart” (“Easter 1916” in Yeats 57-8). Here, the poet exploits a generic space—that of everyday objects and the effort involved in manipulating them—to coordinate an organic input from that taxonomy (the heart) with an inorganic input (a stone) to create the blended idea that too energetic a pursuit of an abstract ideal turns a person into an unfeeling object (the heart-as-stone). Although this particular example corresponds to a familiar rhetorical figure (the metaphor), the value of conceptual blending theory is that it cuts across distinctions of genre, media, language, and discourse level to provide a versatile framework for expressing how one area of human experience is related to another.As indicated, we will exploit this versatility to investigate two ways of objectifying the body through the examination of two contrasting mortuary practices—cremation and inhumation—against different cultural horizons. The first of these is the conceptualisation of the body as an object of a technical process, where the post-mortem cremation of the corpse is analogically correlated with the metallurgical refining of ore into base metal. Our area of focus here will be Bronze Age cremation practices. The second conceptual scheme we will investigate focuses on treatments of the body as a vegetable object; here, the relevant analogy likens the inhumation of the corpse to the planting of a seed in the soil from which future growth will come. This discussion will centre on the Classical Era. Burning: The Body as Manufactured ObjectThe Early and Middle Bronze Age in Western Europe (2500-1200 BCE) represented a period of change in funerary practices relative to the preceding Neolithic, exemplified by a move away from the use of Megalithic monuments, a proliferation of grave goods, and an increase in the use of cremation (Barrett 38-9; Cooney and Grogan 105-121; Brück, Material Metaphors 308; Waddell, Bronze Age 141-149). Moreover, the Western European Bronze Age is characterised by a shift away from communal burial towards single interment (Barrett 32; Bradley 158-168). Equally, the Bronze Age in Western Europe provides us with evidence of an increased use of cist and pit cremation burials concentrated in low-lying areas (Woodman 254; Waddell, Prehistoric 16; Cooney and Grogan 105-121; Bettencourt 103). This greater preference for lower-lying location appears to reflect a distinctive change in comparison to the distribution patterns of the Neolithic burials; these are often located on prominent, visible aspects of a landscape (Cooney and Grogan 53-61). These new Bronze Age burial practices appear to reflect a distancing in relation to the territories of the “old ancestors” typified by Megalithic monuments (Bettencourt 101-103). Crucially, the Bronze Age archaeological record provides us with evidence that indicates that cremation was becoming the dominant form of deposition of human remains throughout Central and Western Europe (Sørensen and Rebay 59-60).The activities associated with Bronze Age cremations such as the burning of the body and the fragmentation of the remains have often been considered as corporeal equivalents (or expressions) of the activities involved in metal (bronze) production (Brück, Death 84-86; Sørensen and Rebay 60–1; Rebay-Salisbury, Cremations 66-67). There are unequivocal similarities between the practices of cremation and contemporary bronze production technologies—particularly as both processes involve the transformation of material through the application of fire at temperatures between 700 ºC to 1000 ºC (Musgrove 272-276; Walker et al. 132; de Becdelievre et al. 222-223).We assert that the technologies that define the European Bronze Age—those involved in alloying copper and tin to produce bronze—offered a new conceptual frame that enabled the body to be objectified in new ways. The fundamental idea explored here is that the displacement of inhumation by cremation in the European Bronze Age was motivated by a cognitive shift, where new smelting technologies provided novel conceptual metaphors for thinking about age-old problems concerning human mortality and post-mortem survival. The increased use of cremation in the European Bronze Age contrasts with the archaeological record of the Near Eastern—where, despite the earlier emergence of metallurgy (3300–3000 BCE), we do not see a notable proliferation in the use of cremation in this region. Thus, mortuary practices (i.e. cremation) provide us with an insight into how Western European Bronze Age cultures mediated the body through changes in technological objects and processes.In the terminology of conceptual blending, the generic space in question centres on the technical manipulation of the material world. The first input space is associated with the anxiety attending mortality—specifically, the cessation of personal identity and the extinction of interpersonal relationships. The second input space represents the technical knowledge associated with bronze production; in particular, the extraction of ore from source material and its mixing with other metals to form an alloy. The blended space coordinates these inputs to objectify the human body as an object that is ritually transformed into a new but more durable substance via the cremation process. In this contention we use the archaeological record to draw a conceptual parallel between the emergence of bronze production technology—centring on transition of naturally occurring material to a new subsistence (bronze)—and the transitional nature of the cremation process.In this theoretical framework, treating the body as a mixture of substances that can be reduced to its constituents and transformed through technologies of cremation enabled Western European Bronze Age society to intervene in the natural process of putrefaction and transform the organic matter into something more permanent. This transformative aspect of the cremation is seen in the evidence we have for secondary burial practices involving the curation and circulation of cremated bones of deceased members of a group (Brück, Death 87-93). This evidence allows us to assert that cremated human remains and objects were considered products of the same transformation into a more permanent state via burning, fragmentation, dispersal, and curation. Sofaer (62-69) states that the living body is regarded as a person, but as soon as the transition to death is made, the body becomes an object; this is an “ontological shift in the perception of the body that assumes a sudden change in its qualities” (62).Moreover, some authors have proposed that the exchange of fragmented human remains was central to mortuary practices and was central in establishing and maintaining social relations (Brück, Death 76-88). It is suggested that in the Early Bronze Age the perceptions of the human body mirrored the perceptions of objects associated with the arrival of the new bronze technology (Brück, Death 88-92). This idea is more pronounced if we consider the emergence of bronze technology as the beginning of a period of capital intensification of natural resources. Through this connection, the Bronze Age can be regarded as the point at which a particular natural resource—in this case, copper—went through myriad intensive manufacturing stages, which are still present today (intensive extraction, production/manufacturing, and distribution). Unlike stone tool production, bronze production had the addition of fire as the explicit method of transformation (Brück, Death 88-92). Thus, such views maintain that the transition achieved by cremation—i.e. reducing the human remains to objects or tokens that could be exchanged and curated relatively soon after the death of the individual—is equivalent to the framework of commodification connected with bronze production.A sample of cremated remains from Castlehyde in County Cork, Ireland, provides us with an example of a Bronze Age cremation burial in a Western European context (McCarthy). This is chosen because it is a typical example of a Bronze Age cremation burial in the context of Western Europe; also, one of the authors (MG) has first-hand experience in the analysis of its associated remains. The Castlehyde cremation burial consisted of a rectangular, stone-lined cist (McCarthy). The cist contained cremated, calcined human remains, with the fragments generally ranging from a greyish white to white in colour; this indicates that the bones were subject to a temperature range of 700-900ºC. The organic content of bone was destroyed during the cremation process, leaving only the inorganic matrix (brittle bone which is, often, described as metallic in consistency—e.g. Gejvall 470-475). There is evidence that remains may have been circulated in a manner akin to valuable metal objects. First of all, the absence of long bones indicates that there may have been a practice of removing salient remains as curatable records of ancestral ties. Secondly, remains show traces of metal staining from objects that are no longer extant, which suggests that graves were subject to secondary burial practices involving the removal of metal objects and/or human bone. To this extent, we can discern that human remains were being processed, curated, and circulated in a similar manner to metal objects.Thus, there are remarkable similarities between the treatment of the human body in cremation and bronze metal production technologies in the European Bronze Age. On the one hand, the parallel between smelting and cremation allowed death to be understood as a process of transformation in which the individual was removed from processes of organic decay. On the other hand, the circulation of the transformed remains conferred a type of post-mortem survival on the deceased. In this way, cremation practices may have enabled Bronze Age society to symbolically overcome the existential anxiety concerning the loss of personhood and the breaking of human relationships through death. In relation to the former point, the resurgence of cremation in nineteenth century Europe provides us with an example of how the disposal of a human body can be contextualised in relation to socio-technological advancements. The (re)emergence of cremation in this period reflects the post-Enlightenment shift from an understanding of the world through religious beliefs to the use of rational, scientific approaches to examine the natural world, including the human body (and death). The controlled use of fire in the cremation process, as well as the architecture of crematories, reflected the industrial context of the period (Rebay-Salisbury, Inhumation 16).With respect to the circulation of cremated remains, Smith suggests that Early Medieval Christian relics of individual bones or bone fragments reflect a reconceptualised continuation of pre-Christian practices (beginning in Christian areas of the Roman Empire). In this context, it is claimed, firstly, that the curation of bone relics and the use of mobile bone relics of important, saintly individuals provided an embodied connection between the sacred sphere and the earthly world; and secondly, that the use of individual bones or fragments of bone made the Christian message something portable, which could be used to reinforce individual or collective adherence to Christianity (Smith 143-167). Using the example of the Christian bone relics, we can thus propose that the curation and circulation of Bronze Age cremated material may have served a role similar to tools for focusing religiously oriented cognition. Burying: The Body as a Vegetable ObjectGiven that the designation “the Classical Era” nominates the entirety of the Graeco-Roman world (including the Near East and North Africa) from about 800 BCE to 600 CE, there were obviously no mortuary practices common to all cultures. Nevertheless, in both classical Greece and Rome, we have examples of periods when either cremation or inhumation was the principal funerary custom (Rebay-Salisbury, Inhumation 19-21).For instance, the ancient Homeric texts inform us that the ancient Greeks believed that “the spirit of the departed was sentient and still in the world of the living as long as the flesh was in existence […] and would rather have the body devoured by purifying fire than by dogs or worms” (Mylonas 484). However, the primary sources and archaeological record indicate that cremation practices declined in Athens circa 400 BCE (Rebay-Salisbury, Inhumation 20). With respect to the Roman Empire, scholarly opinion argues that inhumation was the dominant funerary rite in the eastern part of the Empire (Rebay-Salisbury, Inhumation 17-21; Morris 52). Complementing this, the archaeological and historical record indicates that inhumation became the primary rite throughout the Roman Empire in the first century CE. Inhumation was considered to be an essential rite in the context of an emerging belief that a peaceful afterlife was reflected by a peaceful burial in which bodily integrity was maintained (Rebay-Salisbury, Inhumation 19-21; Morris 52; Toynbee 41). The question that this poses is how these beliefs were framed in the broader discourses of Classical culture.In this regard, our claim is that the growth in inhumation was driven (at least in part) by the spread of a conceptual scheme, implicit in Greek fertility myths that objectify the body as a seed. The conceptual logic here is that the post-mortem continuation of personal identity is (symbolically) achieved by objectifying the body as a vegetable object that will re-grow from its own physical remains. Although the dominant metaphor here is vegetable, there is no doubt that the motivating concern of this mythological fabulation is human mortality. As Jon Davies notes, “the myths of Hades, Persephone and Demeter, of Orpheus and Eurydice, of Adonis and Aphrodite, of Selene and Endymion, of Herakles and Dionysus, are myths of death and rebirth, of journeys into and out of the underworld, of transactions and transformations between gods and humans” (128). Thus, such myths reveal important patterns in how the post-mortem fate of the body was conceptualised.In the terminology of mental mapping, the generic space relevant to inhumation contains knowledge pertaining to folk biology—specifically, pre-theoretical ideas concerning regeneration, survival, and mortality. The first input space attaches to human mortality; it departs from the anxiety associated with the seeming cessation of personal identity and dissolution of kin relationships subsequent to death. The second input space is the subset of knowledge concerning vegetable life, and how the immersion of seeds in the soil produces a new generation of plants with the passage of time. The blended space combines the two input spaces by way of the funerary script, which involves depositing the body in the soil with a view to securing its eventual rebirth by analogy with the sprouting of a planted seed.As indicated, the most important illustration of this conceptual pattern can be found in the fertility myths of ancient Greece. The Homeric Hymns, in particular, provide a number of narratives that trace out correspondences between vegetation cycles, human mortality, and inhumation, which inform ritual practice (Frazer 223–404; Carney 355–65; Sowa 121–44). The Homeric Hymn to Demeter, for instance, charts how Persephone is abducted by Hades, god of the dead, and taken to his underground kingdom. While searching for her missing daughter, Demeter, goddess of fertility, neglects the earth, causing widespread devastation. Matters are resolved when Zeus intervenes to restore Persephone to Demeter. However, having ingested part of Hades’s kingdom (a pomegranate seed), Persephone is obliged to spend half the year below ground with her captor and the other half above ground with her mother.The objectification of Persephone as both a seed and a corpse in this narrative is clearly signalled by her seasonal inhumation in Hades’ chthonic realm, which is at once both the soil and the grave. And, just as the planting of seeds in autumn ensures rebirth in spring, Persephone’s seasonal passage from the Kingdom of the Dead nominates the individual human life as just one season in an endless cycle of death and rebirth. A further signifying element is added by the ingestion of the pomegranate seed. This is evocative of her being inseminated by Hades; thus, the coordination of vegetation cycles with life and death is correlated with secondary transition—that from childhood to adulthood (Kerényi 119–183).In the examples given, we can see how the Homeric Hymn objectifies both the mortal and sexual destiny of the body in terms of thresholds derived from the vegetable world. Moreover, this mapping is not merely an intellectual exercise. Its emotional and social appeal is visible in the fact that the Eleusinian mysteries—which offered the ritual homologue to the Homeric Hymn to Demeter—persisted from the Mycenaean period to 396 CE, one of the longest recorded durations for any ritual (Ferguson 254–9; Cosmopoulos 1–24). In sum, then, classical myth provided a precedent for treating the body as a vegetable object—most often, a seed—that would, in turn, have driven the move towards inhumation as an important mortuary practice. The result is to create a ritual form that makes key aspects of human experience intelligible by connecting them with cyclical processes like the seasons of the year, the harvesting of crops, and the intergenerational oscillation between the roles of parent and child. Indeed, this pattern remains visible in the germination metaphors and burial practices of contemporary religions such as Christianity, which draw heavily on the symbolism associated with mystery cults like that at Eleusis (Nock 177–213).ConclusionWe acknowledge that our examples offer a limited reflection of the ethnographic and archaeological data, and that they need to be expanded to a much greater degree if they are to be more than merely suggestive. Nevertheless, suggestiveness has its value, too, and we submit that the speculations explored here may well offer a useful starting point for a larger survey. In particular, they showcase how a recurring existential anxiety concerning death—involving the fear of loss of personal identity and kinship relations—is addressed by different ways of objectifying the body. Given that the body is not reducible to the objects with which it is identified, these objectifications can never be entirely successful in negotiating the boundary between life and death. In the words of Jon Davies, “there is simply no let-up in the efforts by human beings to transcend this boundary, no matter how poignantly each failure seemed to reinforce it” (128). For this reason, we can expect that the record will be replete with conceptual and cognitive schemes that mediate the experience of death.At a more general level, it should also be clear that our understanding of human corporeality is rewarded by the study of mortuary practices. 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IntroductionOn a sunny afternoon in early spring 2014, five researchers were strolling through the streets of Old Aberdeen. They had known each other for only a few days since an event had brought them together. The event was Performance Reflexivity, Intentionality and Collaboration: A Sourcing Within Worksession, convened by anthropologist Caroline Gatt and performer Gey Pin Ang, as part of the ERC Advanced Grant project “Knowing from the Inside,” at the department of Anthropology, University of Aberdeen. This workshop aimed to explore aspects of creative decision-making in performance to assess their relevance to anthropological practice. For three days, participants had engaged in intensive physical and vocal training, seeking to act in ways that felt intuitive and not forced. Five of those participants—Brian Schultis, Peter Loovers, Ragnhild Freng Dale, Valeria Lembo, and myself—unintentionally continued those explorations after the workshop.Our wanderings around the old town took us to the St Machar’s Cathedral. As we were lingering by the graveyard, Valeria took out of her bag a yarn of golden thread. This, she said, was an object of “personal relevance” that she had brought along to the workshop as a prop to work with, following Gey Pin’s instructions. Now she was unravelling it, offering one point to each of us. As we untangled the yarn, we resumed walking. Held from different points, the yarn became a web. Its threads shifted, vibrations reaching our fingertips as we moved. As we entered Seaton Park, which is adjacent to the Cathedral, the threads registered our encounters with the bumpy path, trees, wind, and passers-by as visible, tactile, and kinetic qualities. Pulls, resistances, flows, and gaps triggered a sense of “enmeshment” (Ingold, Lines 11) in a living, breathing world, something greater than ourselves.Walking Threads (henceforth WT), as we retrospectively named the experience, has since developed into a publication (Ang et al.) and a series of invitations extended to larger groups, at conferences and symposia, to walk with the golden thread (walkingthreads.wordpress.com). In our basic WT practice, the yarn is passed around. The thread unravels and we begin to move. No instruction is given to participants, in order to avoid their over-conceptualising the walk. We begin in silence in order to encourage an attitude of “listening,” that is, of opening one’s perceptual awareness to what is happening in the moment. This has not prevented participants from spontaneously using their voice at later stages of the walk, through song, recitation or the exploring of vocal sound.While WT outings are sporadic, the golden thread has continued to be part of my life in subtle ways. Since the last walk in September 2015 at the Beyond Perception symposium in Aberdeen, the thread has repeatedly come to mind. I began to pay attention to these appearances of the thread not as a material object but as a so-called “mental image.” By focusing on the image of the thread, I intentionally recalled some of its properties as a thing that connects, tangles, ties, and is untied, properties that the WT had made salient. By allowing those properties to inform my relationship with my body, the thread turned into a somatic image, a process that I describe in this paper. Thus, this paper continues the WT project’s creative explorations of bodies with threads. This time, however, the thread is not conceived of as a material object but as an image.A few words on my understanding of images are in order. Since 2006 I have been dancing and researching butoh, a dance style that originated in Japan in the post-World War II years. Butoh is a formless dance: it resists codification into a conclusive system of movement, relying on intensified proprioception—the perception of one’s own body—to sustain movement work instead. The use of verbal imagery is widespread among butoh dancers: words act as devices to evoke sensory experiences and “scaffold” (Downey) perceptual attention in order to achieve nuanced qualities of movement. The practice of butoh has informed my understanding of mental images not as merely visual but also as kinaesthetic, that is, engaging the sense of movement. This connection is hardly new; Csordas, for instance, talks of “physical” or “sensory” imagery, rather than merely visual (146–47).While I never intentionally used butoh to relate to the thread, my training and sensitivities as a butoh dancer are likely to have played a role in my relations with this object, as filtered through the WT experiences. Based on my background as a butoh dancer and “thread-walker,” the approach of this paper may be understood as one of anthropology with art: one in which the modes of observation supporting artistic and anthropological inquiries coincide (Ingold, Making 8). An artist’s engagement with materials, tools and things—including the body—is speculative, experimental and open-ended, rather than descriptive or documentary. This type of engagement can question established ways of seeing. For instance, we generally think of objects and bodies as belonging to different domains—the inanimate and the animate, the lifeless and the living. This paper questions this assumption and hypothesises that, through a particular kind of perceptual engagement, which mobilises the somatic and the imaginary simultaneously, objects and bodies can merge. An object can be embodied and, vice versa, a body can become a thing.The paper draws on autoethnographic occurrences of relating to the image of the thread, in the form of short somatic narratives, or narratives “from the body” (Farnell). Each narrative aligns the image of the thread to a particular aspect of somatic awareness: thinking, breathing, and muscle-bones. Far from claiming universal validity, these personal accounts engage a “somatic mode of attention” (Csordas 139) to venture in the potentialities of image-based thinking (Sousanis; Jackson). The exploration finds that, as the materiality of the thread retreats into the background, its image unlocks aspects of self-perception that normally escape conscious awareness (Leder). The image of the thread becomes a perceptual device that, by facilitating access to somatic awareness, reshapes relations with the world and, internally, with the body. It is in this sense that I embody the thread. Beginning with a Loose End: Spinning Thought into Thread-FormAs I begin to write this paper, I witness my thinking taking the form of a thread. It first appears as a loose end. I see it in my mind’s eye, and from a short distance. The loose end of a golden thread floating in a dark space. I cannot see how far it extends. Instead, the gaze of my imagination glides towards its surface as though attempting to grab it. Even so close, I cannot touch it. Still I can contemplate few of its qualities. I meet its reassuring continuity. A glimmer catches my attention: it is a few silver filaments inside the thread, glittering. The thought-form of the thread is a sensation of thin electric current between the temples. I sense the space between my eyes and forehead, their muscles and bones, subtly engaging. The same space begins to narrow down into a corridor. It is narrower and narrower. My thought spins itself into thread-form.In the 1980s, movement therapist Thomas Hanna defined a perspective from inside as “somatic,” that is, pertaining to soma, the ancient Greek word for “living body” (20). The somatic involves the perception of the corporeal from the inside rather than the outside: “to yourself, you are a soma. To others, you are a body. Only you can perceive yourself as a soma—no one else can do so” (20). As a first-person perspective on the body, the somatic involves attention to perceptual processes (Csordas). Yet, in daily life, self-perception is the exception rather than the norm. Being in the world is active rather than reflective (Leder). Otherwise put, being alive requires a mode of engagement that goes “forwards” rather than “in reverse” (Ingold, Making 8).Were we constantly aware of our own presence and actions, this would obstruct their unfolding (Leder 19–20). In order not to inhibit its capacity for being, the body must remain to a great extent “absent” to itself (Leder 19). Some reflective possibilities nonetheless exist. In meditation, for instance, one can attend directly to bodily processes, with aesthetic and contemplative benefits (18–19). The opening somatic narrative presented my visualising of the golden thread as such a kind of reflexive engagement. There, the activity of visualising ceased to be an orientation towards an externally conceived “object” (the thread), becoming itself the end, or object, of perception.One may ask: What kind of sensory perception is mobilised in positing the “visualising” of the thread as “object” rather than as background process? I suggest it is proprioceptively-oriented kinaesthesia or, the perception of self-movement. In this mode of perception, the activity of visualising the thread yields kinetic and spatial impressions. Visualising, that is, is perceived as a movement of attention (Sheets-Johnstone 420–22).The image of the thread, meanwhile, has suggestively merged with the activity of visualisation, in two stages. First, it has guided my attention towards an otherwise-recessive bodily process. Secondly, it has lent its form to an otherwise-indeterminate bundle of sensations. I elaborate on this latter aspect in the following section, where the next somatic narrative posits thinking as a perceptual object, in the form of the image of a web of threads.Seeing through the Veil Walking home one day I noticed some thoughts unpleasantly affecting my mood. In recognising their negative impact, I decided that I should try and detach myself from them. I imagined that the thoughts were like threads woven together. This image of interwoven thoughts developed into another image: a coherent system of thoughts, or worldview, was like a “veil” spread between my eyes and the world. I could, quite literally, “remove” the veil through an act simultaneously of proprioceptive awareness and imagination, leaving my mind uncluttered. As new thoughts rushed in to form a new veil, I could also remove these and so on. As a reminder of this experience, I jotted down these words:If the veil is made of ideasThen thinking is weaving.Sometimes I can see the veilMade of the substance ofMy thoughts.When I see it,When I see the fabricOf thought that forms it,Then it disappears.When I see itWhen I can really see the veil,It’s by a certain way of seeingWhich is in my forehead.To see that way,Really look, with yourEyes as well asWith your mindFor the mind itselfCan attune,Can look, can see through the veil.Leder writes, “insofar as I perceive through an organ, it necessarily recedes from the perceptual field it discloses. I do not smell my tissue, hear my ear, or taste my taste buds but perceive with and through such organs” (14). Similarly, in ordinary conditions, I cannot think about my own mind. To see through the veil of thoughts requires a reflexive effort. It is to attend to the act, not the content, of thinking.This form of awareness can be seen as gestural, as it calls into play the body—a certain way of seeing/which is in my forehead. It is both a stepping back from thoughts, which allows me to see them as objects (a veil), and a removing of them, as though they were tangible things.Weaving the Body into the Night: Breath and Physical Forces as KnotsThe definition of somatic in the previous section anchors it to the point of view of the perceiver. The next somatic narrative describes how, through the image of thread, the perceiving I dissipates into contiguity with the world. Following my experience of perceiving my own thoughts as a veil, I further practised “moving my thoughts” through that image. One night the image of the veil “moved me,” that is, my entire body, in turn.As I cycle back home in the light rain I sense my own presence weaving in the fabric of the night. The fresh air flowing into and out of my nostrils and lungs, my feet pressing against the pedals, pushing my body up from the saddle, my legs looping. Dynamic energy mingles with currents of air passing through my body, and shining asphalt flowing under the wheels. Rhythm, like sowing my presence onto the air. And though the road is steep, tonight cycling up the hill feels effortless. My mind is empty and alert, engaging with the fabric of reality I can see. Is this “reality” or just my imagination? It would not make much difference to me. This somatic narrative reintroduces the image of the veil on a different scale. Now I see the veil as though through a microscope: myriad intertwining threads, and I am part of it. Threads run out of my limbs and lungs: gathering and propelling, pushes and pulls, in- and out-breaths. They weave with the night’s very limbs and lungs: streets, trees, the hill, the breeze, the deep embrace of the sky.For Ingold “every living being is a line or, better, a bundle of lines” (Lines 3). Lines are the movements that living beings perform as they relate—“corresponding,” “clinging,” “tying,” and “untying” (3–7)—to other living beings and the world. Breathing also is a line: “as we breathe in and out, the air mingles with our bodily tissues, filling the lungs and oxygenating the blood” (70). Or rather, breathing is a knot: it ties the inside with the outside. “Breathing is the way in which beings can have unmediated access to one another, on the inside, while yet spilling out into the cosmos in which they are equally immersed” (67).Cycling up-hill, breathing in and out, pushing and propelling, is a weaving of my body, a bundle of lines, with the ebb and flow of the weather-world (Ingold, Lines). This image evokes an outer spatial dimension to the body, an opening. It recalls my being one of multiple people holding and walking with the thread in the WT project. As with WT, feelings of resistance, flux, and being part of something bigger emerge.The image of threads feeds into the somatic perception of body-in-action, and vice versa. Here, engaging in action and imagination are not in contradiction but imply one another. They “correspond” (Ingold, Making): it is because my actions unfold through the imaginary framework of the night as veil that they can flow as they do, sinking in perceptual tracks of extended being.Muscle-Bones as ThreadsFor anthropologist Michael Jackson, metaphors reveal the identity of domains of being that the intellect strives to keep separate, such as the cultural and the natural. “Metaphor reveals unities; it is not a figurative way of denying dualities. Metaphor reveals, not the ‘thisness of a that’ but rather that ‘this is that’” (142, emphasis in the original). Whenever a crisis occurs, which undermines the unity of being-in-the-world, metaphors can be called upon to resolve the impasse and to make people “whole” (149).The final somatic narrative is an example of how an image can restore the unity of the physical and the mental. By imbuing the visceral body with the tangible qualities of a thing, the image of the thread turns the absent body into a sentient, responsive body. This, in turn, helps to overcome the impasse created by physical pain.Lying on the floor, sinking into it. The pain has been with me for years now. When stressed or tired, it spreads through the left side of my body. I have begun imagining the pain’s epicenter as a knot inside the pelvis, between left hip and tailbone. Looking inwards, I try and see the muscular fibres enveloping my limbs, connecting top to bottom. I summon the image of the thread. I make its fibres overlap with my muscle fibres. I want the thread to be the muscles, and the muscles to be the thread. This way I can disentangle the knots and find relief. My body is a deep, dark well. Breath is the rope that takes me down. Breathing in and out creates ripples of movement. They gently undo the knot, ease the pain. In this somatic narrative, my body is, once again, a bundle of threads. This time, however, this image has an anatomical inflection. Instead of generic movements, it is my very muscles that are threads. Early modern Dutch anatomist Ruysch also described muscles as made “of many parallel threads of different lengths,” which fitted with his overall view of the human body as divine “embroidery” (van de Roemer 180–82).In the previous section, a knot was a device for binding and securing life relations to survive a world that is, by its very nature, adrift (Ingold, Lines 67). Breathing enacted one such kind of knot “tying” the inside with the outside. In contrast, now a knot is a place of stagnation, of tension, where movement does not flow as it should. Breathing triggers minute movements throughout the body, which allow me to gradually undo the knot, releasing tensions and bringing relief.ConclusionDrawing on personal experiences, this article has sought to show that corporeal relations with an object can transcend its materiality. By engaging imagination and somatic attention, the thread lived a second life within and through my body.Based on the object’s characteristics and properties, the image of the thread refashioned, albeit momentarily, my relation with my body and the world. It allowed me to fill a perceived gap between body and world, between imagining and being.Finally, in relating to “unthinkable” aspects of being—mental and physical pain—the image of the thread was beneficial and even healing. 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