Littérature scientifique sur le sujet « Picture-books=2013-11-03 »

Early childhood emotional dysregulation is critical in recognizing and preventing psychological well-being disorders, laying the groundwork for developing healthy emotional behaviors early on. This study aims to determine the direct influence of smartphone addiction, executive function, and the mother-child relationship on emotional dysregulation in early childhood in West Sumatra. This research method is a quantitative survey. The data collection technique in this research uses a questionnaire design on 309 parents who were selected using a simple random sampling method. This data processing tool uses the SmartPLS software. The results of the study indicate that smartphone addiction has a significant impact on emotional dysregulation in early childhood, executive function has a positive and significant effect on emotional dysregulation in early childhood, and the mother-child relationship has a positive and significant influence on emotional dysregulation in early childhood. 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Transmedia storytelling, as defined by Henry Jenkins in 2006 in his book Convergence Culture, highlights a production strategy that aims to augment the narration of a cultural work by scattering it across several media platforms—digital or non-digital. The term is certainly quite recent, but the practices are not new and allow us to understand the evolution of the cultural industries and the creation of a new media ecosystem. As Matthew Freeman states, transmedia storytelling always relies on industrial changes, the narration adapting itself to new media synergies and novelties to create engaging and coherent storyworlds.Producers of American TV shows, showrunners, and networks are more and more eager to develop narrative universes on other media platforms in order to target new audiences and to give food for thought to fans, as well as reward them for their intellectual and emotional investment. Ancillary content and tie-ins sometimes take the form of novelisations or comic books, highlighting the fact that strategies of transmedia storytelling can be deployed on non-digital platforms and still enhance the narrative aspects of the show. For example, Twin Peaks (1990) developed The Diary of Laura Palmer (1990), a journal written by the character Laura Palmer who gave insights on her life and details about her relationships with other characters before she was murdered at the beginning of the series. How I Met Your Mother (2005-2014) published The BroCode (2008), first seen on episode “The Goat” (season 3 episode 17), and The Playbook (2012), first seen in an episode entitled “The Playbook” (season 5 episode 8). They are bibles written by character Barney Stinson that contain rules or advice for picking up women. For instance, The BroCode contains 150 articles, a glossary of terms, a definition of “a bro,” history of the code, amendments, violations, and approved punishments, all invented by Barney; some of these components were talked about on the show, while others were original additions for the book.Another way to create transmedia storytelling around TV shows is by developing comic books. This article will explore this specific media form in relation to transmedia strategies and will try to underline how comic books can make a narrative richer by focusing on parts of the plot, characters, times, or locations. First, I will focus on the importance of seriality from a historical perspective, because seriality appears to be one of the main principles of transmedia storytelling. Yet, is this narrative continuity always coherent and always canon when it comes to the publication of comic books? I will then propose a typology of the narratives comic books exploit to augment the storytelling of a show. I will give examples to illustrate how comic books can enrich the narrative universe of a given show and how characters can smoothly move from one platform to the other.A Transmedia World: Television and Comic Books Hand in HandSeriality is one of the main pillars of transmedia storytelling, and, according to Jenkins, “it is about breaking things down into chapters which are satisfying on their own terms, but which motivate us to come back for more” (“Transmedia”). These characteristics are already present in the way TV series are written, produced, and broadcast, and in the way comic books are created. They rely on episodes for TV shows and on issues for comic books that usually end with suspense and a suspension in the narrative continuity, commonly known as a cliff-hanger. For comic books, this narrative continuity took root in the early comic strips of the 18th and 19th century (Maigret and Stefanelli), which played a huge part in what we now know as comic books. As Pagello explains:The extensive practice of narrative serialisation played a major role in this context: the creative process, the industrial production and distribution, the editorial practices and, finally, the experience of comics readers all underwent dramatic changes when comics started to develop an identity distinguished from satirical cartoons, illustrated books and the various forms of children’s picture stories.According to Derek Johnson, these evolutions, in terms of production and reception, are closely linked to the widespread use of the franchise model in media industries. Johnson explains thatcomic books, video games, and other markets once considered ancillary now play increasingly significant and recentered roles in the production and consumption of everyday film and television properties such as Heroes, Transformers, and the re-envisioned Star Trek in ways that only very few innovators (such as George Lucas and his carefully elaborated and expanded Star Wars empire) had previously conceived in the twentieth century.The creation of transmedia strategies that capitalize on narrative continuity and seriality call for some synergies between media and for a “gatekeeper” of the stories who will ensure that all is coherent in the storyworld. Thus, “in 2006, the management of Heroes, for example, became a job for a professional ‘Transmedia Team’ charged with implementing creative coordination across television, comics, and the Internet” (Johnson).Another principle of transmedia storytelling, closely linked to seriality and the essence of the definition, is the creation of a narrative universe, that is “world-building,” in which plots and characters develop, and which will lay the foundations for the story. These foundations will be written in what is called a Bible, a document containing all the narrative elements in order to ensure coherence. In the notion of world-building, a matrix of possibilities is deployed, since stories can potentially become threads to weave, and re-weave. This rhizomatic world can be extended to infinity in a canonical way (by the official production) and in a non-canonical one (by the creations of fans). For Mark Wolf, these narrative worlds work like dynamic entities, and are transformative, transmedial, and transauthorial, which are similar to the notions and possibilities of transmedia storytelling, and media and cultural convergence. Stories that cannot be contained within the “real” of a single medium will be expended and developed on another or several other ones, creating a rich storyworlds. Comic books can be one of these tie-in media.New Term, Old Creations: An Historical OverviewMatthew Freeman wrote in his latest book Historicising Transmedia Storytelling that these transmedia practices do have a past and existed long before the introduction of the term due to new technologies, production strategies, and reception tactics. Comic books were often an option to enrich storylines and further develop the characters. For example, L. Frank Baum created a storyworld around The Wizard of Oz made of mock newspapers, conferences, billboards, novels, musicals, and comic strips in order to “appeal to a migratory audience” (Jenkins, “I Have”) and to deepen the characters, introduce new ones, and discover the land of Oz as if it were a real location. The author used techniques of advertising to promote and above all to expand his storyworld. As newspaper comic strips were quite popular at the time, Baum created several tie-in extensions in the newspapers and in a novel format. As Jason Scott underlines, “serial narratology enhances the possibilities of advertising and exploitation through the established market for the second and subsequent instalment” (14). The series of comic strips entitled Queer Visitor from the Marvellous Land of Oz (1904-1905) picked up, in terms of narration, just after the end of the book, offering a new temporality and life for the characters. As Freeman notes, this choice follows an economic logic:The era’s newspaper comic strips and their institutional tendency to prioritize recurring characters as successful advertising mechanisms (as witnessed in the cross-media dispersion of Buster Brown) had in fact influenced Baum to return to the series’ more familiar faces of Dorothy, the Scarecrow, and the Tin Woodman (2371).Here, the beloved characters are moving from one medium to the next, giving new insights on their life after the end of the book, and enhancing their stories beyond its pages.A Typology of Comic Books and Tie-in Extensions of TV SeriesBefore diving into a tentative typology, I want to look at the definition of canon in a transmedia storyworld. There is a strong debate in academic discussions around the issues of canonicity, and here I understand canonicity as the production of official texts around a given cultural content. That is because of precisely what is qualified as an official text or an official extension, and what is not. In the book I co-edited with Benjamin W.L. Derhy Kurtz (Derhy Kurtz and Bourdaa), we respond by coining the term “transtexts,” which includes officially produced texts and fantexts in the same narrative universe. The dichotomy between both kinds of texts is thus diminished. Nonetheless, in production and transmedia strategies, canonicity is hard to evaluate because “few television series have attempted to create transmedia extensions that offer such a (high level of) canonic integration, with interwoven story events that must be consumed across media for full comprehension” (Mittell 298). He follows by proposing a typology of two possible transmedia extensions based on a canon perspective versus a non-canon one: “what is extensions” extend the storyworld canonically and in a coherent way, whereas “what if extensions” “pose(s) hypothetical possibilities rather than canonical certainties, inviting viewers to imagine alternate stories and approaches to storytelling that are distinctly not to be treated as potential canon” (Mittell 298). Mark Wolf refers to the term growth to qualify canonical materials which are going to expand a given storyworld and which nourish the stories. As argued by Gabriel et al., “Wolf’s definition of ‘growth’ makes it clear that, for him, a transmedial product can only be considered to contribute to a world’s growth if it adds new ‘canonical’ material, i.e. material that presents new pieces of information that are “true” for the fictional world” (Gabriel et al. 169). This notion of “truth” to the diegesis can be opposed in this context to the notion of alternate stories and alternate versions of the characters.My attempted typology lays its foundation upon this opposition between what is seen as an official extension and what is seen as an unofficial extension, but offers alternate perspectives to expand the storyworld using new characters, locations, or universes. The first category will look at canonical extensions and how they can deepen characters’ development and temporalities. The second category will deal with “canon divergent” (to use fans’ language) extensions and how they can offer new entries into the stories by creating new characters or presenting new locations.Canonical Extensions: CharactersTie-in extensions in the form of comic books help to deepen the characters, especially supporting characters, by delving into their motivations and psychology, or by giving them backstories and origin stories. According to Paolo Bertetti, “the transmedia character is a fictional hero whose adventures are told on several media platforms, each providing details about the character's life” (2344). Actually, motivated characters are the quintessential element of the narration of the classic Hollywood era, which was then reused in the narration of TV series, which were then penned into comic books. In her definition of transmedia superstructures, Marsha Kinder based her analysis on how characters moved from one medium to the next, making them the centre of the narrative universe and the element audiences would follow.For example, Fringe (2008), in a deal with DC comics, extended its stories and its characters in comic books, which were an integral part of the storyworld, and which included canon materials by offering Easter Eggs to fans and rewarding them for their investment in the narrative universe. Each issue of the second series dealt with a major or recurring character from the show, deepening them by giving them backgrounds. That way, audiences can discover the backstories of Agent Broyles, Nina Sharp, the CEO of Massive Dynamic, or even Gene, Walter’s cow, all of which are featured in the series but not well developed.Written by actor Tim Rozon (who plays Doc Holliday on the show) and author Beau Smith, Wynonna Earp Season Zero (2017) focuses on the past of main character Wynonna Earp when she was an outlaw and before she comes back to her hometown, Purgatory. The past comes to life on the pages, while it was only hinted at in the show. It is a good introduction to the main character before the show, since Wynonna comes back to Purgatory by bus at the beginning of the very first episode and there are no flashback episode relating her story earlier. Because the two authors of this comic book are part of the creative crew of the show, an actor and a writer, they ensure a sense of coherence in the extensions they write.In collaboration with Dynamite Entertainment, an American comic book company, NBC Universal launched a series of comic book issues entitled Origins (2008) as an ancillary text to Battlestar Galactica (2004). “Origin stories” are a specific genre related to superhero franchises. M.J. Clarke underlines that,the use of Origins Stories is influenced by the economic structure of the comic book industry, which continues to produce stories over years and decades. ... By remaining faithful to the Origins (which are frequently modified in their consistency), readers can discover a story without having to navigate in more than 400 numbers of commix. (54)The goal of these comic books is to create a "past" for the human characters that appeared in the series. The collection of comic books thus focuses on five main characters in 11 issues, spread out over a year: William Adama, Zarek, Gaius Baltar, Kara "Starbuck” Thrace, and Karl "Helo" Agathon. These issues are collected in an eponymous Omnibus. Likewise, Orphan Black (2011) also offered backstories for its “clone club” without disrupting the pace of the show. The stories, tied to the events of the series, focus on the opportunity to better understand the emotions, thoughts, and feelings that exemplify the characters of the show.It is interesting to note that the authors of these comic book extensions were in close contact with Ronald D. Moore and David Eick, showrunners of the Battlestar Galactica series, which guaranteed coherence and canonicity to the newly created material. In a personal interview, Robert Napton, writer of Origins, explained the creative process:so every week we would watch episodes and make sure our stories matched as closely as possible to what the television series was doing …we tried to make it feel like it was very much part of the series, so they were untold adventures and we tried to fit it into the continuity of the series as much as possible.Brandon Jerwa, writer for Battlestar Galactica comic book series Season Zero and Ghosts (2009), confirmed that, “It is my understanding that the comics were passed through Mr. Moore’s office, and they were certainly vetted by Syfy and Universal.” Jerwa also added an interesting input on perception of canonicity versus non-canonicity by fans who can be picky about the ancillary contents and added materials that extend a storyworld:Most comic tie-ins have a hard time being considered a legitimate part of the canon, and that is simply beyond the control of the creative team. I worked very hard to make sure that I was writing material that adhered to the continuity of the show as closely as humanly possible. I don’t believe in writing a licensed property in such a way as to put forward ‘my vision’ of the universe; I believe very firmly that it is my responsibility to serve the source material above all else.Canonical Extensions: TemporalitiesComic books as a licensed product can expand the temporalities of the show and tell stories before the beginning of the series and after it ended, as well as fill time voids and ellipses. For example, now in its 11th season in comic books, Joss Whedon managed to keep Buffy the Vampire Slayer (1997-2003) alive and to attract new fans without alienating its original fanbase. Blogger and web entrepreneur Keith McDuffee felt that reading Buffy as a comic book after seeing it on television for seven years was strange, but the new format was a good sign because: “the medium lets creativity go completely wild without budget worries.” The comic books focus on the famous characters and created a life for them after the end of the show, making them jump from the screen onto the pages. Sometimes, the comic books told original stories that might seem out-of-character, like the issue in which Buffy sleeps with a woman. That kind of storyline wasn’t explored in the TV show, and comics offer one way to go deeper into the characters’ backgrounds and psychology. Sometimes, the tie-ins do not strictly follow the continuity and become non-canon regarding the stories of the TV shows. For example, DC/Wildstorm presented comic book issues around The X-Files (1993-) that were set in continuity of the show but failed to refer to main plot events (for example, Scully’s pregnancy). “Rather than offering ‘additive comprehension’ to a pre-existing television and film narrative, Spotnitz chose to write licensed comics on their own terms” (Pillai 112).DC is familiar with offering new adventures for its superhero characters in the form of comic books (which are first published online), going back to the basics. Of course, in this case, the relationship between the comic book medium and the television medium is more intricate, as the TV series are based on comic book characters whose stories are then extended again in comic books, which are created specifically to extend the TV shows’ storyworlds. The creation of the comic book series The Flash Season Zero (2015) set the stories between the episodes of the first season of The Flash and focus on the struggles of Barry Allen as he juggles between his job as a CSI, his love for Iris West, his childhood sweetheart, and his new identity as a vigilante with superpowers. This allows viewers to better understand a part of Barry Allen’s life that was not well developed in the show, adding temporal layers to the stories. The Adventures of Supergirl vol. 1 (2016) also depict the battles of the girl of steel between episodes, as well as her life with her sister, Alex (who is also a new addition in the comic book), and her co-workers at the DEO. For Arrow,the digital tie-ins offer producers [opportunities] to explore side stories they are unable to cover on screen. In the case of Season 2.5, the 22-chapter comic enabled the producers to fill in the blanks in between the seasons, thus offering more opportunities to explore the dynamics of fan-favorite characters such as Felicity and Diggle. (Bourdaa and Chin 183)These DC comic books are examples of giving life to a TV show beyond the TV screen, enhancing the timeframe of the stories and providing new content. The characters pass through the screen to live new adventures in comic books. In some cases, the involvement of the series' actor and writer in comic book scripting confirms the desire for consistency in the extensions of the series, whatever the medium used and whatever the objectives.Canon Divergent Extensions or the Real PossibilitiesFinally, comic books can deploy stories that will display a new point of view on the canon: a “multiplicity” (Jenkins, “La Licorne”) or a “what-if story” (Mittell), which will explore new possibilities and new characters.The second series of Orphan Black comic book tie-ins entitled Helsinki (2016) dealt with clones in the capital of Finland. The readers discover the lives of other clones, how they deal with the discovery of their “condition,” and that they have a caretaker. The comics are written by John Fawcett, who is also a showrunner for the series. The narrative universe is stretched into new possibilities, seen with new eyes, and shown from the perspective of new clones. The introduction of new characters gives opportunities to tell new stories and diverge from the canonical content, especially in terms of the characters’ development and depth.Battlestar Galactica, after the show ended, partnered once again with Dynamite Entertainment, to publish a new set of comic books entitled BSG: Ghosts (2009), which tells the story of new characters surviving the Cylon genocide. Writer Brandon Jerwa asks in BSG: Ghosts: "And if a squadron of secret agents had also survived Cylon Attack?" For him, comic books are a good opportunity to relaunch the narrative universe by introducing new characters in a well-known storyworld.The comic books will definitely have to evolve in order to survive because at some point we will end up exhausting the interest of the readers on the narrative continuity. Projects like Ghosts are definitely a good way to test public reaction to new ideas in a familiar environment. (Jerwa)Conclusion: From One Medium to the Next, From Narrative Extensions to MarketingThis article offers an overview of how comic books are used as tie-in products to extend TV series’ narrative universe. The ambition was not to give an exhaustive panorama but to propose a typology with some examples. I showed that characters’ development, temporalities, and new points of view are narrative angles exploited in comic books to give depth to a storyworld. Of course, this raises issues of labour, authorship, and canon content, which are already discussed elsewhere (see, for example: Clarke, Pillai, Scott). Yet, comic books are an integral part of transmedia storytelling and capitalise on notions of seriality, offering readers new stories, continuity, depth, and character motivations in order to enrich storylines and make them live beyond the screen. However, Robert Napton, in our interview, underlines an interesting opposition between licensing and marketing: “Frankly, comic books are considered licensing and marketing, not official canon. The only TV comic that is canon is Buffy Season 8 and 9 because Joss Whedon says they are, but that is not the normal situation.” He clearly draws a line between what he considers to be a licensed product, in this article what I describe as canonical content, and a marketing product, which could be understood in this article as a canon divergent tie-in. The debate here is clearly on, since understandings of transmedia vary between the perspectives of production companies, which are trying to gain profit by providing new content, the perspectives of fans, who know the storyworlds and the characters extensively and could be very possessive of them, and the perspectives of extension authors, who “have very strict story guidelines” (Jerwa) and have to make their stories fit within the narrative universe as it is told onscreen.ReferencesBertetti, Paolo. “Towards a Typology of Transmedia Characters.” International Journal of Communication 8 (2014): 2344-2361.Boni, Marta. World Building: Transmedia, Fans, Industries. 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Season premiere. 2007. <http://www.aoltv.com/2007/03/16/buffy-the-vampire-slayer-the-long-way-home-season-premiere/.>.Mittell, Jason. Complex TV: The Poetics of Contemporary Television Storytelling. New York: NYU Press, 2015.Napton, Robert. Personal Correspondence. 2013.Pagello, Federico. “Before the Comics: On Seriality of Graphic Narratives during the Nineteenth Century.” Belphégor 14 (2016). <http://journals.openedition.org/belphegor/810>.Pillai, Nicolas. “What Am I Looking at Mulder?: Licensed Comics and Freedoms of Transmedia Storytelling.” Science Fiction and Television 6.1 (2013): 101-117.Scott, Jason. “The Character-Orientated Franchise: Promotion and Exploitation of Pre-Sold Characters in American Film, 1913–1950.” Scope: An Online Journal of Film and Television Studies (2009): 10–28.

IntroductionNordic mythology, also known as Norse mythology, is a term used to describe Medieval creation myths and tales of Gods and otherworldly realms, told and retold by Northern Germanic and Scandinavian tribes of the ninth century AD (see for example Gaiman).I discuss a new type of Nordic mythology that is being created through popular culture, social media, books, and television shows. I am interested in how contemporary portrayals of the Nordic countries has created a kind of mythological place called Scandinavia, where things, people, and ideas are better than in other places.Whereas the old myths portray a fierce warrior race, the new myths create a utopian Scandinavia as a place that is inherently good; a place that is progressive and harmonious. In the creation of these new myths the underbelly of the North is often neglected, producing a homogenised representation of a group of countries that are in actuality diverse and inevitably imperfect.ScandimaniaGenerally the term Scandinavia always refers to Denmark, Norway, and Sweden. When including Finland and Iceland, it is more accurate to refer to the five as the Nordic countries. I was born and grew up in Denmark. My observations are skewed towards a focus on Denmark, rather than Scandinavia as a whole. Though I will use the term Nordic and Scandinavia throughout the article, it is worth noting that these definitions describe a group of countries that despite some commonalities are also quite different in geography, and culture.Whether we are speaking strictly of Scandinavia or of the Nordic countries as a whole, one thing is certain: in recent years there has been a surge of popularity in all things Nordic. Scandinavian design has been popular since the 1950s, known for its functionality and simplistic beauty, and globalised through the Swedish furniture chain IKEA. Consequently, Nordic interior design has become a style widely praised and emulated, as has Nordic fashion, architecture, and innovation.The fact that Scandinavian people are often represented as being intelligent and beautiful adds to the notion of stylish and aesthetically pleasing ideals. This is partly why sperm from Danish sperm donors is the most sought after and widely distributed in the world: perhaps prospective parents find the idea of having a baby of Viking stock appealing (Kale). Nordic countries are also known for their egalitarian societies, which are described as “the holy grail of a healthy economy and society” (Cleary). These are countries where the collective good is cherished. Tax rates are high (in Denmark between 55 per cent and 60 per cent of income), which leads to excellent welfare systems.In recent years other terms have entered the collective Western vocabulary. New Nordic Cuisine describes a trend that has taken the culinary world by storm. This term refers to food that is created with seasonal, local, and foraged ingredients. The emphasis being a renewed connection to nature and old ways. In 2016 the Danish word hygge was shortlisted by the Oxford Dictionary as word of the year. A word, which has no direct English translation, it means “a quality of cosiness and comfortable conviviality that engenders a feeling of contentment or well-being (regarded as a defining characteristic of Danish culture)”. Countless books were published in the United Kingdom, and elsewhere, explaining the art of hygge. Other Scandinavian words are now becoming popular, such as the Swedish lagom, meaning “just enough”.In the past two years, the United Nations’ World Happiness Report listed Denmark and Norway as the happiest places on earth. Other surveys similarly put the Nordic countries on top as the most prosperous places on earth (Anderson).Mythologies and Discursive FormationsThe standard definition of myth is a “traditional story, especially one concerning the early history of a people or explaining a natural or social phenomenon, and typically involving supernatural beings or events.” Or “A widely held but false belief or idea” (Oxford Dictionaries, Myth).During what became known as the “discursive turn”, both Barthes and Foucault expanded the conception of myth by placing it within a wider socio-political and historical contexts of power and truth. “Discursive formations” became a commonly accepted way of describing a cluster of ideas, images, and practices that define particular “truths” within a given cultural context (Hall 6). In other words, myths serve specific purposes within given socio-cultural constructions.I argue that the current idolisation of Scandinavia is creating a common global narrative of a superior society. A mythical place that has “figured it out”, and found the key to happiness. The mythologised North is based on an array of media stories, statistics, reports, articles, advertising, political rhetoric, books, films, TV series, exhibitions, and social media activity. These perpetuate a “truth” of the Nordic countries as being especially benign, cultured, and distinguished. The Smiling PolicemanIn his well-known essay Myth Today, Barthes analyses an image of a North African boy in uniform saluting the French flag on the front cover of a magazine. Barthes argues that by analysing the semiotic meaning of the image in two stages, one can identify the “myth”.The first level is the signifiers (what we see), a dark skinned boy, a uniform, a raised arm, a flag. The signified is our recognition of these as a North African boy raising his arm to the French flag. The second level of interpretation is the wider context in which we understand what we see: the greatness of France is signified in the depiction of one of her colonial subjects submitting to and glorifying the flag. That is to say, the myth generated by the image is the story of France as a great colonial and military nation.Now take a look at this image, which was distributed the world over in newspapers, online media, and in turn social media (Warren; Kolff). This image is interesting because it epitomises much of what is believed about Scandinavia (the new myths). If we approach the image through the semiotic lens of Barthes, we firstly describe what is seen in the picture (signifiers): a blonde policeman, a girl of dark complexion, a road in the countryside, a van in the distance, and some other people with backpacks on the side of the road. When we put these elements together in context, we understand that the image to be depicting a Danish policeman, blonde, smiling and handsome, playing with a Syrian refugee girl on an empty Danish highway, with her fellow refugees behind her.The second level of interpretation (the myth) is created by combining the elements into a story: A friendly police officer is playing with a refugee girl, which is unusual because policemen are commonly seen as authoritarian and unfriendly to illegal immigrants. This policeman is smiling. He is happy in his job. He is healthy, good-looking, and compassionate.This fits the image of Scandinavian men as good fathers (they have paternity leave, and often help equally with child rearing). The image confirms that the happiest people on earth would of course also have happy, friendly policemen. The belief that the Scandinavian social model is one to admire would appear to be endorsed.The fact that this is in a rural setting with green landscapes adds further to the notion of Nordic freshness, naturalness, environmentalism, and food that comes from the wild. The fact that the policeman is well-groomed, stylish, well-built, and handsome reinforces the notion that Scandinavia is a place of style and taste, where the good Viking gene pool produces fit and beautiful people.It makes sense that in a place with a focus on togetherness and the common good, refugees are also treated well. Just as the French image of a dark-skinned boy saluting the French flag sent out messages of French superiority, this image sends out messages of inherent Nordic goodness in a time where positive images of the European refugee crisis are few and far between.In a discursive discussion, one asks not only what meanings does this image convey, but why is this image chosen, distributed, shared, tweeted, and promoted over other images? What purpose does its proliferation serve? What is the historical context in which it is popularised? What is the cultural imagination/narrative that is served? In the current often depressing socio-political situation in Europe, people like to know that there is a place where compassion and play exists.Among other news stories of death, despair, and border protection, depictions of an idealised North can help calm anxieties by implying the existence of a place that is free of conflict. Jakob Stougaard-Nielsen writes:The flood of journalistic and popular ethnographic explorations of the Nordic region in the UK is an expression, perhaps, of a search for a lost sense of identity, a nostalgic longing for an imagined past society more in tune with pre-Thatcherite welfarist values, by way of consuming, appropriating and exoticising proximate cultural identities such as the now much hyped Danish or Nordic utopias. (Nordic Noir, 6)In The Almost Nearly Perfect People, British writer Michael Booth wonders: “one thing in particular about this new-found love of all things Scandinavian … which struck me as particularly odd: considering all this positive PR, and with awareness of the so-called Nordic miracle at an all-time high, why wasn’t everyone flocking to live here [in Denmark]?” (7).In actuality not many people in the West are interested in living in the Nordic countries. Rather, as Barbara Goodwin writes: “utopias hold up a mirror to the fears and aspirations of the time in which they were written” (2). In other words, in an age of anxiety, where traditional norms and stabilities are shifting, to believe that there is a place where contemporary societies have found a way of living in happiness and togetherness provides a sense of hope. People are not flocking to live in Scandinavia because it is not in their interests to have their utopian ideals shattered by the reality that, though the North has a lot to offer, it is inevitably not a utopia (Sougaard-Nielsen, The Truth Is).UnderbellyParadoxically, in recent years, Scandinavia has become well known for its “Nordic Noir” crime fiction and television. In the documentary TV series Scandimania, British TV personality Hugh Fearnley-Whittingstall travels through Denmark, Sweden, and Norway, exploring the culture, scenery, and food. He finds it curious that Denmark has become so famous for its sombre crime series, such as The Killing and The Bridge, because it seems so far removed from the Denmark he experiences riding around the streets of Copenhagen on his bike.Fearnley-Whittingstall ponders that one has to look hard to find the dark side of Denmark, and that perhaps it does not actually exist at all. This observation points to something essential. Even though millions of viewers worldwide have seen shows such as The Killing, which are known for their dark story lines, bleak urban settings, complex but realistic characters, progressive gender equality, and social commentary, the positive mythologising of Scandinavia remains so strong that it engenders a belief that the underbelly shown in Nordic Noir is perhaps entirely fictional.Stougaard-Nielsen (see also Pitcher, Consuming Race) argues that perhaps the British obsession with Nordic Noir (and this could be applied to other western countries) can be attributed to “a more appropriate white cosmopolitan desire to imagine rooted identities in an age of globalisation steeped in complex identity politics” (Nordic Noir, 8). That is to say that, for a segment of society which feels overwhelmed by contemporary multiculturalism, there may be a pleasure in watching a show that is predominantly populated by white Nordic protagonists, where the homes and people are stylish, and where the Nordic model of welfare and progressive thinking provides a rich identity source for white people as a symbolic point of origin.The watching/reading of Nordic Noir, as well as other preoccupations with all things Nordic, help build upon a mythological sense of whiteness that sets itself apart from our usual notions of race politics, by being an accepted form of longing for the North of bygone ages: a place that is progressive, moral, stylish, and imbued with aspirational ways of living, thinking, and being (Pitcher, Racial Politics).The image of the Danish police officer and the refugee girl fits this ideal of a progressive society where race relations are uncomplicated. The policeman who epitomises the Nordic ideal is in a position of power, but this is an authority which is benevolent. The girl is non-threatening in her otherness, because she is a child and female, and therefore does not fit the culturally dreaded Muslim/terrorist stereotype. In this constellation the two can meet beautifully.The reality, of course, is that the race relations and issues surrounding immigration in Denmark, and in other Nordic countries, are as complicated and often messy and hateful as they are in other countries. In Sweden, as Fearnley-Whittingstall touches upon in Scandimania, there are escalating problems with integration of the many new Swedes and growing inequalities in wealth. In Norway, the underlying race tensions became acutely topical in the aftermath of the 2011 massacre, where right-wing extremist Anders Breivik killed 77 people. Denmark has one of the harshest anti-immigration laws in Europe, laws that are continuously being tightened (Boserup); and whenever visiting Denmark I have been surprised to see how much space and time discussions about immigration and integration take up in the news and current affairs.If we contrast the previous image with the image above, taken within a similar timeframe on the same Danish highway, we can see the reality of Danish immigration policies. Here we are exposed to a different story. The scene and the location is the same, but the power dynamics have shifted from benign, peaceful, and playful to aggressive, authoritarian, and conflict ridden. A desperate father carries his daughter, determined to march on towards their destination of Sweden. The policeman is pulling his arm, attempting to detain the refugees so that they cannot go further, the goal being to deport the Syrians back to their previous place of detention, just over the border in Germany (Harticollis). While the previous image reflects the humanity of the refugee crisis, this image reflects the politics, policies, and to a large extent public opinion in Denmark, which is not refugee-friendly. This image, however, was not widely distributed, partly because it feeds into the same depressing narrative of an unsolvable refugee crisis seen so often elsewhere, and partly because it does not fit into the narrative of the infallible North. It could not be tweeted with the hashtag #Humanity, nor shared on Facebook with a smiley face and liked with an emoji heart.Another image from Denmark, in the form of a politically funded billboard, shows that there are deep-seated tendencies within Danish society that want to promote and retain a Denmark which adheres to its traditional values and ethnic whiteness. The image was displayed all over the country, at train stations, bus stops, and other public spaces when I visited in 2016. It was issued by Dansk Folkeparti (the Danish People’s Party); a party which is anti-immigration and which was until recently the country’s second largest party. The title says “Our Denmark”, while the byline cleverly plays with the double meaning of passe på: it can mean “there is so much we need to take care of”, but also “there is so much we need to beware of.” In other words, the white working-class family needs to take care of their Denmark, and beware of anyone who does not fit into this norm. Though hugely contested and criticised (Cremer; see a counter-reaction designed by opponents below), the fact that thinly veiled anti-immigration propaganda can be so readily distributed speaks of an underbelly in Danish society that is not made of the dark murder mysteries in The Killing, but rather of a quietly brewing distain for the foreigner that reigns within stylishly designed living rooms. ConclusionMyths are stories cultures tell and retell until they form a belief system that becomes a natural part of our collective narrative. For Barthes, these stories were intrinsically connected to our understanding of language and our ability to read images, films, artifacts, and popular culture more generally. To later cultural theorists, the notion of discursive formations expands this understanding, to see myth within a broader network of socio-political discourses placed within a certain place and time in history. When connected, small narratives (images, advertising, film, music, news stories, social media sharing, scientific evidence, etc.) come together to form a common narrative (the myth) about how things are and should be in relation to a particular topic. The culminating popularity of numerous Nordic themes (Nordic television/film, interior design, fashion, cuisine, architecture, lifestyle, sustainability, welfare system, school system, gender equality, etc.) has created a grand narrative of the Nordic countries as a type of utopia: one that shows the rest of the world that an egalitarian society of togetherness and progressive innovation is possible. This mythologisation serves to quell anxieties about the flux and uncertainty of contemporary times, and may also serve to legitimise a yearning for a simple, benign, and progressive whiteness, where we imagine Nordic families sitting peacefully at their beechwood dining tables, candles lit, playing board games. This is a projected yearning which is otherwise largely disallowed in today’s multicultural societies.ReferencesAnderson, Elizabeth. “The Most Prosperous Countries in the World, Based on Happiness and Financial Health.” The Telegraph, 2 Nov. 2015. <http://www.telegraph.co.uk/finance/economics/11966461/The-most-prosperous-countries-in-the-world-based-on-happiness-and-financial-health.html>.Barthes, Roland. Mythologies. London: Vintage, 2000 [1957].———. “Myth Today.” Mythologies. London: Vintage, 2000 [1957].Booth, Michael. The Almost Nearly Perfect People. London: Jonathan Cape, 2014.Boserup, Rasmus Alenius. “Denmark’s Harsh New Immigration Law Will End Badly for Everyone.” Huffington Post. <https://www.huffingtonpost.com/rasmus-alenius-boserup/denmark-immigration-law_b_9112148.html>.Bridge, The. (Danish: Broen.) Created by Hans Rosenfeldt. Sveriges Television and DR, 2013-present.Cleary, Paul. “Norway Is Proof That You Can Have It All.” The Australian, 15 July 2013. <http://www.theaustralian.com.au/life/norway-is-proof-that-you-can-have-it-all/news-story/3d2895adbace87431410e7b033ec84bf>.Colson, Thomas. “7 Reasons Denmark Is the Happiest Country in the World.” The Independent, 26 Sep. 2016. <http://www.independent.co.uk/news/world/europe/7-reasons-denmark-is-the-happiest-country-in-the-world-a7331146.html>.Cremer, Justin. “The Strangest Political Story in Denmark Just Got Stranger.” The Local, 19 May 2016. <https://www.thelocal.dk/20160519/strangest-political-story-in-denmark-just-got-stranger>.Dregni, Eric. “Why Is Norway the Happiest Place on Earth?” Star Tribune, 11 June 2017. <http://www.startribune.com/the-height-of-happy/427321393/#1>.Foucault, Michel. The History of Sexuality: The Will to Knowledge. London: Penguin Books, 1998 [1976]. Gaiman, Neil. “Neil Gaiman Retells Classic Norse Mythology.” Conversations. Radio National 30 Mar. 2017.Goodwin, Barbara, ed. The Philosophy of Utopia. London: Frank Cass, 2001.Hall, Stuart, ed. Representation: Cultural Representations and Signifying Practices. London: Sage, 1997.Hartocollis, Anemona. “Traveling in Europe’s River of Migrants.” New York Times, 9 Sep. 2015. <https://www.nytimes.com/interactive/projects/cp/reporters-notebook/migrants/denmark-refugees-migrants>.Helliwell, J., R. Layard, and J. Sachs. World Happiness Report 2017. New York: Sustainable Development Solutions Network, 2017.Kale, Sirin. “Women Are Now Pillaging Sperm Banks for Viking Babies.” Vice, 2 Oct. 2015. <https://broadly.vice.com/en_us/article/3dx9nj/women-are-now-pillaging-sperm-banks-for-viking-babies>.Killing, The. (Danish: Forbrydelsen.) Created by Søren Sveistrup. DR, 2007-2012.Kolff, Louise. “Part III: The Hunk & the Refugee.” Perspectra, 3 Dec. 2015. <https://perspectra.org/2015/12/03/danish-police-and-refugee-girl/>.Oxford Dictionaries. “Hygge.” <https://en.oxforddictionaries.com/definition/hygge>.Oxford Dictionaries. “Myth.” <https://en.oxforddictionaries.com/definition/myth>.Pitcher, Ben. Consuming Race. London: Routledge, 2014.———. “The Racial Politics of Nordic Noir.” Mecetes, 9 April 2014. <http://mecetes.co.uk/racial-politics-nordic-noir/>.Scandimania. Featuring H. Fearnley-Whittingstall. Channel 4, 2014.Sougaard-Nielsen, Jacob. “Nordic Noir in the UK: The Allure of Accessible Difference.” Journal of Aesthetics & Culture 8.1 (2016). 1 Oct. 2017 <http://www.tandfonline.com/doi/full/10.3402/jac.v8.32704>.———. “The Truth Is, Scandinavia Is Neither Heaven nor Hell.” The Conversation, 19 Aug. 2014. <https://theconversation.com/the-truth-is-scandinavia-is-neither-heaven-nor-hell-30641>.Warren, Rossalyn. “The Touching Moment a Policeman Sat Down to Play with a Syrian Refugee.” BuzzFeed News, 15 Sep. 2015. <https://www.buzzfeed.com/rossalynwarren/the-adorable-moment-a-policeman-sat-down-to-play-with-a-syri?utm_term=.qjzl2WEk7#.kgZXOp76M>.

Photo by 187929822 © Victor Moussa | Dreamstime.com INTRODUCTION The nonconsensual taking of a human organ to use in transplantation medicine violates ethical principles, including autonomy, informed consent, and human rights, as well as criminal laws. When such an organ harvesting is not just nonconsensual, but performed in a way that causes a death or uses the pretense of brain death without meeting the criteria, it also violates the dead donor[1] rule.[2] The dead donor rule is both ethical and legal. It prevents organ retrieval that would predictably cause the death of the organ donor.[3] Retrieval of a vital organ is permissible only after a declaration of death.[4] Forced organ harvesting may breach the dead donor rule as it stands. A reimagined, broader dead donor rule could consider a larger timeframe in the forced organ harvesting context. In doing so, the broad dead donor rule could cover intent, premeditation, aiding and abetting, and due diligence failures. A broad definition of forced organ harvesting is ‘‘the removal of one or more organs from a person by means of coercion, abduction, deception, fraud, or abuse of power. . .’’[5] A more targeted definition is “[t]he killing of a person so that their organs may be removed without their free, voluntary and informed consent and transplanted into another person.”[6] In the global organ harvesting context, forced organ harvesting violates the World Health Organization (WHO) Guiding Principle 3, which says “live organ donors should be acting willingly, free of any undue influence or coercion.”[7] Furthermore, WHO states live donors should be “genetically, legally, or emotionally” attached to the recipient. Guiding Principle 1 applies to deceased donors, covers consent, and permits donation absent any known objections by the deceased.[8] Principle 7 says, “Physicians and other health professionals should not engage in transplantation procedures, and health insurers and other payers should not cover such procedures if the cells, tissues or organs concerned have been obtained through exploitation or coercion of, or payment to, the donor or the next of kin of a deceased donor.”[9] There are underground markets in which organ hunters prey on the local poor in countries with low wages and widespread poverty[10] and human trafficking that targets migrants for the purpose of organ harvesting.[11] This paper explores forced harvesting under the backdrop of the dead donor rule, arguing that a human rights violation so egregious requires holding even distant participants in the chain of events accountable. By interfering with resources necessary to carry out bad acts, legislation and corporate and institutional policies can act as powerful deterrents. A broader dead donor rule would highlight the premeditation and intent evidenced well before the act of organ retrieval. I. Background and Evidence In China, there is evidence that people incarcerated for religious beliefs and practices (Falun Gong) and ethnic minorities (Uyghurs) have been subjects of forced organ harvesting. A tribunal (the China Tribunal) found beyond a reasonable doubt that China engaged in forced organ harvesting.[12] Additionally, eight UN Special Rapporteurs found a system of subjecting political prisoners and prisoners of conscience to blood tests and radiological examinations to determine the fitness of their organs.[13] As early as 2006, investigators found evidence of forced organ harvesting from Falun Gong practitioners. [14] Over a million Uyghurs are in custody there, and there is ample evidence of biometric data collection.[15] An Uyghur tribunal found evidence of genocide.[16] “China is the only country in the world to have an industrial-scale organ trafficking practice that harvests organs from executed prisoners of conscience.”[17] Witnesses testified to the removal of organs from live people without ample anesthesia,[18] summonses to the execution grounds for organ removal,[19] methods of causing death for the purpose of organ procurement,[20] removing eyes from prisoners who were alive,[21] and forcing live prisoners into operating rooms.[22] The current extent of executions to harvest organs from prisoners of conscience in China is unknown. The Chinese press has suggested surgeons in China will perform 50,000 organ transplants this year.[23] Doctors Against Forced Organ Harvesting (DAFOR) concluded, “[f]orced organ harvesting from living people has occurred and continues to occur unabated in China.”[24] China continues to advertise in multiple languages to attract transplant tourists.[25] Wait times for organs seem to remain in the weeks.[26] In the United States, it is common to wait three to five years.[27] II. The Nascent System of Voluntary Organ Donation in China In China, throughout the 1990s and early 2000s, the supply of organs for transplant was low, and there was not a national system to register as a donor. A 1984 act permitted death row prisoners to donate organs.[28] In 2005, a Vice Minister acknowledged that 95 percent of all organ transplants used organs from death row prisoners.[29] In 2007 the planning of a voluntary system to harvest organs after cardiac death emerged. According to a Chinese publication, China adopted brain death criteria in 2013.[30] There had been public opposition due partly to cultural unfamiliarity with it.[31] Cultural values about death made it more difficult to adopt a universal brain death definition. Both Buddhist and Confucian beliefs contradicted brain death.[32] Circulatory death was traditionally culturally accepted.[33] The Ministry of Health announced that by 2015 organ harvesting would be purely voluntary and that prisoners would not be the source of organs.[34] There are cultural barriers to voluntary donation partly due to a Confucian belief that bodies return to ancestors intact and other cultural and religious beliefs about respect for the dead.[35] An emphasis on family and community over the individual posed another barrier to the Western approach to organ donation. Public awareness and insufficient healthcare professional knowledge about the process of organ donation are also barriers to voluntary donation.[36] Although the Chinese government claims its current system is voluntary and no longer exploits prisoners,[37] vast evidence contradicts the credibility of the voluntary transplant program in China.[38] III. Dead Donor Rule: A Source of Bioethical Debate It seems tedious to apply this ethical foundation to something as glaring as forced organ harvesting. But the dead donor rule is a widely held recognition that it is not right to kill one person to save another.[39] It acts as a prohibition on killing for the sake of organ retrieval and imposes a technical requirement which influences laws on how death is declared. The dead donor rule prevents organ harvesting that causes death by prohibiting harvesting any organ which the donor agreed to donate only after death prior to an official declaration of death. There is an ongoing ethical debate about the dead donor rule. Many in bioethics and transplant medicine would justify removing organs in specific situations prior to a declaration of death, abandoning the rule.[40] Some use utilitarian arguments to justify causing the death of someone who is unconscious and on life support irreversibly. Journal articles suggest that the discussion has moved to one of timing and organ retrieval.[41] Robert Truog and Franklin Miller are critics of the dead donor rule, arguing that, in practice, it is not strictly obeyed: removing organs while a brain-dead donor is still on mechanical ventilation and has a beating heart and removing organs right after life support is removed and cardio-pulmonary death is declared both might not truly meet the requirement of the dead donor rule, making following the rule “a dubious norm.”[42] Miller and Truog question the concept of brain death, citing evidence of whole body integrated functions that continue indefinitely. They challenge cardio-pulmonary death, asserting that the definition includes as dead, those who could be resuscitated. Their hearts could resume beating with medical intervention. Stopping life support causes death only in those whose lives are sustained by it. Some stipulate that the organ retrieval must not itself cause the death. Some would rejigger the cause of death: Daniel Callahan suggests that the underlying condition causes the death despite removal of life support.[43] But logically, a person could continue life support and be alive, so clearly, removing life support does cause death. Something else would have caused brain death or the circumstance that landed the person on mechanical ventilation. To be more accurate, one could say X caused the irreversible coma and removing life support caused the death itself. Miller and Truog take the position that because withdrawal of life support does cause death, the dead donor rule should be defunct as insincere. To them, retrieving vital organs from a technically alive donor should be permissible under limited conditions. They look to the autonomous choices of the donor or the surrogate (an autonomy-based argument). They appreciate the demand for organs and the ability to save lives, drawing attention to those in need of organs. Live donor organ retrieval arguably presents a slippery slope, especially if a potential donor is close to death, but not so close to label it imminent. They say physicians would not be obligated to follow the orders of a healthy person wishing to have vital organs removed, perhaps to save a close friend or relative. Similarly, Radcliffe-Richards, et al. argue that there is no reason to worry about the slippery slope of people choosing death so they can sell their vital organs, whether for money for their decedents or their creditors.[44] The movement toward permissibility and increased acceptance of medical aid in dying also influence the organ donation arena. The slippery slope toward the end of life has potential to become a realistic concern. Older adults or other people close to death may want to donate a vital organ, like their heart, to a young relative in need. That could greatly influence the timing of a decision to end one’s life. IV. Relating the Dead Donor Rule to Forced Organ Harvesting There is well documented evidence that in China organs have been removed before a declaration of death.[45] But one thing the dead donor rule does not explicitly cover is intent and the period prior to the events leading to death. It tends to apply to a near-death situation and is primarily studied in its relationship to organ donation. It is about death more than it is about life. Robertson and Lavee investigated data on transplantation of vital organs in China and they document cases where the declaration of death was a pretense, insincere, and incorrect. Their aim was to investigate whether the prisoners were in fact dead prior to organ harvesting.[46] (The China Tribunal found that organs have been removed from live prisoners and that organ harvesting has been the cause of death.) They are further concerned with the possible role of doctors as executioners, or at least as complicit in the execution as the organ harvesting so closely follows it. V. A Broader Dead Donor Rule A presumed ethical precursor to the dead donor rule may also be an important ethical extension of the rule: the dead donor rule must also prohibit killing a person who is not otherwise near death for the purpose of post-death organ harvesting. In China, extra-judicial killings of prisoners of conscience are premeditated ― there is ample evidence of blood tests and radiology to ensure organ compatibility and health.[47] To have effective ethical force, the dead donor rule should have an obvious application in preventing intentional killing for an organ retrieval, not just killing by way of organ retrieval. When we picture the dead donor rule, bioethicists tend to envision a person on life support who will either be taken off it and stop breathing or who will be declared brain dead. But the dead donor rule should apply to healthy people subject to persecution at the point when the perpetrator lays the ground for the later killing. At that point, many organizations and people may be complicit or unknowingly contributing to forced organ harvesting. In this iteration of the dead donor rule, complicity in its violations would be widespread. The dead donor rule could address the initial action of ordering a blood or radiology test or collecting any biometric data. Trained physicians and healthcare technicians perform such tests. Under my proposed stretch of the dead donor rule, they too would be complicit in the very early steps that eventually lead to killing a person for their organs. I argue these steps are part of forced organ harvesting and violate the dead donor rule. The donor is very much alive in the months and years preceding the killing. A conspiracy of indifference toward life, religious persecution, ethnic discrimination, a desire to expand organ transplant tourism, and intent to kill can violate this broader dead donor rule. The dead donor rule does not usually apply to the timing of the thought of organ removal, nor the beginning of the chain of events that leads to it. It is usually saved for the very detailed determination of what may count as death so that physicians may remove vital and other organs, with the consent of the donor.[48] But I argue that declaring death at the time of retrieval may not be enough. Contributing to the death, even by actions months or years in advance, matter too. Perhaps being on the deathbed awaiting a certain death must be distinguished from going about one’s business only to wind up a victim of forced organ harvesting. Both may well be declared dead before organ retrieval, but the likeness stops there. The person targeted for future organ retrieval to satisfy a growing transplant tourism business or local demand is unlike the altruistic person on his deathbed. While it may seem like the dead donor rule is merely a bioethics rule, it does inform the law. And it has ethical heft. It may be worth expanding it to the arena of human trafficking for the sake of organ removal and forced organ harvesting.[49] The dead donor rule is really meant to ensure that death was properly declared to protect life, something that must be protected from an earlier point. VI. Complicity: Meaning and Application Human rights due diligence refers to actions that people or institutions must take to ensure they are not contributing to a human rights violation. To advise on how to mitigate risk of involvement or contribution to human rights violations, Global Rights Compliance published an advisory that describes human rights due diligence as “[t]he proactive conduct of a medical institution and transplant-associated entity to identify and manage human rights risks and adverse human rights impacts along their entire value and supply chain.”[50] Many people and organizations enable forced organ harvesting. They may be unwittingly complicit or knowingly aiding and abetting criminal activity. For example, some suppliers of medical equipment and immunosuppressants may inadvertently contribute to human rights abuses in transplantation in China, or in other countries where organs were harvested without consent, under duress, or during human trafficking. According to Global Rights Compliance, “China in the first half of 2021 alone imported ‘a total value of about 24 billion U.S. dollars’ worth of medical technology equipment’, with the United States and Germany among the top import sources.”[51] The companies supplying the equipment may be able to slow or stop the harm by failing to supply necessary equipment and drugs. Internal due diligence policies would help companies analyze their suppliers and purchasers. Corporations, educational institutions, and other entities in the transplantation supply chain, medical education, insurance, or publishing must engage in human rights due diligence. The Global Rights Compliance advisory suggests that journals should not include any ill-gotten research. Laws should regulate corporations and target the supply chain also. All actors in the chain of supply, etc. are leading to the death of the nonconsenting victim. They are doing so while the victim is alive. The Stop Forced Organ Harvesting Act of 2023, pending in the United States, would hold any person or entity that “funds, sponsors, or otherwise facilitates forced organ harvesting or trafficking in persons for purposes of the removal of organs” responsible. The pending legislation states that: It shall be the policy of the United States—(1) to combat international trafficking in persons for purposes of the removal of organs;(2) to promote the establishment of voluntary organ donation systems with effective enforcement mechanisms in bilateral diplomatic meetings and in international health forums;(3) to promote the dignity and security of human life in accordance with the Universal Declaration of Human Rights, adopted on December 10, 1948; and(4) to hold accountable persons implicated, including members of the Chinese Communist Party, in forced organ harvesting and trafficking in persons for purposes of the removal of organs.[52] The Act calls on the President to provide Congress a list of such people or entities and to sanction them by property blocking, and, in the case of non-US citizens, passport and visa denial or revocation. The Act includes a reporting requirement under the Foreign Assistance Act of 1961 that includes an assessment of entities engaged in or supporting forced organ harvesting.[53] The law may have a meaningful impact on forced organ harvesting. Other countries have taken or are in the process of legal approaches as well.[54] Countries should consider legislation to prevent transplant tourism, criminalize complicity, and require human rights due diligence. An expanded dead donor rule supports legal and policy remedies to prevent enabling people to carry out forced organ harvesting. VII. Do Bioethicists Mention Human Rights Abuses and Forced Organ Harvesting Enough? As a field, bioethics literature often focuses on the need for more organs, the pain and suffering of those on organ transplant waitlists, and fairness in allocating organs or deciding who belongs on which waitlist and why. However, some bioethicists have drawn attention to forced organ harvesting in China. Notably, several articles noted the ethical breaches and called on academic journals to turn away articles on transplantation from China as they are based on the unethical practice of executing prisoners of conscience for their organs.[55] The call for such a boycott was originally published in a Lancet article in 2011.[56] There is some acknowledgement that China cares about how other countries perceive it,[57] which could lead to either improvements in human rights or cover-ups of violations. Ill-gotten research has long been in the bioethics purview with significant commentary on abuses in Tuskegee and the Holocaust.[58] Human research subjects are protected by the Declaration of Helsinki, which requires acting in the best interests of research subjects and informed consent among other protections.[59] The Declaration of Helsinki is directed at physicians and requires subjects enroll in medical research voluntarily. The Declaration does not explicitly cover other healthcare professionals, but its requirements are well accepted broadly in health care. CONCLUSION The dead donor rule in its current form really does not cover the life of a non-injured healthy person at an earlier point. If it could be reimagined, we could highlight the link between persecution for being a member of a group like Falun Gong practitioners or Uyghurs as the start of the process that leads to a nonconsensual organ retrieval whether after a proper declaration of death or not. It is obviously not ethically enough to ensure an execution is complete before the organs are harvested. It is abuse of the dead donor rule to have such a circumstance meet its ethical requirement. And obviously killing people for their beliefs or ethnicity (and extra-judicial killings generally) is not an ethically acceptable action for many reasons. The deaths are intentionally orchestrated, but people and companies who may have no knowledge of their role or the role of physicians they train or equipment they sell are enablers. An expanded dead donor rule helps highlight a longer timeframe and expanded scope of complicity. The organ perfusion equipment or pharmaceuticals manufactured in the United States today must not end up enabling forced organ harvesting. With an expanded ethical rule, the “donor is not dead” may become “the donor would not be dead if not for. . .” the host of illegal acts, arrests without cause, forced detention in labor camps, extra-judicial killings, lacking human rights due diligence, and inattention to this important topic. The expanded dead donor rule may also appeal to the bioethics community and justify more attention to laws and policies like the Stop Forced Organ Harvesting Act of 2023. - [1] The word “donor” in this paper describes any person from whom organs are retrieved regardless of compensation, force, or exploitation in keeping with the bioethics literature and the phrase “dead donor rule.” [2] Robertson, M.P., Lavee J. (2022). Execution by organ procurement: Breaching the dead donor rule in China. Am J Transplant, Vol.22,1804– 1812. doi:10.1111/ajt.16969. [3] Robertson, J. A. (1999). Delimiting the donor: the dead donor rule. Hastings Center Report, 29(6), 6-14. [4] Retrieval of non-vital organs which the donor consents to donate post-death (whether opt-in, opt-out, presumed, or explicit according to local law) also trigger the dead donor rule. [5] The Stop Forced Organ Harvesting Act of 2023, H.R. 1154, 118th Congress (2023), https://www.congress.gov/bill/118th-congress/house-bill/1154. [6] Do No Harm: Mitigating Human Rights Risks when Interacting with International Medical Institutions & Professionals in Transplantation Medicine, Global Rights Compliance, Legal Advisory Report, April 2022, https://globalrightscompliance.com/project/do-no-harm-policy-guidance-and-legal-advisory-report/. [7] WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation, as endorsed by the sixty-third World Health Assembly in May 2010, in Resolution WHA63.22 https://apps.who.int/iris/bitstream/handle/10665/341814/WHO-HTP-EHT-CPR-2010.01-eng.pdf?sequence=1. [8] WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation (2010). [9] WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation (2010). [10] Promchertchoo, Pichayada (Oct. 19, 2019). Kidney for sale: Inside Philippines’ illegal organ trade. https://www.channelnewsasia.com/asia/kidney-for-sale-philippines-illegal-organ-trade-857551; Widodo, W. and Wiwik Utami (2021), The Causes of Indonesian People Selling Covered Kidneys from a Criminology and Economic Perspective: Analysis Based on Rational Choice Theory. European Journal of Political Science Studies, Vol 5, Issue 1. [11] Van Reisen, M., & Mawere, M. (Eds.). (2017). Human trafficking and trauma in the digital era: The ongoing tragedy of the trade in refugees from Eritrea. African Books Collective. [12] The Independent Tribunal into Forced Organ Harvesting from Prisoners of Conscience in China (China Tribunal) (2020). https://chinatribunal.com/wp-content/uploads/2020/03/ChinaTribunal_JUDGMENT_1stMarch_2020.pdf [13] UN Office of the High Commissioner, Press Release, China: UN human Rights experts alarmed by ‘organ harvesting’ allegations (UN OTHCHR, 14 June 2021), https://www.ohchr.org/en/press-releases/2021/06/china-un-human-rights-experts-alarmed-organ-harvesting-allegations. [14] David Matas and David Kilgour, Bloody Harvest. The killing of Falun Gong for their organs (Seraphim Editions 2009). [15] How China is crushing the Uyghurs, The Economist, video documentary, July 9, 2019, https://youtu.be/GRBcP5BrffI. [16] Uyghur Tribunal, Judgment (9 December 2021) (Uyghur Tribunal Judgment) para 1, https://uyghurtribunal.com/wp-content/uploads/2022/01/Uyghur-Tribunal-Judgment-9th-Dec-21.pdf. [17] Ali Iqbal and Aliya Khan, Killing prisoners for transplants: Forced organ harvesting in China, The Conversation Published: July 28, 2022. https://theconversation.com/killing-prisoners-for-transplants-forced-organ-harvesting-in-china-161999 [18] Testimony demonstrated surgeries to remove vital organs from live people, killing them, sometimes without ample anesthesia to prevent wakefulness and pain. China Tribunal (2020), p. 416-417. https://chinatribunal.com/wp-content/uploads/2020/03/ChinaTribunal_JUDGMENT_1stMarch_2020.pdf; Robertson MP, Lavee J. (2022), Execution by organ procurement: Breaching the dead donor rule in China. Am J Transplant, Vol.22,1804– 1812. doi:10.1111/ajt.16969. [19] Doctors reported being summoned to execution grounds and told to harvest organs amid uncertainty that the prisoner was in fact dead. China Tribunal (2020), p. 52-53. [20]In testimony to the China Tribunal, Dr. Huige Li noted four methods of organ harvesting from live prisoners: incomplete execution by shooting, after lethal injection prior to death, execution by removal of the heart, and after a determination of brain death prior to an intubation (pretense of brain death). China Tribunal (2020), pp. 54-55. https://chinatribunal.com/wp-content/uploads/2020/03/ChinaTribunal_JUDGMENT_1stMarch_2020.pdf [21] A former military medical student described removing organs from a live prisoner in the late 1990s. He further described his inability to remove the eyes of a live man and his witnessing another doctor forcefully remove the man’s eyes. China Tribunal (2020), p. 330. [22] In 2006, a nurse testified that her ex-husband, a surgeon, removed the eyes of 2,000 Falun Gong practitioners in one hospital between 2001 and 2003. She described the Falun Gong labor-camp prisoners as being forced into operating rooms where they were given a shot to stop their hearts. Other doctors removed other organs. DAFOH Special Report, 2022. https://epochpage.com/wp-content/uploads/sites/3/2022/12/DAFOH-Special-Report-2022.pdf [23] Robertson MP, Lavee J. (2022), Execution by organ procurement: Breaching the dead donor rule in China. Am J Transplant, Vol.22,1804– 1812. doi:10.1111/ajt.16969. [24] DAFOH Special Report, 2022. https://epochpage.com/wp-content/uploads/sites/3/2022/12/DAFOH-Special-Report-2022.pdf; DAFOH’s physicians were nominated for a Nobel Prize for their work to stop forced organ harvesting. Šućur, A., & Gajović, S. (2016). Nobel Peace Prize nomination for Doctors Against Forced Organ Harvesting (DAFOH) - a recognition of upholding ethical practices in medicine. Croatian medical journal, 57(3), 219–222. https://doi.org/10.3325/cmj.2016.57.219 [25] Robertson and Lavee (2022). [26] Stop Organ Harvesting in China, website (organization of the Falun Dafa). https://www.stoporganharvesting.org/short-waiting-times/ [27] National Kidney Foundation, The Kidney Transplant Waitlist – What You Need to Know, https://www.kidney.org/atoz/content/transplant-waitlist [28] Wu, Y., Elliott, R., Li, L., Yang, T., Bai, Y., & Ma, W. (2018). Cadaveric organ donation in China: a crossroads for ethics and sociocultural factors. Medicine, 97(10). [29] Wu, Elliott, et al., (2018). [30] Su, Y. Y., Chen, W. B., Liu, G., Fan, L. L., Zhang, Y., Ye, H., ... & Jiang, M. D. (2018). An investigation and suggestions for the improvement of brain death determination in China. Chinese Medical Journal, 131(24), 2910-2914. [31] Huang, J., Millis, J. M., Mao, Y., Millis, M. A., Sang, X., & Zhong, S. (2012). A pilot programme of organ donation after cardiac death in China. The Lancet, 379(9818), 862-865. [32] Yang, Q., & Miller, G. (2015). East–west differences in perception of brain death: Review of history, current understandings, and directions for future research. Journal of bioethical inquiry, 12, 211-225. [33] Huang, J., Millis, J. M., Mao, Y., Millis, M. A., Sang, X., & Zhong, S. (2015). Voluntary organ donation system adapted to Chinese cultural values and social reality. Liver Transplantation, 21(4), 419-422. [34] Huang, Millis, et al. (2015). [35] Wu, X., & Fang, Q. (2013). Financial compensation for deceased organ donation in China. Journal of Medical Ethics, 39(6), 378-379. [36] An, N., Shi, Y., Jiang, Y., & Zhao, L. (2016). Organ donation in China: the major progress and the continuing problem. Journal of biomedical research, 30(2), 81. [37] Shi, B. Y., Liu, Z. J., & Yu, T. (2020). Development of the organ donation and transplantation system in China. Chinese medical journal, 133(07), 760-765. [38] Robertson, M. P., Hinde, R. L., & Lavee, J. (2019). Analysis of official deceased organ donation data casts doubt on the credibility of China’s organ transplant reform. BMC Medical Ethics, 20(1), 1-20. [39] Miller, F.G. and Sade, R. M. (2014). Consequences of the Dead Donor Rule. The Annals of thoracic surgery, 97(4), 1131–1132. https://doi.org/10.1016/j.athoracsur.2014.01.003 [40] For example, Miller and Sade (2014) and Miller and Truog (2008). [41] Omelianchuk, A. How (not) to think of the ‘dead-donor’ rule. Theor Med Bioeth 39, 1–25 (2018). https://doi-org.ezproxy.cul.columbia.edu/10.1007/s11017-018-9432-5 [42] Miller, F.G. and Truog, R.D. (2008), Rethinking the Ethics of Vital Organ Donations. Hastings Center Report. 38: 38-46. [43] Miller and Truog, (2008), p. 40, citing Callahan, D., The Troubled Dream of Life, p. 77. [44] Radcliffe-Richards, J., Daar, A.S., Guttman, R.D., Hoffenberg, R., Kennedy, I., Lock, M., Sells, R.A., Tilney, N. (1998), The Case for Allowing Kidney Sales, The Lancet, Vol 351, p. 279. (Authored by members of the International Forum for Transplant Ethics.) [45] Robertson and Lavee, (2022). [46] Robertson and Lavee, (2022). [47] China Tribunal (2020). [48] Consent varies by local law and may be explicit or presumed and use an opt-in or opt-out system and may or may not require the signoff by a close family member. [49] Bain, Christina, Mari, Joseph. June 26, 2018, Organ Trafficking: The Unseen Form of Human Trafficking, ACAMS Today, https://www.acamstoday.org/organ-trafficking-the-unseen-form-of-human-trafficking/; Stammers, T. (2022), "2: Organ trafficking: a neglected aspect of modern slavery", Modern Slavery and Human Trafficking, Bristol, UK: Policy Press. https://bristoluniversitypressdigital.com/view/book/978144736. [50] Do No Harm: Mitigating Human Rights Risks when Interacting with International Medical Institutions & Professionals in Transplantation Medicine, Global Rights Compliance, Legal Advisory Report, April 2022, https://globalrightscompliance.com/project/do-no-harm-policy-guidance-and-legal-advisory-report/. [51] Global Rights Compliance, p. 22. [52] The Stop Forced Organ Harvesting Act of 2023, H.R. 1154, 118th Congress (2023). https://www.congress.gov/bill/118th-congress/house-bill/1154. [53] The Stop Forced Organ Harvesting Act of 2023, H.R. 1154, 118th Congress (2023), https://www.congress.gov/bill/118th-congress/house-bill/1154. [54] Global Rights Compliance notes that Belgium, France (passed law on human rights due diligence in the value supply chain), United Kingdom, United States, Canada, Australia, and New Zealand have legal approaches, resolutions, and pending laws. p. 45. [55] For example, Caplan, A.L. (2020), The ethics of the unmentionable Journal of Medical Ethics 2020;46:687-688. [56] Caplan, A.L. , Danovitch, G., Shapiro M., et al. (2011) Time for a boycott of Chinese science and medicine pertaining to organ transplantation. Lancet, 378(9798):1218. doi:10.1016/S0140-6736(11)61536-5 [57] Robertson and Lavee. [58] Smolin, D. M. (2011). The Tuskegee syphilis experiment, social change, and the future of bioethics. Faulkner L. Rev., 3, 229; Gallin, S., & Bedzow, I. (2020). Holocaust as an inflection point in the development of bioethics and research ethics. Handbook of research ethics and scientific integrity, 1071-1090. [59] World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964, and amended multiple times, most recently by the 64th WMA General Assembly, Fortaleza, Brazil, October 2013. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/