Articoli di riviste sul tema "Coalition for the Advancement of Jewish Education"

The act of providing fund for political candidate by wealthy private individual and group has become a recurrent phenomenon in the United State electoral system. It is a pervasive campaign practice that cannot be isolated from the US politics. Individual and group donate huge sum of money to support political candidate or political parties of their choices. Of greater concern is the ease with which interest group adopts the strategy of campaign finance to influence state apparatus to achieve interest based policy concession. The Jewish lobby group is a loosed coalition of interest group whose primary objective is the advancement of the US- Israel relation for favourable foreign policy toward Israel. It is a prominent interest group with members who are often the richest and highest campaign donor in any election circle in the United States. The group over the years capitalised on the strategy of campaign financing to stronghold the United States Congress and the executive in order to shape the country Middle East foreign policy in favour of Israel. The study seeks to examine the dynamic role of interest group, the link between campaign financing and interest group using the Powerful Jewish lobby group as the basis of analysis. The theoretical foundation for the work is the elite theory postulated by Gaetano Mosca and the Italian school of elitism. Secondary source of data collection was adopted to extrapolate fact that are relevant to the study. The article find out that campaign fiancé is an integral part of the United States politics and cannot be divorced. Interest group such as the Jewish lobby group adopts the instrumentality of campaign financing to advance private interest

At sixty-four Israel is still a comparatively young nation state, just passing from the 'developing' to the 'developed' phase. It has had five different history curricula for the Jewish 'Mamlakhti' (public non-religious) and the Arab sectors, which account for the majority of the students. For the first five decades the history curriculum did not ignite much controversy. The first curriculum was a rallying curriculum centered on the Jewish national movement and the establishment of Israel. In 1975 an 'academized' curriculum incorporated historical thinking goals – a move away from just an identification stance and towards an analytic stance. The mandatory baccalaureate examination, however, pushed for memorization and coverage. The fourth curriculum in 1993 integrated Jewish and world history with a slightly greater emphasis on world history, covered Israel's first three wars, and historical Jewish Diasporas and ethnicities. One textbook in the late nineties included cases of the deportation of Palestinian civilians during Israel's independence war. The decade since the turn of the millennia has been turbulent and inconsistent. New 'heritage' projects sponsored by right-wing Ministers of Education have alternated with curriculum emphasizing critical thinking, interpretation and multiple sources. The pendulum swung from expressive populist ethnocentricity to critical inquiry and diversity and back. New policies are haphazardly and partially enforced until a rival coalition reaches power and 'debates' curricula by publicizing the attempts to undo or alter them. Little attention was given to the ways teachers or students actually enacted and perceived the curriculum.

Abstract This article examines the case of Karla Galarza v. Washington, DC Board of Education. On April 3, 1947, Karla Galarza refused to accept the board's directive to withdraw from the Black segregated Margaret Murray Washington Vocational School. Her father, Dr. Ernesto Galarza, supported her decision and worked to challenge the expulsion, and the system of segregation, as unconstitutional. The authors analyze materials from regional and national archives, oral accounts, legal documents, and personal collections, focusing on Dr. Galarza's voice in over one hundred pages of correspondence. Dr. Galarza brought together an interracial legal team, including Charles Hamilton Houston, the National Association for the Advancement of Colored People, the American Civil Liberties Union, the American Jewish Congress, and the National Lawyers Guild. Dr. Galarza lauded the pedagogy of a Black teacher and the pluralism cultivated in a Black school community as evidence of democracy in action. The legal team proposed that Karla's expulsion constituted a violation of the Fifth Amendment, naming education as a property right. However, after extensive research and discussion across ten months, the organizations determined they should not pursue the case in court. The authors assert that this attempted legal intervention is an unnamed forerunner in the attack on Plessy v. Ferguson and complicates previous narratives of the long struggle to end school segregation.

Prompts for "reading" actually existed since when the revelation of God was revealed for the first time received by the prophet Muhammad SAW. In Holly Bible the book of Christians reveals that in the tradition of the Jewish command "Reading" after there is a book and reading to understand history and law. So before "reading" must do writing first. Thus, according to them, that the word of God "read" contained in his book is meaning "writing", which this thing is written directly in the book of output 17: 14 who was ordered to write history, and the book of Deuteronomy 4: 13-14 where God write 10 commands and teach commands. This research was conducted to find out and reveal the different meanings of the word "read" in Christian-Islamic Education. "Read-write" Text correlation in learning. The research method used is a theoretically oriented qualitative approach is a way of looking at the world, the assumptions that people embrace about something important, and what makes people work. So that the meaning of the word "read" in Islamic education means "reading" based on the word of God which first came down to the Prophet Muhammad, namely 'Iqra' in the letter Al-Alaq. Whereas in Christian education means "writing". Based on the word of God to the Prophet Moses in the book EXPLANATION 17: 14 in the Torah or the old agreement. The difference, the author tries to combine that reading and writing is a unity that cannot be separated in an education and learning. Therefore read-write that was not respected and preserved in learning must be rebuilt for the advancement of students as the nation's successor.

The genesis of changes in Polish historical scholarship, for which the events of March 1968 became a catalyst, is rooted in the first half of the 1960s. It was then that the ever clearer generational splits became marked among Polish historians, related to the academic advancement of historians belonging to the younger generations, who had already obtained their education in the People’s Poland. It was some of the scholars who had made their careers in the 1950s who took a standpoint which was increasingly clearly opposed to the PUWP’s policy, the latter being tinted with nationalism. On the eve of the events of March, the Polish historians’ milieux were thus split, with the intra-community conflicts reinforced by the restrictive censorship policies of the PUWP authorities and their striving to make scholars conform to the current policy. The events of March 1968 became a catalyst of both the processes occurring in Polish historical scholarship in the 60s and the PUWP policy aimed at strengthening political control over scholarship. The brutal dispersal, by the ‘Citizens Militia’, of the students’ rally in the courtyard of Warsaw University on 8th March resulted in protests not only on the part of the students, but also on that of the professors of Warsaw University and the Polish Academy of Sciences. Among their numbers were the historians Juliusz Bardach, Bogusław Leśnodorski, Tadeusz Manteuffel, Henryk Samsonowicz. The attitudes of the scholarly staff of Warsaw University’s Department of History were strongly influenced by the prestige of the ‘old’ professors. To a limited degree, the historians’ milieu was affected by the repressions on the part of the authorities after the March events. The institutions which suffered most were the Jewish Historical Institute and the Institute of History at the University of Łódź. The number of appointments of so-called ‘March docents’ among the historians was relatively small and most of them have later written and defended their post-doctoral dissertations. As a result of the anti-Semitic campaign, more than a dozen historians of Jewish extraction probably left Poland. Another effect that the March events had on scholarship was the re-organisation of scholarly structures and numerous personal changes in institutions and to the editorial committees of scholarly journals, as well as the acceleration of the generational change. Some liberalisation of the censorship also occurred between March and September 1968, and the assessment of the image of Poland’s history changed to to become more optimistic.

During the “Third Reich,” the majority of German gynecologists and obstetricians did not hesitate to put themselves at the service of those in power. In 1933, many gynecologists initially only focused on the fact that the biopolitical objectives of the National Socialists matched their own long-standing demands for population policy measures and the early detection and prevention of cancer. In addition, cooperating with the Nazis promised the political advancement of the profession, personal advantages, and the honorary title of <i>Volksgesundheitsführer</i> (national health leaders). As a result, gynecologists exchanged resources with the regime and thus contributed significantly to the implementation of the criminal racial policies of the Nazis. At the congresses of the <i>Deutsche Gesellschaft für Gynäkologie</i> (German Society of Gynecology) “non-Aryan” members, mostly of Jewish descent, were excluded, the law on forced sterilization of 1933 (<i>Gesetz zur Verhütung erbkranken Nachwuchses</i>/Law for the Prevention of Offspring with Hereditary Diseases) was scientifically legitimized, its implementation was propagated, and relevant surgical techniques were discussed with regard to their “certainty of success.” In the course of these forced sterilizations, existing pregnancies were also terminated and the victims were misused for illegal scientific examinations or experiments. Drawing upon racial and utilitarian considerations, gynecologists did not even shy away from carrying out late abortions on forced laborers from the East during the Second World War, which were strictly prohibited even under the laws of the time. Some gynecologists carried out cruel experiments on humans in concentration camps, which primarily served their own careers and the biopolitical goals of those in power. The few times gynecologists did protest or resist was when the very interests of their profession seemed threatened, as in the dispute over home births and the rights of midwives. Social gynecological initiatives from the Weimar Republic, which were mainly supported and carried out by gynecologists persecuted for their Jewish descent since 1933, were either converted into National Socialist “education programs” or simply came to an end due to the exclusion of their initiators. German gynecologists had hoped for a large-scale promotion of the early detection of malignant diseases of the uterus and breasts, to which they had already made important contributions since the beginning of the 20th century. But even though the fight against cancer was allegedly one of the priorities of the Nazis, no comprehensive measures were taken. Still, a few locally limited initiatives to this end proved to be successful until well into the Second World War. In addition, German gynecologists established the modern concept of prenatal care and continued to advance endocrinological research and sterility therapy. After the end of the Nazi dictatorship, the historical guilt piled up during this period was suppressed and denied for decades. Its revision and processing only began in the 1990s.

This article reviews recent developments in tertiary educational policy in New Zealand. It considers the implications of these on skill development and innovation and identifies network creation as a key aim of the Labour-led coalition. The article assesses its impact on the competition for advancement through education, and concludes by arguing that in some respects, Labour has been more conservative than previous New Right governments in New Zealand.

China pays attention to test-oriented education and emphasizes the role of a teacher as a knowledge distributor. Thus, the classroom teaching is mainly based on the injection of knowledge, while our public education is lacking in setting general education courses for Arts and Humanities. Taking competitive advancement as the core, our students complete the independent learning model in the traditionally competitive way and emphasize the accumulation of personal knowledge to increase personal competitiveness. This article studies the Jewish learning method, that is, the Havruta learning method theory. This article starts from investigating the initial application scope of the Havruta learning method. Then it gives the definition, constituent elements, deployment and implementation of the Havruta learning method. Meanwhile, it demonstrates how to set in the process of teaching to make use of the teaching method. According to the research, we suggest that it is rather necessary for us to introduce the Havruta learning method in order to promote the students' moral education, cultivate their wisdom, and establish the way of critical thinking, especially under the current test-oriented education for schools that uses competitive individual learning as a means of entering a higher education, extracurricular tutoring classes that focus on strengthening test-oriented classroom knowledge, and utilitarian families that blindly pursue scores.

Metaverse has been confirmed as a relatively amorphous concept of innovation, which refers to technological advancement. Metaverse, i.e., a coalition between reality world and virtual world, has created significant significance and convenience in education, communication, economy, etc. The COVID-19 outbreak has stimulated the growth of metaverse applications in medicine. The above-mentioned technology has broad applications while comprising online remote medical treatment, online conferences, medical education, preparation of surgical plans, etc. Moreover, technical, security, and financial challenges should be tackled down by the future widespread use of metaverse. Metaverse is limitlessly promising, and it will exert a certain effect on future scientific and technological advancements in the medical industry. The review article primarily aims to summarize the application of the metaverse in medicine and their challenge in the future of medicine.

Purpose The purpose of this paper is to show how the impact of White Supremacy and Christian hegemony on the educational system. By highlighting interconnectedness across targeted groups, the authors assert that through coalition building, groups are stronger than they would be working alone. Solidarity gives hope to combating hatred of all kinds. Learning that there is a long history of antisemitism is an important component of fighting bias. With book banning and controversy over teaching critical race theory in schools, it is important that educators reflect on their social justice education. Design/methodology/approach The authors analyze the definitions and enactment of multicultural, culturally responsive and anti-bias education as well as critical theory. They then investigate how antisemitism is of concern to all identities targeted by White Supremacy and Christian Nationalism (LGBTQIA+, minoritized races, non-Christians, etc.) and the importance of education in fighting hate and influencing policy and practice. Findings Although 2 % of the US population identifies as Jewish, 11% of incidents educators reported were classified as antisemitic. Education is the key to fighting antisemitism and Holocaust denial (Greene et al., 2021; Stanton and Marcus, 2019). The authors make recommendations for addressing antisemitism, including addressing antisemitic incidents, the importance of Holocaust studies, the need for religious literacy, fighting the banning of books and narrowing the school curriculum. The authors ended by reinforcing the need for Jewish people to be included in multicultural, culturally responsive, anti-bias education and the need for “Heb-crit” as a sub-study of critical race theory. Social implications Anti-bias education must include antisemitism and show how connected hatred is rather than having groups compare their struggles. The authors explained the diversity among Jewish people to highlight the complexity of an identity group that is often inaccurately oversimplified. Originality/value There is a need for scholarship on modern-day antisemitism and internalized antisemitism and reflective narratives as commonly used in Black and Latinx studies (Rubin, 2020). With the rise in Holocaust denial and antisemitic groups (Southern Poverty Law Center, 2024), it is important to advocate and teach about these topics, which are not often discussed in PK-12 or Schools of Education (Muller, 2022).

Education is an important matter in Indonesia and also globally. This importance of education is ingrained in the Indonesian Law Constitution in 1945 (Undang-Undang Dasar 1945), chapter 31 where it states that: every Indonesian citizen deserves to receive education, and is obliged to attend basic education and the government is obliged to pay for it. In addition, the government is to seek and organize a national education system which increases faith and piety as well as noble character in the context of educating the life of the nation, which is regulated by law. The state prioritizes the education budget of at least twenty percent of the state revenue and expenditure budget as well as from the regional revenue and expenditure budget to meet the needs of implementing national education. It alsoadvances science and technology by supporting high religious values and national unity for the advancement of civilization and the welfare of mankind. As a result, the Indonesian government provides a free of charge education at public schools from grades one to nine to give an opportunity of equal education to every citizen which includes nine subjects. The challenge, however, is that all students in the public schools are required to take nine subjects every academic year. This could be overwhelmingly difficult for the students both academically and also mentally. Thus, this article attempts to propose a solution academically as to how students could cope with their forgetfulness to achieve the maximum grades. This solution, it is argued, can be discovered in the Targum and is tested through a cognitive psychology approach. Targums which form a part of the Jewish traditional literature from the Second Temple period are not merely a translation of the Hebrew Torah text into Aramaic, but also possess immense Talmudic wisdom that illuminates the Biblical stories but also provide us with important tried and tested lessons for today.

Watch VIDEO. Science plays a pivotal role in the advancement of democratic societies, and there is a growing consensus advocating for its recognition as both a common good and a fundamental human right. To effectively fulfil this role, science necessitates the trust of society, the support of policy makers, and robust international collaboration, enabling the mobility of researchers and the free flow of knowledge. To encourage this, our responsibilities as researchers extend beyond the realm of academic publishing. They encompass science outreach, education, diplomacy, policy advocacy, entrepreneurship, and collaborations aimed at addressing global challenges or progress towards more equitable societies. However, this is hampered by current research assessment practices and the academic reward system, which perpetuate a 'publish or perish' research culture that confines the scope of science to academic publishing, fosters privilege-based biases, and prioritises quantity over quality, as well as prestige over integrity. During this talk, I will share my personal journey as an early career researcher from the Global South, now affiliated with one of the most innovative research labs worldwide. My research journey, which was enabled by securing highly competitive funding since early stages of my career, provided me with first-hand insight into the biases and repercussions of current research assessment practices on the trajectories of researchers. Further validating this perspective is a ground-breaking study I co-led with colleagues from the Global Young Academy, exploring research assessment for career advancement on a global scale. This study shows that research institutions worldwide heavily rely on bibliometrics to evaluate career progression, irrespective of the academic discipline. However, while more established institutions appear to be walking away from these practices, these are becoming more popular in emerging research institutions from low-middle income countries. These findings highlight the need for transformational global (inclusive) initiatives. I am privileged to be part of one such initiative – The Coalition for Advancing Research Assessment (CoARA). CoARA brings together a community of researchers and research enablers dedicated to reforming this perilous research culture. CoARA’s guiding principles centre on acknowledging the diversity of contributions and careers in science, shifting research evaluation towards qualitative aspects where research ethics and integrity are at the core, and recognizing that excellence is context-dependent, varying for each candidate, role, and projects. A standout feature of CoARA is its unwavering commitment to early career researchers, placing them at the heart of its principles, governance, structures, and interventions. Thus, ensuring that future generation of scientific leaders is well-equipped to navigate and transform the landscape of research assessment and scientific culture.

Abstract The duties encompassed within public health, according to Acheson's definition, are to be undertaken by society as a whole. This is further emphasised within 'ASPHER's European List of Core Competencies for the Public Health Professional' which mentions that public health responsibilities fall upon the 'public health workforce'. If even those outside the medical profession are considered part of the public health workforce, why are medical students being overlooked as a group who can contribute? As representatives of the future generation of medical professionals, shouldn't they be an obvious starting point for practising public health advocacy? Medical students have the potential to act and, with better integration into the public health workforce, could become an asset. Despite them having a legal obligation to contribute in emergency situations, there are insufficiencies or a lack of clarity within the guidelines to highlight and elaborate on what students are specifically expected to be able to carry out in various situations. This is in stark contrast to the predefined lists of competencies against which medical professionals are assessed. This workshop will focus on identifying the core competencies regarding medical students in their contribution to emergency preparedness and how these could be integrated into the existing framework for effecting a structured and organised response. The primary outcome is to achieve better advocacy for public health in future medical professionals with a focus on preparedness for emergency situations. To begin with, research carried out to elucidate whether different countries have set guidelines or competencies that are expected of medical students by the conclusion of their medical studies will be presented. Such guidelines both on national and regional levels were identified and then compared following analysis. This will be followed by more personal accounts from medical students and a discussion of the potential steps that could be introduced to improve emergency preparedness. Shortcomings of such guidelines concerning medical student competencies are further highlighted in times of crisis such as the ongoing COVID-19 pandemic. It is during this time when healthcare systems are stretched and their contribution may be most valuable. The nature of this contribution within the context of international pandemic plans will be explored and debated. Finally this workshop will conclude by opening up the floor for discussion between the panellists and the audience regarding the topics and issues raised. This workshop aims to highlight the need for core competencies in medical education and bring this topic to the forefront for further discussion and analysis amongst professionals, with the eventual international unification, simplification and clarification of these being the ultimate goal. This could be pivotal for the future of public health and in the advancement and evolution of education. Key messages Armed with suitable competencies, medical students can be an asset to the public health workforce if utilised effectively and in doing so can enhance preparedness response. This project’s outcomes are in alignment with ASPHER’s European Public Health Core Competencies Programme (EPHCCP) and the WHO Coalition of Partners (CoP).

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. Orthopedic reviews, 14(3), 37498. https://doi.org/10.52965/001c.37498 [2] 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. Orthopedic reviews, 14(3), 37498. https://doi.org/10.52965/001c.37498 [3] International Society for Stem Cell Research. (2023). Laboratory-based human embryonic stem cell research, embryo research, and related research activities. International Society for Stem Cell Research. https://www.isscr.org/guidelines/blog-post-title-one-ed2td-6fcdk; Kimmelman, J., Hyun, I., Benvenisty, N. et al. Policy: Global standards for stem-cell research. Nature 533, 311–313 (2016). https://doi.org/10.1038/533311a [4] International Society for Stem Cell Research. (2023). Laboratory-based human embryonic stem cell research, embryo research, and related research activities. International Society for Stem Cell Research. https://www.isscr.org/guidelines/blog-post-title-one-ed2td-6fcdk [5] Concerning the moral philosophies of stem cell research, our paper does not posit a personal moral stance nor delve into the “when” of human life begins. To read further about the philosophical debate, consider the following sources: Sandel M. J. (2004). Embryo ethics--the moral logic of stem-cell research. The New England journal of medicine, 351(3), 207–209. https://doi.org/10.1056/NEJMp048145; George, R. P., & Lee, P. (2020, September 26). Acorns and Embryos. The New Atlantis. https://www.thenewatlantis.com/publications/acorns-and-embryos; Sagan, A., & Singer, P. (2007). The moral status of stem cells. Metaphilosophy, 38(2/3), 264–284. http://www.jstor.org/stable/24439776; McHugh P. R. (2004). Zygote and "clonote"--the ethical use of embryonic stem cells. The New England journal of medicine, 351(3), 209–211. https://doi.org/10.1056/NEJMp048147; Kurjak, A., & Tripalo, A. (2004). The facts and doubts about beginning of the human life and personality. Bosnian journal of basic medical sciences, 4(1), 5–14. https://doi.org/10.17305/bjbms.2004.3453 [6] Vazin, T., & Freed, W. J. (2010). Human embryonic stem cells: derivation, culture, and differentiation: a review. Restorative neurology and neuroscience, 28(4), 589–603. https://doi.org/10.3233/RNN-2010-0543 [7] Socially, at its core, the Western approach to ethics is widely principle-based, autonomy being one of the key factors to ensure a fundamental respect for persons within research. For information regarding autonomy in research, see: Department of Health, Education, and Welfare, & National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1978). The Belmont Report. Ethical principles and guidelines for the protection of human subjects of research.; For a more in-depth review of autonomy within the US, see: Beauchamp, T. L., & Childress, J. F. (1994). Principles of Biomedical Ethics. Oxford University Press. [8] Sherley v. Sebelius, 644 F.3d 388 (D.C. Cir. 2011), citing 45 C.F.R. 46.204(b) and [42 U.S.C. § 289g(b)]. https://www.cadc.uscourts.gov/internet/opinions.nsf/6c690438a9b43dd685257a64004ebf99/$file/11-5241-1391178.pdf [9] Stem Cell Research Enhancement Act of 2005, H. R. 810, 109th Cong. (2001). https://www.govtrack.us/congress/bills/109/hr810/text; Bush, G. W. (2006, July 19). Message to the House of Representatives. National Archives and Records Administration. https://georgewbush-whitehouse.archives.gov/news/releases/2006/07/20060719-5.html [10] National Archives and Records Administration. (2009, March 9). Executive order 13505 -- removing barriers to responsible scientific research involving human stem cells. National Archives and Records Administration. https://obamawhitehouse.archives.gov/the-press-office/removing-barriers-responsible-scientific-research-involving-human-stem-cells [11] Hurlbut, W. B. (2006). Science, Religion, and the Politics of Stem Cells. Social Research, 73(3), 819–834. http://www.jstor.org/stable/40971854 [12] Akpa-Inyang, Francis & Chima, Sylvester. (2021). South African traditional values and beliefs regarding informed consent and limitations of the principle of respect for autonomy in African communities: a cross-cultural qualitative study. BMC Medical Ethics. 22. 10.1186/s12910-021-00678-4. [13] Source for further reading: Tangwa G. B. (2007). Moral status of embryonic stem cells: perspective of an African villager. Bioethics, 21(8), 449–457. https://doi.org/10.1111/j.1467-8519.2007.00582.x , see also Mnisi, F. M. (2020). An African analysis based on ethics of Ubuntu - are human embryonic stem cell patents morally justifiable? African Insight, 49(4). [14] Jecker, N. S., & Atuire, C. (2021). Bioethics in Africa: A contextually enlightened analysis of three cases. Developing World Bioethics, 22(2), 112–122. https://doi.org/10.1111/dewb.12324 [15] Jecker, N. S., & Atuire, C. (2021). Bioethics in Africa: A contextually enlightened analysis of three cases. Developing World Bioethics, 22(2), 112–122. https://doi.org/10.1111/dewb.12324 [16] Jackson, C.S., Pepper, M.S. Opportunities and barriers to establishing a cell therapy programme in South Africa. Stem Cell Res Ther 4, 54 (2013). https://doi.org/10.1186/scrt204; Pew Research Center. (2014, May 1). Public health a major priority in African nations. Pew Research Center’s Global Attitudes Project. https://www.pewresearch.org/global/2014/05/01/public-health-a-major-priority-in-african-nations/ [17] Department of Health Republic of South Africa. (2021). Health Research Priorities (revised) for South Africa 2021-2024. National Health Research Strategy. https://www.health.gov.za/wp-content/uploads/2022/05/National-Health-Research-Priorities-2021-2024.pdf [18] Oosthuizen, H. (2013). Legal and Ethical Issues in Stem Cell Research in South Africa. In: Beran, R. (eds) Legal and Forensic Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32338-6_80, see also: Gaobotse G (2018) Stem Cell Research in Africa: Legislation and Challenges. J Regen Med 7:1. doi: 10.4172/2325-9620.1000142 [19] United States Bureau of Citizenship and Immigration Services. (1998). Tunisia: Information on the status of Christian conversions in Tunisia. UNHCR Web Archive. https://webarchive.archive.unhcr.org/20230522142618/https://www.refworld.org/docid/3df0be9a2.html [20] Gaobotse, G. (2018) Stem Cell Research in Africa: Legislation and Challenges. J Regen Med 7:1. doi: 10.4172/2325-9620.1000142 [21] Kooli, C. Review of assisted reproduction techniques, laws, and regulations in Muslim countries. Middle East Fertil Soc J 24, 8 (2020). https://doi.org/10.1186/s43043-019-0011-0; Gaobotse, G. (2018) Stem Cell Research in Africa: Legislation and Challenges. J Regen Med 7:1. doi: 10.4172/2325-9620.1000142 [22] Pang M. C. (1999). Protective truthfulness: the Chinese way of safeguarding patients in informed treatment decisions. Journal of medical ethics, 25(3), 247–253. https://doi.org/10.1136/jme.25.3.247 [23] 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 [24] Wang, Y., Xue, Y., & Guo, H. D. (2022). Intervention effects of traditional Chinese medicine on stem cell therapy of myocardial infarction. Frontiers in pharmacology, 13, 1013740. https://doi.org/10.3389/fphar.2022.1013740 [25] Li, X.-T., & Zhao, J. (2012). Chapter 4: An Approach to the Nature of Qi in TCM- Qi and Bioenergy. 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.

IntroductionIn a 2013 press release issued by Blind Citizens Australia, the advocacy group announced they were lodging a human rights complaint against the Australian government and the ABC over the lack of audio description available on the public broadcaster. Audio description is a track of narration included between the lines of dialogue which describes important visual elements of a television show, movie or performance. Audio description is broadly recognised as an essential feature to make television accessible to audiences who are blind or vision impaired (Utray et al.). Indeed, Blind Citizens Australia maintained that audio description was as important as captioning on Australian television:people who are blind have waited too long and are frustrated that audio description on television remains indefinitely beyond our reach. Our Deaf or hearing impaired peers have always seen great commitment from the ABC, but we continue to feel like second class citizens.While audio description as a technology was developed in the 1960s—around the same time as captions (Ellis, “Netflix Closed Captions”)—it is not as widely available on television and access is therefore often considered to be out of reach for this group. As a further comparison, in Australia, while the provision of captions was mandated in the Broadcasting Services Act (BSA) 1992 and television sets had clear Australian standards regarding their capability to display captions, there is no legislation for audio description and no consistency regarding the ability of television sets sold in Australia to display them (Ellis, “Television’s Transition”). While as a technology, audio description is as old as captioning it is not as widely available on television. This is despite the promise of technological advancements to facilitate its availability. For example, Cronin and King predicted that technological change such as the introduction of stereo sound on television would facilitate a more widespread availability of audio description; however, this has not eventuated. Similarly, in the lead up to the transition from analogue to digital broadcasting in Australia, government policy documents predicted a more widespread availability of audio description as a result of increased bandwidth available via digital television (Ellis, “Television’s Transition”). While these predictions paved way for an audio description trial, there has been no amendment to the BSA to mandate its provision.Audio description has been experienced on Australian broadcast television in 2012, but only for a 14-week trial on ABC1. The trial report, and feedback from disability groups, identified several technical impediments and limitations which effected the experience of audio described content during this trial, including: the timing of the trial during a period in which the transition from analogue to digital television was still occurring (creating hardware compatibility issues for some consumers); the limitations of the “ad hoc” approach undertaken by the ABC and manual implementation of audio description; and the need for upgraded digital receivers (ABC “Trial of Audio Description”, 2). While advocacy groups acknowledged the technical complexities involved, the expected stakeholder discussions that were due to be held post-trial, in part to attempt to resolve the issues experienced, were never undertaken. As a result of the lack of subsequent commitments to providing audio description, in 2013 advocacy group Blind Citizens Australia lodged their formal complaints of disability discrimination against the ABC and the Federal Government. Since the 2012 trial on ABC1, the ABC’s catch-up portal iView instigated another audio description trial in 2015. Through the iView trial it was further confirmed that audio description held considerable benefits for people with a vision impairment. They also demonstrated that audio description was technically feasible, with far less ‘technical difficulties’ than the experience of the 2012 broadcast-based trial. Over the 15 month trial on ABC iView 1,305 hours of audio described content was provided and played 158, 277 times across multiple platforms, including iOS, Android, the Freeview app and desktop computers (ABC, “ABC iView Audio Description Trial”).Yet despite repeated audio description trials and the lodgement of discrimination complaints, there remains no audio description on Australian broadcast television. Similarly, whereas 55 per cent of DVDs released in Australia have captions, only 25 per cent include an audio description track (Media Access Australia). At the time of writing, the only audio description available on Australian television is on Netflix Australia, a subscription video on demand provider.This article seeks to highlight the importance of television access for people with disability, with a specific focus on the provision of audio description for people with vision impairments. Research consistently shows that despite being a visual medium, people with vision impairments watch television at least once a day (Cronin and King; Ellis, “Netflix Closed Captions”). However, while television access has been a priority for advocates for people who are Deaf and hard of hearing (Downey), audiences advocating audio description are only recently making gains (Ellis, “Netflix Closed Captions”; Ellis and Kent). These gains are frequently attributed to technological change, particularly the digitisation of television and the introduction of subscription video on demand where users access television content online and are not constrained by broadcast schedules. This transformation of how we access television is also considered in the article, again with a focus on the provision–or lack thereof—of audio description.This article also reports findings of research conducted with Australians with disabilities accessing the emerging video on demand environment in 2016. The survey was run online from January to February 2016. Survey respondents included people with disability, their families, and carers, and were sourced through disability organisations and community groups as well as via disability-focused social media. A total of 145 people completed the survey and 12 people participated in follow-up interviews. Insights were gained into both how people with disability are currently using video on demand and their anticipated usage of services. Of note is that most subscription video on demand services (Netflix Australia, Stan, and Presto) had only been introduced in Australia in the year before the survey being carried out, with only Foxtel Play and Quickflix having been in operation for some time prior to that.Finally, the article ends by looking at past and current advocacy in this area, including a discussion on existing—albeit, to date, limited—political will.Access to Television for People with DisabilitiesTelevision can be disabling in different ways for people with impairments, yet several accessibility features exist to translate information. For example, people who are D/deaf or hard of hearing may require captions, while people with vision impairments prefer to make use of audio description (Alper et al.). Similarly, people with mobility and dexterity impairments found the transition to digital broadcasting difficult, particularly with relation to set top box set up (Carmichael et al.). As Joshua Robare has highlighted, even legislation has generally favoured the inclusion of audiences with hearing impairments, while disregarding those with vision impairments. Similarly, much of the literature in this area focuses on the provision of captions—a vital accessibility feature for people who are D/deaf or hard of hearing. Consequently, research into accessibility to television for a diversity of impairments, going beyond hearing impairments, remains deficient.In a study of Australian audiences with disability conducted between September and November 2013—during the final months of the analogue to digital simulcast period of Australian broadcast television—closed captions, clean audio, and large/colour-coded remote control keys emerged as the most desired access features (see Ellis, “Digital Television Flexibility”). Audio description barely registered in the top five. In a different study conducted two years ago/later, when disabled Australian audiences of video on demand were asked the same question, captions continued to dominate at 63.4 per cent; however, audio description was also seen to be a necessary feature for almost one third of respondents (see Ellis et al., Accessing Subcription Video).Robert Kingett, founder of the Accessible Netflix Project, participated in our research and told us in an interview that video on demand providers treat accessibility as an “afterthought”, particularly for blind people whom most don’t think of as watching television. Yet research dating back to the 1990s shows almost 100 per cent of people with vision impairments watch television at least once a day (Cronin & King). Statistically, the number of Australians who identify as blind or vision impaired is not insignificant. Vision Australia estimates that over 357,000 Australians have a vision impairment, while one in five Australians have a disability of some form. With an ageing population, this number is expected to grow exponentially in the next ten years (Australian Network on Disability). Kingett therefore describes this lack of accessibility as evidence video on demand is “stuck in the dark ages”, and advocates that people with vision impairments do use video on demand and therefore continue to have unmet access needs.Video on Demand—Transforming TelevisionSubscription video on demand services have caused a major shift in the way television is used and consumed in Australia. Prior to 2015, there was a small subscription video on demand industry in this country. However, in 2015, following the launch of Netflix Australia, Stan, and Presto, Australia was described as having entered the “streaming wars” (Tucker) where consumers would benefit from the increased competition. As Netflix gained dominance in the video on demand market internationally, people with disability began to recognise the potential this service could have in transforming their access to television.For example, the growing availability of video on demand services continues to provide disruptive change to the way in which consumers enjoy information and entertainment. While traditional broadcast television has provided great opportunities for participation in news, events, and popular culture, both socially and in the workplace, the move towards video on demand services has seen a notable decline in traditional television viewing habits, with online continuing to increase at the expense of Australian free-to-air programming (C-Scott).For the general population, this always-on, always-available, and always-shareable nature of video on demand means that the experience is both convenient and instant. If a television show is of interest to friends and family, it can be quickly shared through popular social media with others, allowing everyone to join in the experience. For people with disability, the ability to both share and personalise the experience of television is critical to the popularity of video on demand services for this group. This gives them not only the same benefits as others but also ensures that people with disability are not unintentionally excluded from participation—it allows people with disability the choice as to whether or not to join in. However, exclusion from video on demand is a significant concern for people with disability due to the lack of accessibility features in popular subscription services. The lack of captions, audio description, and interfaces that do not comply with international Web accessibility standards are resulting in many people with disability being unable to fully participate in the preferred viewing platforms of family and friends.The impact of this expands beyond the consumption patterns of audiences, shifting the way the audience is defined and conceptualised. With an increasing distribution of audience attention to multiple channels, products, and services, the ability to, and strategies for, acquiring a large audience has changed (Napoli). As audience attention is distributed, it is broken up, into smaller, fragmented groups. The success, therefore, of a new provider may be to amass a large audience through the aggregation of smaller, niche audiences. This theory has significance for consumers who require audio description because they represent a viable target group. In this context, accessibility is reframed as a commercial opportunity rather than a cost (Ellis, “Netflix Closed Captions”).However, what this means for future provision of audio description in Australia is still unclear. Chris Mikul from Media Access Australia, author of Access on Demand, was interviewed as part of this research. He told us that the complete lack of audio description on local video on demand services can be attributed to the lack of Australian legislation requiring it. In an interview as part of this research he explained the central issue with audio description in this country as “the lack of audio description on broadcast TV, which is shocking in a world context”.International providers fare only slightly better. Robert Kingett established the Accessible Netflix Project in 2013 with the stated aim of advocating for the provision of audio description on Netflix. Netflix, despite a lack of a clear accessibility policy, are seen as being in front in terms of overall accessibility—captions are available for most content. However, the provision of audio description was initially not considered to be of such importance, and Netflix were initially against the idea, citing technical difficulties. Nevertheless, in 2015—shortly after their Australian launch—they did eventually introduce audio description on original programming, describing the access feature as an option customers could choose, “just like choosing the soundtrack in a different language” (Wright). However, despite such successful trials, the issue in the Australian market remains the absence of legislation mandating the provision of audio description in Australia and the other video on demand providers have not introduced audio description to compete with Netflix. As the Netflix example illustrates, both legislation and recognition of people with disability as a key audience demographic will result in a more accessible television environment for this group.Currently, it is debatable as to whether this increasingly competitive market, the shifting perception of audience attraction and retention, and the entry of multiple international video on demand providers, has influenced how accessibility is viewed, both for broadcast television and video on demand. Although there is some evidence for an increasing consideration of people with disability as “valid” consumers—take, for example, the iView audio description trial, or the inclusion of audio description by Netflix—our research indicates accessibility is still inconsistently considered, designed for, and applied by current providers.Survey Response: Key Issues Regarding AccessibilityRespondents were asked to provide an overall impression of video on demand services, and to tell us about their positive and negative experiences. Analysis of 68 extended responses, and the responses provided by the interview participants, identified a lack of availability of accessibility features such as audio description as a key problem. What our results indicate is that while customers with a disability are largely accommodating of the inaccessibility of providers—they use their own assistive technology to access content—they are keenly aware of the provisions that could be made. As one respondent put it:they could do a lot better: talking menus, spoken sub titles, and also spoken messages on screen.However, many expressed low expectations due to the continued absence of audio description on broadcast television:so, the other thing is, my expectations are quite low because of years of not having audio descriptions. I have slightly different expectations to other people.This reflection is important in considering both the shifting expectations regarding video on demand providers but also the need for a clear communication of what features are available so that providers can cater to—and therefore capture—niche markets.The survey identified captioning as the main accessibility problem of video on demand services. However, this may not accurately reflect the need for other accessibility features such as audio description. Rather, it may be indicative that this feature is often the only choice given to consumers. As, Chris Mikul identified, “the only disability being catered for to any great extent is deafness/hearing impairment”. Kingett agreed, noting:people who are deaf and hard of hearing are placed way before the rest because captions are beyond easy and cheap to create now. Please, there’s even companies that people use to crowd source captions so companies don’t have to do it anymore. This all came about because the deaf community has [banded] together … to achieve a cause. I know audio description isn’t as cheap to make as captions but, by these companies’ budgets that’s like dropping a penny.Advocacy and Political WillAs noted above, it has been argued by some that accessibility features that address vision impairments have been neglected. The reason behind this is twofold—the perception that this disability is experienced by a minority of the population and that, because blind people “don’t watch television”, it is not an important accessibility feature. This points towards a need for both disability advocacy and political will by politicians to introduce legislation. As one survey respondent identified, the reality is that, in Australia, neither politicians nor people with vision impairments have yet to address the issue on audio description in an organised or sustained way:we have very little audio described content available in Australia. We don’t have the population of blind people nor the political will by politicians to force providers to provide for us.However, Blind Citizens Australia—the coalition of television audiences with vision impairments who lodged the human rights complaint against the government and the ABC—suggest the tide is turning. Whereas advocates for people with vision impairments have traditionally focused on access to the workforce, the issue of television accessibility is increasingly gaining attention, particularly as a result of international activist efforts and the move towards video on demand (see Ellis and Kent).For example, Kingett’s Accessible Netflix Project in the US is considered one of the most successful accessibility movements towards the introduction of audio description. While its members are predominantly US-based, it does include several Australian members and continues to cover Netflix Australia’s stance on audio description, and be covered by Australian media and organisations (including Media Access Australia and Life Hacker). When Netflix launched in Australia, Kingett encouraged Australians to become more involved in the project (Ellis and Kent).However, despite the progress towards mandating of audio description in parliament and the resolution of efforts made by advocacy groups (including Vision Australia and Blind Citizens Australia), the status of audio description remains uncertain. Whilst some support has been gained—specifically through motions made by Senator Siewert and the ABC iView audio description trials—significant change has been slow. For example, conciliation discussions are still ongoing regarding the now four-year-old complaint brought against the ABC and the Federal Government by Blind Citizens Australia. Meanwhile, although the Senate supported Senator Siewert’s motion to change the Broadcasting Services Act to include audio description, the Act has yet to be amended.The results of multiple ABC trials of audio description remain in discussion. Whilst the recently released report on the findings of the April 2015—July 2016 iView trial states that the “trial has identified that those who utilised the audio description service found it a valuable enhancement to their media engagement and their social interactions” (ABC, “ABC iView Audio Description Trial” 18), it also cautioned that “any move to introduce AD services in Australia would have budgetary implications for the broadcasters in a constrained financial environment” and “broader legislative implications” (ABC, “ABC iView Audio Description Trial” 18). Indeed, although the trial was considered “successful”—in that experiences by users were generally positive and the benefits considerable (Media Access Australia, “New Report”)—the continuation of audio description on iView alone was clarified as representing “a systemic failure to provide people who are blind or have low vision with basic access to television now, given that iView is out of reach for many people in the blindness and low vision community” (Media Access Australia, “New Report”). Indeed, the relatively low numbers of plays of audio described content during the trial (158, 277 plays, representing 0.58% of total program plays on iView) were likely a result of a lack of access to smartphones or Internet technology, prohibitive data speeds and/or general Internet costs, all factors which affect the accessibility of video on demand significantly more for people with disability (Ellis et al., “Access for Everyone?”).On a more positive note, the culmination of advocacy pressure, the ABC iView trial, political attention, and increasing academic literature on the accessibility of Australian media has resulted in the establishment of an Audio Description Working Group by the government. This group consists of industry representatives, advocacy group representatives, academics, and “consumer representatives”. The aims of the group are to: identify options to sustainably increase access to audio description services; identify any impediments to the implementation of audio description; provide expert advice on audio description implementation options; and develop a report on the findings due at the end of 2017.ConclusionIn the absence of audio description, people who are blind or vision impaired report a less satisfying television experience (Cronin and King; Kingett). However, with each technological advancement in the delivery of television, from stereo sound to digital television, this group has held hopes for a more accessible experience. The reality, however, has been a continued lack of audio description, particularly in broadcast television.Several commentators have compared the provision of audio description with closed captioning. They find that audio description is not as widely available, and reflect this is likely a result of lack of legislation (Robare; Ellis, “Digital Television Flexibility”)—for example, in the Australian context, whereas the provision of captions is mandated in the Broadcasting Services Act 1992, audio description is not. As a result, there have been limited trials of audio description in this country and inconsistent standards in how to display it. As discussed throughout this paper, people with vision impairments and their allies therefore often draw on the example of the widespread “acceptance” of captions to make the case that audio description should also be more widely available.However, following the introduction of subscription video on demand in Australia, and particularly Netflix, the issue of audio description is receiving greater attention. It has been argued that video on demand has transformed television, particularly the ways in which television is accessed. Video on demand could also potentially transform the way we think about accessibility for audiences with disability. While captions are a well-established accessibility feature facilitating television access for people with a range of disabilities, video on demand is raising the profile of the importance of audio description for audiences with vision impairments.ReferencesABC. “Audio Description Trial on ABC Television: Report to the Minister for Broadband, Communications and the Digital Economy”. Dec. 2012. 8 Apr. 2017 <https://www.communications.gov.au/sites/g/files/net301/f/ABC-Audio-Description-Trial-Report2.pdf>.ABC. “ABC iView Audio Description Trial: Final Report to The Department of Communications and the Arts.” Oct. 2016. 6 Apr. 2017 <https://www.communications.gov.au/documents/final-report-trial-audio-description-abc-iview>.Alper, Meryl, et al. “Reimagining the Good Life with Disability: Communication, New Technology, and Humane Connections.” Communication and the Good Life. Ed. H. Wang. New York: Peter Lang, 2015.Australian Network on Disability. “Disability Statistics.” Mar. 2017. 30 Apr. 2017 <https://www.and.org.au/pages/disability-statistics.html>.Blind Citizens Australia. Government and ABC Fail to Deliver on Accessible TV for Australia’s Blind. Submission. 10 July 2013. 1 May 2017 <http://bca.org.au/submissions/>.C-Scott, Marc. “The Battle for Audiences as Free-TV Viewing Continues Its Decline.” Mumbrella 22 Apr. 2016. 24 May 2016 <https://mumbrella.com.au/the-battle-for-audiences-as-free-tv-viewing-continues-its-decline-362010>.Carmichael, Alex, et al. “Digital Switchover or Digital Divide: A Prognosis for Useable and Accessible Interactive Digital Television in the UK.” Universal Access in the Information Society 4 (2006): 400–16.Cronin, Barry J., and Sharon Robertson King. “The Development of the Descriptive Video Services.” National Center to Improve Practice in Special Education through Technology, Media and Materials. Sep. 1998. 8 May 2014 <https://www2.edc.org/NCIP/library/v&c/Cronin.htm>.Downey, G. “Constructing Closed-Captioning in the Public Interest: From Minority Media Accessibility to Mainstream Educational Technology.” Info 9.2–3 (2007): 69–82.Ellis, Katie. “Digital Television Flexibility: A Survey of Australians with Disability.” Media International Australia 150 (2014): 96.———. “Netflix Closed Captions Offer an Accessible Model for the Streaming Video Industry, But What about Audio Description?” Communication, Politics & Culture 47.3 (2015).———. “Television’s Transition to the Internet: Disability Accessibility and Broadband-Based TV in Australia.” Media International Australia 153 (2014): 53–63.Ellis, Katie, and Mike Kent. “Accessible Television: The New Frontier in Disability Media Studies Brings Together Industry Innovation, Government Legislation and Online Activism.” First Monday 20 (2015). <http://firstmonday.org/ojs/index.php/fm/article/view/6170>.Ellis, Katie, et al. Accessing Subscription Video on Demand: A Study of Disability and Streaming Television in Australia. Australian Communications Consumer Action Network. Aug. 2016. <https://accan.org.au/grants/current-grants/1066-accessing-video-on-demand-a-study-of-disability-and-streaming-television>.Ellis, Katie, et al. “Access for Everyone? Australia’s ‘Streaming Wars’ and Consumers with Disabilities.” Continuum (2017, publication pending).Kingett, Robert. “The Accessible Netflix Project Advocates Taking Steps to Ensure Netflix Accessibility for Everyone.” 2014. 30 Jan. 2014 <https://netflixproject.wordpress.com>.Media Access Australia. “Statistics on DVD Accessibility in Australia.” 2012. 21 Nov. 2014 <https://mediaaccess.org.au/dvds/Statistics%20on%20DVD%20accessibility%20in%20Australia>.———. “New Report on the Trial of A.D. on ABC iView.” 7 Mar. 2017. 30 Apr. 2017 <https://mediaaccess.org.au/latest_news/television/new-report-on-the-trial-of-ad-on-abc-iview>.Napoli, Philip M., ed. Audience Evolution: New Technologies and the Transformation of Media Audiences. New York: Columbia UP, 2011.Robare, Joshua S. “Television for All: Increasing Television Accessibility for the Visually Impaired through the FCC’s Ability to Regulate Video Description Technology.” Federal Communications Law Journal 63.2 (2011): 553–78.Tucker, Harry. “Netflix Leads the Streaming Wars, Followed by Foxtel’s Presto.” News.com.au 24 June 2016. 18 May 2016 <http://www.news.com.au/technology/home-entertainment/tv/netflix-leads-the-streaming-wars-followed-by-foxtels-presto/news-story/7adf45dcd7d9486ff47ec5ea5951287f>.Utray, Francisco, et al. “Monitoring Accessibility Services in Digital Television.” International Journal of Digital Multimedia Broadcasting (2012): 9.