tag:theconversation.com,2011:/institutions/university-of-virginia-752/articlesThe University of Virginia2024-03-29T12:45:47Ztag:theconversation.com,2011:article/2226892024-03-29T12:45:47Z2024-03-29T12:45:47ZCompetitive workplaces don’t work for gender equality<figure><img src="https://images.theconversation.com/files/584523/original/file-20240326-24-25vphy.jpg?ixlib=rb-1.1.0&rect=43%2C0%2C5748%2C3812&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Not famously laid-back. </span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/FinancialMarketsWallStreet/12747cf8a46d43f1a935595940ce876a/photo?Query=%22Wall%20Street%22%20%22sign%22&mediaType=photo&sortBy=&dateRange=Anytime&totalCount=1629&currentItemNo=15">Mary Altaffer/AP Photo</a></span></figcaption></figure><p>Ultra-competitive workplaces – places where employees battle against each other for rank, bonuses and promotions – are common in many high-status fields, including <a href="https://www.ft.com/content/59211933-5494-4b35-b3e5-a0a791b1fd18">law</a> and <a href="https://www.businessinsider.com/how-wall-streets-culture-is-contributing-to-the-loneliness-crisis-2023-11">finance</a>. But while having a highly competitive culture is, on its face, gender-neutral, it actually worsens gender inequality. </p>
<p>That’s the key finding of <a href="https://doi.org/10.1177/00197939231223178">our new study</a> with colleague <a href="https://liberalarts.tamu.edu/economics/profile/ragan-petrie/">Ragan Petrie</a>, published in the most recent issue of the ILR Review. As economists who study workplace diversity and career-family conflicts for women, we wanted to investigate how competition at work plays out in people’s lives. We couldn’t just compare people with more and less competitive jobs, because they differ in a lot of other ways as well. So we set up a few experiments.</p>
<p>In our first experiment, which took place at a college library, we hired more than 200 people for a one-time research assistant job to be performed over a single hourlong session for a $25 payment. When workers arrived, we divided them into groups of four – each with two men and two women – and set them to work testing a computer program that was designed to be used in economics research.</p>
<p>During their training, we told workers they would be paid the $25 salary as long as they worked for at least 10 minutes – but we also asked them to work as long and hard as they could. We explained the purpose of the job was to measure how well people can perform the task over time, so the longer the workers stayed, the more useful their work would be. </p>
<p>In some randomly selected sessions, we also offered our main treatment: a competitive, high-stakes bonus of $30 paid to the worker in that group who earned the most points. Workers accumulated points by clicking on squares that periodically appeared on their screens. The only way to earn more points was by staying longer and trying harder. </p>
<p>Although we found that <a href="https://www.degruyter.com/document/doi/10.1515/9781400883172-005/html">social and intrinsic motivations</a> were enough to get most workers to stay beyond the required work time, offering the $30 bonus prize induced people to work for much longer. More than half of the bonus-eligible workers stayed on task for 40 minutes, the maximum time permitted, and work times increased by 83% overall. </p>
<p>Because these bonus payments reduced the costs of extracting effort by a third, they would have been very profitable to a real employer. </p>
<p>We also found that the high-stakes prize created gender gaps in effort (work time), output (points earned) and pay that weren’t present in other conditions. This result shows that <a href="https://doi.org/10.1146/annurev-economics-111809-125122">gender differences</a> found in limited-time contests are also present when people can choose how long to work. </p>
<p>In our second experiment, we told more than 700 applicants for a job testing the same computer program about the possibility of a bonus, and we asked them to choose between a fixed overtime wage rate and tournaments with varying prize levels. Men and women were both increasingly likely to opt into the tournament at higher prize levels, but men responded much more than women to rising prize levels. </p>
<p>In other words, as the stakes rose, the gender gap in tournament entry grew.</p>
<h2>Why it matters</h2>
<p>Our research suggests that highly competitive workplaces worsen gender inequality in two ways. The first is that women are less willing to enter and persist in high-stakes tournaments. Our findings here are consistent with previous research showing that women are <a href="https://doi.org/10.1162/qjec.122.3.1067">less attracted</a> than men to competitive work environments and tend to <a href="https://doi.org/10.1162/00335530360698496">perform worse</a> in them.</p>
<p>Our finding that workplace competition increases work hours across the board suggests a second, indirect way that it stymies women’s careers. The fact that women <a href="https://stats.oecd.org/index.aspx?queryid=54757">do more unpaid caretaking and household work</a> than men means they are less able to devote the long hours needed to outperform co-workers. This suggests that competition produces the “<a href="https://www.nytimes.com/2019/04/26/upshot/women-long-hours-greedy-professions.html">greedy</a>” jobs that demand <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/soin.12029">undivided commitment</a> from workers recently highlighted by <a href="https://www.nobelprize.org/prizes/economic-sciences/2023/press-release/">Nobel Prize-winning economist Claudia Goldin</a> as a major barrier to gender equality. </p>
<h2>What still isn’t known</h2>
<p>While researchers are getting a better understanding of the problem, solutions remain elusive. Our research shows that workplace competition can be a great profit driver for employers and is attractive to some workers. That means fixing the problem will be difficult. </p>
<p>Our findings suggest that remote-work technologies may not be <a href="http://doi.org/10.1257/aer.104.4.1091">as effective as hoped</a> at eliminating long work hours – and the resulting gender pay gaps – at elite jobs. They also suggest that encouraging women <a href="https://doi.org/10.1073/pnas.2108337118">to enter</a> <a href="https://doi.org/10.1093/jeea/jvy036">and persist</a> in competitive occupations, while important, isn’t enough to ensure they succeed.</p>
<p>Assuming that workplace competition remains a <a href="http://doi.org/10.1257/jep.32.3.195">central feature of elite jobs</a>, making more equitable workplaces won’t be easy. But maybe we don’t need to make that assumption in the first place. It may be worthwhile for employers to consider noncompetitive alternatives for motivating workers – for example, using performance measures that aren’t <a href="https://www.forbes.com/sites/erikaandersen/2012/07/06/the-management-approach-guaranteed-to-wreck-your-best-people/?sh=578609485743">based on rank order comparisons</a>, when possible. We encourage researchers to investigate these alternatives.</p>
<p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take on interesting academic work.</em></p><img src="https://counter.theconversation.com/content/222689/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Wall Street and big law firms are famous for their hard-charging, cutthroat work cultures. Here’s one reason they should reconsider.Amalia Rebecca Miller, Georgia S. Bankard Professor of Economics, University of VirginiaCarmit Segal, Professor of Managerial Economics, University of ZurichLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2261942024-03-27T12:38:28Z2024-03-27T12:38:28ZHow to have the hard conversations about who really won the 2020 presidential election − before Election Day 2024<figure><img src="https://images.theconversation.com/files/584166/original/file-20240325-9980-p8v9yo.jpg?ixlib=rb-1.1.0&rect=0%2C35%2C7951%2C5261&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">It's important to democracy to have difficult discussions across political lines.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/chat-bubbles-with-mouths-showing-sharp-teeth-royalty-free-image/1399061447">MirageC/Moment via Getty Images</a></span></figcaption></figure><p>Millions of Americans believe that the <a href="https://www.prri.org/spotlight/after-three-years-and-many-indictments-the-big-lie-that-led-to-the-january-6th-insurrection-is-still-believed-by-most-republicans/">2020 presidential election was stolen</a>. They think Donald Trump won by a landslide in 2020 and lost only because of widespread voter fraud. Some of the people who hold these views are my relatives, neighbors and professional associates. Because I reject these claims, it can be difficult to talk to those who accept them.</p>
<p>Often, we avoid the topic of politics. But as a <a href="https://millercenter.org/experts/robert-strong">political science scholar</a>, I expect that as the 2024 election gets closer, conversations about 2020 will become more common, more important and more unavoidable.</p>
<p>So, what does someone like me, who concludes that the last presidential election was legitimately won by Joe Biden, say to those who think that Trump was the actual winner? Here are a few of the questions I raise in my own conversations about 2020.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/584168/original/file-20240325-28-2snc9f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Rioters climb the walls of the U.S. Capitol on Jan. 6, 2021." src="https://images.theconversation.com/files/584168/original/file-20240325-28-2snc9f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/584168/original/file-20240325-28-2snc9f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/584168/original/file-20240325-28-2snc9f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/584168/original/file-20240325-28-2snc9f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/584168/original/file-20240325-28-2snc9f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/584168/original/file-20240325-28-2snc9f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/584168/original/file-20240325-28-2snc9f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">This is not what democracy looks like.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/CapitolRiotSeattlePolice/d55c50d30d884d738559a35b01ecf9be/photo">AP Photo/Jose Luis Magana</a></span>
</figcaption>
</figure>
<h2>Polls and pollsters</h2>
<p>I usually begin by asking about polls. Polls and pollsters are often wrong about close elections, and many prominent pollsters tilt toward Democrats. They predicted a Hillary <a href="https://projects.fivethirtyeight.com/2016-election-forecast/">Clinton victory in 2016</a>.</p>
<p>But even those polls and pollsters would be unlikely to have missed a 2020 landslide for Trump – or Biden. Unless, of course, as was the case, <a href="https://www.politifact.com/factchecks/2021/jan/07/donald-trump/trump-clings-fantasy-landslide-victory-egging-supp/">the landslide did not exist</a>. </p>
<p>Recent political <a href="https://fortune.com/2022/11/16/pollsters-got-it-wrong-2018-2020-elections-statistical-sophistry-accuracy-sonnenfeld-tian/">polling has been less accurate</a> than many people expect. And all polls have margins of error: They provide an imperfect picture of public sentiment in a closely divided nation.</p>
<p>That said, even polls with a sizable margin of error should have been able to find a Trump landslide in 2020 – but they didn’t, because there wasn’t one. The last American presidential landslide, Reagan in 1984, was <a href="https://www.washingtonpost.com/archive/politics/1984/10/31/conflicting-campaign-polls-point-to-one-certainty-some-are-wrong/30636083-2905-4e24-93a2-73ba76a7a587/">clearly seen in preelection polling</a>.</p>
<p>If millions of fraudulent votes were cast in 2020, reputable pollsters would have discovered a discrepancy between their data and official election results. This would have been particularly true for the pollsters trusted by Republicans.</p>
<p>Trump himself has often <a href="https://www.vox.com/2020/10/7/21506391/rasmussen-poll-biden-vs-trump-landslide">praised the Rasmussen polling organization</a>. But just before Election Day 2020, Rasmussen reported that Trump could win a narrow victory in the Electoral College <a href="https://www.newsweek.com/trumps-favorite-poll-shows-him-narrowly-losing-presidency-one-day-before-election-1544099">only if he swept all the toss-up states</a> – a daunting task. Rasmussen found no evidence of a forthcoming Trump landslide and projected that Biden would get 51% of the national popular vote. That’s almost exactly the percentage he received <a href="https://www.fec.gov/resources/cms-content/documents/federalelections2020.pdf#page=10">in the official count</a>.</p>
<h2>Where is the congressional investigation of 2020 voter fraud?</h2>
<p>The House Republicans have not convened a special committee to investigate the 2020 election. Such a committee could summon witnesses, hold high-profile hearings and issue a detailed report. It could explain to the American people exactly what happened in the presidential election, how the election was stolen and who was responsible. If the evidence collected justified it, they could make criminal referrals to the Justice Department. <a href="https://january6th-benniethompson.house.gov/">The Democrats did all of these things in connection to the events of Jan. 6, 2021</a>. </p>
<p>What could be more important to the American public than a full and fair account of 2020 voter fraud? Donald Trump calls it <a href="https://theweek.com/donald-trump/1013604/trump-announces-the-crime-of-the-century-a-forthcoming-book-about-the-2020">“one of the greatest crimes in the history of our country</a>.” Yet the Republicans on Capitol Hill have not authorized a major public and professional investigation of those alleged crimes. Perhaps, as former U.S. Rep. Liz Cheney claims, most Republican members of Congress know that Trump’s statements about massive voter fraud are false. </p>
<p>It would be hard, even for Congress, to investigate something that did not happen.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/AbMCdSjz5KM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Former U.S. Rep. Liz Cheney says many Republicans in Congress don’t believe Trump’s lies.</span></figcaption>
</figure>
<h2>When the big lie goes to court</h2>
<p>Like Congress, or professional pollsters, the judicial system has ways to expose election fraud. Immediately after the 2020 election, the Trump campaign <a href="https://www.usatoday.com/in-depth/news/politics/elections/2021/01/06/trumps-failed-efforts-overturn-election-numbers/4130307001/">went to court more than 60 times</a> to challenge voting procedures and results. </p>
<p>They lost in <a href="https://www.usatoday.com/in-depth/news/politics/elections/2021/01/06/trumps-failed-efforts-overturn-election-numbers/4130307001/">all but one case</a>. </p>
<p>Related lawsuits have also been decided against those who claimed that the 2020 election was stolen. </p>
<p>For instance, Fox News was sued for defamation because of broadcasts <a href="https://casetext.com/case/us-dominion-inc-v-fox-news-network-llc-1">linking Dominion voting machines to allegations of a rigged 2020 election</a>. Fox, a powerful and wealthy corporation, could have taken the case to trial but didn’t. Instead, <a href="https://www.npr.org/2023/04/18/1170339114/fox-news-settles-blockbuster-defamation-lawsuit-with-dominion-voting-systems">it paid three-quarters of a billion dollars to settle the case</a>.</p>
<p>In another case, Rudy Giuliani has been ordered to <a href="https://apnews.com/article/rudy-giuliani-georgia-election-workers-defamation-case-cde7186493b3a1bd9ab89bc65f0f5b06">pay $148 million to Georgia election workers he falsely accused of misconduct</a>. More civil suits are pending.</p>
<p>Trump’s claim of a win in 2020 – known by its critics as <a href="https://www.newyorker.com/news/letter-from-bidens-washington/forced-to-choose-between-trumps-big-lie-and-liz-cheney-the-house-gop-chooses-the-lie">“The Big Lie”</a> – has regularly and repeatedly lost in court. If there were any truth to what Trump and his supporters say about the 2020 election, shouldn’t there be lawyers who present effective evidence and judges who give it credence? So far, there are not.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/JOCRo97NoJ8?wmode=transparent&start=4551" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Donald Trump doesn’t think the U.S. is a democracy.</span></figcaption>
</figure>
<h2>Democracy in America?</h2>
<p>Hard conversations about election integrity often come around to a more fundamental question: Do we still have democracy in America?</p>
<p>I think we do. Our democracy is fragile and <a href="https://www.npr.org/2022/01/11/1071082955/imagine-another-american-civil-war-but-this-time-in-every-state">under greater stress than at any time since the Civil War</a>. But it is still a democracy. The rule of law may be slow, but it prevails. Harassed and threatened election officials do their jobs with courage and integrity. Joe Biden, the official winner of the 2020 election, sits in the White House.</p>
<p>Supporters of Donald Trump are likely to <a href="https://doi.org/10.1371%2Fjournal.pone.0295747">think that the U.S. is not a democracy</a>. In their beliefs about how America works, millions of illegal votes are cast and counted on a regular basis; news is fake; violence is justified to halt fraudulent government proceedings; and it’s OK for a presidential candidate <a href="https://www.usatoday.com/story/news/politics/elections/2023/12/11/donald-trump-dictator-one-day-reelected/71880010007/">to want to be a dictator</a> – if only for a day.</p>
<p>In a functioning democracy, everyone has constitutionally protected rights to hold and express their political opinions. But I believe we should all be willing to discuss and evaluate the evidence that supports, or fails to support, those opinions.</p>
<p>There is no verified evidence of widespread voter fraud in 2020. You can’t find it in the polls. You won’t get it from Congress. Claims of election wrongdoing have failed in the courts. I sometimes ask my friends what I am missing. Maybe what’s really missing is a readiness for the hard political conversations that I believe must be had in the 2024 election season.</p><img src="https://counter.theconversation.com/content/226194/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Robert A. Strong does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>What does someone like me, who believes that the last presidential election was legitimately won by Joe Biden, say to those who think the 2020 election was stolen?Robert A. Strong, Emeritus Professor of Politics, Washington and Lee University; Senior Fellow, Miller Center, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2266702024-03-26T20:54:50Z2024-03-26T20:54:50ZAbortion drug access could be limited by Supreme Court − if the court decides anti-abortion doctors can, in fact, challenge the FDA<figure><img src="https://images.theconversation.com/files/584450/original/file-20240326-30-a29mv8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Pro-abortion rights activists rally in front of the Supreme Court on March 26, 2024, the day justices heard oral arguments about the use of mifepristone.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/abortion-rights-activist-rally-in-front-of-the-us-supreme-news-photo/2107843451?adppopup=true">Drew Angerer/AFP via Getty Images </a></span></figcaption></figure><p><em>Who has the legal right to challenge decisions by the U.S. Food and Drug Administration? And should the moral umbrage of a group of anti-abortion rights doctors shift policy across the country, limiting women’s ability to get the widely used abortion drug mifepristone?</em></p>
<p><em>These are a few of the central questions that the <a href="https://www.cbsnews.com/news/supreme-court-abortion-pill-arguments-mifepristone/">Supreme Court fielded on March 26, 2024</a>, during the oral arguments in <a href="https://www.scotusblog.com/case-files/cases/food-and-drug-administration-v-alliance-for-hippocratic-medicine-2/">FDA v. Alliance for Hippocratic Medicine</a>. A group of doctors is challenging the FDA, saying that the federal agency’s decision allowing people to get mifepristone via telehealth, at up to 10 weeks of pregnancy, is causing some medical professionals harm.</em></p>
<p><em>Amy Lieberman, politics and society editor at The Conversation U.S., spoke with family law and reproductive justice scholars <a href="https://scholar.google.com/citations?user=gCJEShUAAAAJ&hl=en">Naomi Cahn</a> and <a href="https://www.law.gwu.edu/sonia-m-suter">Sonia Suter</a> to better understand what’s behind the oral arguments before the Supreme Court – and how the court’s eventual decision, expected in June, could affect people’s ability to get abortions by using mifepristone, one of two drugs used for medication abortion.</em> </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="White boxes of Mifepristone are seen stacked in a shelf." src="https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A cabinet holds mifepristone at a health clinic in Casper, Wyo., in June 2023.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/cabinet-containing-mifepristone-seen-in-wellspring-health-news-photo/1258730531?adppopup=true">Rachel Woolf for The Washington Post via Getty Images</a></span>
</figcaption>
</figure>
<p><strong>What is this case about?</strong></p>
<p><strong>Sonia Suter:</strong> It’s about whether the FDA’s regulations for the use of <a href="https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation">mifepristone were appropriately loosened in 2016 and 2021</a>. These changes generally make mifepristone more accessible by allowing people to have the medication prescribed via a telehealth visit and then getting the pill in the mail.</p>
<p><strong>Naomi Cahn:</strong> That 2016 regulation also extended the time during which mifepristone could be prescribed, increasing it from seven to 10 weeks gestation. Medication abortions accounted for <a href="https://www.guttmacher.org/2024/03/medication-abortion-accounted-63-all-us-abortions-2023-increase-53-2020">63% of all abortions</a> that occurred in the U.S. in 2023. This percentage has increased since the Supreme Court overturned the constitutional right to an abortion in 2022.</p>
<p><strong>Why are these guidelines being challenged?</strong></p>
<p><strong>Suter:</strong> A group of doctors and medical associations that oppose abortion <a href="https://www.nytimes.com/2024/03/26/us/erin-hawley-abortion-pill-supreme-court.html">are challenging these guidelines</a> and using this court case as a way, we believe, to limit the ability to get an abortion by using medication. </p>
<p>They challenged the drug’s initial approval by the FDA and the relaxed restrictions on how it is used. They claimed that the FDA exceeded its authority, did not rely on proper data and did not have adequate support from scientific studies for its decision that mifepristone could be safely prescribed. Their initial arguments, which the lower court accepted, would have banned mifepristone. But that decision was not upheld by the <a href="https://www.ca5.uscourts.gov/opinions/pub/23/23-10362-CV1.pdf">5th Circuit Court</a>. </p>
<p>Instead, the issues before the Supreme Court focus on whether the FDA should have expanded the use of mifepristone. Virtually all studies have shown that <a href="https://www.nytimes.com/interactive/2023/04/01/health/abortion-pill-safety.html">mifepristone is not dangerous</a>, even with the relaxed conditions on its use. </p>
<p><strong>What is the federal government’s central argument against these claims?</strong></p>
<p><strong>Cahn:</strong> The government is stating that the FDA appropriately reviewed all of the evidence and its decision was appropriate. </p>
<p>Indeed, the attorney representing the mifepristone manufacturer, <a href="https://www.supremecourt.gov/oral_arguments/argument_transcripts/2023/23-235_p8k0.pdf">Jessica Ellsworth</a>, pointed out that <a href="https://apnews.com/article/abortion-pill-mifepristone-redacted-studies-supreme-court-ebd60519fd44dc69c5ac213580d1c1ba#:%7E:text=A%20medical%20journal%20has%20retracted,and%20flaws%20in%20their%20research.">the studies cited by the challengers have either been</a> discredited <a href="https://www.npr.org/sections/health-shots/2024/02/09/1230175305/abortion-pill-mifepristone-retraction-supreme-court">or withdrawn because they were unreliable</a>. </p>
<p>Another critical issue, as <a href="https://www.nytimes.com/live/2024/03/26/us/abortion-pill-supreme-court">U.S. Solicitor General Elizabeth Prelogar said to the justices today</a>, is whether the organization challenging this ruling actually has legal standing – the right to sue – to bring a lawsuit against the FDA. </p>
<p><strong>Why is the question of who can sue the FDA important here?</strong></p>
<p><strong>Suter:</strong> Under U.S. law, you cannot succeed in court every time you are unhappy. The Supreme Court has ruled that the Constitution requires parties who bring suit in federal court to <a href="https://www.law.cornell.edu/constitution-conan/article-3/section-2/clause-1/standing-requirement-overview">have “standing.”</a> This means parties have to show that they have been injured in some tangible way or threatened with such an injury by the acts that are the basis of the lawsuit. In this case, a group of doctors morally opposed to abortion are saying they have been injured. Their claim is that with the changes in the FDA’s regulation of mifepristone prescriptions, patients will come to them in the emergency room, requiring medical care that violates these religious beliefs and causes them stress. </p>
<p>The government’s response is that the FDA is not making them do anything, including prescribe these pills or treat these patients. And <a href="https://www.hhs.gov/conscience/conscience-protections/index.html">there are conscience laws</a> that say if the treatment is against a health care provider’s beliefs, they do not need to provide that care. So the government asks: How are the doctors harmed here?</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A line of people in formal clothing are seen behind barricades outside the Supreme Court on a grey day." src="https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">People wait outside the Supreme Court to hear oral arguments on mifepristone on March 26, 2024.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/people-wait-in-line-outside-us-supreme-court-to-hear-oral-news-photo/2107843290?adppopup=true">Drew Angerer/AFP via Getty Images</a></span>
</figcaption>
</figure>
<p><strong>What is your impression from the justices, listening to these arguments?</strong></p>
<p><strong>Cahn:</strong> I was surprised by how much time the justices spent asking about legal standing and whether there was a direct enough connection between the plaintiffs and the FDA’s guidance. </p>
<p><strong>What’s the potential impact of the court’s eventual ruling on this case?</strong></p>
<p><strong>Cahn:</strong> The court’s decision has implications for the whole FDA approval process as well as access to medication abortion, including through telehealth and the mail. If the court rules for the doctors challenging the FDA, mifepristone would still be available, but access to it would be severely limited because people would need an in-person visit before they could get it.</p><img src="https://counter.theconversation.com/content/226670/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Two legal scholars who study abortion-related laws explain what happened at the Supreme Court in a case that could make it harder to get an abortion.Naomi Cahn, Professor of Law, University of VirginiaSonia Suter, Professor of Law, George Washington UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2256192024-03-20T12:28:41Z2024-03-20T12:28:41ZBiden cannot easily make Roe v. Wade federal law, but he could still make it easier to get an abortion<figure><img src="https://images.theconversation.com/files/582808/original/file-20240319-20-n2gu76.jpg?ixlib=rb-1.1.0&rect=419%2C62%2C4759%2C3385&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A protester marks the Dobbs v. Jackson Women's Health Organization decision anniversary outside the Supreme Court building on June 23, 2023. </span> <span class="attribution"><a class="source" href="https://mapi.associatedpress.com/v2/items/39d8d89cb379472ea647b7756c313426/preview/AP23175098262311.jpg?wm=api&tag=app_id=1,user_id=904438,org_id=101781">Associated Press/Nathan Howard</a></span></figcaption></figure><p>President Joe Biden promised during his State of the Union address on March 7, 2024, that he would make the right to get an abortion a federal law. </p>
<p>“If you, the American people, send me a Congress that supports the right to choose, I promise you I will restore Roe v. Wade as the <a href="https://www.whitehouse.gov/briefing-room/speeches-remarks/2024/03/08/remarks-by-president-biden-in-state-of-the-union-address-3/">law of the land again</a>,” Biden said. </p>
<p>If Biden meant simply that he would sign a bill enshrining the right to an abortion, then he can keep his promise. But, as he noted, such a bill is unlikely to be enacted by this current Congress, <a href="https://pressgallery.house.gov/member-data/party-breakdown">in which the House majority is Republican</a>. Moreover, if Biden expected such a law to be upheld by this Supreme Court, or even a different set of justices, he could be seriously disappointed.</p>
<p>On the other hand, there is much that Biden’s administration and Congress can do to offset the impact of the Supreme Court’s 2022 <a href="https://www.oyez.org/cases/2021/19-1392">Dobbs v. Jackson Women’s Health Organization</a> ruling, which removed federal constitutional protection for the right to get an abortion and sent the regulation of abortion back to the states. </p>
<p><a href="https://www.law.virginia.edu/faculty/profile/nrc8g/2915359">As experts</a> on <a href="https://www.law.gwu.edu/alan-b-morrison">constitutional law</a> and <a href="https://www.law.gwu.edu/sonia-m-suter">reproductive health and justice</a>, we are sorting out just what the federal government can do to protect access to abortion.</p>
<p>Most Americans think of the federal government and the president as capable of doing anything that a majority of Congress thinks is appropriate. But that is not true. </p>
<p>The president has various powers under the Constitution, including the authority to issue <a href="https://constitutioncenter.org/blog/executive-orders-101-what-are-they-and-how-do-presidents-use-them">executive orders</a>. </p>
<p>That’s what <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2022/07/08/executive-order-on-protecting-access-to-reproductive-healthcare-services/">Biden did</a> shortly after the Dobbs decision when he issued an executive order that called on different government officials and agencies to promote access to reproductive care, including abortion. </p>
<p>Biden can also have government agencies craft rules that protect abortion rights. The Department of Health and Human Services, for example, has proposed <a href="https://www.hhs.gov/about/news/2023/04/12/hhs-proposes-measures-bolster-patient-provider-confidentiality-around-reproductive-health-care.html#:%7E:text=Today%2C%20the%20U.S.%20Department%20of,protected%20health%20information%20(PHI)%20to">a rule to increase privacy protections</a> for reproductive health information, including abortion information. </p>
<p>But Biden has only limited authority to do this: These efforts could be undone by <a href="https://constitutioncenter.org/blog/executive-orders-101-what-are-they-and-how-do-presidents-use-them">Congress overriding</a> executive orders – or his successors reversing them – and courts invalidating agency decisions. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/582806/original/file-20240319-26-k3xw86.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Joe Biden is seen standing at a podium, in front of a large American flag and several people around him, including Vice President Kamala Harris" src="https://images.theconversation.com/files/582806/original/file-20240319-26-k3xw86.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582806/original/file-20240319-26-k3xw86.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582806/original/file-20240319-26-k3xw86.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582806/original/file-20240319-26-k3xw86.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582806/original/file-20240319-26-k3xw86.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582806/original/file-20240319-26-k3xw86.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582806/original/file-20240319-26-k3xw86.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">President Joe Biden speaks during the State of the Union address on March 7, 2024.</span>
<span class="attribution"><a class="source" href="https://mapi.associatedpress.com/v2/items/8a914f2c68444fefb2f27f6cfa4ab597/preview/AP24068158996875.jpg?wm=api&tag=app_id=1,user_id=904438,org_id=101781">Associated Press/Andrew Harnik</a></span>
</figcaption>
</figure>
<h2>Congress’ hands are partially tied</h2>
<p>Biden specifically said in February 2024 that he needs a Congress that will help him support a “woman’s right to choose.”</p>
<p>Two of us have written <a href="https://slate.com/news-and-politics/2022/01/congress-roe-law-abortion-alternative.html">about how Congress</a> does not have the authority to override a state’s decision to make abortions unlawful in most circumstances – although we <a href="https://twitter.com/jdmortenson/status/1521580604323737600">recognize that some</a> observers and experts would <a href="https://crsreports.congress.gov/product/pdf/LSB/LSB10787">question this conclusion</a>.</p>
<p>Congress has the power to pass laws, but only on a limited list of subjects. While the understanding of Congress’ power has expanded over time, there are still very real limits. </p>
<p>Congress is able to regulate commerce between states, but the Supreme Court has determined that its powers only reach activities that are <a href="https://crsreports.congress.gov/product/pdf/IF/IF11971">economic in nature</a>. So, the court ruled in 1994 that the federal government could not ban the possession of guns in a “<a href="https://www.oyez.org/cases/1994/93-1260">school zone</a>,” since there was no direct economic element involved. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/582919/original/file-20240319-30-7pp40o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Two white boxes say the words 'Mifepristone tablets' and are on a black table." src="https://images.theconversation.com/files/582919/original/file-20240319-30-7pp40o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582919/original/file-20240319-30-7pp40o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582919/original/file-20240319-30-7pp40o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582919/original/file-20240319-30-7pp40o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582919/original/file-20240319-30-7pp40o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582919/original/file-20240319-30-7pp40o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582919/original/file-20240319-30-7pp40o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Packages of Mifepristone tablets are displayed in April 2023 at the family planning clinic in Rockville, Md.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/in-this-photo-illustration-packages-of-mifepristone-tablets-news-photo/1481950657?adppopup=true">Anna Moneymaker/Getty Images</a></span>
</figcaption>
</figure>
<h2>Other options for protecting abortion rights</h2>
<p>The president and the federal government have other ways to make it easier and more affordable to get an abortion. Some of these methods might even be effective in states where there are partial or full bans.</p>
<p>First, Congress could amend existing federal laws to provide economic assistance for abortion. For example, it could repeal the <a href="https://crsreports.congress.gov/product/pdf/IF/IF12167#:%7E:text=The%20Hyde%20Amendment%2C%20according%20to,are%20not%20obligated%20to%20cover.">Hyde Amendment</a>, which is an annual restriction passed in 1976 that prohibits federal money from being used to fund abortions, except when necessary to save the life of a pregnant person or when a pregnancy is the result of rape or incest. </p>
<p>Biden promised to remove the Hyde Amendment in his 2020 campaign but has been unable to do so because of lack of congressional support. But eliminating the Hyde Amendment would have minimal impact in <a href="https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html">states with abortion bans</a>. </p>
<p>Second, some states with abortion bans, like Idaho and Alabama, <a href="https://apnews.com/article/abortion-texas-idaho-alabama-state-lines-trafficking-d314933f3f7db93858561a0c6ad0b188">are threatening to prosecute women</a> who travel to another state to get an abortion. Congress could enact legislation that protects the right to interstate travel for an abortion. Congress could also make it a federal offense for anyone, including state prosecutors, to interfere with that right. </p>
<p>Justice Brett Kavanaugh, <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf">in his concurring opinion in Dobbs</a>, asserted that if states criminalized interstate travel for people to get an abortion, those laws would fail “based on the constitutional right to interstate travel.” </p>
<p>Since Dobbs, <a href="https://apnews.com/article/idaho-abortion-minors-criminalization-b8fb4b6feb9b520d63f75432a1219588">Idaho has passed a law</a> making it a felony for adults who are not the parent of a pregnant minor to help that minor cross state lines for an abortion. A <a href="https://apnews.com/article/idaho-abortion-trafficking-travel-ban-270a403d7b4a5e99e566433556614728">district court has temporarily stayed</a> this law as unconstitutional. In addition, <a href="https://www.texastribune.org/2024/02/09/texas-abortion-transgender-care-outside-state-borders/#:%7E:text=In%201974%2C%20just%20after%20Roe,they%20travel%20to%20that%20State.%E2%80%9D">four counties and a few cities in Texas</a> have passed so-called “abortion trafficking laws,” which allow individuals to sue people who travel to get abortions out of state and those who help them.</p>
<p>Third, the Food and Drug Administration has approved, and in 2016 and 2021 expanded, the <a href="https://theconversation.com/medication-abortion-could-get-harder-to-obtain-or-easier-theres-a-new-wave-of-post-dobbs-lawsuits-on-abortion-pills-198978">availability of mifepristone</a>, one of the two drugs used for medication abortions. The Supreme Court is <a href="https://www.scotusblog.com/2023/12/justices-will-review-lower-court-ruling-on-access-to-abortion-pill/">considering a challenge</a> to some of the FDA’s rules about access to mifepristone and will hear <a href="https://www.scotusblog.com/case-files/cases/food-and-drug-administration-v-alliance-for-hippocratic-medicine-2/">oral arguments in that case on March 26, 2024</a>. </p>
<p>But even if the FDA prevails, an anti-abortion president could replace the head of this federal agency. The FDA might then rescind the current rules that have <a href="https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation">expanded access</a> to mifepristone, including allowing the pill to be used later in pregnancy. </p>
<p>To prevent that from happening, Biden could ask <a href="https://crsreports.congress.gov/product/pdf/IF/IF12269">Congress to pass a law</a> that would guarantee the same kind of access to mifepristone that the FDA currently allows. </p>
<p>Congress could also ensure that <a href="https://theconversation.com/an-obscure-1800s-law-is-shaping-up-to-be-the-center-of-the-next-abortion-battle-legal-scholars-explain-whats-behind-the-victorian-era-comstock-act-204728">mailing abortion pills is legal</a>. It could do so by repealing a Victorian law called the Comstock Act, which <a href="https://www.nytimes.com/interactive/2023/04/08/us/court-decision-invalidating-approval-of-mifepristone.html">some judges</a> have interpreted as prohibiting the mailing of abortion pills, and directly declaring that such acts are legal. </p>
<p>The Department of Justice issued an <a href="https://theconversation.com/an-obscure-1800s-law-is-shaping-up-to-be-the-center-of-the-next-abortion-battle-legal-scholars-explain-whats-behind-the-victorian-era-comstock-act-204728">opinion in 2022</a> that the Comstock Act does not override the FDA rule allowing mifepristone to be delivered by mail. But legislation would make it impossible for a future president to reverse that opinion alone, or reverse that decision without congressional approval. </p>
<h2>Biden’s actions could still matter</h2>
<p>Biden’s attempt to explicitly codify Roe would probably not succeed. </p>
<p>But Biden can recommend that Congress undertake many other legal reforms that are not constitutionally barred, and he could also take some limited actions based on his own authority. These could remove some obstacles to getting an abortion.</p><img src="https://counter.theconversation.com/content/225619/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>While both Congress and the president have extensive legal powers, they cannot easily change the law to protect abortions under federal law.Naomi Cahn, Professor of Law, University of VirginiaAlan Morrison, Professor of public interest and public service law, George Washington UniversitySonia Suter, Professor of law, George Washington UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2202712024-03-19T12:26:28Z2024-03-19T12:26:28ZBuilding fairness into AI is crucial – and hard to get right<figure><img src="https://images.theconversation.com/files/582656/original/file-20240318-18-u3qu8i.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C3478%2C3071&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Are the AIs making decisions about your life fair?</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/personnel-evaluation-by-artificial-royalty-free-illustration/1733429687?phrase=Artificial+intelligence+hiring">sorbetto/DigitalVision Vectors via Getty Images</a></span></figcaption></figure><p>Artificial intelligence’s capacity to process and analyze vast amounts of data has revolutionized decision-making processes, making operations in <a href="https://doi.org/10.7861%2Ffhj.2021-0095">health care</a>, <a href="https://doi.org/10.1287/mnsc.2016.2644">finance</a>, <a href="https://nij.ojp.gov/topics/articles/using-artificial-intelligence-address-criminal-justice-needs">criminal justice</a> and other sectors of society more efficient and, in many instances, more effective.</p>
<p>With this transformative power, however, comes a significant responsibility: the need to ensure that these technologies are developed and deployed in a manner that is <a href="https://doi.org/10.48550/arXiv.1610.02413">equitable and just</a>. In short, AI needs to be fair. </p>
<p>The pursuit of fairness in AI is not merely an ethical imperative but a requirement in order to foster trust, inclusivity and the <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2023/10/30/executive-order-on-the-safe-secure-and-trustworthy-development-and-use-of-artificial-intelligence/">responsible advancement of technology</a>. However, ensuring that AI is fair is a major challenge. And on top of that, my research as a computer scientist <a href="https://scholar.google.com/citations?hl=en&user=ASf9Q04AAAAJ&view_op=list_works&sortby=pubdate">who studies AI</a> shows that attempts to ensure fairness in AI can have unintended consequences.</p>
<h2>Why fairness in AI matters</h2>
<p>Fairness in AI has emerged as a <a href="https://www.aies-conference.com/2024/">critical area of focus</a> for researchers, developers and policymakers. It transcends technical achievement, touching on <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2023/10/30/executive-order-on-the-safe-secure-and-trustworthy-development-and-use-of-artificial-intelligence/">ethical, social and legal dimensions of the technology</a>.</p>
<p>Ethically, fairness is a cornerstone of building trust and acceptance of AI systems. People need to trust that AI decisions that affect their lives – for example, hiring algorithms – are made equitably. Socially, AI systems that embody fairness can help address and mitigate historical biases – for example, those against women and minorities – fostering inclusivity. Legally, embedding fairness in AI systems helps bring those systems into alignment with anti-discrimination laws and regulations around the world.</p>
<p>Unfairness can stem from two primary sources: the input data and the algorithms. Research has shown that input data can <a href="https://dx.doi.org/10.2139/ssrn.2477899">perpetuate bias</a> in various sectors of society. For example, in hiring, algorithms processing data that reflects societal prejudices or lacks diversity can <a href="https://doi.org/10.1145/3351095.3372828">perpetuate “like me” biases</a>. These biases favor candidates who are similar to the decision-makers or those already in an organization. When biased data is then used to train a machine learning algorithm to aid a decision-maker, the algorithm can <a href="http://proceedings.mlr.press/v81/buolamwini18a.html?mod=article_inline&ref=akusion-ci-shi-dai-bizinesumedeia">propagate and even amplify these biases</a>.</p>
<h2>Why fairness in AI is hard</h2>
<p>Fairness is inherently subjective, influenced by cultural, social and personal perspectives. In the context of AI, researchers, developers and policymakers often translate fairness to the idea that algorithms <a href="https://fairmlbook.org/index.html">should not perpetuate or exacerbate</a> existing biases or inequalities.</p>
<p>However, measuring fairness and building it into AI systems is fraught with subjective decisions and technical difficulties. Researchers and policymakers have proposed <a href="https://doi.org/10.48550/arXiv.1610.02413">various definitions of fairness</a>, such as demographic parity, equality of opportunity and individual fairness.</p>
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<figcaption><span class="caption">Why the concept of algorithmic fairness is so challenging.</span></figcaption>
</figure>
<p>These definitions involve different mathematical formulations and underlying philosophies. They also often conflict, highlighting the <a href="https://doi.org/10.1145/3433949">difficulty of satisfying all fairness criteria</a> simultaneously in practice.</p>
<p>In addition, fairness cannot be distilled into a single metric or guideline. It encompasses a spectrum of considerations including, but not limited to, <a href="https://fairmlbook.org/index.html">equality of opportunity, treatment and impact</a>.</p>
<h2>Unintended effects on fairness</h2>
<p>The multifaceted nature of fairness means that AI systems must be scrutinized at every level of their development cycle, from the initial design and data collection phases to their final deployment and ongoing evaluation. This scrutiny reveals another layer of complexity. AI systems are seldom deployed in isolation. They are used as part of often complex and important decision-making processes, such as making recommendations about hiring or allocating funds and resources, and are subject to many constraints, including <a href="https://dx.doi.org/10.2139/ssrn.4589207">security and privacy</a>.</p>
<p>Research my colleagues and I conducted shows that constraints such as <a href="https://doi.org/10.48550/arXiv.2312.03886">computational resources, hardware types</a> and <a href="https://doi.org/10.24963/ijcai.2021/78">privacy</a> can significantly influence the fairness of AI systems. For instance, the need for computational efficiency can lead to simplifications that inadvertently overlook or misrepresent marginalized groups. </p>
<p>In our study on network pruning – a method to make complex machine learning models smaller and faster – we found that this process <a href="https://doi.org/10.48550/arXiv.2205.13574">can unfairly affect certain groups</a>. This happens because the pruning might not consider how different groups are represented in the data and by the model, leading to biased outcomes.</p>
<p>Similarly, privacy-preserving techniques, while crucial, can obscure the data necessary to identify and mitigate biases or disproportionally affect the outcomes for minorities. For example, when statistical agencies add noise to data to protect privacy, this can <a href="https://doi.org/10.24963/ijcai.2021/78">lead to unfair resource allocation</a> because the added noise affects some groups more than others. This disproportionality can also <a href="https://doi.org/10.24963/ijcai.2022/766">skew decision-making processes</a> that rely on this data, such as resource allocation for public services. </p>
<p>These constraints do not operate in isolation but intersect in ways that compound their impact on fairness. For instance, when privacy measures exacerbate biases in data, it can further amplify existing inequalities. This makes it important to have a comprehensive understanding and approach to both privacy and fairness for AI development.</p>
<h2>The path forward</h2>
<p>Making AI fair is not straightforward, and there are no one-size-fits-all solutions. It requires a process of continuous learning, adaptation and collaboration. Given that bias is pervasive in society, I believe that people working in the AI field should recognize that it’s not possible to achieve perfect fairness and instead strive for continuous improvement. </p>
<p>This challenge requires a commitment to rigorous research, thoughtful policymaking and ethical practice. To make it work, researchers, developers and users of AI will need to ensure that considerations of fairness are woven into all aspects of the AI pipeline, from its conception through data collection and algorithm design to deployment and beyond.</p><img src="https://counter.theconversation.com/content/220271/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ferdinando Fioretto receives funding from the National Science Foundation, Google, and Amazon. </span></em></p>Bias in AI has been getting a lot of attention lately, but it’s just one aspect of the larger – and thornier – problem of fairness in AI.Ferdinando Fioretto, Assistant Professor of Computer Science, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2248382024-03-14T12:42:48Z2024-03-14T12:42:48ZCOVID-19 vaccines: CDC says people ages 65 and up should get a shot this spring – a geriatrician explains why it’s vitally important<figure><img src="https://images.theconversation.com/files/580030/original/file-20240305-30-xa43f3.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C7951%2C5297&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Even if you got a COVID-19 shot last fall, the spring shot is still essential for the 65 and up age group.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/old-asian-senior-couple-wearing-face-mask-virus-royalty-free-image/1332149015?phrase=covid-19+shots+and+seniors&adppopup=true">whyframestudio/iStock via Getty Images Plus</a></span></figcaption></figure><p>In my mind, the spring season will always be associated with COVID-19. </p>
<p>In spring 2020, the federal government <a href="https://www.federalregister.gov/documents/2020/03/18/2020-05794/declaring-a-national-emergency-concerning-the-novel-coronavirus-disease-covid-19-outbreak">declared a nationwide emergency</a>, and life drastically changed. Schools and businesses closed, and masks and social distancing were mandated across much of the nation. </p>
<p>In spring 2021, after the vaccine rollout, the Centers for Disease Control and Prevention said those who were fully vaccinated against COVID-19 could <a href="https://www.cnn.com/2021/05/13/health/cdc-mask-guidance-vaccinated/index.html">safely gather with others who were vaccinated</a> without masks or social distancing.</p>
<p>In spring 2022, with the increased rates of vaccination across the U.S., the <a href="https://www.nytimes.com/live/2022/03/26/world/covid-19-mandates-cases-vaccine#hawaii-lifts-its-indoor-mask-mandate-and-travel-restrictions-the-last-state-to-do-so">universal indoor mask mandate</a> came to an end. </p>
<p>In spring 2023, the federal declaration of COVID-19 as a <a href="https://www.hhs.gov/about/news/2023/05/09/fact-sheet-end-of-the-covid-19-public-health-emergency.html">public health emergency ended</a>.</p>
<p>Now, as spring 2024 fast approaches, the CDC reminds Americans that even though the public health emergency is over, the risks associated with COVID-19 are not. But those risks are higher in some groups than others. Therefore, the agency recommends that adults age 65 and older receive an <a href="https://www.cdc.gov/media/releases/2024/s-0228-covid.html">additional COVID-19 vaccine</a>, which is <a href="https://www.yalemedicine.org/news/updated-covid-vaccine-10-things-to-know">updated to protect against a recently dominant variant</a> and is effective against the current dominant strain. </p>
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<figcaption><span class="caption">You have a 54% less chance of being hospitalized with severe COVID-19 if you’ve had the vaccine.</span></figcaption>
</figure>
<h2>Increased age means increased risk</h2>
<p>The shot is <a href="https://www.medicare.gov/coverage/coronavirus-disease-2019-covid-19-vaccine">covered by Medicare</a>. But do you really need yet another COVID-19 shot?</p>
<p><a href="https://uvahealth.com/findadoctor/Laurie-Archbald-Pannone-1356544233">As a geriatrician</a> who exclusively cares for people over 65 years of age, this is a question I’ve been asked many times over the past few years.</p>
<p>In early 2024, the short answer is yes.</p>
<p>Compared with other age groups, <a href="https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-who-is-at-risk/art-20483301">older adults have the worst outcomes</a> with a COVID-19 infection. Increased age is, simply put, a <a href="https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html#">major risk factor</a>.</p>
<p>In January 2024, the average death rate from COVID-19 for all ages was <a href="https://covid.cdc.gov/covid-data-tracker/#demographicsovertime">just under 3 in 100,000 people</a>. But for those ages 65 to 74, <a href="https://www.cidrap.umn.edu/covid-19/older-adults-made-90-us-covid-deaths-2023">it was higher</a> – about 5 for every 100,000. And for people 75 and older, the rate jumped to nearly 30 in 100,000. </p>
<p>Even now, four years after the start of the pandemic, people 65 years old and up are about twice as likely to die from COVID-19 than the rest of the population. People 75 years old and up are <a href="https://covid.cdc.gov/covid-data-tracker/#demographicsovertime">10 times more likely to die</a> from COVID-19. </p>
<h2>Vaccination is still essential</h2>
<p>These numbers are scary. But the No. 1 action people can take to decrease their risk <a href="https://www.cdc.gov/media/releases/2024/p0301-respiratory-virus.html">is to get vaccinated</a> and keep up to date on vaccinations to ensure top immune response. Being appropriately vaccinated is as critical in 2024 as it was in 2021 to help prevent infection, hospitalization and death from COVID-19. </p>
<p>The <a href="https://www.yalemedicine.org/news/updated-covid-vaccine-10-things-to-know">updated COVID-19 vaccine</a> <a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html">has been shown to be safe and effective</a>, with the benefits of vaccination continuing to <a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e5.htm">outweigh the potential risks of infection</a>. </p>
<p>The CDC has been observing side effects on the more than 230 million Americans <a href="https://usafacts.org/visualizations/covid-vaccine-tracker-states/">who are considered fully vaccinated</a> with what it calls the “<a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/reporting-systems.html#">most intense safety monitoring in U.S. history</a>.” Common side effects <a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect.html">soon after receiving the vaccine</a> include discomfort at the injection site, transient muscle or joint aches, and fever. </p>
<p>These symptoms can be alleviated with over-the-counter pain medicines or a cold compress to the site after receiving the vaccine. Side effects are less likely if you are well hydrated when you get your vaccine.</p>
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<figcaption><span class="caption">Getting vaccinated is at the top of the list of the new recommendations from the CDC.</span></figcaption>
</figure>
<h2>Long COVID and your immune system</h2>
<p>Repeat infections carry increased risk, not just from the infection itself, but also for developing long COVID <a href="https://time.com/6553340/covid-19-reinfection-risk/">as well as other illnesses</a>. Recent evidence shows that even mild to moderate COVID-19 infection can negatively affect cognition, with changes similar to seven years of brain aging. But being up to date with COVID-19 immunization has a <a href="https://www.scientificamerican.com/article/vaccination-dramatically-lowers-long-covid-risk/">fourfold decrease in risk of developing long COVID symptoms</a> if you do get infected. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mounting-research-shows-that-covid-19-leaves-its-mark-on-the-brain-including-with-significant-drops-in-iq-scores-224216">Mounting research shows that COVID-19 leaves its mark on the brain, including with significant drops in IQ scores</a>
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</em>
</p>
<hr>
<p>Known as <a href="https://doi.org/10.3389/fragi.2022.900028">immunosenescence</a>, this puts people at higher risk of infection, including severe infection, and decreased ability to <a href="https://doi.org/10.1016/j.it.2020.11.002">maintain immune response to vaccination </a> as they get older. The older one gets – over 75, or over 65 with other medical conditions – the more immunosenescence takes effect. </p>
<p>All this is why, if you’re in this age group, even if you received your last COVID-19 vaccine in fall 2023, the spring 2024 shot is still essential to boost your immune system so it can act quickly if you are exposed to the virus. </p>
<p>The bottom line: If you’re 65 or older, it’s time for another COVID-19 shot.</p><img src="https://counter.theconversation.com/content/224838/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laurie Archbald-Pannone receives funding from PRIME, Accredited provider of medical and professional education; supported by an independent educational grant from GlaxoSmithKline, LLC as Course Director "Advancing Patient Engagement to Protect Aging Adults from Vaccine-Preventable Diseases: An Implementation Science Initiative to Activate and Sustain Participation in Recommended Vaccinations”</span></em></p>As you get older, you’re at higher risk of severe infection and your immunity declines faster after vaccination.Laurie Archbald-Pannone, Associate Professor of Medicine and Geriatrics, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2252222024-03-06T16:08:15Z2024-03-06T16:08:15ZLes acides gras oméga-3 sont liés à une meilleure santé pulmonaire<p>Les <a href="https://www.anses.fr/fr/content/les-acides-gras-om%C3%A9ga-3">acides gras oméga-3</a> suscitent un grand intérêt chez les patients et les cliniciens en raison de leurs <a href="https://doi.org/10.3945/an.111.000893">potentiels effets protecteurs sur la santé</a>, y compris sur la santé pulmonaire. Dans une étude publiée récemment, mes collègues et moi-même avons constaté qu’un apport alimentaire plus élevé en acides gras oméga-3 est lié à une <a href="https://doi.org/10.1016/j.chest.2023.09.035">meilleure fonction pulmonaire et une survie plus longue</a> chez les patients atteints de <a href="http://www.maladies-pulmonaires-rares.fr/">fibrose pulmonaire</a>, une maladie respiratoire chronique.</p>
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<p>
<em>
<strong>
À lire aussi :
<a href="https://theconversation.com/lalimentation-positive-cest-sinspirer-du-regime-mediterraneen-et-limiter-le-sucre-222821">L’alimentation positive, c’est s’inspirer du régime méditerranéen et limiter le sucre</a>
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</p>
<hr>
<p>Présents dans les aliments tels que le poisson et les noix, ainsi que dans certains compléments alimentaires, les <a href="https://chem.libretexts.org/Courses/Willamette_University/WU%3A_Chem_199_-_Better_Living_Through_Chemistry/01%3A_Chemicals_in_Food/1.04%3A_Macro-_and_Micronutrients/1.4.02%3A_Fats_and_Cholesterol">acides gras oméga-3</a> sont des graisses polyinsaturées qui sont des nutriments essentiels pour l’homme. Ils remplissent plusieurs fonctions importantes dans l’organisme, telles que la structuration des cellules et la régulation de l’inflammation.</p>
<p>Les chercheurs pensent que deux acides gras oméga-3, <a href="https://doi.org/10.1042/bst20160474">l’acide docosahexaénoïque et l’acide eicosapentaénoïque, ou DHA et EPA</a>, sont les plus bénéfiques pour la santé en général. Lorsque l’organisme les décompose, leurs sous-produits présentent des <a href="https://doi.org/10.1016/j.atherosclerosis.2020.11.018">effets anti-inflammatoires</a>.</p>
<hr>
<p>
<em>
<strong>
À lire aussi :
<a href="https://theconversation.com/en-2024-le-nutri-score-evolue-pourquoi-et-que-faut-il-en-retenir-221697">En 2024, le Nutri-score évolue : pourquoi, et que faut-il en retenir ?</a>
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<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Chemical structure of EPA and DHA" src="https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=507&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=507&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=507&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=637&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=637&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=637&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">l’EPA (pour l’anglais eicosapentaenoic acid) et le DHA (pour l’anglais docosahexaenoic acid) sont deux acides gras oméga-3 particulièrement bénéfiques pour la santé.</span>
<span class="attribution"><a class="source" href="https://med.libretexts.org/Courses/Allan_Hancock_College/Introduction_to_Nutrition_Science_(Bisson_et._al)/07%3A_Lipids/7.04%3A_Fatty_Acid_Types_and_Food_Sources">Minutemen/Wikimedia via LibreTexts</a></span>
</figcaption>
</figure>
<p>Je suis <a href="https://scholar.google.com/citations?user=QeKA8ZoAAAAJ&hl=en">pneumologue</a> à la faculté de médecine de l’université de Virginie (aux États-Unis), et mon équipe de recherche et moi-même travaillons à l’identification des facteurs de risque susceptibles de contribuer au développement de la <a href="https://asso-fpf.com/">fibrose pulmonaire</a>. Dans cette maladie, le tissu pulmonaire cicatrisé peut entraîner une insuffisance respiratoire et la mort.</p>
<p>Nous avons examiné si des niveaux plus élevés de DHA et d’EPA dans le sang de patients atteints de fibrose pulmonaire dans différents groupes de personnes participant à des travaux de recherche aux États-Unis étaient liés à la progression de la maladie. Nous avons constaté que les patients ayant des niveaux plus élevés d’acides gras oméga-3 dans leur sang présentaient un <a href="https://doi.org/10.1016/j.chest.2023.09.035">déclin plus lent de la fonction pulmonaire et une survie plus longue</a>. Il est à noter que ces résultats ont persisté même après la prise en compte d’autres facteurs tels que l’âge et les maladies concomitantes.</p>
<h2>Pourquoi c’est important</h2>
<p>Il existe actuellement <a href="https://doi.org/10.1111/crj.13466">très peu de traitements</a> pour la fibrose pulmonaire. Et ceux qui existent ont des effets secondaires importants. Nos résultats suggèrent que l’augmentation des acides gras oméga-3 dans le régime alimentaire d’un patient peut ralentir la progression de cette maladie dévastatrice.</p>
<p>Les chercheurs étudient le rôle de la nutrition dans de nombreuses autres maladies. Mais ce rôle reste peu étudié dans les maladies pulmonaires chroniques, y compris la fibrose pulmonaire. Notre étude ainsi que d’autres travaux de recherches suggèrent que des <a href="https://doi.org/10.1183/13993003.00262-2023">modifications au niveau de l’alimentation</a> peuvent influencer la trajectoire de cette maladie et améliorer la capacité du patient à tolérer le traitement.</p>
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<figcaption><span class="caption">Réunion sur la fibrose pulmonaire organisée le 8 février 2024 par le Centre de référence des maladies pulmonaires rares (de l’adulte) – OrphaLung, sous la coordination du Pr Vincent Cottin (Hôpital Louis Pradel, HCL).</span></figcaption>
</figure>
<p>Par ailleurs, d’autres études menées sur des souris ont mis en lumière la façon dont les acides gras oméga-3 peuvent <a href="https://doi.org/10.1186/1471-2466-14-64">protéger contre la fibrose pulmonaire</a> en régulant l’activité des cellules inflammatoires et en ralentissant la formation de tissu cicatriciel dans les poumons.</p>
<h2>Ce que l’on ne sait pas encore</h2>
<p>Comme nous n’avons pas pu mesurer les taux d’acides gras oméga-3 dans le sang qu’à un seul moment, nous n’avons pas pu déterminer si l’évolution de ces taux au cours du temps est corrélée à l’évolution de la fibrose pulmonaire.</p>
<p>Il est donc essentiel de savoir si l’augmentation des niveaux d’acides gras oméga-3 dans le sang aura un effet significatif sur la vie des patients atteints de fibrose pulmonaire. Ces taux d’acides gras oméga-3 pourraient ne pas avoir d’effet direct sur la fibrose pulmonaire et pourraient simplement être le reflet de modes de vie et de régimes alimentaires plus sains.</p>
<p>Des essais cliniques sont donc nécessaires pour déterminer si les acides gras oméga-3 sont bénéfiques pour les patients atteints de maladies respiratoires.</p>
<h2>Les prochaines étapes</h2>
<p>Nous prévoyons de poursuivre nos recherches pour déterminer si les acides gras oméga-3 ont un effet protecteur contre la fibrose pulmonaire.</p>
<p>Plus précisément, nous espérons déterminer le mécanisme par lequel des apports enrichis en oméga-3 affectent les poumons des patients atteints de fibrose pulmonaire.</p>
<p>Il s’agit là d’étapes importantes pour identifier les patients qui pourraient être particulièrement réceptifs aux thérapies à base d’oméga-3 et pour faire progresser ces traitements vers des essais cliniques.</p><img src="https://counter.theconversation.com/content/225222/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>John Kim est financé par le National Institute of Health et la Chest Foundation.</span></em></p>Les acides gras essentiels présents, entre autres, dans le poisson et les fruits à coque sont bénéfiques pour la santé. Les chercheurs découvrent aussi leur rôle positif en cas de fibrose pulmonaire.John Kim, Assistant Professor of Medicine, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2247182024-03-04T18:49:30Z2024-03-04T18:49:30ZThe Constitution sets some limits on the people’s choices for president - but the Supreme Court rules it’s unconstitutional for state governments to decide on Trump’s qualifications<figure><img src="https://images.theconversation.com/files/579002/original/file-20240229-24-47x21c.jpg?ixlib=rb-1.1.0&rect=174%2C174%2C2495%2C1526&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A 1935 painting depicts the 1787 meeting that adopted the U.S. Constitution.</span> <span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:%27The_Adoption_of_the_U.S._Constitution_in_Congress_at_Independence_Hall,_Philadelphia,_Sept._17,_1787%27_(1935),_by_John_H._Froehlich.jpg">John H. Froehlich via Wikimedia Commons</a></span></figcaption></figure><p>When the Supreme Court ruled on March 4, 2024, that former President Donald Trump <a href="https://www.supremecourt.gov/opinions/23pdf/23-719_19m2.pdf">could appear on state presidential ballots</a> for the 2024 election, it did not address an idea that seemed simple and compelling when Justice Brett Kavanaugh raised it during the Feb. 8, 2024, oral arguments in the case:</p>
<blockquote>
<p>“<a href="https://www.supremecourt.gov/oral_arguments/argument_transcripts/2023/23-719_5he6.pdf">What about the idea that we should think about democracy</a>, think about the right of the people to elect candidates of their choice, of letting the people decide?”</p>
</blockquote>
<p>In essence, he was asking whether it would be better to let the people, rather than a court or a state official, decide whether a controversial candidate should return to the White House.</p>
<p>Kavanaugh had a point. Under the Constitution, the people can be – and are – trusted to make a great many important decisions.</p>
<p>But Kavanaugh also missed a key point that I learned in years of <a href="https://my.wlu.edu/directory/profile?ID=x1345">teaching about the presidency, the Constitution and impeachment</a>. Right from the very beginning of the nation, and persisting until today, there have been rules that limit the ability of the people to choose their leaders.</p>
<h2>The Constitutional Convention of 1787</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/579003/original/file-20240229-18-i9mxdb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man in formal 18th century dress." src="https://images.theconversation.com/files/579003/original/file-20240229-18-i9mxdb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/579003/original/file-20240229-18-i9mxdb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=767&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579003/original/file-20240229-18-i9mxdb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=767&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579003/original/file-20240229-18-i9mxdb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=767&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579003/original/file-20240229-18-i9mxdb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=964&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579003/original/file-20240229-18-i9mxdb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=964&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579003/original/file-20240229-18-i9mxdb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=964&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Gouverneur Morris.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Portrait_of_Gouverneur_Morris_(1752-1816),_1817.jpg">Ezra Ames via Wikimedia Commons</a></span>
</figcaption>
</figure>
<p>The drafters of the Constitution already had the discussion Kavanaugh was trying to start during the oral arguments.</p>
<p>In July 1787, the delegates to the Constitutional Convention, where the Constitution was written, were discussing impeachment. Gouverneur Morris – a Pennsylvania delegate who <a href="https://www.neh.gov/article/confessions-gouverneur-morris">wrote the preamble to the Constitution</a>, including its opening phrase, “<a href="https://constitutioncenter.org/the-constitution/preamble">We the People of the United States</a>” – made an argument Kavanaugh’s question would echo 237 years later.</p>
<p>When discussing <a href="https://www.smithsonianmag.com/history/inside-founding-fathers-debate-over-what-constituted-impeachable-offense-180965083/">whether it should be possible for Congress to remove the president</a>, Morris said no.</p>
<p>The people could decide for themselves, he said. Making the president subject to impeachment, Morris said, “<a href="https://press-pubs.uchicago.edu/founders/documents/a1_2_5s7.html">will hold him in such dependence</a> that he will be no check on the Legislature, (nor) a firm guardian of the people and of the public interest.” With regular national elections, Morris said, a flawed chief executive could be removed from office by the voters. Morris added, “<a href="https://press-pubs.uchicago.edu/founders/documents/a1_2_5s7.html">In case he should be reelected</a>, that will be sufficient proof of his innocence.”</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/579005/original/file-20240229-16-zek6xd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man in formal 18th century dress." src="https://images.theconversation.com/files/579005/original/file-20240229-16-zek6xd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/579005/original/file-20240229-16-zek6xd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=699&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579005/original/file-20240229-16-zek6xd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=699&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579005/original/file-20240229-16-zek6xd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=699&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579005/original/file-20240229-16-zek6xd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=879&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579005/original/file-20240229-16-zek6xd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=879&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579005/original/file-20240229-16-zek6xd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=879&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">George Mason.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:George_Mason.jpg">Dominic W. Boudet after John Hesselius via Wikimedia Commons</a></span>
</figcaption>
</figure>
<p>But George Mason, a Virginia delegate and slaveholder who <a href="https://www.smithsonianmag.com/history/george-mason-forgotten-founder-he-conceived-the-bill-of-rights-64408583/">championed the idea for the Bill of Rights</a>, was ready with a response. Pointing out that true and fair elections were key to the new nation’s success, Mason noted that if criminal conduct by some future president involved corruption of the election process, the people might have trouble deciding the culprit’s fate in a subsequent election:</p>
<blockquote>
<p>“<a href="https://press-pubs.uchicago.edu/founders/documents/a1_2_5s7.html">Shall any man be above Justice?</a> Above all shall that man be above it, who can commit the most extensive injustice? … Shall the man who has practised corruption and by that means procured his appointment in the first instance, be suffered to escape punishment, by repeating his guilt?”</p>
</blockquote>
<p><a href="https://press-pubs.uchicago.edu/founders/documents/a1_2_5s7.html">Others chimed in with similar replies</a>: Benjamin Franklin of Pennsylvania; James Madison of Virginia, a future president; Elbridge Gerry of Massachusetts, a future vice president; and Edmund Randolph of Virginia, a future U.S. attorney general and secretary of state.</p>
<p>The records of the Constitutional Convention say this at the conclusion of that section of debate: </p>
<blockquote>
<p>“Mr. Gouverneur Morris’s opinion had been changed by the arguments used in the discussion. … Our Executive was not like a Magistrate having a life interest, much less like one having an hereditary interest in his office. He may be bribed by a greater interest to betray his trust … The Executive ought therefore to be impeachable for treachery; Corrupting his electors, and incapacity.” </p>
</blockquote>
<p>The outcome of that discussion resulted in the first of several rules that prevent the American people from choosing just anyone as the president.</p>
<h2>Key restrictions</h2>
<p><a href="https://constitution.congress.gov/constitution/article-1/#article-1-section-3-clause-6">Section 3 of Article 1 of the Constitution</a> is the most direct result of the debate between Morris and Mason. It says that people, including the president, who are impeached and convicted can be barred from office.</p>
<p><a href="https://constitution.congress.gov/constitution/article-2/#article-2-section-1-clause-5">Section 1 of Article 2 of the Constitution</a> imposes more limits. It declares that some people <a href="https://constitution.congress.gov/constitution/article-2/#article-2-section-1-clause-5">simply can’t be president</a> – those not born U.S. citizens, those under age 35 and those who have lived less than 14 years of their lives in the U.S.</p>
<p>Eight decades later, Congress and the states agreed to add a new restriction: <a href="https://constitution.congress.gov/constitution/amendment-14/#amendment-14-section-3">Section 3 of the 14th Amendment</a>, ratified in 1868, says those seeking to hold federal and state offices who have previously taken an oath to support the Constitution <a href="https://theconversation.com/why-14th-amendment-bars-trump-from-office-a-constitutional-law-scholar-explains-principle-behind-colorado-supreme-court-ruling-219763">may not have attemped to subvert or overthrow the Constitution</a>.</p>
<p>And in 1951, the <a href="https://constitution.congress.gov/constitution/amendment-22/">22nd Amendment to the Constitution</a> was ratified, declaring that nobody who had been president for two terms could become president again.</p>
<p>All of these rules stand in the way of simply “letting the people decide,” as Kavanaugh suggested. Strictly speaking, those rules are not democratic. But they are intended to protect democracy itself.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/579006/original/file-20240229-18-uxjqr6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A large room with chairs and desks." src="https://images.theconversation.com/files/579006/original/file-20240229-18-uxjqr6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/579006/original/file-20240229-18-uxjqr6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=233&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579006/original/file-20240229-18-uxjqr6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=233&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579006/original/file-20240229-18-uxjqr6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=233&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579006/original/file-20240229-18-uxjqr6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=293&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579006/original/file-20240229-18-uxjqr6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=293&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579006/original/file-20240229-18-uxjqr6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=293&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The U.S. Senate is one of the less democratic elements of the federal government.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/File:United_States_Senate_Floor.jpg">U.S. Senate via Wikimedia Commons</a></span>
</figcaption>
</figure>
<h2>Democracy isn’t always democratic</h2>
<p>There are plenty of provisions in the Constitution that run counter to simple democracy. </p>
<p>The Senate and the Electoral College give <a href="https://theconversation.com/why-does-the-electoral-college-exist-and-how-does-it-work-5-essential-reads-149502">extra power to states with relatively small populations</a>.</p>
<p>No Congress – even one whose members were each elected by huge majorities – can pass a law abridging freedom of religion or freedom of speech. If a Congress were to pass such a law, the Supreme Court, which has been called <a href="https://www.thirteen.org/wnet/supremecourt/democracy/history.html">the nation’s least democratic branch</a>, could declare it unconstitutional.</p>
<p>Democratic majorities in America are both empowered and constrained by the Constitution. The founders wanted the will of the people to be heard and respected but never given absolute power. Absolute power of any kind was to be checked by a complicated set of prohibitions and procedures.</p>
<p>Kavanaugh was wise to call attention to the fact that in a democracy, the preferences of the people get a high level of deference. Voters certainly can <a href="https://www.pewresearch.org/short-reads/2023/07/21/little-change-in-americans-views-of-trump-over-the-past-year/">judge the conduct and character of Donald Trump</a> – and many have done so, both favorably and unfavorably.</p>
<p>But George Mason was also right. When politicians corrupt the electoral process, or try to do so, it makes little sense to use elections as the mechanism to fix the problem. </p>
<p>The constitutional provisions for impeachment and the 14th Amendment make clear that people who are found guilty of serious wrongdoing while in office, or violate an oath to support the Constitution, are ineligible to hold high office thereafter. In short, the people can’t choose a Senate-convicted official or an oath-breaking insurrectionist, even if they want to. </p>
<p>America’s Constitution has long acknowledged that the preservation of the republic may, in some cases, require the disqualification of candidates and officeholders who commit crimes while in positions of power or participate in insurrection against the very government they have sworn to serve. </p>
<p>The Supreme Court has sidestepped the question of whether Trump’s actions disqualify him from office and declared instead that Congress must make that determination, under the various constitutional restrictions that continue to exist about who is allowed to serve as president. The practical effect of its decision will be to let the people decide this vital question in the coming presidential election.</p><img src="https://counter.theconversation.com/content/224718/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Robert A. Strong does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Right from the very beginning of the nation, there have been rules that limit the ability of the people to choose their leaders.Robert A. Strong, Emeritus Professor of Politics, Washington and Lee University; Senior Fellow, Miller Center, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2225452024-03-01T13:39:34Z2024-03-01T13:39:34ZBen Shapiro’s hip-hop hypocrisy and white male grievance lands him on top of pop music charts for a brief moment<figure><img src="https://images.theconversation.com/files/575372/original/file-20240213-30-rqc3ch.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Conservative political commentator Ben Shapiro speaks at the 2018 Politicon in Los Angeles.</span> </figcaption></figure><p>Over the past decade, conservative commentator and podcaster <a href="https://www.economist.com/open-future/2019/03/28/inside-the-mind-of-ben-shapiro-a-radical-conservative">Ben Shapiro</a> has made a living telling his followers that <a href="https://x.com/benshapiro/status/156246995978293248?s=20">rap isn’t music</a>. </p>
<p>If anyone thinks so, <a href="https://twitter.com/benshapiro/status/156246995978293248">Shapiro tweeted</a> in 2012, “you’re stupid.”</p>
<p>Shapiro <a href="https://www.youtube.com/watch?v=MSxoLJujM-k">explained his reasoning</a> during a 2019 interview: </p>
<p>“In my view, and in the view of my music theorist father who went to music school, there are three elements to music,” Shapiro said. “There is harmony, there is melody and there is rhythm. Rap only fulfills one of these, the rhythm section.”</p>
<p>As a result, Shapiro concluded, rap is “basically spoken rhythm.”</p>
<p>“It’s not actually a form of music,” he said. “It’s a form of rhythmic speaking.” </p>
<p>Leave it to Shapiro, then, to drop a “rhythmic speaking” song filled with <a href="https://www.theguardian.com/music/2020/dec/30/audiences-dont-want-white-anger-how-white-rap-grew-a-conscience">white grievance</a> during the early days of the 2024 U.S. presidential campaign. </p>
<p>Teaming up with Canadian rapper <a href="https://www.rollingstone.com/music/music-features/the-right-wing-troll-rappers-are-coming-1341251/">Tom MacDonald</a>, Shapiro released “<a href="https://www.youtube.com/watch?v=5kGpohEpuTE">Facts</a>” in January 2024. Given today’s bitter partisan divide and <a href="https://abcnews.go.com/US/culture-wars-identity-center-politics-america/story?id=100768380">extremist culture wars</a>, it comes as no surprise that Shapiro’s track quickly found a devoted following. But his racist, anti-rap rap lyrics ultimately repeat the same tired charges right-wing politicians have <a href="https://theconversation.com/scapegoating-rap-hits-new-low-after-july-fourth-mass-shooting-186443">used against hip-hop</a> since its birth over 50 years ago. </p>
<h2>Pop goes racism</h2>
<p>My father isn’t a music theorist. But as a scholar who <a href="https://news.clemson.edu/clemson-doctoral-student-produces-rap-album-for-dissertation-it-goes-viral/">earned a Ph.D. by writing a rap album</a> and continues to release rap music about race and American society as <a href="https://www.cambridge.org/core/journals/twentieth-century-music/article/abs/leaders-of-the-new-school-music-departments-hiphop-and-the-challenge-of-significant-difference/D6025AE31E4FF60A4A57347CDCE4AC86">my academic work</a>, I knew a hit song filled with racist diatribes like “Facts” was <a href="https://www.theringer.com/rap/2023/8/14/23831167/hip-hop-50th-anniversary-future-of-rap-music-ad-carson-virginia">bound to happen</a>. </p>
<p>It’s not the first time blatant racism has propelled an artist to the top of music charts. </p>
<p>In July 2023, Jason Aldean, a white country singer, <a href="https://www.bbc.com/news/world-us-canada-66248807">released a video for “Try That In A Small Town”</a> that was criticized for promoting racial violence. That <a href="https://www.washingtonpost.com/entertainment/music/2024/01/31/ben-shapiro-song-tom-macdonald/">song shot up</a> to No. 1. </p>
<p>In November 2023, a video of country singer Morgan Wallen, who is also white, surfaced and went viral. In the video, he is captured saying, “take care of this p— a– n—.” While Wallen was roundly condemned and apologized for his racist and sexist language, <a href="https://www.theroot.com/despite-morgan-wallens-racist-past-america-is-still-ob-1851059418">his music has also topped the charts</a>. </p>
<p>But to simply call MacDonald and Shapiro’s “Facts” racist would be too quick a dismissal of all that is at play.</p>
<p>By performing over a popular-sounding trap-style beat, Shapiro and MacDonald might lead listeners to overlook their heavy reliance on <a href="https://theconversation.com/everyday-african-american-vernacular-english-is-a-dialect-born-from-conflict-and-creativity-193194">Black vernacular speech</a>, which toes the line between <a href="https://www.pbs.org/wgbh/americanexperience/features/foster-blackface-minstrelsy/">minstrelsy</a> and abject <a href="https://www.nytimes.com/2022/09/30/t-magazine/cultural-appropriation.html">cultural appropriation</a>. </p>
<p>Because it’s delivered in the form of a conventional rap song, a listener might even be convinced that the racism and sexism the artists are performing are expectations, and Shapiro and McDonald are just doing what all rappers do. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1750977386676711740"}"></div></p>
<p>It’s a clever gambit. It’s “rapwashing” racism so audiences don’t perceive the obvious intent. </p>
<p>Early in the song, MacDonald tries out a melodic delivery, rap-singing:</p>
<p><em>“This ain’t rap. This ain’t money, cars, and clothes.
We won’t turn your sons into thugs or your daughters into h—.”</em> </p>
<p>The song goes further: </p>
<p><em>“Claim that I’m racist. Yeah, alright.
I’m not ashamed because I’m white.
If every Caucasian’s a bigot, I guess every Muslim’s a terrorist.
Every liberal is right.”</em></p>
<p>For a brief moment, during the last week of January, the song hit No. 1 on the iTunes U.S. chart, which gave Shapiro the audacity, and the apparent receipts, to call himself the “#1 rapper in America.”</p>
<h2>White male grievance</h2>
<p>It’s not surprising that such a large swath of music consumers would find “Facts” entertaining. </p>
<figure class="align-center ">
<img alt="A white man dressed in black clothes appears on stage with a band." src="https://images.theconversation.com/files/578931/original/file-20240229-16-7kl1wv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/578931/original/file-20240229-16-7kl1wv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/578931/original/file-20240229-16-7kl1wv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/578931/original/file-20240229-16-7kl1wv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/578931/original/file-20240229-16-7kl1wv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/578931/original/file-20240229-16-7kl1wv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/578931/original/file-20240229-16-7kl1wv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Hip-hop artist Eminem performs in Los Angeles in 2022.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/inductee-eminem-performs-on-stage-during-the-37th-annual-news-photo/1439523090?adppopup=true">Jeff Kravitz/FilmMagic</a></span>
</figcaption>
</figure>
<p>Eminem, a white rapper, might be a case study. In the early 2000s, he achieved great success in part because of the way <a href="https://www.latimes.com/archives/la-xpm-2001-feb-21-mn-28235-story.html">he gave voice</a> to the repressed rage of certain segments of “<a href="https://www.vulture.com/2017/01/eminems-white-america-15-years-later.html">White America</a>.” </p>
<p>But since the presidential election of Donald Trump in 2016, that rage felt all across white America has been politicized and commercialized <a href="https://news.berkeley.edu/2022/11/14/loss-fear-and-rage-are-white-men-rebelling-against-democracy">to such a degree</a> that I believe hip-hop listeners have heard enough of <a href="https://www.theguardian.com/music/2020/dec/30/audiences-dont-want-white-anger-how-white-rap-grew-a-conscience">white grievance</a>. </p>
<p>It also seems white artists like Eminem took notice.</p>
<p>In his <a href="https://www.vice.com/en/article/d3ybbz/lets-all-settle-down-about-eminems-bet-hip-hop-awards-cypher">2017 BET Hip Hop Awards freestyle cypher</a>, Eminem went to great lengths to distance himself from the actions of his fans who seemed to be <a href="https://ew.com/music/2017/10/11/eminem-trump-storm-lyrics/">politically aligned with Trump</a> and <a href="https://www.splcenter.org/fighting-hate/extremist-files/ideology/alt-right">the alt-right</a>. </p>
<p>Eminem’s freestyle affected his popularity badly enough that he <a href="https://www.thefader.com/2018/08/31/eminem-regret-anti-trump-freestyle-secret-service-interview">later backtracked his remarks</a> and apologized to his Trump-loving fans on a song called “<a href="https://www.youtube.com/watch?v=tT150Zl0Ay0">The Ringer</a>” on his 2018 album “<a href="https://www.youtube.com/watch?v=undRq8xKR8Q">Kamikaze</a>.” </p>
<h2>Hip-hop capitalism</h2>
<p>From its start more than 50 years ago, hip-hop has never been singularly focused <a href="https://www.rollingstone.com/music/music-features/is-hip-hop-still-radical-1234950995/">on mainstream measures of success</a> such as Grammy nominations and awards, music industry chart rankings or sold-out concerts. Nor have its cultural practitioners and producers been gender or race exclusive. </p>
<p>In fact, before rap became <a href="https://projects.apnews.com/features/2023/hip-hop-50th-history/getting-the-money.html">an international multibillion dollar industry</a>, early rappers were wary of the mainstream music industry, and many believed it would negatively affect the integrity of the music and culture. </p>
<p>But even early rappers were forced to find a complicated balance between culture and capitalism. </p>
<p>For instance, in the late 1990s, Yasiin Bey, formerly known as <a href="https://www.billboard.com/music/rb-hip-hop/yasiin-bey-clarifies-drake-comments-1235593284/">Mos Def</a>, and <a href="https://www.huffpost.com/entry/talib-kweli-social-media_n_639bafffe4b0aeb2ace22f13">Talib Kweli</a> released their first album, “Mos Def & Talib Kweli Are Black Star.” </p>
<figure class="align-center ">
<img alt="A Black man wearing sunglasses is surrounded by a group of other Black men." src="https://images.theconversation.com/files/578929/original/file-20240229-30-1qku6n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/578929/original/file-20240229-30-1qku6n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=592&fit=crop&dpr=1 600w, https://images.theconversation.com/files/578929/original/file-20240229-30-1qku6n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=592&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/578929/original/file-20240229-30-1qku6n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=592&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/578929/original/file-20240229-30-1qku6n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=743&fit=crop&dpr=1 754w, https://images.theconversation.com/files/578929/original/file-20240229-30-1qku6n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=743&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/578929/original/file-20240229-30-1qku6n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=743&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Mos Def in New York City before a Black Star concert in 2022.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/mos-def-attends-black-star-in-concert-at-sony-hallon-news-photo/1441918449?adppopup=true">Johnny Nunez/WireImage</a></span>
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<p>The <a href="https://www.okayplayer.com/originals/yasiin-bey-talib-kweli-black-star-timeline.html">critically acclaimed project</a> was filled with lyrics focused on Black consciousness, the perils of mainstream hip-hop and a kind of <a href="https://colorlines.com/article/yasiin-bey-aka-mos-def-talks-about-his-move-south-africa/">Pan-Africanism</a>. </p>
<p>Their label, <a href="https://www.theguardian.com/media/2011/jul/11/james-murdoch-hip-hop">Rawkus Records</a>, was known for recording and signing several underground rap acts including <a href="https://www.rollingstone.com/music/music-news/eminem-blows-up-91979/">Eminem</a>, <a href="https://www.billboard.com/music/music-news/pharaohe-monch-mental-health-9607525/">Pharoahe Monch</a> and <a href="https://www.npr.org/2023/07/24/1189040805/hip-hop-50-chicago">Common</a>. </p>
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<figcaption><span class="caption">Yasiin Bey, formerly Mos Def, responds to a question about Drake, pop music and hip-hop.</span></figcaption>
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<p>But Rawkus was just as much a part of the music industry as any other record label. </p>
<p>It was co-founded and <a href="https://www.fastcompany.com/90411108/that-cringe-worthy-rap-on-succession-must-be-a-reference-to-james-murdoch-erstwhile-hip-hop-mogul">financially backed</a> by James Murdoch, a son of the <a href="https://www.reuters.com/business/media-telecom/rupert-murdoch-billionaire-mogul-helm-global-media-empire-2023-09-21/">media mogul Rupert Murdoch</a>. The label was eventually bought by Murdoch’s News Corp.</p>
<p>Over the past five decades, rap music and hip-hop culture has come to mean a lot of different things to a lot of different people.</p>
<p>For Bey, though, the question goes beyond the money or popularity.</p>
<p>“Where’s the message that I can use?” he asked during a 2024 interview. </p>
<p>I would love to believe that racist, sexist, white male grievance rap isn’t where the zeitgeist is in America. </p>
<p>But Ben Shapiro and his conservative followers are betting that it is – at least for a brief moment.</p><img src="https://counter.theconversation.com/content/222545/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>A.D. Carson does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Since its birth 50 years ago, hip-hop music has embraced artists of every race and ethnic background. An avowed hip-hop hater might be a step too far.A.D. Carson, Associate Professor of Hip-Hop, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2227052024-02-29T17:13:16Z2024-02-29T17:13:16ZWhat does a state’s secretary of state do? Most run elections, a once-routine job facing increasing scrutiny<figure><img src="https://images.theconversation.com/files/576849/original/file-20240220-28-5ht4hm.jpeg?ixlib=rb-1.1.0&rect=21%2C5%2C3573%2C2387&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Georgia Secretary of State Brad Raffensperger holds a news conference on Nov. 6, 2020, on the status of ballot counting in the close presidential race between Joe Biden and Donald Trump. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/georgia-secretary-of-state-brad-raffensperger-holds-a-press-news-photo/1229492060?adppopup=true">Jessica McGowan/Getty Images</a></span></figcaption></figure><p>They may be the most important government officials you can’t name. Their decisions have the potential to alter election results. Scholars have referred to them as the “<a href="https://books.google.com/books?id=bpPeCwAAQBAJ&printsec=frontcover#v=onepage&q&f=false">guardians of the democratic process</a>.” </p>
<p>Who are these unknown, but essential, officials? </p>
<p>State secretaries of state.</p>
<p>You probably know only one person with the title “secretary of state,” <a href="https://www.state.gov/secretary/">Antony Blinken, who conducts foreign policy</a> for the U.S. The others serve their individual states, overseeing numerous crucial state functions. In Michigan, the secretary of state <a href="https://www.michigan.gov/sos">provides motor-vehicle services</a>, such as driver’s licenses and auto registrations. In California, the secretary of state heads the <a href="https://www.sos.ca.gov/archives/">public archives</a> that document California history. And in many states, such as Pennsylvania, the secretary of state manages the process <a href="https://file.dos.pa.gov/">for business registration</a>. </p>
<p>Perhaps the most vital role that state secretaries of state play is that of chief election official. </p>
<p>In 38 states, the secretary of state supervises elections. This power is not confined simply to state and local elections, as the position title might suggest, but includes those on the federal level too.</p>
<p>Despite their importance, secretaries of state have historically managed to avoid being the center of attention during election seasons. Times are changing, though. </p>
<p><a href="https://theconversation.com/state-courts-are-fielding-sky-high-numbers-of-lawsuits-ahead-of-the-midterms-including-challenges-to-voting-restrictions-and-to-how-elections-are-run-192682">Disputes over election results and ballot access</a> have become more prominent over the past half-decade. In turn, secretaries of state have <a href="https://www.politico.com/news/2024/02/16/nass-secretaries-state-election-bipartisanship-00141840">faced newfound scrutiny and are likely to become more central figures</a> in coming elections.</p>
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<h2>Power from the Constitution</h2>
<p>The basis for secretary of states’ comprehensive authority is found in the text of the U.S. Constitution: Article I gives states <a href="https://constitution.congress.gov/browse/article-1/section-4/">the power</a> to regulate the “times, places, and manner” of holding congressional elections. Under Article II, the states <a href="https://constitution.congress.gov/browse/article-2/section-1/clause-2/">get to choose</a> how they pick their electors in presidential elections. </p>
<p>The administration of federal elections is thus largely a state affair. Secretaries of state derive their power over state and local elections <a href="https://constitution.congress.gov/constitution/amendment-10/">from the 10th Amendment</a>, which reserves to the states all powers not expressly delegated or prohibited by the Constitution.</p>
<p>This dynamic explains why the Maine secretary of state’s actions can range from keeping former President Donald Trump <a href="https://www.maine.gov/sos/news/2023/BellowsDecisionChallengeTrumpPrimaryPetitionsDec2023.html">off the presidential primary ballot</a> to overseeing <a href="https://www.newscentermaine.com/article/news/politics/elections/maine-local-municipal-elections-june-13-2023/97-a5b1f140-6740-4bef-be4e-3257069cbf87">the 2023 local elections</a>. </p>
<p>It explains why controversies over election certification by Georgia’s secretary of state occurred in both the <a href="https://www.brennancenter.org/our-work/research-reports/fact-check-trumps-georgia-call-raffensperger">2020 presidential election</a> and <a href="https://www.ajc.com/news/state--regional-govt--politics/georgia-certifies-election-results-after-nearly-two-weeks-drama/VOUIvFPmmzxad39XQFuoPP/">2018 gubernatorial election</a>. </p>
<p>As the chief election official, a secretary of state’s influence over the democratic process can extend to every single elected office. </p>
<h2>Substantial sway</h2>
<p>The election-related powers wielded by secretaries of state naturally vary by state. There are, nevertheless, common features. </p>
<p>The majority of secretaries of state determine ballot eligibility for political parties and candidates. Such determinations are typically straightforward: Is the candidate old enough? Are they a natural-born citizen? </p>
<p>Yet, as recent events <a href="https://www.cnn.com/2024/01/31/politics/colorado-secretary-of-state-tells-supreme-court-to-keep-trump-off-ballot/index.html">in Colorado</a> <a href="https://www.maine.gov/sos/news/2023/BellowsDecisionChallengeTrumpPrimaryPetitionsDec2023.html">and Maine</a> concerning Trump’s presidential eligibility under the 14th Amendment show, such decisions have the potential to be complex and <a href="https://theconversation.com/us-supreme-court-decision-on-trump-colorado-ballot-case-monumental-for-democracy-itself-not-just-2024-presidential-election-220643">extraordinarily significant</a>.</p>
<p>The majority of secretaries of state also have the job of certifying the winners of primary and general elections within their states. This is why secretaries were often named as defendants <a href="https://campaignlegal.org/results-lawsuits-regarding-2020-elections">in Trump’s 2020 legal cases</a> challenging the presidential election results.</p>
<p>Secretaries of state often have substantial sway over how you vote. This can include what your ballot looks like on Election Day. </p>
<p>For example, the Montana secretary of state, like many secretaries, has the power to “<a href="https://leg.mt.gov/bills/mca/title_0130/chapter_0120/part_0020/section_0020/0130-0120-0020-0020.html">adopt statewide uniform rules</a>” setting out, among other things, the ordering of candidates on the ballot, how to handle write-in candidates and the procedure for correcting ballots. </p>
<p>These decisions may seem trivial, but as the <a href="https://www.theguardian.com/us-news/2019/nov/19/bad-ballot-design-2020-democracy-america">infamous 2000 election fiasco in Florida showed</a>, ballot design can quite literally affect electoral outcomes. That ballot was ordered in a way that caused some Al Gore supporters to accidentally vote for third-party candidate Pat Buchanan. <a href="https://www.gsb.stanford.edu/faculty-research/publications/butterfly-did-it-aberrant-vote-buchanan-palm-beach-county-florida">Experts have argued</a> that this cost Gore the election. </p>
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<a href="https://images.theconversation.com/files/576855/original/file-20240220-22-8a9gyt.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Many boxes of ballots spread across a large room." src="https://images.theconversation.com/files/576855/original/file-20240220-22-8a9gyt.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/576855/original/file-20240220-22-8a9gyt.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/576855/original/file-20240220-22-8a9gyt.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/576855/original/file-20240220-22-8a9gyt.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/576855/original/file-20240220-22-8a9gyt.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/576855/original/file-20240220-22-8a9gyt.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/576855/original/file-20240220-22-8a9gyt.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">In Industry, Calif., on Nov. 9, 2022, ballots were received, sorted and verified at the LA County ballot processing facility.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/industry-ca-wednesday-november-9-2022-ballots-are-received-news-photo/1244649591?adppopup=true">Robert Gauthier/Los Angeles Times via Getty Images</a></span>
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<h2>Potential for abuse</h2>
<p>Secretaries of state can also control how your vote is counted. In Nevada, the secretary of state <a href="https://law.justia.com/codes/nevada/2022/chapter-293/statute-293-3677/">can adopt regulations</a> imposing statewide standards for vote counting. </p>
<p>That system gave rise to conflict in the 2022 midterms between the Nevada secretary of state and county officials, when the secretary <a href="https://apnews.com/article/2022-midterm-elections-nevada-reno-barbara-cegavske-4366bc3882e828dd6eab3d8a1c90d954">would not permit</a> county officials to conduct a hand count of mail-in ballots before election day. </p>
<p>Likewise, numerous secretaries of state have the ability to authorize the use – or nonuse – of voting equipment. Such powers were showcased in the wake of the 2020 election when many secretaries <a href="https://www.reuters.com/world/us/pennsylvania-decertifies-countys-voting-machines-after-2020-audit-2021-07-21/">decertified voting machines</a> that were subject to “Stop the Steal” audits by Trump supporters.</p>
<p>This list of powers is far from comprehensive. Indeed, some secretaries of state are granted such broad election authority that they have <a href="https://www.pbs.org/newshour/politics/why-should-you-care-about-your-secretary-of-state">provoked concerns</a> over the potential for abuse. </p>
<p>The Arizona secretary of state, for example, can determine the “<a href="https://www.azleg.gov/ars/16/00411.htm">maximum allowable wait time</a>” at polls. Given <a href="https://www.democracydocket.com/analysis/how-long-lines-affect-turnout/">the negative relationship</a> between poll line length and voter turnout, such power, if misused, could effectively reduce voter participation.</p>
<p>The Arizona secretary of state can furthermore <a href="https://codes.findlaw.com/az/title-16-elections-and-electors/az-rev-st-sect-16-407/">refuse to approve the certification of</a> any election officer – people who help administer elections – seemingly for any reason that does not meet the secretary’s “satisfaction.” </p>
<p>While this authority normally would not raise red flags under a secretary of state acting in good faith, it could allow a secretary with an agenda – perhaps <a href="https://www.ocregister.com/2022/11/18/americans-rejected-stop-the-steal-state-secretaries-in-midterms/">election denialism</a> or favoring one candidate over another – to staff the state’s election administration regime with ideologues.</p>
<h2>How to hold accountable?</h2>
<p>I do not raise these examples to suggest that state secretaries of state are figures to be feared. The vast majority are, from my observations as <a href="https://www.law.virginia.edu/faculty/profile/tpv6dy/jmartin">a practitioner and scholar</a> of election law, excellent public servants. </p>
<p>Nevertheless, their immense influence over the democratic process demonstrates the need for accountability measures in situations where secretaries of state abuse their power – perhaps by <a href="https://www.aclu.org/news/voting-rights/state-officials-who-have-power-suppress-vote">deliberately suppressing the vote</a> or <a href="https://kansasreflector.com/2022/10/22/secretaries-of-state-play-changing-role-in-administering-elections-and-not-in-a-good-way/">acting in an overly partisan manner</a>. </p>
<p>The most obvious means of public accountability is elections. In most states in which the secretary of state is the chief election official, the secretary is in fact elected by the people. </p>
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<p>In seven such states, however, the secretary of state is a political appointee of either the governor or legislature. Appointment certainly does not immunize a secretary from accountability. The barrier for removal, however, may be higher when politics enters the calculation – e.g., requiring a supermajority legislative vote for impeachment.</p>
<p>The drawback to this kind of accountability: lack of immediacy. If a secretary of state is actively harming the democratic process, waiting until the next election year to vote them out may not seem like the best option. </p>
<p>One alternative involves a lawsuit. In 2018, for instance, Georgia advocacy groups <a href="https://kansasreflector.com/2022/10/22/secretaries-of-state-play-changing-role-in-administering-elections-and-not-in-a-good-way/">got a federal court</a> to block then-Secretary of State Brian Kemp from tossing out absentee ballots without notifying voters. </p>
<p>Lawsuits are an imperfect solution. For one, voters will not always have <a href="https://www.law.cornell.edu/constitution-conan/article-3/section-2/clause-1/standing-requirement-overview">the legal right</a> to sue a secretary of state in every instance of wrongdoing. Furthermore, when a lawsuit is brought, the implication is often that harm has already been done.</p>
<p>Internal checks and balances can provide additional accountability. When a secretary of state makes an important election-related decision, that decision could be subject to the scrutiny of another official. This is how it is done in Louisiana, where the secretary of state’s decisions on issues <a href="https://law.justia.com/codes/louisiana/2011/rs/title18/rs18-1306">such as absentee and early voting</a> require the approval of the state’s attorney general.</p><img src="https://counter.theconversation.com/content/222705/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>John J. Martin does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There are dozens of secretaries of state in the US. Only one deals with foreign affairs. The majority of the rest, state secretaries of state, have powerful positions running elections in each state.John J. Martin, Research Assistant Professor of Law, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2245862024-02-27T20:00:16Z2024-02-27T20:00:16ZUS temporarily avoids government shutdown but threat remains: 4 essential reads<figure><img src="https://images.theconversation.com/files/578384/original/file-20240227-24-l6d3lt.jpg?ixlib=rb-1.1.0&rect=129%2C931%2C8497%2C4811&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">President Biden and Vice President Harris met on Feb. 27, 2024, with congressional leaders to find a way to avoid a shutdown.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/Biden/ff2a1de2d69744cf80a497414c3edd8f/photo?Query=biden&mediaType=photo&sortBy=creationdatetime:desc&dateRange=Anytime&totalCount=124199&currentItemNo=7">AP Photo/Evan Vucci</a></span></figcaption></figure><p>Congress <a href="https://www.bloomberg.com/news/articles/2024-02-29/house-passes-short-term-spending-to-avert-us-government-shutdown?srnd=homepage-americas&sref=Hjm5biAW">temporarily averted</a> a <a href="https://www.bloomberg.com/news/articles/2024-02-26/government-shutdown-q-a-will-it-shut-down-and-what-you-should-know">partial government shutdown</a> that would have taken effect on March 2, 2024, by passing a very short-term funding extension.</p>
<p>The measure – which gives Congress more time to finalize spending packages for the current fiscal year – keeps funds flowing to government agencies until March 8 for some departments and until March 22 for the others. A short-term spending deal <a href="https://www.cnn.com/politics/live-news/federal-government-shutdown-funding-11-14-23/index.html">reached just a little over three months ago</a>, which helped prevent the last threatened shutdown, had given Congress two deadlines: March 1 and March 8, 2024, with different departments closing down if funding wasn’t passed by each date. </p>
<p>Democrats and Republicans have been far apart on funding the government, as a group of hard-right lawmakers <a href="https://www.nytimes.com/2024/02/27/world/europe/republicans-spending-shutdown.html">demands spending cuts and conservative policies</a> such as new restrictions on abortion access, as part of any agreement. </p>
<p>If following U.S. politics feels a little like “<a href="https://www.imdb.com/title/tt0107048/">Groundhog Day</a>,” you’re not alone. The Conversation has been covering the increasingly frequent shutdown close calls in recent years by asking experts in politics, economics and other fields to provide context and explain the consequences of a government shutdown. The following is a roundup of some of those articles from our archive. </p>
<h2>1. A shutdown is the wrong way to negotiate a budget</h2>
<p>The small band of conservatives who keep staging these showdown standoffs often use fiscal discipline as a rallying cry. The government is spending too much money, they say, and it’s up to them to put a stop to it. </p>
<p>On the goal of reducing the high U.S. budget deficit – currently about $1.6 trillion – <a href="https://theconversation.com/gop-shutdown-threat-is-the-wrong-way-to-win-a-budget-war-history-shows-a-better-strategy-for-reducing-the-deficit-213938">you won’t get an argument</a> from <a href="https://www.linkedin.com/in/raymond-scheppach-19b98536">Raymond Scheppach</a>, former deputy director of the Congressional Budget Office and retired professor of public policy at the University of Virginia. </p>
<p>But trying to cut the deficit by holding the government hostage is the wrong way to do it, he wrote. </p>
<p>“First of all, shutdowns don’t get results,” Scheppach explained. “The U.S. has had 21 shutdowns over the past five decades, three of which have been major. These have all caused real harm to the U.S. economy, but they haven’t led to the spending levels Republicans wanted.”</p>
<p>If today’s conservatives are serious about cutting the swelling budget deficit, Scheppach suggested they take a different tack – genuine negotiation – which has generally yielded just the results they sought. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/gop-shutdown-threat-is-the-wrong-way-to-win-a-budget-war-history-shows-a-better-strategy-for-reducing-the-deficit-213938">GOP shutdown threat is the wrong way to win a budget war − history shows a better strategy for reducing the deficit</a>
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<h2>2. Why political brinkmanship keeps getting worse</h2>
<p>One big problem with negotiation is that many lawmakers in both political parties are encouraged by increasing levels of hyperpartisanship to dig in their heels and refuse to compromise. And compromise is a key part of any reasonable negotiation.</p>
<p>That’s the assessment of <a href="https://scholar.google.com/citations?user=cfH3-8sAAAAJ&hl=en&oi=ao">Laurel Harbridge-Yong</a>, a Northwestern University political scientist and a specialist in partisan conflict. <a href="https://theconversation.com/with-government-funding-running-out-soon-expect-more-brinkmanship-despite-public-dismay-at-political-gridlock-217252">She doesn’t expect this to change anytime soon</a> – even though the public wants it to.</p>
<p>“So you now have many Republicans who are more willing to fight quite hard against the Democrats because they don’t want to give a win to Biden,” Harbridge-Yong wrote. “However, even if individual members think they’re representing their constituents, representation at the aggregate level can be poor. What the public as a whole – which tends to be more moderate – wants is compromise and resolution.”</p>
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Read more:
<a href="https://theconversation.com/with-government-funding-running-out-soon-expect-more-brinkmanship-despite-public-dismay-at-political-gridlock-217252">With government funding running out soon, expect more brinkmanship despite public dismay at political gridlock</a>
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<h2>3. Shutdowns have long-lasting costs</h2>
<p>The group of Americans most directly affected by a shutdown are federal workers. When a shutdown happens, most are furloughed without pay, while others whose work is deemed essential – such as many in national defense – must still work, but also without getting a paycheck. </p>
<p>When the shutdown ends and the government is funded again, paychecks resume and workers get back pay for however long it lasted. But shutdowns <a href="https://theconversation.com/government-shutdowns-hurt-federal-worker-morale-long-after-paychecks-resume-especially-for-those-considered-nonessential-214431">can have lingering effects on worker morale and retention rates</a>. That drives up the price tag of shutting down the government and can cause long-term damage, wrote <a href="https://scholar.google.com/citations?user=AJLW1HwAAAAJ&hl=en&oi=ao">Susannah Bruns Ali</a>, an assistant professor of public policy and administration at Florida International University. </p>
<p>“Shutdowns lead to more people being more likely to leave government employment – and higher workloads and lower motivation for those who remain,” she explained. “These conditions may feed Republican political goals, but they harm the millions of Americans who depend on competent, timely assistance from the public servants on the government payroll. This ultimately leads to lower work performance and employee retention problems.”</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/government-shutdowns-hurt-federal-worker-morale-long-after-paychecks-resume-especially-for-those-considered-nonessential-214431">Government shutdowns hurt federal worker morale, long after paychecks resume − especially for those considered 'nonessential'</a>
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<h2>4. Shutdowns are uniquely American</h2>
<p>Many other countries also seem to have a great deal of political partisanship, so you might expect fights over government shutdowns to be relatively common. </p>
<p>If you thought that, <a href="https://theconversation.com/shutdowns-are-a-uniquely-american-drama-in-the-uk-its-just-not-parliaments-cup-of-tea-213928">you’d be wrong</a>, according to <a href="https://www.american.edu/sis/faculty/garretm.cfm">Garret Martin</a>, who studies transatlantic relations at the American University School of International Service. </p>
<p>“Other Western democracies experience polarization and political turmoil, too, yet do not experience this problem,” he explained. Take the British system, famous for its raucous Parliamentary sessions: “Government shutdowns just don’t happen – in fact, there has never been one and likely never will be.”</p>
<p>The reason for the difference comes down to four factors, Martin explained: legislative power, ease of passing a budget, political stakes and appropriation rules.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/shutdowns-are-a-uniquely-american-drama-in-the-uk-its-just-not-parliaments-cup-of-tea-213928">Shutdowns are a uniquely American drama − in the UK, it's just not Parliament's cup of tea</a>
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<p><em>This article was updated on March 1, 2024, to reflect a new short-term funding deal.</em></p><img src="https://counter.theconversation.com/content/224586/count.gif" alt="The Conversation" width="1" height="1" />
Congress is again on the brink of a government shutdown less than four months after the last close call.Bryan Keogh, Managing EditorLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2229702024-02-27T12:30:24Z2024-02-27T12:30:24ZOmega-3 fatty acids are linked to better lung health, particularly in patients with pulmonary fibrosis<figure><img src="https://images.theconversation.com/files/577659/original/file-20240223-30-2mxmmk.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C3840%2C2160&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Your diet may play a role in maintaining lung health.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/human-respiratory-system-lungs-anatomy-royalty-free-image/1249730889">magicmine/iStock via Getty Images</a></span></figcaption></figure><p>Omega-3 fatty acids have garnered significant interest among patients and clinicians for their potential <a href="https://doi.org/10.3945/an.111.000893">protective health effects</a>, including lung health. In our recently published research, my colleagues and I found that higher dietary intake of omega-3 fatty acids is linked to <a href="https://doi.org/10.1016/j.chest.2023.09.035">better lung function and longer survival</a> in patients with pulmonary fibrosis, a chronic respiratory disease.</p>
<p>Found in foods such as fish and nuts and in some supplements, <a href="https://chem.libretexts.org/Courses/Willamette_University/WU%3A_Chem_199_-_Better_Living_Through_Chemistry/01%3A_Chemicals_in_Food/1.04%3A_Macro-_and_Micronutrients/1.4.02%3A_Fats_and_Cholesterol">omega-3 fatty acids</a> are polyunsaturated fats that are essential nutrients for people. They serve several important functions in the body, such as providing structure to cells and regulating inflammation.</p>
<p>Researchers believe two omega-3 fatty acids, <a href="https://doi.org/10.1042/bst20160474">docosahexaenoic and eicosapentaenoic acids, or DHA and EPA</a>, are the most beneficial to overall health. When the body breaks them down, their byproducts have <a href="https://doi.org/10.1016/j.atherosclerosis.2020.11.018">anti-inflammatory effects</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Chemical structure of EPA and DHA" src="https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=507&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=507&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=507&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=637&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=637&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577668/original/file-20240223-26-i1nth6.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=637&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">EPA and DHA are two omega-3 fatty acids particularly linked to health benefits.</span>
<span class="attribution"><a class="source" href="https://med.libretexts.org/Courses/Allan_Hancock_College/Introduction_to_Nutrition_Science_(Bisson_et._al)/07%3A_Lipids/7.04%3A_Fatty_Acid_Types_and_Food_Sources">Minutemen/Wikimedia Commons via LibreTexts</a></span>
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<p>I <a href="https://scholar.google.com/citations?user=QeKA8ZoAAAAJ&hl=en">am a pulmonologist</a> at the University of Virginia School of Medicine, and my research team and I are working to identify risk factors that may contribute to the development of <a href="https://www.lung.org/lung-health-diseases/lung-disease-lookup/pulmonary-fibrosis/introduction#">pulmonary fibrosis</a>. In this disease, scarred lung tissue can lead to respiratory failure and death.</p>
<p>We examined whether higher levels of DHA and EPA in the blood of patients with pulmonary fibrosis in different groups of research participants in the U.S. were linked to disease progression. We found that patients with higher levels of omega-3 fatty acids in their blood had a <a href="https://doi.org/10.1016/j.chest.2023.09.035">slower decline in lung function and longer survival</a>. Notably, these findings persisted even after we accounted for other factors such as age and co-occurring diseases. </p>
<h2>Why it matters</h2>
<p>Currently, there are <a href="https://doi.org/10.1111/crj.13466">very few treatments</a> available for pulmonary fibrosis. Those that do exist have significant side effects. Our findings suggest that increasing omega-3 fatty acids in a patient’s diet may slow the progression of this devastating disease.</p>
<p>Researchers have investigated the role of nutrition in many other diseases, but it remains understudied in chronic lung diseases, including pulmonary fibrosis. Our study, along with other published research, suggests <a href="https://doi.org/10.1183/13993003.00262-2023">dietary modifications</a> may influence the trajectory of this disease and improve a patient’s ability to tolerate treatment.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/dQt4_KQUCnk?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Scarring in lung tissue makes it more difficult to breathe.</span></figcaption>
</figure>
<p>Furthermore, other studies using mice have shed light on how omega-3 fatty acids may <a href="https://doi.org/10.1186/1471-2466-14-64">protect against pulmonary fibrosis</a> by regulating the activity of inflammatory cells and slowing buildup of scar tissue in the lungs. </p>
<h2>What still isn’t known</h2>
<p>Since we were able to measure omega-3 fatty acid levels in the blood at only one point in time, we could not determine whether changing levels over time correlates with changes in pulmonary fibrosis. </p>
<p>Crucially, it remains unknown whether increasing omega-3 fatty acid levels in the blood will have a meaningful effect on the lives of patients with pulmonary fibrosis. Omega-3 fatty acids in the blood might not directly affect pulmonary fibrosis and may simply reflect healthier lifestyles and diets. </p>
<p>Clinical trials are necessary to actually determine whether omega-3 fatty acids are beneficial for patients with respiratory diseases.</p>
<h2>What’s next</h2>
<p>We plan to continue researching whether omega-3 fatty acids have a protective effect against pulmonary fibrosis. </p>
<p>Specifically, we hope to determine the mechanism by which omega-3-enriched interventions affect the lungs of patients with pulmonary fibrosis. </p>
<p>These will be important steps to identify patients who may be particularly responsive to omega-3 therapies and move these treatments toward clinical testing.</p><img src="https://counter.theconversation.com/content/222970/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>John Kim receives funding from the National Institute of Health and Chest Foundation. </span></em></p>Essential fats found in fish and nuts are tied to many protective health benefits. Researchers found they may also slow decline of lung function and prolong the lives of pulmonary fibrosis patients.John Kim, Assistant Professor of Medicine, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2242972024-02-23T14:49:16Z2024-02-23T14:49:16ZLos nitazenos, una potente droga callejera que está surgiendo en EE. UU.<figure><img src="https://images.theconversation.com/files/577576/original/file-20240207-20-k3tcfe.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C7790%2C5217&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Los nitazenos, como esta muestra en polvo, son una clase de opiáceos sintéticos más potentes que la morfina y el fentanilo.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/alex-krotulski-associate-director-and-forensic-toxicologist-news-photo/1836064649">Joe Lamberti/The Washington Post via Getty Images</a></span></figcaption></figure><p><em><a href="https://bouldercounty.gov/news/emerging-drug-information-nitazenes/">Dos muertes en el condado de Boulder, Colorado, en 2023</a> son las últimas atribuidas en Estados Unidos a una potente clase de opioides sintéticos llamados nitazenos. La mayoría de los sistemas sanitarios no pueden detectar estas sustancias, por lo que se desconoce el número exacto de sobredosis, pero se sabe que están implicadas en <a href="https://doi.org/10.7759/cureus.40736">más de 200 muertes</a> en Europa y Norteamérica desde 2019, incluidas <a href="https://cdn.theconversation.com/static_files/files/3058/Colorado_nitazenes.pdf?1707842742">11 en Colorado desde 2021</a>. Una de las dos muertes del condado de Boulder se relaciona con una nueva formulación llamada N-Desetil etonitazeno, que fue <a href="https://www.cfsre.org/nps-discovery/monographs/n-desethyl-etonitazene">identificada por un laboratorio nacional</a>, y se cree que es la primera muerte por este compuesto.</em>.</p>
<p><em>The Conversation ha entrevistado a <a href="https://scholar.google.com/citations?hl=en&user=Ne94jgIAAAAJ">Christopher Holstege</a>, profesor de medicina de urgencias y pediatría en la Facultad de Medicina de la Universidad de Virginia y director del Centro de Toxicología de Blue Ridge, donde están aumentando las sobredosis de opioides. Explica por qué los nitazenos son tan potentes y mortales.</em></p>
<h2>¿Qué son los nitazenos?</h2>
<p>Los nitazenos son una clase de opioides sintéticos que engloba más de 20 compuestos únicos, <a href="https://www.dea.gov/stories/2022/2022-06/2022-06-01/new-dangerous-synthetic-opioid-dc-emerging-tri-state-area">incluido el isotonitazeno</a>, que se identificó por primera vez en 2019 y se conoce popularmente como ISO. También incluye el protonitazeno, el metonitazeno y el etonitazeno.</p>
<p>Los nitazenos son sustancias psicoactivas o <a href="https://doi.org/10.1177%2F2045125320967197">“drogas de diseño”</a> que no están controladas por ninguna ley o convención, pero <a href="https://www.unodc.org/LSS/Page/NPS">suponen un riesgo significativo para la salud pública</a>. Estas drogas han aparecido recientemente como drogas ilegales en las calles. </p>
<p>Los investigadores disponen de relativamente poca información sobre cómo reacciona el cuerpo humano a los nitazenos, ya que nunca se han sometido a ensayos clínicos. Pero las pruebas de laboratorio muestran que algunos de ellos podrían ser <a href="https://doi.org/10.7759/cureus.40736">cientos o miles de veces más potentes</a> que la morfina y de 10 a 40 veces más potentes que el fentanilo.</p>
<p>La Administración de Control de Drogas de EE. UU. ha clasificado muchas formulaciones de nitazenos como <a href="https://www.federalregister.gov/documents/2021/12/07/2021-26263/schedules-of-controlled-substances-temporary-placement-of-butonitazene-etodesnitazene-flunitazene">drogas de la Lista 1 de la Ley de Sustancias Controladas</a>, lo que significa que no tienen uso médico y presentan un alto riesgo de abuso.</p>
<h2>¿Cuándo se desarrollaron por primera vez?</h2>
<p>Los nitazenos fueron inicialmente <a href="https://www.deadiversion.usdoj.gov/drug_chem_info/benzimidazole-opioids.pdf">desarrollados en la década de 1950</a> por los laboratorios de investigación farmacéutica de la empresa química suiza CIBA. Esta empresa sintetizó numerosas sustancias de esta clase para utilizarlas como analgésicos. </p>
<p>Sin embargo, nunca fueron aprobados por la Administración de Alimentos y Medicamentos de EE. UU. <a href="https://doi.org/10.7759/cureus.40736">para uso médico en humanos</a>. Prácticamente cayeron en el olvido fuera de los círculos de investigación especializados hasta que resurgieron como drogas callejeras en 2019. </p>
<p>A medida que las fuerzas del orden han tomado medidas enérgicas contra otras drogas, como el fentanilo, los laboratorios ilegales han utilizado <a href="https://doi.org/10.7759/cureus.40736">investigaciones farmacológicas históricas</a> para formular análogos de los nitazenos como drogas callejeras. </p>
<p>Desde 2019, <a href="https://doi.org/10.1093%2Fjat%2Fbkab117">al menos seis fórmulas</a> proceden de la patente original, pero otras, como la detectada en Boulder, son completamente nuevas. Se requieren <a href="https://doi.org/10.1093%2Fjat%2Fbkab117">pruebas de laboratorio especializadas</a> para identificar nitazenos en muestras de toxicología. <a href="https://www.ccsa.ca/sites/default/files/2022-03/CCSA-CCENDU-Drug-Alert-Nitazenes-2022-en_0.pdf">Las tiras reactivas de fentanilo no pueden detectar análogos de nitazeno</a>.</p>
<p>Desde que <a href="https://doi.org/10.1016/j.forsciint.2021.110686">se detectaron por primera vez</a>, estas sustancias han sido responsables de <a href="https://doi.org/10.7759/cureus.40736">200 muertes por sobredosis relacionadas con drogas</a> en Europa y Estados Unidos. Aunque ya están identificadas como drogas ilegales en numerosos países, muchos profesionales médicos ni siquiera <a href="https://doi.org/10.7759/cureus.40736">saben que existen</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Píldoras azules sobre fondo negro" src="https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">El isotonitazeno ha aparecido en forma de píldora mezclado con otras drogas como la oxicodona.</span>
<span class="attribution"><a class="source" href="https://www.dea.gov/onepill/images">DEA</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
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<h2>¿Qué tipos de nitazenos circulan en las calles?</h2>
<p>El nitazeno apareció por primera vez en 2019 en el Medio Oeste de EE. UU. como un <a href="https://www.federalregister.gov/documents/2023/08/18/2023-17778/schedules-of-controlled-substances-placement-of-metonitazene-in-schedule-i">polvo blanco</a> similar a la cocaína. <a href="https://www.dea.gov/stories/2022/2022-06/2022-06-01/new-dangerous-synthetic-opioid-dc-emerging-tri-state-area">Más tarde se detectó</a> en las calles de Washington D.C. como polvos amarillos, marrones y blancos. Desde 2022, la DEA ha encontrado otros tipos de nitazenos tanto en <a href="https://www.federalregister.gov/documents/2023/10/25/2023-23379/schedules-of-controlled-substances-temporary-placement-of-n-desethyl-isotonitazene-and-n-piperidinyl">polvo como en pastillas azules</a>.</p>
<p>Los nitazenos también se <a href="https://www.federalregister.gov/documents/2023/10/25/2023-23379/schedules-of-controlled-substances-temporary-placement-of-n-desethyl-isotonitazene-and-n-piperidinyl">mezclan con otras drogas callejeras</a> como la heroína y el fentanilo y con pastillas falsas de oxicodona, sin que los usuarios lo sepan. </p>
<p>El Departamento de Justicia ha acusado a varias <a href="https://www.justice.gov/opa/pr/justice-department-announces-eight-indictments-against-china-based-chemical-manufacturing">empresas de China</a> de enviar las materias primas químicas para fabricarlos a México y EE. UU., donde los cárteles y traficantes las mezclan y luego las distribuyen en las calles.</p>
<h2>¿Cuáles son los síntomas de una sobredosis?</h2>
<p>Los efectos tóxicos del nitazeno se asemejan a los asociados a otros opiáceos clásicos como la morfina y el fentanilo e incluyen pupilas reducidas y ralentización de los sistemas respiratorio y nervioso central, lo que puede conducir a la muerte.</p>
<p>Debido a su potencia, los síntomas pueden desarrollarse rápidamente después de que alguien se vea expuesto, causándole la muerte antes de que pueda recibir atención médica.</p>
<h2>¿La naloxona contrarresta los efectos de la sobredosis?</h2>
<p>La naloxona, comúnmente <a href="https://theconversation.com/fda-approval-of-over-the-counter-narcan-is-an-important-step-in-the-effort-to-combat-the-us-opioid-crisis-198497">conocida como Narcan</a>, es <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7137a5.htm">supuestamente eficaz</a> para revertir las sobredosis debidas al nitazeno, pero <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7137a5.htm">pueden ser necesarias varias dosis potentes</a>.</p><img src="https://counter.theconversation.com/content/224297/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher P. Holstege no recibe salario, ni ejerce labores de consultoría, ni posee acciones, ni recibe financiación de ninguna compañía u organización que pueda obtener beneficio de este artículo, y ha declarado carecer de vínculos relevantes más allá del cargo académico citado.</span></em></p>Una muerte por sobredosis en Colorado (EE UU) se ha relacionado con una nueva y potente droga de diseño cuyo uso en humanos nunca se ha aprobado.Christopher P. Holstege, Professor of Emergency Medicine and Pediatrics, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2186822024-02-21T13:19:25Z2024-02-21T13:19:25ZMarriage is not as effective an anti-poverty strategy as you’ve been led to believe<figure><img src="https://images.theconversation.com/files/575664/original/file-20240214-26-6cr98q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Despite the popular guidance, marriage can be an economic risk for single parents with unstable partners.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/divorce-process-royalty-free-image/1329914655">simarik/iStock/Getty Images Plus</a></span></figcaption></figure><p>Brides.com predicts that 2024 will be the “<a href="https://www.brides.com/marriage-proposal-boom-2024-8358024">year of the proposal</a>” as engagements tick back up after a pandemic-driven slowdown.</p>
<p>Meanwhile, support for marriage has found new grist in recent books, including <a href="https://sociology.as.virginia.edu/people/w-bradford-wilcox">sociologist</a> Brad Wilcox’s “<a href="https://www.amazon.com/Get-Married-Americans-Families-Civilization/dp/0063210851">Get Married: Why Americans Must Defy the Elites, Forge Strong Families and Save Civilization</a>” and economist Melissa Kearney’s “<a href="https://press.uchicago.edu/ucp/books/book/chicago/T/bo205550079.html">The Two-Parent Privilege</a>.”</p>
<p>Kearney’s book was <a href="https://www.city-journal.org/article/review-of-the-two-parent-privilege-by-melissa-kearney">hailed by economist Tyler Cowen</a> as possibly “the most important economics and policy book of this year.” This is not because it treads new ground but because, as author <a href="https://www.city-journal.org/article/review-of-the-two-parent-privilege-by-melissa-kearney">Kay Hymowitz writes</a>, it breaks the supposed “taboo about an honest accounting of family decline.” </p>
<p>These developments are good news for the marriage promotion movement, which <a href="https://www.dol.gov/general/aboutdol/history/webid-moynihan">for decades</a> has claimed that marriage supports children’s well-being and combats poverty. The movement dates back at least to the U.S. Department of Labor’s <a href="https://www.dol.gov/general/aboutdol/history/webid-moynihan">Moynihan Report of 1965</a>, which argued that <a href="https://www.theatlantic.com/politics/archive/2015/09/the-moynihan-report-an-annotated-edition/404632/">family structure aggravated Black poverty</a>.</p>
<p>Forty years after the Moynihan Report, George W. Bush-era programs such as the <a href="https://www.acf.hhs.gov/ocs/policy-guidance/csbg-im-no-89-healthy-marriage-initiative">Healthy Marriage Initiative</a> sought to <a href="https://www.jstor.org/stable/4624797">enlist churches</a> and other community groups in an effort to channel childbearing back into marriage. These initiatives continue today, with the federally subsidized <a href="https://www.acf.hhs.gov/ofa/programs/healthy-marriage-responsible-fatherhood">Healthy Marriage and Responsible Fatherhood programs</a>.</p>
<p>Still, nearly <a href="https://www.census.gov/newsroom/stories/single-parent-day.html">30% of U.S. children</a> live in single-parent homes today, compared with 10% in 1965.</p>
<p>We are <a href="https://scholar.google.com/citations?user=gCJEShUAAAAJ&hl=en&oi=ao">law professors</a> who have written extensively about <a href="https://scholar.google.com/citations?user=0BBCYNAAAAAJ&hl=en&oi=ao">family structure</a> and <a href="https://www.fordham.edu/school-of-law/faculty/directory/full-time/eleanor-brown/">poverty</a>. We, and others, have found that there is almost no evidence that federal programs that promote marriage <a href="https://www.bgsu.edu/content/dam/BGSU/college-of-arts-and-sciences/NCFMR/documents/FP/FP-14-02_HMIInitiative.pdf">have made a difference</a> in encouraging two-parent households. That’s in large part because they forgo effective solutions that directly address poverty for measures that embrace the culture wars. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/575989/original/file-20240215-28-q3xgpp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Child hangs upside down on playground equipment" src="https://images.theconversation.com/files/575989/original/file-20240215-28-q3xgpp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/575989/original/file-20240215-28-q3xgpp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/575989/original/file-20240215-28-q3xgpp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/575989/original/file-20240215-28-q3xgpp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/575989/original/file-20240215-28-q3xgpp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/575989/original/file-20240215-28-q3xgpp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/575989/original/file-20240215-28-q3xgpp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Having a parent who has a college degree makes kids less likely to live in poverty than having parents who are married.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/girl-upside-down-on-the-jungle-gym-royalty-free-image/1127705002">Mayur Kakade/Moment Collection via Getty Images</a></span>
</figcaption>
</figure>
<h2>Marriage and social class</h2>
<p>Today’s marriage promoters claim that <a href="https://ifstudies.org/blog/the-benefits-of-marriage-shouldnt-only-be-for-elites">marriage should not be just for elites</a>. The emergence of marriage as a marker of class, they believe, is a sign of societal dysfunction.</p>
<p>According to census data released in 2021, 9.5% of children living with two parents – and 7.5% with married parents – <a href="https://ojjdp.ojp.gov/statistical-briefing-book/population/faqs/qa01203#:%7E:text=In%202021%2C%209.5%25%20of%20children,17.4%25">lived below the poverty level</a>, compared with 31.7% of children living with a single parent.</p>
<p>Kearney’s argument comes down to: 1 + 1 = 2. Two parents have more resources, including money and time to spend with children, than one. She marshals extensive research designed to show that children from married couple families are <a href="https://doi.org/10.1146/annurev-economics-063016-103749">more likely to graduate</a> from high school, complete college and earn <a href="https://doi.org/10.1146/annurev-economics-063016-103749">higher incomes as adults</a> than the children of single parents.</p>
<p>It is undoubtedly true that two parents – that is, two nonviolent parents with reliable incomes and cooperative behavior – have <a href="https://www.brookings.edu/articles/cohabiting-parents-differ-from-married-ones-in-three-big-ways/">more resources for their children</a> than one parent who has to work two jobs to pay the rent. However, this equation <a href="https://doi.org/10.31235/osf.io/pmyhj">does not address causation</a>. In other words, parents who have stable incomes and behaviors are more likely to stay together than parents who don’t.</p>
<p>Ethnographic studies indicate, for example, that the most common reasons unmarried women are no longer with the fathers of their children are the men’s <a href="https://ssrn.com/abstract=3841832">violent behavior, infidelity</a> and <a href="https://www.ucpress.edu/book/9780520335233/essential-dads">substance abuse</a>.</p>
<p>Moreover, income volatility disproportionately affects parents who don’t go to college. So while they may have more money to invest in children together than apart, when one of these parents experiences a substantial drop in income, the other parent may have to decide whether to <a href="https://elibrary.law.psu.edu/cgi/viewcontent.cgi?article=1455&context=fac_works">support the partner or the children</a> on what is often a meager income.</p>
<p>The <a href="https://theconversation.com/having-a-single-parent-doesnt-determine-your-life-chances-the-data-shows-poverty-is-far-more-important-217841">impact of having single parents</a> also plays out differently by race and class. As sociologist and researcher <a href="https://www.nytimes.com/2019/12/09/opinion/two-parent-family.html">Christina Cross explains</a>, “Living apart from a biological parent does not carry the same cost for Black youths as for their white peers, and being raised in a two-parent family is not equally beneficial.” </p>
<p>For example, Cross found that living in a single-mother family is less likely to affect high school completion rates for Black children than for white children. Also, Black families tend to be more embedded in extended family than white families, and this additional support system may help protect children from negative outcomes associated with single-parent households.</p>
<p><iframe id="A2rK0" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/A2rK0/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<h2>Making men more ‘marriageable’</h2>
<p>Kearney, to her credit, does note that economic insecurity largely explains what is happening to working-class families, and that no parent should have to tolerate violence or substance abuse. But she doubles down on the need to restore a norm of two-parent families.</p>
<p>Many of her policy prescriptions are sensible. She advocates for better opportunities for low-income men – to make them, in the words of <a href="https://press.uchicago.edu/ucp/books/book/chicago/T/bo13375722.html">sociologist William Julius Wilson</a>, “marriageable.” Such policies would include wage subsidies to improve their job opportunities, investment in community colleges that provide skills training, and the <a href="https://theconversation.com/banning-the-box-would-help-people-released-from-prison-rebuild-their-lives-45539">removal of questions about criminal histories</a> from job applications, so that candidates who have previously been incarcerated are not immediately disqualified.</p>
<h2>A new marriage model</h2>
<p>What marriage promotion efforts overlook, however, are the underlying changes in what marriage has become – both legally and practically. </p>
<p>The new marriage model rests on three premises.</p>
<p>The first is a moral command: Have sex if you want to, but don’t have children until you are ready. While the shotgun marriage once served as the primary response to unplanned pregnancy, such marriages today often derail education and careers and are <a href="https://today.duke.edu/2016/11/shotgun-marriage-dead#:%7E:text=After%20a%20decade%2C%2030%20percent,prior%20to%20a%20child's%20conception.">more likely to result in divorce</a> than other marriages. Research shows that lower-income women’s pregnancies are much <a href="https://www.guttmacher.org/sites/default/files/factsheet/fb-unintended-pregnancy-us_0_4.pdf">more likely to be unplanned</a>. </p>
<p>The second is the ability to pick a partner who will support you and assume joint responsibility for parenting. As women have attained more economic independence, they are less in need of men to raise children, particularly if their partners are insensitive or abusive. With healthy relationships, couples pick partners based on trust, commitment and equal respect. This is more difficult to do in communities with high rates of incarceration and few opportunities for stable employment. </p>
<p>And the third is economic and behavioral stability. Instability undermines even committed unions. Parents who wait until they find the right partner and have stable lives bring a lot more to parenting, whether they marry or not.</p>
<p>We believe that creating opportunities for low-income parents to reach this middle-class model is likely to be the most effective marriage promotion policy.</p>
<h2>Economic support is key</h2>
<p>In relationships that fall outside of these premises, 1 + 1 often becomes 1 + -1, which equals 0.</p>
<p>Being committed to a partner who can’t pay speeding tickets, runs up credit card bills, comes home drunk or can’t be relied on to pick up the children after school is not a recipe for success. </p>
<p>Economic principles suggest that businesses with more volatile income streams need a stronger capital base to withstand the downturns. Working-class couples who face economic insecurity see commitment as similarly misguided; without a capital base, a downturn for one partner can wipe out the other.</p>
<p>The Biden administration’s child tax credit expansion included in the <a href="https://www.bloomberg.com/news/newsletters/2024-02-08/the-child-tax-credit-bill-seems-destined-for-defeat-in-the-senate?embedded-checkout=true">American Rescue Plan Act of 2021</a> helped cut the child poverty rate – after accounting for government assistance – <a href="https://www.cbpp.org/research/poverty-and-inequality/governments-pandemic-response-turned-a-would-be-poverty-surge-into">to a record low</a> that year. It did more to address child poverty than <a href="https://www.sciencedaily.com/releases/2014/01/140106094155.htm">marriage promotion efforts have ever done</a>.</p>
<p>Researchers have described such income-support policies as the “<a href="https://doi.org/10.1007/s12187-020-09782-0">ultimate multipurpose policy instrument</a>.” They improve the economic circumstances of single-parent families and, in doing so, may also provide greater support for two-parent relationships. </p>
<p>Policymakers know how to solve child poverty – and these measures are far more effective than efforts to put two married parents in every household.</p><img src="https://counter.theconversation.com/content/218682/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Marriage on its own won’t do away with child poverty, and in fact it can create even more instability for low-income families.Eleanor Brown, Professor of Law, Fordham UniversityJune Carbone, Professor of Law, University of MinnesotaNaomi Cahn, Professor of Law, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2222442024-02-15T13:33:58Z2024-02-15T13:33:58ZNitazenes are a powerful class of street drugs emerging across the US<figure><img src="https://images.theconversation.com/files/574223/original/file-20240207-20-k3tcfe.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C7790%2C5217&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Nitazenes, like this powder sample, are a class of synthetic opioids more potent than morphine and fentanyl.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/alex-krotulski-associate-director-and-forensic-toxicologist-news-photo/1836064649">Joe Lamberti/The Washington Post via Getty Images</a></span></figcaption></figure><p><em><a href="https://bouldercounty.gov/news/emerging-drug-information-nitazenes/">Two deaths in Boulder County, Colorado, in 2023</a> are the latest in the U.S. to be blamed on the powerful class of synthetic opioids called nitazenes. Most health systems cannot detect nitazenes, so the exact number of overdoses is unknown, but they’re implicated in <a href="https://doi.org/10.7759/cureus.40736">more than 200 deaths</a> in Europe and North America since 2019, including <a href="https://cdn.theconversation.com/static_files/files/3058/Colorado_nitazenes.pdf?1707842742">11 in Colorado since 2021</a>. One of the two Boulder County deaths is linked to a new formulation called N-Desethyl etonitazene, which was <a href="https://www.cfsre.org/nps-discovery/monographs/n-desethyl-etonitazene">identified by a national laboratory</a>, and is thought to be the first related death.</em></p>
<p><em>The Conversation interviewed <a href="https://scholar.google.com/citations?hl=en&user=Ne94jgIAAAAJ">Dr. Christopher Holstege</a>, professor of emergency medicine and pediatrics at the University of Virginia School of Medicine and director of the Blue Ridge Poison Center, where opioid overdoses are increasing. He explains why nitazenes are so potent and deadly.</em></p>
<h2>What are nitazenes?</h2>
<p>Nitazenes are a class of synthetic opioids that contains more than 20 unique compounds, <a href="https://www.dea.gov/stories/2022/2022-06/2022-06-01/new-dangerous-synthetic-opioid-dc-emerging-tri-state-area">including isotonitazene</a>, which was first identified in 2019 and is known on the streets as ISO. It also includes protonitazene, metonitazene and etonitazene.</p>
<p>Nitazenes are psychoactive substances, or <a href="https://doi.org/10.1177%2F2045125320967197">“designer drugs,”</a> that aren’t controlled by any laws or conventions but <a href="https://www.unodc.org/LSS/Page/NPS">pose significant health risk</a> to the public. These substances have recently surfaced as illegal street drugs. </p>
<p>Researchers have relatively little information on how the human body reacts to nitazenes because the drugs have never gone through clinical trials. But lab tests show certain nitazenes could be <a href="https://doi.org/10.7759/cureus.40736">hundreds to thousands of times more potent</a> than morphine and 10 to 40 times stronger than fentanyl.</p>
<p>The U.S. Drug Enforcement Agency has classified many formulations of nitazenes as <a href="https://www.federalregister.gov/documents/2021/12/07/2021-26263/schedules-of-controlled-substances-temporary-placement-of-butonitazene-etodesnitazene-flunitazene">Schedule 1 drugs under the Controlled Substances Act</a>, meaning they have no medical use and have a high risk of abuse.</p>
<h2>When were nitazenes first developed?</h2>
<p>Nitazenes were initially <a href="https://www.deadiversion.usdoj.gov/drug_chem_info/benzimidazole-opioids.pdf">developed in the 1950s</a> by the pharmaceutical research laboratories of the Swiss chemical company CIBA Aktiengesellschaft. It synthesized numerous substances in the drug class to be used as painkillers. </p>
<p>However, nitazenes were never approved by the U.S. Food and Drug Administration <a href="https://doi.org/10.7759/cureus.40736">for medical use in humans</a>. They were nearly forgotten outside of specialized research circles until they reemerged as street drugs in 2019. As law enforcement has cracked down on other drugs such as fentanyl, illegal labs have used <a href="https://doi.org/10.7759/cureus.40736">historical pharmacology research</a> to formulate analogs of nitazenes as street drugs. </p>
<p>Since 2019, <a href="https://doi.org/10.1093%2Fjat%2Fbkab117">at least six formulas</a> have come from the original patent, but others, like the one detected in Boulder, are brand new. <a href="https://doi.org/10.1093%2Fjat%2Fbkab117">Specialized lab testing</a> is required to identify nitazenes in toxicology samples, and <a href="https://www.ccsa.ca/sites/default/files/2022-03/CCSA-CCENDU-Drug-Alert-Nitazenes-2022-en_0.pdf">fentanyl test strips can’t detect nitazene analogs</a>.</p>
<p>But since <a href="https://doi.org/10.1016/j.forsciint.2021.110686">first being detected</a>, nitazenes have been blamed for <a href="https://doi.org/10.7759/cureus.40736">200 drug-related overdose deaths</a> in Europe and the United States. Although nitazenes are now identified as illegal street drugs in numerous countries, many medical providers aren’t <a href="https://doi.org/10.7759/cureus.40736">even aware they exist</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Blue pills on a black background" src="https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574225/original/file-20240207-21-5ih0d9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Isotonitazene has shown up in pill form mixed with other drugs such as oxycodone.</span>
<span class="attribution"><a class="source" href="https://www.dea.gov/onepill/images">DEA</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>What types of nitazenes are showing up on the streets?</h2>
<p>Nitazene first appeared in 2019 in the Midwest as a <a href="https://www.federalregister.gov/documents/2023/08/18/2023-17778/schedules-of-controlled-substances-placement-of-metonitazene-in-schedule-i">white powdery substance</a> similar to cocaine. <a href="https://www.dea.gov/stories/2022/2022-06/2022-06-01/new-dangerous-synthetic-opioid-dc-emerging-tri-state-area">It later appeared</a> on the streets of Washington, D.C., as yellow, brown and white powders. Since 2022, the DEA has found other types of nitazenes in both <a href="https://www.federalregister.gov/documents/2023/10/25/2023-23379/schedules-of-controlled-substances-temporary-placement-of-n-desethyl-isotonitazene-and-n-piperidinyl">powder and blue tablet forms</a>.</p>
<p>Nitazenes are also <a href="https://www.federalregister.gov/documents/2023/10/25/2023-23379/schedules-of-controlled-substances-temporary-placement-of-n-desethyl-isotonitazene-and-n-piperidinyl">mixed with other street drugs</a> such as heroin and fentanyl and with fake oxycodone pills, without users knowing it. </p>
<p>The Justice Department has indicted several <a href="https://www.justice.gov/opa/pr/justice-department-announces-eight-indictments-against-china-based-chemical-manufacturing">companies in China</a>, alleging that they ship the raw chemicals to make nitazenes to Mexico and the U.S., where they get mixed by cartels and traffickers, then distributed on the streets.</p>
<h2>What are signs of a nitazene overdose?</h2>
<p>The toxic effects of nitazene resemble those associated with other classic opioids such as morphine and fentanyl and include small pupils and slowing of the respiratory and central nervous systems, which can lead to death.</p>
<p>Because of the potency of the nitazenes, symptoms can develop rapidly after someone is exposed, killing them before they can get medical care.</p>
<h2>Does naloxone counteract the effects of overdose?</h2>
<p>Naloxone, commonly <a href="https://theconversation.com/fda-approval-of-over-the-counter-narcan-is-an-important-step-in-the-effort-to-combat-the-us-opioid-crisis-198497">known as Narcan</a>, is <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7137a5.htm">reportedly effective</a> in reversing overdoses due to nitazene, but larger and <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7137a5.htm">multiple doses might be required</a>.</p><img src="https://counter.theconversation.com/content/222244/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher P. Holstege does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>An overdose death in Boulder County, Colorado, was linked to a powerful new formulation of a designer drug never approved for use in humans.Christopher P. Holstege, Professor of Emergency Medicine and Pediatrics, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2142082024-02-14T13:24:58Z2024-02-14T13:24:58ZBringing AI up to speed – autonomous auto racing promises safer driverless cars on the road<figure><img src="https://images.theconversation.com/files/575049/original/file-20240212-18-4epn1w.jpg?ixlib=rb-1.1.0&rect=0%2C2%2C1936%2C1165&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">An autonomous race car built by the Technical University of Munich prepares to pass the University of Virginia's entrant.</span> <span class="attribution"><span class="source">Cavalier Autonomous Racing, University of Virginia</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>The excitement of auto racing comes from split-second decisions and daring passes by fearless drivers. Imagine that scene, but without the driver – the car alone, guided by the invisible hand of artificial intelligence. Can the rush of racing unfold without a driver steering the course? It turns out that it can. </p>
<p>Enter autonomous racing, a field that’s not just about high-speed competition but also pushing the boundaries of what autonomous vehicles can achieve and improving their safety.</p>
<p>Over a century ago, at the dawn of automobiles, as society shifted from horse-drawn to motor-powered vehicles, there was <a href="https://doi.org/10.4271/890812">public doubt</a> about the safety and reliability of the new technology. Motorsport racing was organized to <a href="https://www.history.com/this-day-in-history/duryea-motor-wagon-wins-first-car-race-in-u-s">showcase the technological performance</a> and safety of these horseless carriages. Similarly, autonomous racing is the modern arena to prove the reliability of autonomous vehicle technology as driverless cars begin to hit the streets.</p>
<p>Autonomous racing’s high-speed trials mirror the real-world challenges that autonomous vehicles face on streets: adjusting to unexpected changes and reacting in fractions of a second. Mastering these challenges on the track, where speeds are higher and reaction times shorter, leads to safer autonomous vehicles on the road. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/aoWkVDEPBCs?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Autonomous race cars pass, or ‘overtake,’ others on the Las Vegas Motor Speedway track.</span></figcaption>
</figure>
<p>I am a computer science professor who <a href="https://scholar.google.com/citations?hl=en&user=bj_imaYAAAAJ&view_op=list_works&sortby=pubdate">studies artificial intelligence, robotics and autonomous vehicles</a>, and I lead the <a href="https://autonomousracing.dev/">Cavalier Autonomous Racing</a> team at the University of Virginia. The team competes in the <a href="https://www.indyautonomouschallenge.com/">Indy Autonomous Challenge</a>, a global contest where universities pit fully autonomous Indy race cars against each other. Since its 2021 inception, the event has drawn top international teams to prestigious circuits like the Indianapolis Motor Speedway. The field, marked by both rivalry and teamwork, shows that collective problem-solving drives advances in autonomous vehicle safety.</p>
<p>At the Indy Autonomous Challenge passing competition held at the 2024 Consumer Electronics Show in Las Vegas in January 2024, our Cavalier team clinched second place and hit speeds of 143 mph (230 kilometers per hour) while autonomously overtaking another race car, affirming its status as a leading American team. TUM Autonomous Motorsport from the Technical University of Munich <a href="https://www.indyautonomouschallenge.com/tum-autonomous-motorsports-wins-third-annual-autonomous-challenge-ces">won the event</a>.</p>
<h2>Pint-size beginnings</h2>
<p>The field of autonomous racing didn’t begin with race cars on professional race tracks but with miniature cars at robotics conferences. In 2015, my colleagues and I engineered a 1/10 scale autonomous race car. We transformed a remote-controlled car into a small but powerful research and educational tool, which I named <a href="https://www.f1tenth.racing/">F1tenth</a>, playing on the name of the traditional Formula One, or F1, race car. The F1tenth platform is now used by over 70 institutions worldwide to construct their miniaturized autonomous racers. </p>
<p>The <a href="https://f1tenth.org/">F1tenth Autonomous Racing Grand Prix</a> is now a marquee event at robotics conferences where teams from across the planet gather, each wielding vehicles that are identical in hardware and sensors, to engage in what is essentially an intense “battle of algorithms.” Victory on the track is claimed not by raw power but by the advanced AI algorithms’ control of the cars. </p>
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<figcaption><span class="caption">These race cars are small, but the challenges to autonomous driving are sizable.</span></figcaption>
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<p>F1tenth has also emerged as an engaging and accessible gateway for students to delve into robotics research. Over the years, I’ve reached thousands of students via my <a href="https://youtu.be/ZQg61UNbr7Q?si=Hhx9j_qZyVzOI2Tt">courses</a> and <a href="https://www.youtube.com/playlist?list=PL868twsx7OjdnroeAUFVBGlKGnFGi9txc">online lecture series</a>, which explains the process of how to build, drive and autonomously race these vehicles.</p>
<h2>Getting real</h2>
<p>Today, the scope of our research has expanded significantly, advancing from small-scale models to <a href="https://www.indyautonomouschallenge.com/racecar">actual autonomous Indy cars</a> that compete at speeds of upward of 150 mph (241 kph), executing complex overtaking maneuvers with other autonomous vehicles on the racetrack. The cars are built on a modified version of the Indy NXT chassis and are outfitted with sensors and controllers to allow autonomous driving. <a href="https://www.dallara.it/en/dallara-usa/racing">Indy NXT race cars</a> are used in professional racing and are slightly smaller versions of the Indy cars made famous by the <a href="https://www.indianapolismotorspeedway.com/events/indy500">Indianapolis 500</a>.</p>
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<span class="caption">The Cavalier Autonomous Racing team stands behind their driverless race car.</span>
<span class="attribution"><span class="source">Cavalier Autonomous Racing, University of Virginia</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>The gritty reality of <a href="https://doi.org/10.1109/OJITS.2022.3181510">racing these advanced machines on real racetracks</a> pushes the boundaries of what autonomous vehicles can do. Autonomous racing takes the challenges of robotics and AI to new levels, requiring researchers to refine our understanding of how machines perceive their environment, make safe decisions and control complex maneuvers at a high speed where traditional methods begin to falter. </p>
<p>Precision is critical, and the margin for error in steering and acceleration is razor-thin, requiring a sophisticated grasp and exact mathematical description of the car’s <a href="https://proceedings.mlr.press/v229/ning23a.html">movement, aerodynamics and drivetrain system</a>. In addition, autonomous racing researchers create algorithms that use data from cameras, radar and <a href="https://www.autoweek.com/news/a36190274/what-lidar-is/">lidar</a>, which is like radar but with lasers instead of radio waves, to <a href="https://doi.org/10.1109/LRA.2022.3193496">steer around competitors and safely navigate</a> the high-speed and unpredictable racing environment. </p>
<p>My team has shared the world’s first <a href="https://registry.opendata.aws/racecar-dataset/">open dataset</a> for autonomous racing, inviting researchers everywhere to join in refining the algorithms that could help define the future of autonomous vehicles.</p>
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<figcaption><span class="caption">The data from the competitions is available for other researchers to use.</span></figcaption>
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<h2>Crucible for autonomous vehicles</h2>
<p>More than just a technological showcase, autonomous racing is a critical research frontier. When autonomous systems can reliably function in these extreme conditions, they inherently possess a buffer when operating in the ordinary conditions of street traffic. </p>
<p>Autonomous racing is a testbed where competition spurs innovation, collaboration fosters growth, and AI-controlled cars racing to the finish line chart a course toward safer autonomous vehicles.</p><img src="https://counter.theconversation.com/content/214208/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>My research has been funded by National Science Foundation, Commonwealth Cyber Initiative, U.S. Department of Transportation, and Leidos for the period 2018 to 2024. I am also a senior member of Institute of Electrical and Electronics Engineers (IEEE), and an Academic Advisory Council member for the Partners for Automated Vehicle Education (PAVE). </span></em></p>Artificial intelligence systems that can handle the pressure of high-speed auto racing could lead to driverless vehicles that can safely manage the morning commute.Madhur Behl, Associate Professor of Robotics and Artificial Intelligence, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2230572024-02-08T13:39:27Z2024-02-08T13:39:27ZHeart attacks, cancer, dementia, premature deaths: 4 essential reads on the health effects driving EPA’s new fine particle air pollution standard<figure><img src="https://images.theconversation.com/files/574202/original/file-20240207-27-6crply.jpg?ixlib=rb-1.1.0&rect=37%2C7%2C5002%2C3347&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Large industrial facilities like this oil refinery outside Houston are major sources of fine particulate air pollution.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/CongressClimateEnvironmentalJustice/c07295f82f9646db873f5d96baf4f089/photo">AP Photo/David J. Phillip</a></span></figcaption></figure><p>The U.S. Environmental Protection Agency has <a href="https://www.epa.gov/pm-pollution/final-reconsideration-national-ambient-air-quality-standards-particulate-matter-pm">announced a new standard</a> for protecting the public from fine particulate air pollution, known as PM2.5 because the particles are smaller than 2.5 millionths of a meter. These minute particles can penetrate deeply into the body and have been linked to many serious illnesses. </p>
<p>The new rule sets an annual limit of 9 micrograms per cubic meter of air, down from the previous level of 12 micrograms. States will be required to meet this standard and to take it into consideration when they evaluate applications for permits for new stationary air pollution sources, such as electric power plants, factories and oil refineries.</p>
<p>Under the Clean Air Act, the EPA is required to set air pollution standards at levels that <a href="https://www.epa.gov/laws-regulations/summary-clean-air-act">protect public health</a>. In the four articles that follow, scholars wrote about the many ways in which exposure to PM2.5 contributes to cardiovascular disease, lung cancer, other illnesses such as dementia, and premature deaths.</p>
<h2>1. An alarming array of health effects</h2>
<p>Scientists have known since the 1993 <a href="http://dx.doi.org/10.1056/NEJM199312093292401">Six Cities Study</a>, which showed that people were dying faster in dirty cities than in clean cities, that exposure to PM2.5 increased the risk of lung cancer and heart disease. Subsequent research has linked fine particulates to a much broader range of health effects. </p>
<p>Once a person inhales PM2.5, “it causes an inflammatory response that sends signals <a href="https://theconversation.com/fine-particle-air-pollution-is-a-public-health-emergency-hiding-in-plain-sight-106030">throughout the body</a>, much as a bacterial infection would,” wrote public and environmental health scholars <a href="https://scholar.google.com/citations?user=1h3u230AAAAJ&hl=en">Doug Brugge</a> of the University of Connecticut and <a href="https://scholar.google.com/citations?user=SDWANZEAAAAJ&hl=en">Kevin James Lane</a> of Boston University. “Additionally, the smallest particles and fragments of larger particles can leave the lungs and travel through the blood.” </p>
<p>In Brugge and Lane’s view, evidence that PM2.5 could affect brain development, cognitive skills and children’s central nervous systems is particularly notable. They termed fine particle pollution an urgent global health threat. </p>
<p>“Developed countries have made progress in reducing particulate air pollution in recent decades, but much remains to be done to further reduce this hazard,” they observed. “And the situation has gotten dramatically worse in many developing countries – most notably China and India, which have industrialized faster and on vaster scales than ever seen before.”</p>
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Read more:
<a href="https://theconversation.com/fine-particle-air-pollution-is-a-public-health-emergency-hiding-in-plain-sight-106030">Fine particle air pollution is a public health emergency hiding in plain sight</a>
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<figcaption><span class="caption">PM2.5 particles are small enough to evade many of the body’s defenses.</span></figcaption>
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<h2>2. Aging the brain</h2>
<p>Medical researchers are looking closely at air pollution as a possible accelerator of brain aging. University of Southern California preventive medicine specialist <a href="https://scholar.google.com/citations?user=jxckDOcAAAAJ&hl=en">Jiu-Chiuan Chen</a> and his colleagues have found that older women who lived in locations with high levels of PM2.5 suffered <a href="https://theconversation.com/air-pollution-may-contribute-to-alzheimers-and-dementia-risk-heres-what-were-learning-from-brain-scans-148776">memory loss and Alzheimer’s-like brain shrinkage</a> not seen in women living with cleaner air.</p>
<p>Chen and his colleagues compared brains scans taken at five-year intervals of older women who lived in areas with varying levels of air pollution.</p>
<p>“When we compared the brain scans of older women from locations with high levels of PM2.5 to those with low levels, we found dementia risk increased by 24% over the five years,” Chen wrote. </p>
<p>More alarmingly, “(T)hese Alzheimer’s-like brain changes were present in older women with no memory problems,” Chen noted. “The shrinkage in their brains was greater if they lived in locations with higher levels of outdoor PM2.5, even when those levels were within the current (2021) EPA standard.”</p>
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Read more:
<a href="https://theconversation.com/air-pollution-may-contribute-to-alzheimers-and-dementia-risk-heres-what-were-learning-from-brain-scans-148776">Air pollution may contribute to Alzheimer’s and dementia risk – here's what we're learning from brain scans</a>
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<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/CztmbrOOvA2/?utm_source=ig_web_copy_link","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<h2>3. Disadvantaged communities have dirtier air</h2>
<p>As researchers in environmental justice have shown, facilities such as factories and refineries often are concentrated in low-income neighborhoods and communities of color. This means that these areas are exposed to higher pollution levels and face heavier related health burdens.</p>
<p>Regulations put in place under the Clean Air Act have greatly reduced levels of harmful air pollutants across the U.S. over the past 50 years. But when University of Virginia economist <a href="https://scholar.google.co.uk/citations?user=xw8Ml0QAAAAJ&hl=en">Jonathan Colmer</a> and public policy scholar <a href="https://scholar.google.com/citations?user=Z1sqTysAAAAJ&hl=en">Jay Shimshack</a> analyzed data tracing PM2.5 concentrations at more than 8.6 million distinct U.S. locations from 1981 through 2016, they found that the areas that were most polluted in 1981 <a href="https://theconversation.com/fine-particle-air-pollution-has-decreased-across-the-us-but-poor-and-minority-communities-are-still-the-most-polluted-143650">remained the dirtiest nearly 40 years later</a>.</p>
<p>“In 1981 PM2.5 concentrations in the most polluted 10% of census tracts averaged 34 micrograms per cubic meter,” the authors reported. “In 2016 PM2.5 concentrations in the most polluted 10% of census tracts averaged 10 micrograms per cubic meter. PM2.5 concentrations in the least polluted 10% of census tracts averaged 4 micrograms per cubic meter.” In other words, while all areas had cleaner air, people in the most polluted areas still were exposed to PM2.5 levels more than twice as high as people in the cleanest zones.</p>
<p>“For decades, federal and state environmental guidelines have aimed to provide all Americans with the same degree of protection from environmental hazards,” Colmer and Shimshack note. “The EPA’s definition of environmental justice states that ‘no group of people should bear a disproportionate share of the negative environmental consequences.’ On this front, our research suggests that the United States is falling short.”</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/fine-particle-air-pollution-has-decreased-across-the-us-but-poor-and-minority-communities-are-still-the-most-polluted-143650">Fine-particle air pollution has decreased across the US, but poor and minority communities are still the most polluted</a>
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<h2>4. Fine particle pollution hurts wildlife too</h2>
<p>Like the proverbial canaries in coal mines, wild animals can show effects of exposure to pollution that offer broader warnings. One example is wildfires, which produce high levels of gases and particulate matter.</p>
<p>Cornell University conservation biologist <a href="https://scholar.google.com/citations?user=ykHYzwEAAAAJ&hl=en">Wendy M. Erb</a> was studying wild orangutans in Indonesian Borneo when that island suffered large-scale wildfires. Orangutans are semi-solitary animals that communicate with each other through long, booming calls in the tropical forests where they live. </p>
<p>During the fires and for several weeks after the smoke cleared, Erb and her colleagues found that four male orangutans they were following <a href="https://theconversation.com/to-see-how-smoke-affects-endangered-orangutans-we-studied-their-voices-during-and-after-massive-indonesian-wildfires-208153">called less frequently than usual</a> – about three times daily instead of their usual six times. “Their voices dropped in pitch, showing more vocal harshness and irregularities,” Erb reported. “Collectively, these features of vocal quality have been linked to inflammation, stress and disease – including COVID-19 – in human and nonhuman animals.”</p>
<p>Erb hoped to see further study of how toxic smoke affects wildlife. “Using passive acoustic monitoring to study vocally active indicator species, like orangutans, could unlock critical insights into wildfire smoke’s effects on wildlife populations worldwide,” she observed.</p>
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Read more:
<a href="https://theconversation.com/to-see-how-smoke-affects-endangered-orangutans-we-studied-their-voices-during-and-after-massive-indonesian-wildfires-208153">To see how smoke affects endangered orangutans, we studied their voices during and after massive Indonesian wildfires</a>
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<p><em>Editor’s note: This story is a roundup of articles from The Conversation’s archive.</em></p><img src="https://counter.theconversation.com/content/223057/count.gif" alt="The Conversation" width="1" height="1" />
On Feb. 7, 2024, the EPA strengthened the federal limit for annual levels of fine particulate air pollution, or PM2.5. Many serious health effects have been linked to PM2.5 exposure.Jennifer Weeks, Senior Environment + Cities Editor, The ConversationLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2213892024-01-26T13:21:52Z2024-01-26T13:21:52ZMost state abortion bans have limited exceptions − but it’s hard to understand what they mean<figure><img src="https://images.theconversation.com/files/571261/original/file-20240124-27-dzfjqa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Women who were denied abortions, despite serious pregnancy complications, appear outside the Texas Supreme Court in November 2023, following arguments in a lawsuit they brought against the state. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/plaintiffs-including-amanda-zurowski-speaks-at-a-press-news-photo/1807598346?adppopup=true">Suzanne Cordeiro/AFP via Getty Images </a></span></figcaption></figure><p>More than a year after the Supreme Court found there is no <a href="https://www.oyez.org/cases/2021/19-1392">fundamental right to get an abortion</a>, <a href="https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html">21 states have laws in effect</a> that ban abortion well before fetal viability, generally allowing it only in the first trimester. </p>
<p>Fourteen of these 21 states have also issued near-total bans on abortion from the point of conception. But it’s not clear when, if ever, an abortion would be permissible under these near-total bans.</p>
<p>Virtually all states, including Arkansas, North Dakota and Oklahoma, for example, allow an <a href="https://www.kff.org/womens-health-policy/state-indicator/gestational-limit-abortions/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D">abortion when necessary</a> to save the life of the pregnant person. But the laws don’t explain just how close to death the person must be before the abortion can be performed. </p>
<p><a href="https://www.kff.org/womens-health-policy/issue-brief/a-review-of-exceptions-in-state-abortions-bans-implications-for-the-provision-of-abortion-services">Some states</a>, such as Georgia, Indiana and West Virginia, also include exceptions for health concerns, rape, incest or lethal fetal anomalies. </p>
<p>Most of these exceptions are <a href="https://www.nytimes.com/2023/12/17/opinion/kate-cox-abortion-texas-exceptions.html">vaguely worded</a>, leaving physicians and pregnant patients to navigate <a href="https://www.nashvillescene.com/news/citylimits/sarah-needed-an-abortion-her-doctors-needed-lawyers/article_472a621e-7fdb-11ed-bf8d-0797b6012be2.html">whether a particular abortion</a> <a href="https://www.washingtonpost.com/health/2022/07/16/abortion-miscarriage-ectopic-pregnancy-care/">would be legal</a>. </p>
<p><a href="https://www.law.virginia.edu/faculty/profile/nrc8g/2915359">As experts</a> on <a href="https://www.law.gwu.edu/sonia-m-suter">reproductive health and justice</a>, we are trying to untangle just what these different medical exceptions mean. This is an important question for legal experts, but also for doctors and caregivers, as well as people who are pregnant and their families – all trying to make sense of the various bans in effect. </p>
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<a href="https://images.theconversation.com/files/571258/original/file-20240124-17-qkkg3o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="People, some holding posters, march outside of a grey building that says 'Bans off our bodies' in white writing, against a hot pink backdrop." src="https://images.theconversation.com/files/571258/original/file-20240124-17-qkkg3o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571258/original/file-20240124-17-qkkg3o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571258/original/file-20240124-17-qkkg3o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571258/original/file-20240124-17-qkkg3o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571258/original/file-20240124-17-qkkg3o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571258/original/file-20240124-17-qkkg3o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571258/original/file-20240124-17-qkkg3o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Anti-abortion activists protest outside a Planned Parenthood clinic in Washington, D.C., on Jan 18, 2024.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/pro-and-anti-abortion-protesters-are-facing-off-in-front-of-news-photo/1935914291?adppopup=true">Aaron Schwartz/NurPhoto via Getty Images</a></span>
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<h2>Steep penalties, murky legal language</h2>
<p>Because these different state laws use nonmedical language and threaten steep penalties – such as <a href="https://www.americanprogress.org/article/a-year-after-the-supreme-court-overturned-roe-v-wade-trends-in-state-abortion-laws-have-emerged/">life imprisonment</a> – for performing an abortion that violates the statute, some <a href="https://www.nbcnews.com/health/health-news/risky-pregnancy-abortion-doctors-consult-lawyers-rcna37651">physicians have been turning to lawyers for guidance</a>. </p>
<p>For example, Tennessee <a href="https://law.justia.com/codes/tennessee/2021/title-39/chapter-15/part-2/section-39-15-213/">has an exception</a> that allows abortions “necessary to prevent the death of the pregnant woman or to prevent serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman.” And West Virginia allows abortions for “nonviable” fetuses, <a href="https://code.wvlegislature.gov/16-2R-2/">defined as those with a “lethal anomaly</a> … incompatible with life outside of the uterus.”</p>
<p>These exceptions are confusing to health care providers, in part because the laws <a href="https://scholarship.shu.edu/shlr/vol53/iss5/2">assume a certainty in medicine that may not exist</a>. The laws also <a href="https://www.cnn.com/2023/12/15/us/texas-abortion-ban-emergency-medical-exception/index.html">do not rely on medical terms</a>. </p>
<p>This means that health care providers in states where abortion is banned – apart from these limited exceptions – are reluctant to provide abortions under any circumstances, <a href="https://www.latimes.com/world-nation/story/2022-07-29/fearful-of-prosecution-doctors-debate-how-to-treat-pregnant-patients">even in the face of life-threatening conditions</a> or severe <a href="https://jessica.substack.com/p/abortion-exceptions-dont-exist">fetal anomalies</a>. </p>
<p>The rate of abortions in the states where there is a near-total or total ban <a href="https://www.axios.com/2023/10/24/abortion-increase-roe-wade-state-ban">decreased by 100%</a> from April 2022, just before the <a href="https://www.oyez.org/cases/2021/19-1392">Supreme Court overturned</a> the right to an abortion, through June 2023.</p>
<h2>Legal action for answers</h2>
<p>Some health care providers and their patients have sued to find out just when abortions might be permitted. </p>
<p>Courts in different states, from the trial court to the supreme court level, are now being forced to consider these questions and have begun to weigh in with opinions that lead to even more uncertainty. At the heart of this litigation is <a href="https://scholarship.shu.edu/cgi/viewcontent.cgi?article=3550&context=shlr">how to balance doctors’ conflicting obligations</a>
to provide the best medical care, which could include offering an abortion that they fear state bans may prohibit. </p>
<p>And because each state uses its own language to define a ban and its exceptions, one court’s opinion regarding its ban does not dictate how another state’s ban should be interpreted. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/571484/original/file-20240125-21-169abh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman in a black outfit stands at a podium in front of a long row of women who stand looking forward." src="https://images.theconversation.com/files/571484/original/file-20240125-21-169abh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571484/original/file-20240125-21-169abh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571484/original/file-20240125-21-169abh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571484/original/file-20240125-21-169abh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571484/original/file-20240125-21-169abh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571484/original/file-20240125-21-169abh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571484/original/file-20240125-21-169abh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Center for Reproductive Rights attorney Molly Duane speaks outside the Texas Supreme Court in Austin, joined by the plaintiffs in the organization’s abortion clarification suit against the state.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/center-for-reproductive-rights-attorney-molly-duane-news-photo/1807623427?adppopup=true">Suzanne Cordeiro/AFP via Getty Images</a></span>
</figcaption>
</figure>
<h2>Texas’ abortion ban</h2>
<p>Texas is one of the states that banned nearly all abortions in 2022. Texas law allows an abortion only when there is a “medical emergency” for the pregnant person, defined as a “life-threatening physical condition” related to the pregnancy that “poses a serious risk of substantial impairment of a <a href="https://statutes.capitol.texas.gov/Docs/HS/htm/HS.170A.htm#:%7E:text=Sec.-,170A.,induce%2C%20or%20attempt%20an%20abortion.">major bodily function</a>.”</p>
<p>In March 2023, the advocacy group Center for Reproductive Rights filed a lawsuit on behalf of a group of Texas women and two obstetricians-gynecologists, seeking clarification over when Texas’ ban allows an abortion. </p>
<p><a href="https://reproductiverights.org/zurawski-v-texas-plaintiffs-stories-remarks/">The Texas women</a>, who faced serious pregnancy-related health risks or very low odds of their baby’s survival outside the womb, were denied abortions or told to wait until death was more imminent. Some of the women got abortions outside of Texas, and others gave birth to babies who lived only briefly because of serious fetal health problems.</p>
<p><a href="https://reproductiverights.org/case/zurawski-v-texas-abortion-emergency-exceptions/zurawski-v-texas/">The plaintiffs argued</a> that the law’s confusing language – as well as the <a href="https://www.nytimes.com/2023/12/14/podcasts/the-daily/texas-abortion-ban.html?showTranscript=1">threat to physicians</a> of 99 years in jail, $100,000 in fines and a loss of their medical license – led to delays or denials of medical treatment they needed. </p>
<p>In August 2023, a Texas trial court judge blocked enforcement of the state’s abortion ban when “in a physician’s good faith judgment and in consultation with the pregnant person, the pregnant person has an emergent medical <a href="https://statecourtreport.org/sites/default/files/fastcase/additionalPdfs/processed/District%20Court%20-Order%20Granting%20Injunction%20-08.04.2023.pdf">condition requiring abortion care</a>.” This could include medical conditions that make it unsafe to continue the pregnancy or diagnosis of a fetal abnormality that would not allow it to survive after birth. </p>
<p>Texas appealed this decision to the state Supreme Court. The lower court decision is on hold until the Supreme Court issues its final decision; the court has not <a href="https://www.texastribune.org/2023/11/28/texas-supreme-court-abortion/">said when it would rule</a>.</p>
<p>Because there is still no definitive decision on how to interpret the Texas law, pregnant patients have been left in limbo. </p>
<p>Katie Cox, for example, is a Texas woman who was diagnosed when she was 20 weeks pregnant with a <a href="https://msmagazine.com/2023/12/13/welcome-to-the-pro-life-dystopia/">severe fetal anomaly</a> called trisomy 18. Carrying the pregnancy to term would have threatened her fertility, potentially preventing the mother of two from birthing more children in the future. </p>
<p>After <a href="https://www.nytimes.com/2023/12/14/podcasts/the-daily/texas-abortion-ban.html?showTranscript=1">Cox’s doctor</a> explained it was not an option in Texas to terminate the pregnancy, Cox and her doctor went to court seeking judicial approval for <a href="https://www.texastribune.org/2023/12/07/texas-emergency-abortion-lawsuit/">an abortion</a>. </p>
<p>Travis County District Judge Maya Guerra Gamble granted permission in December 2023, finding that it would be a “miscarriage of justice” to prohibit <a href="https://abc13.com/texas-abortion-ban-attorney-general-ken-paxton-katie-cox-block-ruling/14155514/">Cox from ending her pregnancy</a>. </p>
<p>But days later, the Texas Supreme Court blocked the district court ruling. It <a href="https://www.txcourts.gov/media/1457645/230994pc.pdf">conceded that Cox’s pregnancy was “extremely complicated</a>,” but refused to find that state law permitted the abortion. Cox left the state to get an abortion. </p>
<p>The Texas Supreme Court opinion in December still left many questions unanswered. The court stated that a judicial order was not required to permit a doctor to perform an abortion in the case of a medical emergency. <a href="https://www.txcourts.gov/media/1457645/230994pc.pdf">But it also interpreted the law as setting an objective standard as to whether the exception applied</a>. </p>
<p>That left open the possibility that the state could find an expert witness to challenge the physician’s judgment. </p>
<h2>A thread of uncertainty</h2>
<p>Since 2022, the Center for Reproductive Rights has also brought <a href="https://apnews.com/article/supreme-court-abortion-medical-emergencies-idaho-8ca89d7de0c1fa9256dcd27d1847e144#:%7E:text=The%20Supreme%20Court%20is%20allowing,ban%2C%20even%20in%20medical%20emergencies&text=WASHINGTON%20(AP)%20%E2%80%94%20The%20Supreme,while%20a%20legal%20fight%20continues">lawsuits in Idaho</a>, <a href="https://apnews.com/article/abortion-tennessee-lawsuit-fd630c5f55f605597d8eaa2800abbcfd#:%7E:text=WHAT%20THE%20LAWSUIT%20SEEKS%20TO,to%20legally%20receive%20an%20abortion">Tennessee</a> <a href="https://www.reuters.com/world/us/women-denied-abortions-file-lawsuits-idaho-tennessee-oklahoma-over-bans-2023-09-12/">and Oklahoma</a>, <a href="https://reproductiverights.org/exceptions-complaints-idaho-tennessee-oklahoma/">seeking clarity</a> on medical emergency exceptions in the states’ abortion bans.</p>
<p>The lawsuit’s underlying claim is that uncertainty about the scope of the exceptions has, according to the Idaho complaint, “sown confusion, fear and chaos among the medical community, resulting in grave harms to pregnant patients whose health and safety hang in the <a href="https://reproductiverights.org/wp-content/uploads/2023/09/ID-Complaint-Final-9-12.pdf">balance across the state</a>.” </p>
<p>What all of these cases and stories show is that even when abortion bans claim to allow exceptions based on medical judgment, physicians – and their patients – <a href="https://scholarship.shu.edu/cgi/viewcontent.cgi?article=3550&context=shlr">know their decisions</a> can be second-guessed and challenged in court.</p><img src="https://counter.theconversation.com/content/221389/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Women in Texas and in other states with abortion bans are suing, asking for clarification on when medical exceptions could actually be granted.Naomi Cahn, Professor of Law, University of VirginiaSonia Suter, Professor of law, George Washington UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2019272024-01-22T13:27:25Z2024-01-22T13:27:25ZBreaking down fat byproducts could lead to healthier aging − researchers identify a key enzyme that does just that<figure><img src="https://images.theconversation.com/files/569661/original/file-20240116-25-w3uhfy.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A buildup of fat byproducts like glycerol may contribute to accelerated aging.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/oily-water-royalty-free-image/492968264">MagicColors/iStock via Getty Images Plus</a></span></figcaption></figure><p>The journey of aging brings with it an unavoidable reality for many: an increased accumulation of body fat. Though much of society seems mostly focused on the aesthetics of being overweight, doctors look past any cosmetic concerns to focus on the health implications of fat byproducts in the body.</p>
<p><a href="https://www.britannica.com/science/fatty-acid">Fatty acids</a> are one of the molecular building blocks that make up fats. Though essential for various bodily functions, excessive amounts of fatty acids in the body <a href="https://doi.org/10.1111/acel.13048">can be harmful</a>, shortening a person’s <a href="https://theconversation.com/are-you-a-rapid-ager-biological-age-is-a-better-health-indicator-than-the-number-of-years-youve-lived-but-its-tricky-to-measure-198849">health span and life span</a> by increasing their risk of chronic disease, disrupting metabolic processes and promoting inflammation. </p>
<p>Fatty acids are <a href="https://medlineplus.gov/lab-tests/triglycerides-test/">routinely checked</a> during medical examinations, such as blood tests measuring your lipid profile. But clinicians and researchers often overlook the other key component of fat despite its potentially harmful effects: <a href="https://doi.org/10.1016/j.cmet.2009.10.003">glycerol</a>, a compound that links fatty acids to make a fat molecule. </p>
<p>Both of these fat byproducts disrupt cellular and organ function, mirroring the effects of aging. In fact, researchers are increasingly seeing obesity as a <a href="https://doi.org/10.3389%2Ffendo.2019.00266">catalyst for accelerated aging</a>.</p>
<p>The role that fats play in aging is one of the focuses of my work as a <a href="https://scholar.google.com/citations?user=O3qOkKsAAAAJ&hl=en">genomicist and biochemist</a>. My <a href="https://www.agingobesitylab.org">research team</a> and I wondered whether reducing harmful fat byproducts might help slow the aging process and consequently stave off common diseases. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/QhUrc4BnPgg?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Fats perform essential functions in your cells, but not all of them are good for you.</span></figcaption>
</figure>
<h2>Breaking down fat byproducts</h2>
<p>In studying ways to extend the life span and improving the health at late age of lab animals, my colleagues and I saw a <a href="https://doi.org/10.1016/j.cub.2023.01.059">consistent pattern</a>: All the anti-aging interventions we tested led to reduced glycerol levels.</p>
<p>For instance, when placed on a calorie-restricted diet, the nematode <em>Caenorhabditis elegans</em> <a href="https://doi.org/10.1073/pnas.95.22.13091">lives about 40% longer</a>. We found that the glycerol levels in the body of these long-lived worms were lower than in shorter-lived worms that were not food restricted. Calorie restriction also <a href="https://doi.org/10.1016/j.cub.2023.01.059">heightened the activity of an enzyme</a> responsible for breaking down glycerol, ADH-1, in their intestine and muscles.</p>
<p>We saw similar <a href="https://doi.org/10.1016/j.cub.2023.01.059">high ADH-1 activity levels in people</a> undergoing dietary restriction or treated with an anti-aging drug called rapamycin. This finding suggests there may be a common mechanism underlying healthy aging across species, with ADH-1 at its core.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/569663/original/file-20240116-20-gctpab.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Figure showing the chemical structure of glycerol, a fatty acid, and a triglycerol" src="https://images.theconversation.com/files/569663/original/file-20240116-20-gctpab.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569663/original/file-20240116-20-gctpab.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=792&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569663/original/file-20240116-20-gctpab.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=792&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569663/original/file-20240116-20-gctpab.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=792&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569663/original/file-20240116-20-gctpab.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=995&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569663/original/file-20240116-20-gctpab.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=995&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569663/original/file-20240116-20-gctpab.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=995&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Triacylglycerols, also known as triglycerides, are composed of a glycerol linked to three fatty acids.</span>
<span class="attribution"><a class="source" href="https://bio.libretexts.org/Bookshelves/Microbiology/Microbiology_(Boundless)/02%3A_Chemistry/2.05%3A_Organic_Compounds/2.5.02%3A_Lipid_Molecules">Lumen Learning (formerly Boundless) via LibreTexts</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>We hypothesized that elevated ADH-1 activity promotes health in old age by decreasing harmful levels of glycerol. Supporting this hypothesis were <a href="https://doi.org/10.1016/j.cub.2023.01.059">two critical observations</a>. First, we found that adding glycerol to the diet of worms <a href="https://doi.org/10.1016/j.cmet.2009.10.003">shortened their life span by 30%</a>. By contrast, animals genetically modified to boost levels of the glycerol-busting enzyme ADH-1 had low glycerol levels and remained lean and healthy with longer lives, even on unrestricted diets. </p>
<p>The simple molecular structure and wealth of research on ADH-1 make it an attractive target for developing drugs that boost its activity. My lab’s long-term goal is to explore how compounds that activate ADH-1 affect the health and longevity of both mice and people.</p>
<h2>A long-lived society</h2>
<p>Anti-aging research generates both excitement and debate. On the one hand, the benefits of <a href="https://theconversation.com/aging-is-complicated-a-biologist-explains-why-no-two-people-or-cells-age-the-same-way-and-what-this-means-for-anti-aging-interventions-202096">healthy aging</a> are clear. On the other hand, extending life span through healthier aging will likely introduce new societal challenges. </p>
<p>If life spans extending to 120 years become the norm, <a href="https://doi.org/10.1016/S2666-7568(21)00250-6">social structures</a>, including retirement ages and economic models, will need to evolve to accommodate an aging population. Legal and social frameworks regarding the elderly and family care may need revision. The <a href="https://www.washingtonpost.com/parenting/2023/03/22/caregivers-sandwich-generation/">sandwich generation</a>, those with children and living parents and grandparents, might find themselves caring for even more generations simultaneously. Longer lives will require society to rethink and reshape how we integrate and support an increasingly older population in our communities.</p>
<p>Whether through ADH-1 or dietary adjustments, the quest for the solution to healthy aging is not just a medical journey but a societal one.</p><img src="https://counter.theconversation.com/content/201927/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Eyleen Jorgelina O'Rourke does not receive funding from any organization that would benefit from this article. </span></em></p>Although you get your fatty acid levels routinely checked at the doctor’s, rarely do clinicians and researchers consider the effects of their potentially harmful byproducts.Eyleen Jorgelina O'Rourke, Associate Professor of Biology and Cell Biology, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2173572024-01-05T13:46:39Z2024-01-05T13:46:39ZLiterature inspired my medical career: Why the humanities are needed in health care<figure><img src="https://images.theconversation.com/files/564561/original/file-20231208-17-e51tzu.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1998%2C1494&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Medicine is as much about the human experience as it is about biology.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/two-hands-connected-by-a-dramatic-graph-royalty-free-image/545248093">Jonathan Knowles/Stone via Getty Images</a></span></figcaption></figure><p>While there is a long history of doctor-poets – one giant of mid-20th-century poetry, <a href="https://poets.org/poet/william-carlos-williams">William Carlos Williams</a>, was famously also a pediatrician – few people seem to know this or understand the power of combining the humanities and medicine.</p>
<p>As a <a href="https://www.tremblingpillowpress.com/orogeny">published poet</a> and <a href="https://med.virginia.edu/biomedical-ethics/people/irene%E2%80%8B-mathieu/">scholar of the health humanities and ethics</a>, I have a foot squarely planted in each field – or perhaps more accurately, I stand in what I perceive as the overlapping field of healing and poetic practices.</p>
<p>Literature has had a large role in helping me define the kind of physician I strive to be – one who is not only empathetic and a good listener but also a fierce advocate for changing the sociopolitical forces that affect my patients’ lives. I think literature can do this for other health care providers, too.</p>
<h2>Narrative competence in medicine</h2>
<p>Despite having physicians for parents – or perhaps because of it – initially I had no interest in medicine. It seemed too clinical, too sterile. The work stories my parents shared over the dinner table were intentionally devoid of the personal details that would have interested me.</p>
<p>I was preoccupied with characters in the books I read – who lived in conflict zones, who as children were working instead of playing, who had struggles I couldn’t imagine – and wondered why I had my life and not theirs. What intangible forces shaped their lives in ways different from my own? Now I can directly trace my early infatuation with the written word to my chosen career as a pediatrician and public health researcher.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/0a5WYClw3dw?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Medicine is a confluence of scientific and literary thinking.</span></figcaption>
</figure>
<p>Narrative medicine is the practice of close reading and reflective writing to build <a href="https://doi.org/10.1001/jama.286.15.1897">narrative competence</a>. Physician and narrative medicine scholar Rita Charon describes narrative competence as “the ability to acknowledge, absorb, interpret and act on the stories and plights of others.” </p>
<p>Narrative competence, then, could inspire a person to pursue a career in health care and possibly make them a better clinician. In fact, studies of narrative medicine programs have demonstrated that they tend to not only increase students’ <a href="https://doi.org/10.3352%2Fjeehp.2020.17.3">empathy and communication skills</a> but also their <a href="https://doi.org/10.1007/s11606-017-4275-8">tolerance for ambiguity and self-confidence</a>. They also improve their <a href="https://doi.org/10.3390%2Fijerph17041135">open-mindedness, ethical inquiry</a> and <a href="http://dx.doi.org/10.1136/bmjopen-2019-031568">perspective taking</a>.</p>
<p>Books introduced me to the breadth and diversity of human experiences and perspectives, as well as to searing inequalities in life outcomes. I wanted to positively change those outcomes in some way – a desire that led me into the arms of medicine, despite my initial misgivings about it.</p>
<h2>Using the humanities to address health inequity</h2>
<p>Might narrative competence also expand clinicians’ understanding of health disparities and urge them to act in ways that lectures full of statistics couldn’t?</p>
<p>The burgeoning field of <a href="https://doi.org/10.1097/acm.0000000000002871">critical health humanities</a> theorizes that stories and art can help clinicians understand the unequal realities of different people’s lives and make clinician-patient relationships more therapeutic. It can do this by cultivating clinicians’ awareness of the power differences and structural forces that affect their patients and themselves.</p>
<p>Defining features of this field are collaboration between disciplines – such as between medicine and literature – and a broad understanding of narrative medicine beyond the clinical encounter. Understanding not only human biology but also fields like the history of medicine, queer and disability studies, critical race theory and <a href="https://doi.org/10.1097/acm.0000000000002871">other forms of knowledge</a> can inform and improve clinical practice. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Clinician in scrubs sitting on a table between library shelves, reading a book" src="https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Medical trainees often aren’t given the space to engage with the humanities.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/female-intern-finds-quiet-spot-in-library-to-study-royalty-free-image/1434731417">SDI Productions/E+ via Getty Images</a></span>
</figcaption>
</figure>
<p>For example, a clinician might turn to research from the social sciences to learn about the experiences of people with disabilities. This could lead her to make her practice <a href="https://adata.org/factsheet/accessible-health-care">more accessible to her patients</a> – an action that would improve equity in health care for people with disabilities.</p>
<p>Before ever meeting my first patient, I gained an expanded knowledge of the diversity of human experience from the books I read. It made me curious about my patients’ stories. And when I felt this curiosity flagging because of stress, exhaustion or burnout, refocusing on the stories seemed to help.</p>
<p>However, medical students are inundated with information about the human body in their training and <a href="https://www.aamc.org/news/medical-schools-overhaul-curricula-fight-inequities">barely have time</a> to learn about the nonmedical aspects of patient experiences. This negates the fact that disease and health happen in varied and disparate social, cultural and political contexts.</p>
<p>For example, <a href="https://doi.org/10.2337/dci20-0053">diabetes is a very different illness</a> for a patient experiencing homelessness and racism compared with a wealthy patient who doesn’t experience racism. A patient’s access to resources and their <a href="https://theconversation.com/how-racism-in-us-health-system-hinders-care-and-costs-lives-of-african-americans-139425">interactions with health care staff</a> affect their ability to get the care they need and the degree to which their basic needs are being met. Rarely are these nuances discussed in a medical school’s endocrinology lecture about diabetes.</p>
<h2>Fitting in health humanities education</h2>
<p>I believe that physicians must find ways to practice their humanity – perhaps using the humanities – if they wish to be effective healers. But how might they actually do this? </p>
<p>There are ways to fit in more health humanities in all the busyness and bustle of notoriously grueling medical education. As a senior resident, I often distributed poems to my team, printing and posting them above the computers in our cramped hospital workrooms or attaching them to email updates about patient care. Once, during a rare quiet moment in the pediatric ICU, with permission from my colleagues, I read a couple of poems out loud. I remember watching my colleagues’ eyes close and their bodies visibly relax as the words washed over them.</p>
<p>Since then, I have shared poems – my own and others’ – in talks at my institution and across the country. I’ve also led other health care providers in creative writing exercises during workshops, lectures and classes. Many institutions host book clubs, story slams, film screenings and other opportunities for medical learners to engage with the humanities.</p>
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<a href="https://images.theconversation.com/files/564571/original/file-20231208-23-vpq5kw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Clinician holding stethoscope over the chest of a toddler sitting in the lap of their parent" src="https://images.theconversation.com/files/564571/original/file-20231208-23-vpq5kw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564571/original/file-20231208-23-vpq5kw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564571/original/file-20231208-23-vpq5kw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564571/original/file-20231208-23-vpq5kw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564571/original/file-20231208-23-vpq5kw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564571/original/file-20231208-23-vpq5kw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564571/original/file-20231208-23-vpq5kw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Exposing clinicians to the breadth of human experience through the humanities can help them better understand where their patients are coming from.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/male-nurse-examining-baby-girl-with-stethoscope-in-royalty-free-image/1309071117">The Good Brigade/Digital Vision via Getty Images</a></span>
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<p>While poetry can be intimidating to some, many contemporary poems provide approachable emotional experiences.</p>
<p>Pieces like Safiya Sinclair’s “<a href="https://www.triquarterly.org/issues/issue-150/notes-state-virginia-ii">Notes on the State of Virginia, II</a>” viscerally illustrate how a place that seems innocuous or even beautiful to some can be haunting and traumatic for others. </p>
<p>Monica Sok’s “<a href="https://www.poetryfoundation.org/poetrymagazine/poems/144805/abc-for-refugees">ABC for Refugees</a>” powerfully paints a portrait of a young child caught between languages and cultures – a reality that many pediatric patients face. </p>
<p>“<a href="https://www.poetryfoundation.org/poems/155120/ode-to-small-towns">Ode to Small Towns</a>” by Tyree Daye upends common assumptions about rural life and demonstrates the meaning of place in hymnlike vernacular. </p>
<p>In “<a href="https://verse.press/poem/medical-history-7786213513888859947">Medical History</a>,” Nicole Sealey shares a many-layered patient perspective on a part of health care that, for many of my students and colleagues, has been reduced to a series of check boxes on a computer screen. </p>
<p>These and other poems – not to mention short stories, novels, personal essays, films, podcasts and comedy shorts, among other genres of storytelling – provide fertile ground for enhanced understanding of the human condition, as well as inspiration for a clinician’s own potentially transformative reflective writing.</p>
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<img alt="A square box with the words 'Art & Science Collide' and a drawing of a circle surrounding a lightbulb with its wire filament in the shape of a brain." src="https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Art & Science Collide series.</span>
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<p><em><strong><a href="https://theconversation.com/us/topics/art-in-science-series-2024-149583">This article is part of Art & Science Collide</a></strong>, a series examining the intersections between art and science.</em></p>
<p><em>You may be interested in:</em></p>
<p><a href="https://theconversation.com/art-and-science-entwined-this-course-explores-the-long-interrelated-history-of-two-ways-of-seeing-the-world-210250">Art and science entwined: This course explores the long, interrelated history of two ways of seeing the world </a></p>
<p><a href="https://theconversation.com/art-illuminates-the-beauty-of-science-and-could-inspire-the-next-generation-of-scientists-young-and-old-168925">Art illuminates the beauty of science – and could inspire the next generation of scientists young and old</a> </p>
<p><a href="https://theconversation.com/visualizing-the-inside-of-cells-at-previously-impossible-resolutions-provides-vivid-insights-into-how-they-work-195873">Visualizing the inside of cells at previously impossible resolutions provides vivid insights into how they work</a></p>
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<h2>Melding literature and medicine</h2>
<p>The possibilities for collaboration between literature and medicine are wide open. In a country that <a href="https://www.commonwealthfund.org/publications/issue-briefs/2023/oct/high-us-health-care-spending-where-is-it-all-going#">spends more per capita on health care</a> than economically similar nations yet continues to have extreme inequalities in outcomes, it’s clear that the U.S. needs to do things differently. </p>
<p>I believe <a href="https://doi.org/10.1186/s13010-023-00149-1">all clinicians have a role</a> in recognizing and grappling with how everyone has been shaped by an inequitable society. The history, sociopolitical context, imaginative perspective and reflective practices the humanities offer may improve the practice of medicine.</p>
<p>Through understanding others’ experiences and reflecting critically on their own, every clinician can move closer to being the kind of healer they intend to be.</p><img src="https://counter.theconversation.com/content/217357/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Irène Mathieu, MD, MPH is an iTHRIV Scholar. The iTHRIV Scholars Program is supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under award numbers UL1TR003015 and KL2TR003016.</span></em></p>While medical school may teach students about how the body works, it often neglects the social, political and cultural factors that determine health and disease. The humanities can help.Irène Mathieu, Assistant Professor of Pediatrics, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.