An ethics consultation case is presented in which a hospice patient wished to deactivate his Cardiovascular Implantable Electronic Device (CIED), specifically an implantable cardioverter-defibrillator, at the end of life to prevent the prolongation of the dying. The consultants developed an ethical analysis supporting the deactivation of the pacemaker based on authoritative literature and moral reasoning. The consultants’ recommendations to deactivate the pacemaker were ultimately rejected by the medical team based on an alternative assessment which concluded the patient is suicidal, doubts based on the consultants not being physicians, and the healthcare professionals’ sense that deactivating a pacemaker is different from withdrawing other forms of life-sustaining treatment at the end of life. Professional reflections by the consultants and lessons learned are discussed.

The period 1966–1976 saw the rise and fall of the Cultural Revolution. During this period, China witnessed its third wave of decentralized industrialization and the fiercest protests of temporary workers of the Mao era. This chapter starts by providing an overview of the political, economic, and international circumstances of this decade. It then looks at how workers in different positions in the urban exclusion system, particularly precarious workers, protested to improve their conditions, and how these protests were quashed by the government. This is followed by an examination of how gains won from temporary workers’ protests – most importantly, the largest-scale regularization in the Mao era – were carried out in 1971 and 1972, and why temporary employment rebounded thereafter.

This chapter examines the emergence of the CCMCE, a legal/structural innovation that transformed the multinational firm into a constellation of legally separate but operationally unified corporate entities. Tracing its origins to the late nineteenth century, the CCMCE emerged from evolving doctrines of corporate personhood, limited liability, and the state’s adoption of territorial sovereignty as a legal principle. The pivotal shift occurred with New Jersey’s holding company laws (1888–96), enabling corporations to own other corporations and organize control through pyramidal structures. Combined with the formal recognition of intangible property – such as goodwill and future income streams – this model allowed firms to optimize control, risk, and regulatory positioning across jurisdictions. The CCMCE’s international diffusion, initially driven by practical business needs, soon enabled new forms of jurisdictional arbitrage, as corporate groups leveraged legal fragmentation to separate tangible operations from regulatory liabilities. By embedding the firm in a network of legally autonomous subsidiaries, the CCMCE model created opportunities to exploit the ‘law of two prices’ and selectively engage national regulatory regimes.

Abstract: This chapter considers three key types of international judicial remedies, exploring their content, availability, and behavioural influence. Through Mere Adjudication, an adjudicator establishes the existence, applicability, and content of legal rules. Through a Declaration of Breach, a court declares that a party’s conduct violates legal obligations. Where a violation is found, international courts often establish Consequential Duties, determining how a wrongdoer must act to bring an end to its violation and provide reparation for injury. Overall, international judicial remedies seek to prevent states’ adoption of unilateral remedies, grounded on their own understanding of the law and facts. International courts are unable to determine the application of coercive measures against states. Thus, every remedy is a communication regarding either the interpretation of the law or the application of this law to conduct. Judicial pronouncements have remedial value if they are able to mobilise pro-compliance forces, internal and external to states, by which the international normative framework guides state conduct.

This chapter takes forward the exploration of marriage as difference through an examination of what are locally perceived as ‘mixed’ marriages in Penang. Difference can be calibrated in many registers – including age, wealth, class, familial background, religion, language, ‘race’ and ethnicity. The cultural and ethnic diversity of Penang offers unusual scope for marrying outside familiar boundaries. But which sorts of difference are most salient, and which boundaries are more permeable and more easy to bridge? ‘Malayness’ and Islam have a historically privileged legal status in Malaysia, and marrying a Muslim legally requires a non-Muslim spouse to convert. The bodily, culinary, religious and legal concomitants of this conversion are likely to impact close family members of a non-Muslim partner. At the extreme end of a range of possibilities, ‘mixed’ couples encountering or expecting opposition from their families sometimes elope to marry. But, after marriage, a long process of accommodation and absorption is likely to occur. Experiences of ‘mixed’ marriage and the negotiation of difference, which is part of marriage everywhere, offer a perspective on other changes in Malaysia over several decades. But more broadly, it provides a way to understand how intimate worlds may generate wider social transformation.

The refusal and withdrawal of life-sustaining treatment and care by, and on behalf of, people with impairments are the focus of Chapter 4. The chapter argues that greater attention must be given to the socio-economic contexts in which these non-treatment decisions are made. It also argues that the selective non-treatment of disabled infants and the non-consensual withholding and withdrawal of life-sustaining care from people with disorders of consciousness are incompatible with disability rights. The chapter concludes that disabled people, and their health care proxies, should not simply have rights to refuse or withdraw life-sustaining interventions, they must also have rights to request life support.

The spirit of the age is defined as the friend, the harbinger, and the servant of Humanity, but also as the ruler of the age. Martin Luther’s writings on education as well as his exegesis of the Psalms are cited to elaborate on his thoughts on government, and the change of government, particularly his denunciation of the tyranny of monarchs and what he called the rabble. Luther’s praise of German honesty and forthrightness is cited in order to position faith and loyalty as the cornerstone of human society. Klopstock’s poem on the naval warfare between Britain and France is cited in order to argue for the necessity of fairness and reason in all aspects of government. The ability of enlightened monarchs to uphold the spirit of the age is called into question, and Frederick the Great’s correspondence with Voltaire is further cited as evidence of a monarch’s struggles with his own human shortcomings. This is answered with a call for reform of education and politics. The inherent nature of human beings is described in its relationship to society and government, and Gotthold Ephraim Lessing’s dialogue on Freemasonry is cited to elaborate on the importance of reason in civil society and the state.

With advances in critical care technology, survival of acute critical illness has risen drastically, and many of these patients experience persistent deficits in physical and cognitive functioning, termed post-intensive care syndrome (PICS). This chapter provides a comprehensive overview of the pathophysiologic underpinnings of PICS. Perturbations during acute critical illness and early in recovery can have downstream and long-lasting effects. The immune response response is dysregulated with perturbations in both proinflammatory and immunosuppressive pathways. This dysregulation is more pronounced in patients who go on to have worse functional outcomes. Immune dysregulation also contributes to neuroinflammation, blood-brain barrier dysfunction, and disruptions in brain white matter leading to cognitive impairment. Transcriptomic analyses reveal massive shifts in gene expression, with aberrant expression of many genes related to the inflammatory response and extracellular matrix deposition, which clincially correlate with ICU-related complications, such as ICU-acquired weakness. Furthermore, sepsis and inflammation act together to disrupt the microvasculature, which further contributes to organ failure and ICU-acquired weakness. Mitochondrial dysfunction and ubiquitin-proteasome overactivation accelerate skeletal muscle catabolism and can also contribute to weakness. Finally, disruptions in the gut microbiome can disturb blood-brain barrier permeability and alter gene transcription associated with skeletal muscle growth and function. These perturbations interact deleteriously, resulting in the phenotype of PICS.

This chapter explores the rapid expansion of long-form narrative verse in medieval Italy, from a literary horizon dominated by lyric in the 1200s to the presence of a substantial and innovative corpus of vernacular narrative poetry by the start of the 1400s. It reviews formal and metrical innovations that supported the development of medieval Italian narrative verse, as well as analysing the themes and the conceptions of authorship that the poets articulate. The forms reviewed begin with couplet and sonnet as vehicles for narrative poetry in the later Duecento, and move on through Dante’s invention of terza rima, to Trecento terza rima and ottava rima production by poets from Boccaccio and Petrarch to Fazio degli Uberti, Frezzi and Nadal. The chapter explores the adventures in and with narrative that established long-form poetry’s important place within the emerging Italian poetic tradition across the late thirteenth and fourteenth centuries.

This chapter explores how citizens in the Frisian area of the Netherlands joined forces to combat disinformation through the project "De Pit" from September 2022 to September 2023. The project involved three independent regional learning communities with diverse participants investigating and exposing disinformation. The goal was to empower communities to fight disinformation as part of an active community at their local library, (vocational) school, or university. We conducted a multiple experimental case study to analyze how these communities establish rules, roles, and agreements to critically collect, analyze, understand, and report on the information surrounding them in online and offline spaces. Considering the different backgrounds, level of education, ages, and geographical locations enables us to learn if people create similar or different solutions to fight disinformation. Ostrom’s Institutional Analysis and Development framework has supported us in understanding these learning communities and how the participants have developed a research approach enabling them to interpret the facts behind information circulating in the public sphere. Our research indicates that learning communities, backed by local institutions such as libraries, schools, and universities, can provide a secure space for acquiring and practicing skills. This can help in efforts to reduce polarization online and offline by engaging individuals from various backgrounds. Learning communities focus on creating a safe environment where individuals can self-govern with expert guidance. Our study suggests that defending democracy may begin within offline communities, fostering discussions on both local and global issues. Finally, as part of this chapter, we present a ‘roadmap’ with conditions and recommendations to implement a successful learning community to inspire and support others in setting up similar initiatives.

In this chapter, we explore the idea of the social world as a collection of patterned phenomena, and how the social sciences attempt to make sense of those patterns. We value the characteristics of parsimony, predictiveness, falsifiability, fertility, and replicability in research. Research questions are one of four types – normative, hypothetical, factual/procedural, or empirical – depending on the goal or purpose of the investigation. Empirical research questions deal with the world ‘as it is,’ seeking general explanations for patterns of outcomes or classes of phenomena. A good research question is one whose answer takes as much space as your paper has length.

This chapter focuses on the problems of authorship that hover around The Memoirs of a Lady of Quality, an autobiographical text embedded in Tobias Smollett’s Adventures of Peregrine Pickle (1751), and how these debates have served as a proxy for critics’ different accounts of the relation between gender and form. I demonstrate how the notorious aristocrat Lady Vane uses her scandalous memoir to voice her real marital complaints within Smollett’s novel, which despite a predominating misogyny, endorses her bid to rewrite her fallen public character as a literary one. As seen in chapter one, the idea that a woman’s speech could play a determinative role in conferring social legitimacy is treated as a conjectural privilege exercisable only in fiction. The resistant reading I offer here highlights the undeniable limitations of how Smollett and his text think about gender, while finding room for modern readers to re-engage meaningfully with both texts, novel and tale. Discovery of the first standalone publication of Memoirs, as a sumptuous art book with erotic illustrations by Véra Willoughby in 1925, demonstrates the radical feminist and queer potentiality of the text and its embedded form.