Sometimes healthcare professionals conscientiously refuse to treat patients despite the patient requesting legal, medically indicated treatments within the professionals’ remit. Recently, there has been a proliferation of views using the concept of public reason to specify which conscientious refusals of treatment should be accommodated. Four such views are critically assessed, namely, those of Robert Card, Massimo Reichlin, David Scott, and Doug McConnell. This paper argues that McConnell’s view has advantages over the other approaches because it combines the requirement that healthcare professionals publicly justify the grounds of their conscientious refusals of treatment with the requirement that those grounds align with minimally decent healthcare. This relatively restrictive approach accommodates conscientious refusals from minimally decent healthcare professionals while still protecting good healthcare, the independence of the healthcare professions, and the fiduciary relationships.

Doctors have played an important role in the development of health institutions in Latin America. However, they are not the only profession that has had a voice in these matters. There are also other factors influencing the development of ministries of health. This issue has gone unnoticed in the literature. This article suggests that it is possible to identify two distinct trends in the creation of health ministries in Latin America. The first, of an early nature, was seen principally in Central America and the Caribbean in countries dependent on or under the influence of the United States which, from the 1880s, promoted health Pan-Americanism. The second trend, which became apparent from 1924, was characterised by the emergence of ministries in a context of institutional breakdown and the appearance of new actors (military or populist leaders). This second trend was first seen in Chile in 1924. This article analyses the creation of the Ministerio de Higiene, Asistencia y Previsión Social (Ministry of Hygiene, Assistance and Social Security) in Chile in 1924 and its subsequent development through to 1931. The analysis looks at the health measures adopted, the context in which this occurred and the debates triggered by the ministry’s process of institutional development, based on parliamentary discussions, presidential speeches, official statistics, legislation, documents prepared by key actors and the press of the time.

In the 1920s, the art collector John Hilditch tirelessly undertook a public campaign to have his objects exhibited at the Manchester City Art Gallery. This article uses his struggle as a lens through which to examine how the relationship between the civic museum and its citizens was reshaped during the transition to mass democracy. Historians have explored how civic authorities responded to the challenge of mass democratization by encouraging their citizens to become ‘active’, but we know little about how the citizens responded to this call. Hilditch’s campaign allows us to see what public platforms citizens could negotiate to become ‘active’ citizens, and just how far they could influence civic policy.

The ongoing debate within neuroethics concerning the degree to which neuromodulation such as deep brain stimulation (DBS) changes the personality, identity, and agency (PIA) of patients has paid relatively little attention to the perspectives of prospective patients. Even less attention has been given to pediatric populations. To understand patients’ views about identity changes due to DBS in obsessive-compulsive disorder (OCD), the authors conducted and analyzed semistructured interviews with adolescent patients with OCD and their parents/caregivers. Patients were asked about projected impacts to PIA generally due to DBS. All patient respondents and half of caregivers reported that DBS would impact patient self-identity in significant ways. For example, many patients expressed how DBS could positively impact identity by allowing them to explore their identities free from OCD. Others voiced concerns that DBS-related resolution of OCD might negatively impact patient agency and authenticity. Half of patients expressed that DBS may positively facilitate social access through relieving symptoms, while half indicated that DBS could increase social stigma. These views give insights into how to approach decision-making and informed consent if DBS for OCD becomes available for adolescents. They also offer insights into adolescent experiences of disability identity and “normalcy” in the context of OCD.

In 1851, the colonial administration of the Dutch East Indies established a two-year program to educate young Javanese men to become vaccinators in Batavia (today’s Jakarta). During the following sixty years, the medical curriculum was expanded several times; in 1913, it consisted of a ten-year program. In 1927, the Batavia Medical School, granting degrees equivalent to those of Dutch university-affiliated medical schools, commenced operations. Consequently, a steadily increasing number of Indonesian physicians with various credentials were employed by the colonial health service, plantations, sugar factories and mines, or established private practices. They became a social group that occupied an ambiguous and even paradoxical position somewhere between Europeans and the indigenous population. During the 1910s, this inspired these physicians to obtain credentials and professional recognition equal to those of their European colleagues. Several of them became active in journalism, politics and social movements. During the 1920s, several became radicalised and criticised the nature of colonial society. In the 1930s, following the increasingly repressive nature of colonial society, most of them remained active in the public sphere while a small group dedicated itself to improving medical research and health care. After the transfer of sovereignty from the Netherlands to Indonesia on 27 December 1949, this small cadre reestablished medical education and health care, and built the Indonesian medical profession.

This article examines the care provided for the welfare of soldiers by the three combatant countries – China, Korea and Japan – during the East Asian War of 1592–8. Also known as the Imjin War, this large-scale military conflict can also be understood as an encounter between different state cultures and strategies of military medicine. This study focuses on cold-induced injuries, epidemic outbreaks and external wounds suffered during the war. I illuminate provision of prophylactic measures against cold by the Ming state, as well as attempts by the Sino-Chosŏn medical alliance to manage epidemics and treat wounded soldiers. I contrast these measures with the lack of similar centralised support for the Japanese forces, and examine the effect these differences had upon on military outcomes during the war. The difference in the amount of time, efforts and resources that the three combatant states devoted to sick and injured soldiers has implications not only for our understanding of the war but also for illuminating the early modern history of military medicine in East Asia. By exploring East Asian military medicine during and after the Imjin War, this article responds to recent calls for more detailed examination of histories of military medicine in premodern periods and non-European regions.

Existing scholarship on prison diets has emphasised the role of food and its restriction as a key aspect of the deterrent system of prison discipline introduced in the 1860s. Here we suggest that a strong emphasis was placed on dietary regulation after the establishment of the reformist, but also ‘testing’, separate system of confinement in the mid-nineteenth century. While the impact of diet on the physical health of prisoners was a major concern, we argue that the psychological impact of food was also stressed, and some prison administrators and doctors argued that diet had an important protective function in preserving inmates’ mental wellbeing. Drawing on a wide range of prison archives and official reports, this article explores the crucial role of prison medical officers in England and Ireland in implementing prison dietaries. It highlights the importance and high level of individual adaptations to dietary scales laid down centrally, as a means of utilising diet as a tool of discipline or as an intervention to improve prisoners’ health. It examines the forays of some prison doctors into dietary experiments, as they investigated the impact of different dietaries or made more quotidian adjustments to food intake, based on local conditions and food supplies. The article concludes that, despite central policies geared to establishing uniformity and interest in new scientific discourses on nutrition, a wide range of practices were pursued in individual prisons, mostly shaped by practical rather than scientific factors, with many prison medical officers asserting their autonomy in making dietary adjustments.

This paper reexamines the sources used by N. Fancy and M.H. Green in “Plague and the Fall of Baghdad (1258)” (Medical History, 65/2 (2021), 157–177). Fancy and Green argued that the Arabic and Persian descriptions of the Mongol sieges in Iran and Iraq, and in particular, in the conquest of Baghdad in 1258, indicate that the besieged fortresses and cities were struck by Plague after the Mongol sieges were lifted. This, they suggested, is part of a recurrent pattern of the outbreak of Plague transmitted by the Mongol expansion across Eurasia. Fancy and Green concluded that the primary sources substantiate the theory driven by recent paleogenetic studies indicating that the Mongol conquests of the thirteenth century set the stage for the massive pandemic of the mid-fourteenth century. The link between the Plague outbreak and the Mongol siege of Baghdad relies on three near-contemporaneous historical accounts. However, our re-examination of the sources shows that the main text (in Persian) has been significantly misunderstood, and that the two other texts (in Syriac and Arabic) have been mis-contextualized, and thus not understood properly. They do not support the authors’ claim regarding Plague epidemic in Baghdad in 1258, nor do other contemporary and later Arabic texts from Syria and Egypt adduced by them, which we re-examine in detail here. We conclude that there is no evidence for the appearance of Plague during or immediately after the Mongol conquests in the Middle East, certainly not for its transmission by the Mongols.

China's cattle trade before 1949 is effectively invisible to historians. With no geographic center, few dominant firms, and little government oversight, cattle trade left behind no clear archive of sources, leaving scholars to the mercy of conjecture and episodic evidence. Combining insights from business and social history, we focused our attention on trade intermediation as the key to understanding the operations of a diffuse trade system. In the absence of a top–down archive, we composited hundreds of local sources on intermediation in cattle trade and remotely interviewed 80 former brokers. These sources revealed large numbers of individuated trade routes, which we break into three types: persistent supply, specialized demand, and resource circulation. Each type of trade called for distinct forms of intermediation with relatively little overlap between specialized networks. This recreation of China's cattle trade reveals a sophisticated market for animal labor that calls into question the direct causal link between imperialist resource extraction and rural immiseration, and suggests the utility of applying tools and perspectives of social history to other sorts of decentered commercial systems.

This study examines the copy raising constructions in Chinese and proposes an integrated analysis built on the insights of the prominent proposals from recent years. It argues that the matrix subject in Chinese copy raising is base-generated and requires a coindexed copy in the complement. Though concurring with Landau’s (2011) predication theory that recognizes theta assignment and predication as two ways of semantically licensing an argument, this squib differs from him in assuming that languages like Chinese can be parametrized in not treating the perceptual source as thematic. It is further argued that in Chinese, the perceptual source construal of the subject does not come from theta assignment but rather as an implicature which interprets the matrix subject to be involved in the topic event denoted by the perception verb.

The central role of Gold Coast societies, ports, and cities in the emerging Atlantic circuit is critical to understanding the history of the Atlantic world. The study of the causes and effects of Gold Coast societies’ transition from African polities and economies to transatlantic entrepots and trading emporiums and their subsequent impact on the Americas has been the hallmark of Ray Kea's scholarship. Since the beginning of his career, Kea has been a significant contributor to the study of the African Atlantic, and the field's various debates and disciplinary evolutions. While many scholars of the Gold Coast recognize Kea's work as foundational to scholarship on the Gold Coast, engagement with his work has not been rigorous. Kea is often cited in bibliographies and aspects of his work have served as benchmarks for other forays into Gold Coast histories. However, there is a need to go beyond an appreciation for Kea as a trailblazer, passing reference of his scholarship, and bibliographic citation of his work to a more thorough and consistent discourse with his major ideas and propositions. Kea has been, for example, adept at integrating innovations and ideas in various disciplinary arenas. He dexterously applies Marxist and postmodernist theories, diverse historiographies of the Atlantic world, and conceptual tools to traditional archival and oral historical data in his analyses of Gold Coast and diasporic societies. This review essay argues for Kea's importance and the need for a deeper engagement with his work in the field by putting his work into conversation with both classic Atlantic historiographies and recent scholarship that has built off Kea's.

The debate over home state responsibility for human rights has focused on how home states might use accountability mechanisms to promote respect for human rights among their businesses abroad. However, a set of activists and researchers have opened a new front on the question of home state responsibility by focusing on the activities of Canadian diplomats providing advice and consular services to extractive firms abroad. This work documents how home states can be directly implicated in business and human rights controversies and how home state diplomats can put human rights defenders at increased risk. This paper outlines the growing body of research on the hidden influence of Canadian economic diplomacy in human rights controversies, suggesting a troubling disregard for corporate social responsibility and human rights concerns in these contexts, and making the case for robust accountability mechanisms to influence the conduct of both corporate actors and diplomatic officials.

Recent studies highlight the need for ethical and equitable digital health research that protects the rights and interests of racialized communities. We argue for practices in digital health that promote data self-determination for these communities, especially in data collection and management. We suggest that researchers partner with racialized communities to curate data that reflects their wellness understandings and health priorities, and respects their consent over data use for policy and other outcomes. These data governance approach honors and builds on Indigenous Data Sovereignty (IDS) decolonial scholarship by Indigenous and non-indigenous researchers and its adaptations to health research involving racialized communities from former European colonies in the global South. We discuss strategies to practice equity, diversity, inclusion, accessibility and decolonization (EDIAD) principles in digital health. We draw upon and adapt the concept of Precision Health Equity (PHE) to emphasize models of data sharing that are co-defined by racialized communities and researchers, and stress their shared governance and stewardship of data that is generated from digital health research. This paper contributes to an emerging research on equity issues in digital health and reducing health, institutional, and technological disparities. It also promotes the self-determination of racialized peoples through ethical data management.