The United States (US) is frequently portrayed as a nation with a deep distrust of big government and a strong commitment to markets and competition. In contrast, the prevailing image of the European Union (EU) is that of a highly bureaucratized polity favouring interventionist economic governance over free market capitalism. In the context of clean energy, however, these roles appear to be somewhat reversed. A top-level survey of the US clean energy policy landscape reveals a surprisingly pervasive reliance on government subsidies with few, if any, competitive elements. EU clean energy policy, meanwhile, reflects an unexpected commitment to market-based instruments and competition. This article suggests that these counter-intuitive policy trends can be explained by critical differences in the black-letter law of both jurisdictions and its enforcement in the courts, among other factors. Unlike their American counterparts, EU judges prioritize the timely transition to a low-carbon energy economy over unrestricted competition among Member States. As the EU pushes for greater intrastate competition in clean energy policy, the US focuses instead on defending the Founding Fathers’ ideal of unfettered interstate competition.

It is commonly thought that disability is a harm or “bad difference” because having a disability restricts valuable options in life. In his recent essay “Disability, Options and Well-Being,” Thomas Crawley offers a novel defense of this style of reasoning (formulated as the Options Argument) and argues that we and like-minded critics of this brand of argument are guilty of an inconsistency. Our aim in this article is to explain why our view avoids inconsistency, to challenge Crawley's positive defense of the Options Argument, and to suggest that this general line of reasoning employs a double standard.

John Rawls raises three challenges – to which one can add a fourth challenge – to an impartial spectator account: (a) the impartial spectator is a utility-maximizing device that does not take seriously the distinction between persons; (b) the account does not guarantee that the principles of justice will be derived from it; (c) the notion of impartiality in the account is the wrong one, since it does not define impartiality from the standpoint of the litigants themselves; (d) the account would offer a comprehensive, rather than a political, form of liberalism. The narrow aim of the article is to demonstrate that Adam Smith's impartial spectator account can rise to Rawls's challenges. The broader aim is to demonstrate that the impartial spectator account offers the basis for a novel and alternative framework for developing principles of justice, and does so in the context of a political form of liberalism.

Searching for common themes, this afterword questions the meaning and experience of nostalgia in Asia today. The collected essays show the important roles that conflict, trauma, and the need to create a new modernity shape, and are shaped by notions of nostalgia through much of Asia. Perhaps more so than in Europe, nostalgia in Asia seems very national. The case studies in this collection are excellent examples of how nostalgic longings are deployed to enhance national power, as well as a demonstration of the enduring influence of the nation-state over individual imagination across the region.

Health insurance coverage for incarcerated citizens is generally acceptable by Western standards. However, it creates internal tensions with the prevailing justifications for public healthcare. In particular, a conceptualization of medical care as a source of autonomy enhancement does not align with the decreased autonomy of incarceration and the needs-based conceptualization of medical care in cases of imprisonment; and rejecting responsibility as a criterion for assigning medical care conflicts with the use of responsibility as a criterion for assigning punishment. The recent introduction of sofosbuvir in Germany provides a particularly instructive illustration of such tensions. It requires searching for a refined reflective equilibrium regarding the scope, limits, and justifications of publicly guaranteed care.

Each year in the UK there are approximately 250,000 miscarriages, 3,000 stillbirths and 3,000 terminations following a diagnosis of fetal-abnormality. This paper draws from original empirical research into the experience of pregnancy loss and the accompanying decisionmaking processes. A key finding is that there is considerable variation across England in the range of options that are offered for disposal of pregnancy remains and the ways in which information around disposal are communicated. This analysis seeks to outline the key features of what constitutes effective communication in this context, where effective communication is taken to mean that patients are provided with the key information necessary, in an appropriate manner, so that they are fully able to make a decision. A primary source of evidence includes interviews with the bereaved and pregnancy-loss support workers, in order to understand how the options available, and associated necessary procedures, are communicated. In addition, patient information leaflets are also analyzed as they offer an important tool for information delivery at a difficult and emotionally charged time. Following this, an overview is provided of the information that these leaflets should contain, along with guidance on effective presentation of this information.

Although many bioethicists have given attention to the special health issues of Africa and to the ethics of research on the continent, only a handful have considered these issues through the lens of African moral thought. The question has been for the most part neglected as to what a distinctively African moral perspective would be for the analysis and teaching of bioethics issues. To address the oversight, the authors of this paper describe embarking on a project aimed at incorporating African moral perspective, values and philosophy into a teaching curriculum. The authors clarify the rationale for the project and discuss the strategies employed in Africanizing the bioethics curriculum.

The cardiac rehab nurse calls out each of our group’s blood pressures and pulse rates. It is my first posthospitalization class and I am relieved to be in the middle of the pack. Although fully aware that numbers are not fate, I cannot help wondering if the worst performers will fully satisfy the dark needs of heart disease statistics. I presume that others are making similar calculations, yet wince at the ugly direction of my mind. Maybe it is not necessary to do better than another; if we take our meds, eat wisely, and exercise to the max, it is possible that our entire group will do well.

This article explores how the law of England and Wales1 has responded thus far to medical and clinical advances that have enabled patients with prolonged disorders of consciousness to survive. The authors argue that, although the courts have taken account of much of the science, they are now lagging behind, with the result that some patients are being denied their legal rights under the Mental Capacity Act 2005. The article further argues that English law does not comply with the United Kingdom’s commitments under the United Nations Convention on the Rights of Persons with Disabilities. Stressing the need for the law to keep in step with advances in science, the article concludes with robust recommendations for improvements, based on the latest research in neuroscience, to the way in which life-sustaining treatment decisions are made. This would mean that the wishes of patients, including those with covert awareness, can be better reflected in best interests assessments.

This paper describes the Antarctic environment, the mission and work setting at the U.S. research stations, the general population and living conditions, and the healthcare situation. It also dispels some common misconceptions that persist about this environment and about the scope and quality of medicine practiced there. The paper then describes specific ethical issues that arise in this environment, incorporating examples drawn from both the author’s experiences and those of his colleagues. The ethics of providing healthcare in resource-poor environments implies two related questions. The first is: What can we do with the available resources? This suggests that clinicians must not only know how to use all available equipment and supplies in the standard manner, but also that they must be willing and able to go beyond standard procedures and improvise, when necessary. The second question is: Of all the things we can do, which ones should we do? This paper addresses both questions in relation to Antarctic medical care. It describes the wide range of activities required of healthcare providers and some specific ethical issues that arise. Finally, it suggests some remedies to ameliorate some of those issues.

Winfried Siemerling’s The Black Atlantic Reconsidered: Black Canadian Writing, Cultural History, and the Presence of the Historical Past, to put it mildly, is an impressive piece of scholarship that will stand as one of the definitive works on the histories of Black writing in Canada for the foreseeable future. In his preface, Siemerling states that he embarked upon this undertaking when he learned, to his surprise (one is reminded here, incidentally, of Katherine McKittrick’s injunction that Black Canadian Studies is always constituted as a “surprise”), that there had been little written about Black contemporary writing aside from a few of the comprehensive and encyclopedic works that George Elliot Clarke published in the early to mid-1990s. It is this pioneering work upon which Siemerling builds. He starts with a discussion of “Modernity and Canadian Time-Spaces of the Black Atlantic” in his first chapter and introduction, where he lays out the analytical and conceptual approach of the work. Part 1, “Early Testimony and the Black Canadian Nineteenth Century,” includes chapters titled “Slavery and Early Black Canadian Writing” and “The Black Canadian Nineteenth Century.” Part 2, “The Presence of the Past,” highlights chapters that expand on the themes of “Slavery, the Black Canadian Nineteenth Century, and Caribbean Contexts in Contemporary Black Canadian Writing” and move into a discussion of what he calls “Other Black Canadas” and “Coda: Other Canadas, Other Americas, the Black Atlantic Reconsidered.”

Central to Siemerling’s impressive study of black Canadian writing is an optimism about the recuperative potential of historical knowledge. My contribution to the forum acknowledges that potential, while raising questions about the limits of such knowledge for addressing the persistence of racist ideologies and practices. My test case is Siemerling’s fine reading of Lawrence Hill’s novels.

When fertility centers dispose of embryos, how should this be done? Current regulatory guidelines by the Human Fertilisation and Embryology Authority state that, when terminating the development of human embryos, a clinic should act with sensitivity, taking account of the embryo’s “special status” and respecting the interests of the gamete providers and recipients. As yet, it is unclear as to how and to what extent this achieved within fertility clinics in the UK. Resultantly, this paper examines the largely undocumented domain of embryo disposal practice. By undertaking an empirical study into policy and procedure and noting divergence in clinic practice, it then comments on the ethical implications of these protocols for patients and practitioners. Specifically, this paper argues for a more holistic approach to embryo disposal. An approach that effectively meets the requirements of the lab, is respectful of the “special status” of the human embryo, and, perhaps most importantly, reflects the multifaceted needs of the patient.

Although the concept of biobanking is not new, the open and evolving nature of biobanks has created profound ethical, legal, and social implications, including issues around informed consent, community engagement, secondary uses of materials over time, ownership of materials, data sharing, and privacy. Complexities also emerge because of increasing international collaborations and differing national positions. In addition, the degrees and topics of concern vary as legislative, ethical, and social frameworks differ across developed and developing countries. Implementing national laws in an internationally consistent manner is also problematic. However, these concerns should not cause countries, especially developing countries, to lag behind as this novel wave of research gains momentum, particularly while several biobank initiatives are already underway in the developing world. As the law has always struggled to keep up with the fast-evolving scientific arena, this article seeks to identify the ethico-legal frameworks in place in the United Kingdom, Australia, Uganda, and South Africa, for human biobank research, in an attempt to compare and contextualize the approaches to human biobanking in specific developed and developing countries.

This articles intervenes in current debates about the configuration of the contemporary literary system and argues that works coming from the intermediate formation of the semi-periphery can most lucidly register how neoliberalism has transformed the social, economic, and affective structures of the historical present. Drawing on postcolonial criticism, world-systems theory, and theories of combined and uneven development, I propose a comparative study of two novels originating from southern India and southern Italy, Vivek Shanbhag’s Ghachar Ghochar (2013) and Nicola Lagioia’s La Ferocia (2014). By analyzing how residual forces—patriarchy, gender violence, and familism—interact with processes of market neoliberalization and environmental destruction, this article further suggests that only the formal study of novels from semi-peripheral areas can problematize current critical paradigms based on binary oppositions (center/periphery, North/South). To do so, I develop a systemic approach that is attentive to how contextual specificities produce formal outcomes that can best diagnose global socioeconomic inequalities.