Tag Archives: Morte

Recalled experiences surrounding death: More than hallucinations? (Science Daily)


Global scientific team publishes consensus statement and new guidelines

Date: April 12, 2022

Source: NYU Langone Health / NYU Grossman School of Medicine

Summary: Scientific advances in the 20th and 21st centuries have led to a major evolution in the understanding of death. At the same time, for decades, people who have survived an encounter with death have recalled unexplained lucid episodes involving heightened consciousness and awareness. These have been reported using the popular — yet scientifically ill-defined — term ‘near-death experiences’.

Scientific advances in the 20th and 21st centuries have led to a major evolution in the understanding of death. At the same time, for decades, people who have survived an encounter with death have recalled unexplained lucid episodes involving heightened consciousness and awareness. These have been reported using the popular — yet scientifically ill-defined — term “near-death experiences.”

A multidisciplinary team of national and international leaders, led by Sam Parnia, MD, PhD, director of Critical Care and Resuscitation Research at NYU Grossman School of Medicine, have published “Guidelines and Standards for the Study of Death and Recalled Experiences of Death,” a multi-disciplinary consensus statement and proposed future directions in the Annals of the New York Academy of Sciences.Thisstudy, which examined the accumulated scientific evidence to date, represents the first-ever, peer-reviewed consensus statement for the scientific study of recalled experiences surrounding death.

The researchers on the study represent many medical disciplines, including the neurosciences, critical care, psychiatry, psychology, social sciences and humanities, and represent many of the world’s most respected academic institutions including Harvard University, Baylor University, University of California Riverside, University of Virginia, Virginia Commonwealth University, Medical College of Wisconsin, and the Universities of Southampton and London.

Among their conclusions:

  1. Due to advances in resuscitation and critical care medicine, many people have survived encounters with death or being near-death. These people — who are estimated to comprise hundreds of millions of people around the world based on previous population studies — have consistently described recalled experiences surrounding death, which involve a unique set of mental recollections with universal themes.
  2. The recalled experiences surrounding death are not consistent with hallucinations, illusions or psychedelic drug induced experiences, according to several previously published studies. Instead, they follow a specific narrative arc involving a perception of: (a) separation from the body with a heightened, vast sense of consciousness and recognition of death; (b) travel to a destination; (c) a meaningful and purposeful review of life, involving a critical analysis of all actions, intentions and thoughts towards others; a perception of (d) being in a place that feels like “home,” and (e) a return back to life.
  3. The experience of death culminates into previously unidentified, separate subthemes and is associated with positive long-term psychological transformation and growth.
  4. Studies showing the emergence of gamma activity and electrical spikes — ordinarily a sign of heightened states of consciousness on electroencephalography (EEG) — in relation to death, further support the claims of millions of people who have reported experiencing lucidity and heightened consciousness in relation to death.
  5. Frightening or distressing experiences in relation to death often neither share the same themes, nor the same narrative, transcendent qualities, ineffability, and positive transformative effects.

“Cardiac arrest is not a heart attack, but represents the final stage of a disease or event that causes a person to die,” lead author Parnia explains. “The advent of cardiopulmonary resuscitation (CPR) showed us that death is not an absolute state, rather, it’s a process that could potentially be reversed in some people even after it has started.

“What has enabled the scientific study of death,” he continues, “is that brain cells do not become irreversibly damaged within minutes of oxygen deprivation when the heart stops. Instead, they ‘die’ over hours of time. This is allowing scientists to objectively study the physiological and mental events that occur in relation to death.”

So far, the researchers say, evidence suggests that neither physiological nor cognitive processes end with death and that although systematic studies have not been able to absolutely prove the reality or meaning of patients’ experiences and claims of awareness in relation to death, it has been impossible to disclaim them either.

“Few studies have explored what happens when we die in an objective and scientific way, but these findings offer intriguing insights into how consciousness exists in humans and may pave the way for further research,” Parnia adds.

Journal Reference

Sam Parnia, Stephen G. Post, Matthew T. Lee, Sonja Lyubomirsky, Tom P. Aufderheide, Charles D. Deakin, Bruce Greyson, Jeffrey Long, Anelly M. Gonzales, Elise L. Huppert, Analise Dickinson, Stephan Mayer, Briana Locicero, Jeff Levin, Anthony Bossis, Everett Worthington, Peter Fenwick, Tara Keshavarz Shirazi. Guidelines and standards for the study of death and recalled experiences of death––a multidisciplinary consensus statement and proposed future directions. Annals of the New York Academy of Sciences, 2022; DOI: 10.1111/nyas.14740

A Project to Count Climate Crisis Deaths Has Surprising Results (WIRED)


Matt Reynolds

01.18.2022 07:15 AM

Climate change is already killing people, but countries don’t have an easy way to count those deaths. A new project might change that.

Climate change can kill people in all kinds of ways. There are the obvious ones—wildfires, storms, and floods—yet rising temperatures may also lead to the increased spread of deadly diseases, make food harder to come by, and increase the risk of conflict.

Although we know about these wide-ranging but equally terrifying risks, attempts to pinpoint the number of deaths caused by climate change have been piecemeal. One recent study estimated that climate change was to blame for 37 percent of heat-related deaths over the past three decades. In 2021, Daniel Bressler, a PhD student at Columbia University in New York, estimated that every additional 4,400 metric tons of carbon dioxide emitted will cause one heat-related death later this century. He called this number the “mortality cost of carbon.”

Putting a number on climate deaths isn’t just an academic exercise. People are already dying because of extreme temperature and weather events, and we can expect this to become more common as the planet continues to heat up. If governments want to put in place policies to prevent these deaths, they need a way of accurately measuring the deaths and ill health linked to warming. The search is on for the true mortality cost of carbon.

As part of this search, the UK government has made its first attempt at putting a number on climate change deaths. The UK Office for National Statistics (ONS)—an independent government agency responsible for producing official data—has for the first time reported climate-related deaths and hospital admissions in England and Wales. The report covers the years 2001 to 2020, but future reports will be released annually, revealing for the first time detailed information about the impact that climate change is having on health in the two nations. (Statistics for Scotland and Northern Ireland are recorded separately.)

The main finding from this investigation is counterintuitive. The report found that the number of deaths associated with warm or cold temperatures actually decreased between 2001 and 2020. On average, 27,755 fewer people were dying each year due to unusually warm or cold temperatures. In other words, climate change might have actually prevented over half a million deaths in England and Wales over this period. In 2001 there were 993 climate-related deaths per 100,000 people in England and Wales. By 2019 that figure had fallen to 771.

But let’s not get ahead of ourselves. There are a number of reasons why the net number of temperature-related deaths appeared to decline over this period, says Myer Glickman, head of the epidemiological, climate, and global health team at the ONS. For a start, statisticians took a relatively narrow definition of climate-related deaths. They only included deaths from conditions where scientists had previously found a clear link between temperature and disease outcome, and they also excluded any health condition where their own analysis showed no link between temperature and outcome. This means that the mortality data doesn’t include deaths from violence or natural forces (such as storms, landslides, or flooding).

The analysis also excluded deaths from air pollution, which Public Health England estimates is equivalent to between 28,000 and 36,000 deaths each year in the UK. Glickman says that there is no accepted way to separate out the effect that temperature increases have on air pollution. Add all these caveats together and it’s likely that the ONS analysis is a little on the conservative side.

Then there is the big reason why climate change has not led to more deaths in England and Wales: the very mild climate. Although average temperatures in the UK have increased by 0.9 degrees compared to the period from 1961 to 1990, its residents are not some of the 3 billion people who face unlivable conditions if greenhouse gas emissions increase rapidly. And while deaths linked to cold weather were down in England and Wales, on warmer days there was a net increase in hospital admissions linked to warmer weather. This was particularly true when it comes to injuries, which may be because more people do outdoor activities when it’s warmer or might be linked to the increases in violence and mental health problems that are associated with warmer temperatures.

The lower rate of deaths might also be a sign that our attempts to fight back against cold weather are working. Widespread flu vaccinations, support for people to pay their heating bills, and increases in home insulation mean that the coldest days didn’t hit as hard as they might have without these mitigations in place, Glickman says. And warmer homes might be a good thing now, but as summers in the UK get hotter and air-conditioning remains rare, it may start to become a problem.

The ONS will now release this data on a yearly basis, but Glickman’s next project is to look more closely at how temperature changes affected different areas. “We’re going to drill down to a local level temperature,” he says. “That’s going to give us a lot more resolution on what’s happening and who it’s happening to.” The impact of climate change might depend on how wealthy an area is, for example, or whether its residents have easy access to health care or community support.

Glickman also wants to explore indirect impacts of climate on health. “What will be a big interest in the coming years is the lower-level health impacts of things like flooding,” he says. If someone’s home is flooded, it might increase their vulnerability to respiratory disease or worsen their mental health. Researchers from the UK have already found that people with mental illnesses are more at risk of death during hot weather. We don’t know why that is exactly, but researchers think it might be because people with mental illnesses are more likely to be socially isolated or already have poorer health, which makes them more vulnerable when temperatures rise.

The team behind the ONS report are also part of a wider effort to create a global system to count climate-related health impacts. “What we don’t have is a robust set of statistics to categorize the impact of climate on health,” says Bilal Mateen, a senior manager of digital technology at Wellcome Trust, the health charity funding the new climate change health impact initiative.

The first year of the project will be spent identifying countries to partner with before developing and testing different ways of measuring climate change deaths that work for specific countries, says Mateen. The idea is to use this data to help countries devise policies that lessen the health impact of climate change. “We can begin to tease out what works, what doesn’t, and what adaptation and mitigation interventions we should be supporting,” Mateen says.

If it’s true that warmer homes and flu vaccines helped reduce climate change deaths in England and Wales, it’s a sign that populations that are healthier on the whole might be better at surviving the ravages of a heating world. Other countries may want to take note. “All policies are health policies,” says Mateen. “There is a clear need to support job stability, to address fuel poverty and every other policy that’s outside of the mandate of the health minister, because we know that those social determinants of health have downstream impact.”

Recompose, the first human-composting funeral home in the U.S., is now open for business (Seattle Times)


Jan. 22, 2021 at 6:00 am Updated Jan. 22, 2021 at 5:19 pm 9-11 minutos

By Brendan Kiley Seattle Times features reporter

Katrina Spade, who removed her mask a moment for a portrait, is founder and CEO of Recompose, the natural organic reduction (or human composting) funeral home in Kent. Spade stands in front of part of a large array of the “vessels,” eight of which are currently holding bodies for 30 days during the process. In the foreground is a “cradle,” prepared as a demonstration without a body, which would be under a shroud and plant material. (Ken Lambert / The Seattle Times)

Somewhere in Kent, tucked anonymously into acres of warehouses and light-industrial workshops, the first full-service human-composting funeral home in the United States is operational.

After nearly a decade of planning, research and fundraising — not to mention a successful campaign to change state law — Recompose is finally converting people into soil.

Outside, the entrance to Recompose looks like most of its neighbors — just another unit in a tall, almost block-sized building with plain metal siding and big, roll-up warehouse doors. But inside, it feels like an environmentalist’s version of a sleek, futuristic spaceship: spare, calm, utilitarian, with silvery ductwork above, a few soil-working tools (shovels, rakes, pitchforks) on racks, bags of tightly packaged straw neatly stacked on shelves, fern-green walls, potted plants of various sizes.

One immense object dominates the space, looking like an enormous fragment of white honeycomb. These are Recompose’s 10 “vessels,” each a hexagon enclosing a steel cylinder full of soil. One day in mid-January, eight decedents were already inside eight vessels, undergoing the process of natural organic reduction (NOR) or, more colloquially, human composting.

At Recompose, “vessels” full of soil undergo the process of natural organic reduction (NOR) or, more colloquially, human composting. (Ken Lambert / The Seattle Times)
At Recompose, “vessels” full of soil undergo the process of natural organic reduction (NOR) or, more colloquially, human composting. (Ken Lambert / The Seattle Times)

One vessel contained the remains of Ernest “Ernie” Brooks II, a renowned underwater photographer. Organic-farming pioneer Robert “Amigo Bob” Cantisano lay in a second. A third held Paulie Bontrager, a committed environmentalist, vegan and nature lover from West Virginia who died unexpectedly while visiting her daughter in Burien.

Charlotte Bontrager, Paulie’s daughter, had read about Recompose a couple of years ago in a newspaper article.

“I discussed it with my mom,” she said. “We talked about how cool it was and why it took so long to get a service like this. I remember her saying: ‘If it’s at all possible when I die, I want to go that way.’ Longevity runs in my family — her uncle died a year ago at 104 — and I said: ‘Oh mom, you’ll be around another 30 years. I’m sure it’ll be in place by then.”

Two years later, her mother was in a Seattle hospital with a mortal, previously undetected lung condition. Bontrager refused to search for disposition options until her mother had passed. Once she had, at 5:45 a.m., a month before what would’ve been her 75th birthday, Bontrager googled “Seattle” and “human composting” — and found that Recompose was ready.

“My mom was a very humble, loving person and would not want any kind of spotlight,” Bontrager said. “But she’d be thrilled to know she was among this first group of pioneers.”

The first bodies were “laid in” on Dec. 20, 2020, a landmark moment on a nearly 10-year journey for Recompose founder and CEO Katrina Spade. She first began mulling funerary alternatives during a minor mortality crisis of her own, as an architecture student at the University of Massachusetts, Amherst, with a partner and two young children.

Spade researched her options, which were limited to traditional burial (too toxic and expensive), cremation (too carbon-intensive) and rural green burial (too rare and inconvenient for most city dwellers). She started thinking about composting as a kind of soil-based cremation and, in 2013, finished her Master’s thesis: “Of Dirt and Decomposition: Proposing a Place for the Urban Dead.”

Other mileposts followed: feasibility studies in 2015 (with the Department of Forensic Anthropology at Western Carolina University) and 2018 (with soil scientist Lynne Carpenter-Boggs at Washington State University), a push to change state law allowing NOR to be a legal means of disposition for human remains (signed by Gov. Jay Inslee in May 2019) and raising $6.75 million in capital to get Recompose going.

In 2020, two other NOR competitors emerged: Herland Forest, a natural-burial cemetery in Klickitat County with one vessel (which it calls a “cradle”) and Return Home, which plans to open its Auburn facility with dozens of vessels in April.

Recompose costs $5,500 for everything: the body pickup (in King, Pierce and Snohomish counties), the paperwork, the process itself and an optional service. (Body transport from further away can be arranged, for an extra fee, and Recompose has already accepted bodies from California and the East Coast.)

Death care prices in the U.S. tend to be extremely inconsistent and often opaque, with few funeral homes listing costs online — a situation consumer-rights advocates have been shouting about for years. Recompose pricing is transparent and not especially expensive, but it’s not especially cheap. According to a 2020 price survey by local nonprofit the People’s Memorial Association, cremation prices in Washington state vary by 745% (in King County, the range is $525-$4,165) and burial prices by more than 400% (again, in King Country, from $1,390 for the most frugal, direct, no-service burial to $11,100 for a complete, high-end funeral service).

The Recompose process takes 30 days in a vessel full of wood chips and straw, then another few weeks in “curing bins,” large boxes (one per person) where soil is allowed to rest and continue exhaling carbon dioxide. Once that process is complete, friends and chosen family can either retrieve the soil themselves, or donate it to an ecological restoration project at Bells Mountain near Vancouver, Washington. So far, most have elected to donate.

Inside one of Recompose’s “vessels,” which are designed to hold a body, occasionally rotating, during a 30-day process, before going to a curing bin for another 30 days. (Ken Lambert / The Seattle Times)
Inside one of Recompose’s “vessels,” which are designed to hold a body, occasionally rotating, during a 30-day process, before going to a curing bin for another 30 days. (Ken Lambert / The Seattle Times)

Each vessel, Spade explained, is carefully monitored for temperature and moisture content — sensors take temperature readings every 10 minutes — to make sure the microbes inside are getting what they need for safe, efficient composting. Each vessel is slowly rotated a few times during the process. (All compost needs turning.) State regulations say the soil must maintain a temperature of 131 degrees Fahrenheit for 72 hours to safely cook away pathogens like fecal coliform and salmonella. The state also requires Recompose — and a third party — to test for those pathogens in the resulting soil, as well as heavy metals, including arsenic, lead and mercury. (The state also prohibits people who have contracted certain diseases — tuberculosis, prion infections like Creutzfeldt-Jakob disease — from undergoing  NOR.)

“This is a very controlled process, completely driven by microbes,” Spade said. “It’s fueled by plant material and monitored in a very rigorous way.”

Oxygen is another necessary ingredient. Air is blown into each vessel through one set of tubes while exhaust is released through another set, passing through carbon-activated filters.

Steve Van Slyke, compliance director for the Puget Sound Clean Air Agency said the emissions and odors from NOR are expected to be minimal compared to other operations they review, including cremations, demolitions of asbestos-filled buildings and marijuana cultivation. Recompose’s air permit requires no visible emissions from the facility, adequate filters, no detectable odors and independent review by a third party every three months.

Lynne Carpenter-Boggs, who removed her mask for a moment for a portrait, is lead soil research adviser at Recompose, the natural organic reduction funeral home in Kent. Carpenter-Boggs is a professor of sustainable and organic agriculture at Washington State University. (Ken Lambert / The Seattle Times)
Lynne Carpenter-Boggs, who removed her mask for a moment for a portrait, is lead soil research adviser at Recompose, the natural organic reduction funeral home in Kent. Carpenter-Boggs is a professor of sustainable and organic agriculture at Washington State University. (Ken Lambert / The Seattle Times)

Carpenter-Boggs, the soil scientist from WSU, is on hand during the first months of Recompose to keep a careful watch on the soil — and to help Spade and her team care for the dead. (Carpenter-Boggs has served as an unpaid adviser to Recompose for several years but, in her current capacity, she’s working as a paid adviser.)Before each body is laid into its vessel, Spade said, Carpenter-Boggs is usually the one who reminds everybody to take a moment and a few deep breaths. She often recites a poem by the 13th-century Sufi poet Rumi.

“It’s been quite an incredible experience for me,” Carpenter-Boggs said. “I don’t come from the funeral-care world at all and I’ve learned a lot over the past five or six years.”

Friends and chosen family of the deceased can watch that laying-in process over a livestream — or, once coronavirus restrictions are lifted, in person. So far, about 30% of the bereaved have chosen that option, including the Bontrager family, who assembled a soundtrack of their mother’s favorite music. The final song, Charlotte Bontrager said, was “Under the Boardwalk” by the Drifters.

“As I’ve learned more about Recompose, I’ve found it to be a very graceful and beautiful way to go,” Bontrager said. “It’s the natural way, the way every living thing in history has eventually been cared for, from an apple core to a human — you’re not being burned up, not being pumped full of embalming chemicals and taking up space in a container. It seems like a peaceful way for the body to move on to the next phase.”

The covid-19 pandemic is worse than official figures show (The Economist)


But some things are improving, and it will not go on for ever

Sep 26th 2020

AS THE AUTUMNAL equinox passed, Europe was battening down the hatches for a gruelling winter. Intensive-care wards and hospital beds were filling up in Madrid and Marseille—a city which, a few months ago, thought it had more or less eliminated covid-19. Governments were implementing new restrictions, sometimes, as in England, going back on changes made just a few months ago. The al-fresco life of summer was returning indoors. Talk of a second wave was everywhere.

Across the Atlantic the United States saw its official covid-19 death toll—higher than that of all western Europe put together—break the 200,000 barrier. India, which has seen more than half a million new cases a week for four weeks running, will soon take America’s unenviable laurels as the country with the largest official case count.

The world looks set to see its millionth officially recorded death from covid-19 before the beginning of October. That is more than the World Health Organisation (WHO) recorded as having died from malaria (620,000), suicide (794,000) or HIV/AIDS (954,000) over the whole of 2017, the most recent year for which figures are available.

Those deaths represent just over 3% of the recorded covid-19 cases, which now number over 32m. That tally is itself an underestimate of the number who have actually been infected by SARSCoV-2, the virus which causes covid 19. Many of the infected do not get sick. Many who do are never seen by any health system.

A better, if still imperfect, sense of how many infections have taken place since the outbreak began at the end of last year can be gleaned from “serosurveys” which scientists and public-health officials have undertaken around the world. These look for antibodies against SARSCoV-2 in blood samples which may have been taken for other purposes. Their presence reveals past exposure to the virus.

Various things make these surveys inaccurate. They can pick up antibodies against other viruses, inflating their totals—an effect which can differ from place to place, as there are more similar-looking viruses circulating in some regions than in others. They can mislead in the other direction, too. Some tests miss low levels of antibody. Some people (often young ones) fight off the virus without ever producing antibodies and will thus not be recorded as having been infected. As a result, estimates based on serosurveys have to be taken with more than a grain of salt.

But in many countries it would take a small sea’s worth of the stuff to bring the serosurvey figures into line with the official number of cases. The fact that serosurvey data are spotty—there is very little, for example, openly available from China—means it is not possible to calculate the global infection rate directly from the data at hand. But by constructing an empirical relationship between death rates, case rates, average income—a reasonable proxy for intensity of testing—and seropositivity it is possible to impute rates for countries where data are not available and thus estimate a global total.

The graphic on this page shows such an estimate based on 279 serosurveys in 19 countries. It suggests that infections were already running at over 1m a day by the end of January—when the world at large was only just beginning to hear of the virus’s existence. In May the worldwide rate appears to have been more than 5m a day. The uncertainties in the estimate are large, and become greater as you draw close to the present, but all told it finds that somewhere between 500m and 730m people worldwide have been infected—from 6.4% to 9.3% of the world’s population. The WHO has not yet released serosurvey-based estimates of its own, though such work is under way; but it has set an upper bound at 10% of the global population.

As the upper part of the following data panel shows, serosurvey results which can be directly compared with the diagnosed totals are often a great deal bigger. In Germany, where cases have been low and testing thorough, the seropositivity rate was 4.5 times the diagnosed rate in August. In Minnesota a survey carried out in July found a multiplier of seven. A survey completed on August 23rd found a 6.02% seropositivity rate in England, implying a multiplier of 12. A national serosurvey of India conducted from the middle of May to early June found that 0.73% were infected, suggesting a national total of 10m. The number of registered cases at that time was 226,713, giving a multiplier of 44. Such results suggest that a global multiplier of 20 or so is quite possible.

If the disease is far more widespread than it appears, is it proportionately less deadly than official statistics, mainly gathered in rich countries, have made it look? Almost certainly. On the basis of British figures David Spiegelhalter, who studies the public understanding of risk at Cambridge University, has calculated that the risk of death from covid increases by about 13% for every year of age, which means a 65-year-old is 100 times more likely to die than a 25-year-old. And 65-year-olds are not evenly distributed around the world. Last year 20.5% of the EU’s population was over 65, as opposed to just 3% of sub-Saharan Africa’s.

But it is also likely that the number of deaths, like the number of cases, is being seriously undercounted, because many people will have died of the disease without having had a positive test for the virus. One way to get around this is by comparing the number of deaths this year with that which would be predicted on the basis of years past. This “excess mortality” method relies on the idea that, though official statistics may often be silent or misleading as to the cause of death, they are rarely wrong about a death actually having taken place.

The excessive force of destiny

The Economist has gathered all-cause mortality data from countries which report them weekly or monthly, a group which includes most of western Europe, some of Latin America, and a few other large countries, including the United States, Russia and South Africa (see lower part of data panel). Between March and August these countries recorded 580,000 covid-19 deaths but 900,000 excess deaths; the true toll of their share of the pandemic appears to have been 55% greater than the official one. This analysis suggests that America’s official figures underestimate the death toll by 30% or more (America’s Centres for Disease Control and Prevention have provided a similar estimate). This means that the real number of deaths to date is probably a lot closer to 300,000 than 200,000. That is about 10% of the 2.8m Americans who die each year—or, put another way, half the number who succumb to cancer. And there is plenty of 2020 still to go.

Add to all this excess mortality unreported deaths from countries where record keeping is not good enough to allow such assessments and the true death toll for the pandemic may be as high as 2m.

What can be done to slow its further rise? The response to the virus’s original vertiginous ascent was an avalanche of lockdowns; at its greatest extent, around April 10th, at least 3.5bn people were being ordered to stay at home either by national governments or regional ones. The idea was to stop the spread of the disease before health-care systems collapsed beneath its weight, and in this the lockdowns were largely successful. But in themselves they were never a solution. They severely slowed the spread of the disease while they were in place, but they could not stay in place for ever.

Stopping people interacting with each other at all, as lockdowns and limits on the size of gatherings do, is the first of three ways to lower a disease’s reproduction number, R—the number of new cases caused by each existing case. The second is reducing the likelihood that interactions lead to infection; it requires mandated levels of social distancing, hygiene measures and barriers to transmission such as face masks and visors. The third is reducing the time during which an infectious person can interact with people under any conditions. This is achieved by finding people who may recently have been infected and getting them to isolate themselves.

Ensuring that infectious people do not have time to do much infecting requires a fast and thorough test-and-trace system. Some countries, including Canada, China, Germany, Italy, Japan, Singapore and Taiwan, have successfully combined big testing programmes which provide rapid results with a well developed capacity for contact tracing and effective subsequent action. Others have foundered.

Networks and herds

Israel provides a ready example. An early and well-enforced lockdown had the expected effect of reducing new infections. But the time thus bought for developing a test-and-trace system was not well used, and the country’s emergence from lockdown was ill-thought-through. This was in part because the small circle around prime minister Binyamin Netanyahu into which power has been concentrated includes no one with relevant expertise; the health ministry is weak and politicised.

Things have been made worse by the fact that social distancing and barrier methods are being resisted by some parts of society. Synagogues and Torah seminaries in the ultra-Orthodox community and large tribal weddings in the Arab-Israeli community have been major centres of infection. While unhappy countries, like Tolstoy’s unhappy families, all differ, the elements of Israel’s dysfunction have clear parallels elsewhere.

Getting to grips with “superspreader” events is crucial to keeping R low. Close gatherings in confined spaces allow people to be infected dozens at a time. In March almost 100 were infected at a biotech conference in Boston. Many of them spread the virus on: genetic analysis subsequently concluded that 20,000 cases could be traced to that conference.

Nipping such blooms in the bud requires lots of contact tracing. Taiwan’s system logs 15-20 contacts for each person with a positive test. Contact tracers in England register four to five close contacts per positive test; those in France and Spain get just three. It also requires that people be willing to get tested in the first place. In England only 10-30% of people with covid-like symptoms ask for a test through the National Health Service. One of the reasons is that a positive test means self-isolation. Few want to undergo such restrictions, and few are good at abiding by them. In early May a survey in England found that only a fifth of those with covid symptoms had self-isolated as fully as required. The government is now seeking to penalise such breaches with fines of up to £10,000 ($12,800). That will reduce the incentive to get tested in the first place yet further.

As much of Europe comes to terms with the fact that its initial lockdowns have not put an end to its problems, there is increased interest in the Swedish experience. Unlike most of Europe, Sweden never instigated a lockdown, preferring to rely on social distancing. This resulted in a very high death rate compared with that seen in its Nordic neighbours; 58.1 per 100,000, where the rate in Denmark is 11.1, in Finland 6.19 and in Norway 4.93. It is not clear that this high death rate bought Sweden any immediate economic advantage. Its GDP dropped in the second quarter in much the same way as GDPs did elsewhere.

It is possible that by accepting so many deaths upfront Sweden may see fewer of them in the future, for two reasons. One is the phenomenon known, in a rather macabre piece of jargon, as “harvesting”. Those most likely to succumb do so early on, reducing the number of deaths seen later. The other possibility is that Sweden will benefit from a level of herd immunity: once the number of presumably immune survivors in the population grows high enough, the spread of the disease slows down because encounters between the infected and the susceptible become rare. Avoiding lockdown may conceivably have helped with this.

On the other hand, one of the advantages of lockdowns was that they provided time not just for the development of test-and-trace systems but also for doctors to get better at curing the sick. In places with good health systems, getting covid-19 is less risky today than it was six months ago. ISARIC, which researches infectious diseases, has analysed the outcomes for 68,000 patients hospitalised with covid-19; their survival rate increased from 66% in March to 84% in August. The greatest relative gains have been made among the most elderly patients. Survival rates among British people 60 and over who needed intensive care have risen from 39% to 58%.

This is largely a matter of improved case management. Putting patients on oxygen earlier helps. So does reticence about using mechanical ventilators and a greater awareness of the disease’s effects beyond the lungs, such as its tendency to provoke clotting disorders.

Nouvelle vague

As for treatments, two already widely available steroids, dexamethasone and hydrocortisone, increase survival by reducing inflammation. Avigan, a Japanese flu drug, has been found to hasten recovery. Remdesivir, a drug designed to fight other viruses, and convalescent plasma, which provides patients with antibodies from people who have already recovered from the disease, seem to offer marginal benefits.

Many consider antibodies tailor-made for the job by biotech companies a better bet; over the past few years they have provided a breakthrough in the treatment of Ebola. The American government has paid $450m for supplies of a promising two-antibody treatment being developed by Regeneron. That will be enough for between 70,000 and 300,000 doses, depending on what stage of the disease the patients who receive it have reached. Regeneron is now working with Roche, another drug company, to crank up production worldwide. But antibodies will remain expensive, and the need to administer them intravenously limits their utility.

It is tempting to look to better treatment for the reason why, although diagnosed cases in Europe have been climbing steeply into what is being seen as a second wave, the number of deaths has not followed: indeed it has, as yet, barely moved. The main reason, though, is simpler. During the first wave little testing was being done, and so many infections were being missed. Now lots of testing is being done, and vastly more infections are being picked up. Correct for this distortion and you see that the first wave was far larger than what is being seen today, which makes today’s lower death rate much less surprising (see data panel).

The coming winter is nevertheless worrying. Exponential growth can bring change quickly when R gets significantly above one. There is abundant evidence of what Katrine Bach Habersaat of the WHO calls “pandemic fatigue” eating away at earlier behavioural change, as well as increasing resentment of other public-health measures. YouGov, a pollster, has been tracking opinion on such matters in countries around the world. It has seen support for quarantining people who have had contact with someone infected fall a bit in Asia and rather more in the West, where it is down from 78% to 63%. In America it has fallen to 55%.

It is true that infection rates are currently climbing mostly among the young. But the young do not live in bubbles. Recent figures from Bouches-du-Rhône, the French department which includes Marseille, show clearly how a spike of cases in the young becomes, in a few weeks, an increase in cases at all ages.

As the fear of such spikes increases, though, so does the hope that they will not be recurring all that much longer. Pfizer, which has promising vaccine candidate in efficacy trials, has previously said that it will seek regulatory review of preliminary results in October, though new standards at the Food and Drug Administration may not allow it to do so in America quite that soon. Three other candidates, from AstraZeneca, Moderna and J&J, are nipping at Pfizer’s heels. The J&J vaccine is a newcomer; it entered efficacy trials only on September 23rd. But whereas the other vaccines need a booster a month after the first jab, the J&J vaccine is administered just once, which will make the trial quicker; it could have preliminary results in November.

None of the companies will have all the trial data they are planning for until the first quarter of next year. But in emergencies regulators can authorise a vaccine’s use based on interim analysis if it meets a minimum standard (in this case, protection of half those who are vaccinated). Authorisation for use under such conditions would still make such a vaccine more credible than those already in use in China and Russia, neither of which was tested for efficacy at all. But there have been fears that American regulators may, in the run up to the presidential election, set the bar too low. Making an only-just-good-enough vaccine available might see social-distancing collapse and infections increase; alternatively, a perfectly decent vaccine approved in a politically toxic way might not be taken up as widely as it should be.

In either case, though, the practical availability of a vaccine will lag behind any sort of approval. In the long run, billions of doses could be needed. A global coalition of countries known as Covax wants to distribute 2bn by the end of 2021—which will only be enough for 1bn people if the vaccine in question, like Pfizer’s or AstraZeneca’s, needs to be administered twice. The world’s largest manufacturer of vaccines, the Serum Institute in India, recently warned that there will not be enough supplies for universal inoculation until 2024 at the earliest.

Even if everything goes swimmingly, it is hard to see distribution extending beyond a small number of front-line health and care workers this year. But the earlier vaccines are pushed out, the better. The data panel on this page looks at the results of vaccinating earlier versus later in a hypothetical population not that unlike Britain’s. Vaccination at a slower rate which starts earlier sees fewer eventual infections than a much more ambitious campaign started later. At the same time increases in R—which might come about if social distancing and similar measures fall away as vaccination becomes real—make all scenarios worse.

By next winter the covid situation in developed countries should be improved. What level of immunity the vaccines will provide, and for how long, remains to be seen. But few expect none of them to work at all.

Access to the safety thus promised will be unequal, both within countries and between them. Some will see loved ones who might have been vaccinated die because they were not. Minimising such losses will require getting more people vaccinated more quickly than has ever been attempted before. It is a prodigious organisational challenge—and one which, judging by this year’s experience, some governments will handle considerably better than others. ■

This article appeared in the Briefing section of the print edition under the headline “Grim tallies”

O Brasil vive a banalização da morte? (Deutsche Welle)


23.08.2020, por Edison Veiga

Invisível para muitos, a maior tragédia sanitária da história brasileira virou uma macabra estatística. A ilusão da volta ao normal, dizem antropólogos, sociólogos e psicólogos, esconde uma espécie de negação coletiva.

Protesto da ONG Rio da Paz nas areias da praia de Copacabana

Há mais de três meses, em 19 de maio, o Brasil registrou pela primeira vez mais de mil mortos em 24 horas em decorrência da covid-19. Desde então, a situação epidemiológica do país, que já soma oficialmente mais de 113 mil óbitos pela pandemia, estabilizou-se em um trágico platô.

Se a situação sanitária parece longe de estar sob controle, por outro lado os discursos são de retomada de economia: há dois meses as atividades vêm sendo gradualmente reiniciadas em todo o território nacional, o isolamento social se afrouxa, e está sendo discutida a reabertura das escolas.

Para o antropólogo, cientista social e historiador Claudio Bertolli Filho, professor da Universidade Estadual Paulista (Unesp) e autor do livro História da Saúde Pública no Brasil, o país vive um cenário de “banalização da morte”.

Ele entende que isso é decorrente de uma dimensão política — a maneira como o governo federal conduziu e conduz a situação —, de uma aceitação social — o discurso de que “demos azar” ou de que quem tem comorbidades iria “acabar morrendo mesmo” —, e por fim, de aspectos culturais.

“O presidente Jair Bolsonaro é fruto da sociedade brasileira, que, historicamente, banalizou a morte, desde aquele papo que ‘bandido bom é bandido morto'”, diz Bertolli Filho à DW Brasil. “Há ainda uma tendência de nossa cultura, para sobrevivermos psicologicamente, a enfrentar o momento pandêmico negando as mortes, mostrando-nos imunes a elas.”

“É quando rejeito pensar que aquele que morreu é parecido comigo e eventualmente poderia ser eu próprio. Quem morreu é ‘o outro’, o ‘da periferia’, o que ‘tinha comorbidades’, o que ‘não seguiu as normas sanitárias'”, exemplifica o acadêmico.

Já para o historiador e sociólogo Mauro Iasi, professor da Universidade Federal do Rio de Janeiro (UFRJ) e autor de Política, Estado e Ideologia, a sequência diária de mortes, transformadas em estatística, acaba naturalizando-as à população.

“Quando nos vemos diante de um número elevado de mortes, como em um acidente, por exemplo, isso nos choca pela quebra desta aparente casualidade. No caso da pandemia, o ritmo diário das mortes, sua matematização pelas estatísticas, tende a devolver o fenômeno para o campo da casualidade, naturalizando-o”, argumenta ele.

Iasi exemplifica citando as mortes provocadas anualmente pela ação da Polícia Militar no Brasil — 5.804 em 2019. “A rotinização do fato faz com que se banalize o fenômeno, como parte da vida e, portanto, abrindo espaço para sua negação.”

Pesquisador do Núcleo de Estudos da Violência da Universidade de São Paulo (USP), o jornalista, economista e cientista político Bruno Paes Manso compara a sensação transmitida pelas mortes do coronavírus àquela em relação as vítimas de homicídio no país.

“Os grupos que morrem são vistos como aqueles que, de alguma forma, tinham justificativa para morrer. No caso dos homicídios, são as pessoas ‘que procuraram seu próprio destino’. [Para a opinião pública] a vítima é culpada da morte: são negros, pobres, moradores de periferia, suspeitos de serem traficantes”, comenta. “Existe uma certa ilusão de que as mortes se restringem a determinados grupos vistos pelas pessoas como aqueles que ‘podem morrer’. Isso gera não a banalização, mas uma tolerância a esse tipo de ocorrência.”

Ele acredita em uma lógica um tanto parecida nos óbitos decorrentes do coronavírus. Na racionalização, aponta o pesquisador, a opinião geral é de que a doença não atingiria os próximos, mas sim aqueles vistos como “o outro”: o idoso, aquele com comorbidades, os de alguma forma mais vulneráveis. Este raciocínio é balizado pelo que ocorre nas principais cidades — em geral, os distritos com maior número de mortos estão localizados nas periferias.


“O medo da morte iminente que vem junto com a pandemia mobiliza tanto conteúdos de medo e de desamparo, quanto uma espécie de negação coletiva, já que não existe nenhuma figura real de autoridade, nem na ciência, nem na política, que dê conta de ‘funcionar’ como figuras paternas ou maternas que possam cuidar ou proteger contra a morte”, analisa a psicóloga Nancy Ramacciotti de Oliveira-Monteiro, professora da Universidade Federal de São Paulo (Unifesp). “Até porque, em todo o mundo, por enquanto, ninguém sabe ainda como vencer essa ameaça comum a todos os seres humanos, com exceção da esperada chegada de vacinas.”

Ela lembra que o fato de essas mortes serem divulgadas diariamente por meio de estatísticas numéricas também dificulta a “identificação” por parte da população. Isso só não ocorre, pontua a professora, quando as mortes chegam a círculos próximos ou vitimizam alguma celebridade.

Para o psicólogo Ronaldo Pilati, professor da Universidade de Brasília (UnB), o fenômeno não pode ser chamado de “banalização”, mas sim de “minimização”. Ao recordar da comoção que houve no Brasil quando a Itália registrava cerca de mil mortes em um dia, por exemplo, ele ressalta que era um momento em que os brasileiros estavam “mais atentos e conectados à questão”, já que o mês de março foi quando diversas medidas de quarentena e isolamento social foram implementadas de fato.

“Com o passar do tempo e a maneira ineficiente com que o Brasil enfrentou a pandemia, houve uma mudança de comportamento”, observa. “Não houve enfrentamento coordenado [da questão] e isso confirmou a expectativa de desamparo que o brasileiro tem quando depende do Estado para a resolução de problemas.”

No livro Death Without Weeping: The Violence of Everyday Life in Brazil, a antropóloga americana Nancy Scheper-Hughes relata como mães brasileiras de favelas com altos índices de mortalidade infantil acabam lidando com os óbitos de seus filhos. Para a pesquisadora, a impotência faz com que essas mulheres acabem se conformando com a partida daqueles “mais fracos”, exercendo uma espécie de triagem para favorecer os bebês mais saudáveis, com mais “talento para viver”.

Professor da Universidade Estadual de Campinas (Unicamp), o antropólogo e sociólogo Marko Monteiro concorda que essa sensação é decorrente da desigualdade social brasileira. “Convivemos com a morte historicamente, desde a formação do país, a maneira violenta como foi construída a nação. Nossas ações cotidianas são permeadas por violência”, resume. “A banalização é consequência disso: os números mostram que quem está morrendo mais são as pessoas de áreas periféricas, negras, sem acesso… São os fatores modificáveis.”

“Então temos mecanismos sociais e psicológicos para conviver com essas mortes, que muitos consideram inevitáveis. É a clássica atitude do ‘eu não sou coveiro’, do ‘e daí?’… Por que isso ressoa em muita gente? Porque há a ideia de as mortes eram inevitáveis, que essas pessoas morreriam de qualquer jeito”, afirma.

Medo da morte na pandemia oferece uma chance de reconsiderar a vida, diz professor de filosofia (Folha de S.Paulo)


Pedro Duarte, 1 de agosto de 2020

[RESUMO] Professor de filosofia analisa a sensação de medo da morte e de angústia intensificada nos últimos meses pelo coronavírus, o que nos leva a pensar na finitude da vida e em nossa liberdade no mundo, no significado do que fazemos e queremos, processo no qual a escrita tem papel essencial de dar forma ao que vivemos e anunciar o que está por vir.

“Para mim, em breve, será só escuridão.” Essas foram as palavras que Sérgio Sant’Anna escolheu para terminar seu conto publicado na Folha no dia 26 de abril. O texto recorda um treino de futebol do seu amado Fluminense nos anos 1950 e impressiona pelos detalhes. O golpe de mestre, entretanto, está no narrador: a trave. Quem nos conta o conto é a trave do gol.

Ela já está velha. Confessa que funcionários do clube foram vê-la e deram um veredicto: tem que trocar, pode até dar cupim. “Em breve meu tempo terá passado”, diz.

Sérgio morreu no dia 10 de maio em decorrência do coronavírus. É assustador ler o conto sabendo disso, parece que a trave falava por ele, uma profecia assombrosa. É sempre perturbadora a ideia de que alguém pressente a própria morte, mesmo alguém que estava doente.

Sérgio fazia muitos posts no Facebook, o que dava uma sensação de proximidade. Em um deles, semanas antes de morrer, admitia achar aterrorizante essa peste que nos assola e afirmava que só sabia responder a isso escrevendo. Foi o que fez até o fim. Isso é um escritor.

Mesmo quem não é, porém, pode entender a pressa que parecia ter o Sérgio. A consciência de que vamos morrer, a consciência da nossa finitude, pode ter esse efeito. Uma pressa que é desejo de viver. É que, para ele, viver era escrever, e escrever talvez fosse mais até que viver.

O que está em jogo, contudo, é a mesma coisa: o tempo finito que temos, ou melhor, que nós somos. Com a pandemia, é provável que ela, de quem tentamos manter distância, chegue perto de nós: não a morte em si apenas, mas a mortalidade que nos constitui.

Logo antes disso tudo começar, havia falecido Max von Sydow, ator sueco que deu vida, no filme “O Sétimo Selo” (1957), de Ingmar Bergman, ao cavaleiro Antonius Block.

O enredo se passa na Idade Média. O filme narra o retorno do cavaleiro da Cruzada da Fé para a terra natal, onde está a peste, o que suscita uma consciência da morte. O cavaleiro engaja-se em um jogo de xadrez com ela, que aparece como um personagem, vestida de preto. Block descobre no fim, e Sydow anos depois, que ninguém vence a morte. Mas ganhou uns dias de vida enquanto jogava com ela.

Para boa parte de nós, a pandemia de Covid-19 infunde um medo da morte. Isso enseja medidas concretas que ajudam a evitá-la: distanciar-se das outras pessoas que podem portar o vírus, lavar as mãos e até os produtos, usar máscaras no rosto.

São medidas objetivas de proteção, que podem ajudar a preservar a vida. O medo nos oferece o que fazer, pois ele possui um objeto definido ao qual se dirige, mesmo que seja algo invisível, como o vírus.

No entanto, além do medo, a pandemia também pode despertar a angústia. Não me refiro só ao quadro clínico patológico da angústia, e sim à disposição que a filosofia, desde Kierkegaard no século 19, distingue do medo precisamente porque não se refere a um objeto específico no interior do mundo, mas à nossa própria presença finita nele.

O que angustia na angústia somos nós mesmos. Por isso, a angústia nos deixa meio perdidos, sem ter o que fazer. Com ela, não se trata mais de evitar a morte, mas de compreender a vida mortal que temos.

Nesse sentido, o medo pode ser vencido sem que mudemos nada em nós, enquanto a angústia, que não pode ser vencida, mas apenas experimentada, exige a reconsideração da liberdade de nossa presença no mundo. Em outras palavras, o medo nos dá o que fazer, e a angústia coloca em jogo o nosso ser.

Talvez, e só talvez, a parada obrigatória que a pandemia forçou para todos possa fazer pensar. Não digo pensar só nos destinos do mundo, do Estado, do capitalismo e da modernidade, como os filósofos têm feito, embora isso tenha o seu interesse.

Refiro-me a pensar, cada um em seu íntimo, o sentido do que fazemos e queremos a partir dessa interrupção do que vínhamos fazendo e querendo. Um amigo querido se perguntou outro dia o valor de tanta filosofia que aprendeu até aqui. Por angustiante que seja, é uma chance de reconsiderar a vida.

O esvaziamento de nossas ocupações diárias anteriores ou a sua exacerbação sem as folgas e respiros de antigamente podem trazer à tona a questão de seu sentido, do que elas valem para nós. Por falta ou excesso, por tédio ou fartura, podemos perder a naturalidade familiar com nós mesmos e nos estranhar, até mesmo ao ponto de pensar o que antes não se pensava.

Pode ser cedo ainda para formular bem que tipo de suspensão é esta, mas ela está aí. Pois a morte não é o oposto da vida, é seu avesso. Ela é que nos faz ver a finitude da existência. Por isso mesmo, também há a possibilidade de fugirmos da angústia, pois ela nos lança cara a cara conosco e com o mundo em que não temos muitos amparos.

Desconfio inclusive que o apelo dos motes de retorno ao trabalho e volta à normalidade —para além de necessidades reais e dos desejos pujantes, já que nos foi subtraído o próprio convívio amoroso com as outras pessoas— tem força não apenas por causa da economia, mas porque carrega a esperança de acabar com a angústia, de tapar o buraco que foi cavado por um reles vírus.

O problema é que não foi o vírus que cavou esse buraco. Ele já estava lá, e sempre está, como sabiam os filósofos existencialistas. As condições da pandemia podem fazer olharmos para ele. É um vazio, mas cuja abertura nos faz livres.

Ou seja, se tudo fosse preenchido, não haveria margem de liberdade. O nada, que mora no coração do ser, permite deixarmos de ser o que éramos e nos tornarmos outros (na sua poesia, Fernando Pessoa falava de um “outrar-se”). Esse nada impede que nos definamos de uma vez por todas: põe aventura na vida.

Evidentemente, essa especulação um tanto metafísica convive com pressões ordinárias e terríveis que são as pessoas morrendo, como o próprio Sérgio: deixando de ser. Mas o resto de nós, muitos reclusos em casa, é afetado também às vezes por essa “clara noite” da angústia.

É como se a abrupta e radical desarrumação do sentido do mundo deixasse um vazio ou um nada que, por não estar ocupado, permite que o sentir e o pensar se refaçam de outra forma, diferentemente de antes. Nada mais é tão certo. O futuro está perigosamente em aberto.

Como se ignora ainda a duração da pandemia no tempo e os estragos dela na sociedade, há um abismo, como diria o teórico Reinhart Koselleck, entre como concebemos nosso espaço de experiência e nosso horizonte de expectativa. Isso é o que causa angústia, essa espécie de soltura incerta do presente.

Quantos de nós têm segurança de que seus empregos, ou até suas profissões, ainda estarão aí em dois anos? Quantos estão convictos de que vão continuar querendo viver do mesmo jeito? Tudo isso pode significar uma fissura no ser.

Continuaremos a ter perdas. Não somente em relação aos que morrem, mas a um certo modo de viver. Teremos que incorporá-las, achar um lugar no qual a dor dispense a sua cura. Elizabeth Bishop, a poeta norte-americana que viveu no Brasil, tem conhecidos versos nos quais tenta, justamente, apresentar “uma arte”, ou seja, um ofício, um saber, sobre o perder. Na ótima tradução de Paulo Henriques Britto, o poema pode nos ensinar alguma coisa.

A arte de perder não é nenhum [mistério;
Tantas coisas contêm em si o acidente
De perdê-las, que perder [não é nada sério.

Perca um pouquinho a cada dia. [Aceite, austero,
A chave perdida, a hora gasta [bestamente.
A arte de perder não é [nenhum mistério.

Depois perca mais rápido, com mais [critério:
Lugares, nomes, a escala subseqüente
Da viagem não feita. [Nada disso é sério.

Perdi o relógio de mamãe. Ah! E nem [quero
Lembrar a perda de três casas [excelentes.
A arte de perder não é [nenhum mistério.

Perdi duas cidades lindas. E um [império
Que era meu, dois rios, e mais um [continente.
Tenho saudade deles. Mas [não é nada sério.

—Mesmo perder você (a voz, o riso etéreo que eu amo) não muda nada. [Pois é evidente
que a arte de perder não chega a ser [mistério
por muito que pareça [(Escreve!) muito sério.

Essa pedagogia pode nos fazer aprender exatamente que, em cada perda, da menor até a maior, insinua-se a morte. E que, portanto, a morte não é apenas aquele “depois da vida” sobre o qual tanto se especula, mas também o elemento interno que dá à vida seu tempo, que faz da vida algo no tempo. Esses versos talvez possam vir a constituir o epílogo do que está por vir. Escreve!

De novo, Sérgio Sant’Anna. Ele queria escrever enquanto houvesse tempo. E penso na quantidade enorme de textos, como este aqui, que desde o começo do ano são escritos sobre a pandemia. Por um lado, é claro, o tema se impõe e convoca compreensão para nos aproximarmos dele.

Por outro, acredito que há uma vontade de escrever sobre ele no sentido do poema da Bishop: um misto de testemunho e aviso, de lembrança e recomendação. Escrevendo, retemos aquilo que está se passando e advertimos sobre o que ainda pode estar por vir.

Desde os primórdios, a escrita teve essa dupla função: guardar e anunciar. Nos dois casos, ela era uma tentativa de vencer o esquecimento, do passado e no futuro. Para não esquecer o que se passou ontem, registramos. Uma salvaguarda. (Na Grécia, Platão condenou a escrita porque, com ela, nos desincumbiríamos de lembrar as coisas por nós mesmos: a memória deixaria de se localizar dentro de nós e ficaria guardada fora.) Já para não esquecermos o que devemos fazer amanhã, anotamos, como quando usamos um post-it.

Escrever deve ser ainda a forma de se tentar confirmar o que vivemos, já que parece inacreditável. Isso: escrever é uma forma de acreditar, de fazer crer. É de fato o que está acontecendo. Como se precisássemos dar forma a um conteúdo que ainda nos escapa, nos desafia, nos estarrece. É um modo de, a cada dia, saber que estamos de fato acordados, não dormindo ou sonhando. Pois essas duas coisas às vezes parecem se misturar confusamente na rotina insólita.

Vimos, no século 21, guerras, atentados e crises financeiras que dificultavam a vida acordada. Assistimos, no cinema, a sonhos com alienígenas, asteroides, zumbis, aquecimentos, congelamentos e até epidemias que acabam com o mundo.

Filmes de Hollywood nos deram diversas versões de causas não humanas para o fim dos humanos. Como afirmou Fredric Jameson, a julgar pela produção do cinema comercial, parece que ficou mais fácil conceber o fim do mundo do que o fim do capitalismo, já que revoluções sociais foram raramente encenadas.

Entre os filmes sobre o fim do mundo, um que se destaca é “Melancolia” (2011), de Lars von Trier. O diretor dinamarquês pôs em cena dois personagens com modos de vida opostos diante da iminente colisão de um planeta com a Terra: uma melancólica, interpretada por Kirsten Dunst, e um pragmático, interpretado por Kiefer Sutherland (o ator que encarnara o agente antiterrorista americano Jack Bauer na série “24 Horas”, um ícone do pragmatismo).

Ela lida melhor com o desastre. Já era versada na arte de perder; ele, somente na de ganhar. O sujeito se prepara, estoca mantimentos e tudo o mais —contudo, quando fica claro que não dá para vencer o jogo de xadrez, suicida-se. Já ela encontra um conforto simbólico: faz uma cabana imaginária na qual se abriga com a irmã e o sobrinho. O mundo acaba.

Trata-se de um raro filme sobre o fim do mundo no qual o mundo de fato acaba. Na maior parte das vezes, um herói ou super-herói salva a pátria, quer dizer, o planeta, ou então um grupo de pessoas consegue escapar e caberá a ele recomeçar a aventura humana na Terra. Filmes sobre o fim do mundo costumam ser filmes sobre o quase fim do mundo. Não o de Lars von Trier. Tudo acaba mesmo.

Como eu não tenho qualquer simpatia por ele e tampouco por essa ideia, embora goste muito do filme, devo dizer que outro dia, lendo um texto bastante triste de um amigo sobre a pandemia, só consegui me ater a uma frase, no meio daquela tristeza: a pandemia vai passar. Ele a tinha escrito como um mero detalhe. Para mim, a frase diz muito, mesmo que a pandemia não passe tão cedo.

Pois, embora a morte seja o nosso destino certo e irrevogável, nossa presença no mundo não ganha o seu sentido por causa disso. O medo da morte pode acordar certa lucidez, mas, como observou o filósofo José Gil, não deve nos dominar na pandemia, pois ele encolhe o espaço, suspende o tempo, paralisa o corpo.

É preciso ter um medo desse medo. Mesmo a angústia, que nos coloca em relação com a finitude, não o faz em nome da morte, e sim da vida e de sua liberdade no tempo breve em que existimos. Como escreveu Hannah Arendt, os seres humanos, “embora devam morrer, não nascem para morrer, mas para começar”.

Sérgio Sant’Anna parecia saber bem das duas coisas. No dia 5 de abril, publicou um post no Facebook em que dizia que Jorge Luis Borges tem um conto no qual o personagem, um escritor à beira da morte, consegue de Deus que o seu tempo final seja elástico o suficiente para terminar um romance. “Queria isso para a minha novelinha e todo o livro a que ela pertence”, disse Sérgio, “e confesso que rezo todo dia”.

É esse o valor da vida que a morte traz. Sérgio morreu começando. Só queria mais tempo para escrever. Foi-se, dando início. Aos 78 anos.

Cientistas planejam a ressurreição digital com bots e humanoides (Canal Tech)

Por Natalie Rosa | 25 de Junho de 2020 às 16h40 Reprodução

Em fevereiro deste ano, o mundo todo se surpreendeu com a história de Jang Ji-sung, uma sul-coreana que “reencontrou” a sua filha, já falecida, graças à inteligência artificial. A garota morreu em 2016 devido a uma doença sanguínea.

No encontro simulado, a imagem da pequena Nayeon é exibida para a mãe que está em um fundo verde, também conhecido como chroma key, usando um headset de realidade virtual. A interação não foi só visual, como também foi possível conversar e brincar com a criança. Segundo Jang, a experiência foi como um sonho que ela sempre quis ter.

Encontro de Jang Ji-sung com a forma digitalizada da filha (Imagem: Reprodução)

Por mais que pareça uma tendência difícil de ser executada em massa na vida real, além de ser uma preocupação bastante antiga das produções de ficção científica, existem pessoas interessadas nesta forma de imortalidade. A questão que fica, no entanto, é se devemos fazer isso e como irá acontecer.

Em entrevista ao CNET, John Troyer, diretor do Centre for Death and Society (Centro para Morte e Sociedade) da Universidade de Bath, na Inglaterra, e autor do livro Technologies of the Human Corpse, conta que o interesse mais moderno pela imortalidade começou ainda na década de 1960. Na época, muitas pessoas acreditavam na ideia do processo criônico de preservação de corpos, quando um cadáver ou apenas uma cabeça humana eram congelados com a esperança de serem ressuscitados no futuro. Até o momento, ainda não houve tentativa de serem revividas.

“Aconteceu uma mudança na ciência da morte naquele tempo, e a ideia de que, de alguma forma, os humanos poderiam derrotar a morte”, explica Troyer. O especialista conta também que ainda não há uma pesquisa revisada que prove que o investimento de milhões no upload de dados do cérebro, ou ainda manter um corpo vivo, valha a pena.

Em 2016, um estudo publicado na revista acadêmica Plos One descobriu que expor um cérebro preservado a sondas químicas e elétricas o faz voltar a funcionar. “Tudo isso é uma aposta do que é possível no futuro. Mas eu não estou convencido de que é possível da maneira que estão descrevendo ou desejando”, completa.

Superando o luto

O caso que aconteceu na Coreia do Sul não foi o único que envolve o luto. Em 2015, Eugenia Kuyda, co-fundadora e CEO da empresa de softwares Replika, sofreu com a perda do seu melhor amigo Roman após um atropelamento em Moscou, na Rússia. A executiva decidiu, então, criar um chatbot treinado com milhares de mensagens de texto trocadas pelos dois ao longo dos anos, resultando em uma versão digital de Roman, que pode conversar com amigos e família.

“Foi muito emocionante. Eu não estava esperando me sentir assim porque eu trabalhei naquele chatbot e sabia como ele foi construído”, relata Kuyda. A experiência lembra bastante um dos episódios da série Black Mirror, que aborda um futuro distópico da tecnologia. Em Be Right Back, de 2013, uma jovem mulher perde o namorado em um acidente de carro e se inscreve em um projeto para que ela possa se comunicar com “ele” de forma digital, graças à inteligência artificial.

Por outro lado, Kuyda conta que o projeto não foi criado para ser comercializado, mas sim como uma forma pessoal de lidar com a perda do melhor amigo. Ela conta que qualquer pessoa que tentar reproduzir o feito vai encontrar uma série de empecilhos e dificuldades, como decidir qual tipo de informação será considerada pública ou privada, ou ainda com quem o chatbot poderá interagir. Isso porque a forma de se conversar com um amigo, por exemplo, não é a mesma com integrantes da família, e Kuyda diz que não há como fazer essa diferenciação.

A criação de uma versão digital de uma pessoa não vai desenvolver novas conversas e nem emitir novas opiniões, mas sim replicar frases e palavras já ditas, basicamente, se encaixando com o bate-papo. “Nós deixamos uma quantidade insana de dados, mas a maioria deles não é pessoal, privada ou baseada em termos de que tipo de pessoa nós somos”, diz Kuyda. Em resposta ao CNET, a executiva diz que é impossível obter dados 100% precisos de uma pessoa, pois atualmente não há alguma tecnologia que possa capturar o que está acontecendo em nossas mentes.

Sendo assim, a coleta de dados acaba sendo a maior barreira para criar algum tipo de software que represente uma pessoa após o falecimento. Parte disso acontece porque a maioria dos conteúdos postados online são de uma empresa, passando a pertencer à plataforma. Com isso, se um dia a companhia fechar, os dados vão embora junto com ela. Para Troyer, a tecnologia de memória não tende a sobreviver ao tempo.

Imagem: Reprodução

Cérebro fresco

A startup Nectome vem se dedicando à preservação do cérebro, pensando na possível extração da memória após a morte. Para que isso aconteça, no entanto, o órgão precisa estar “fresco”, o que significaria que a morte teria que acontecer por uma eutanásia.

O objetivo da startup é conduzir os testes com voluntários que estejam em estado terminal de alguma doença e que permitam o suicídio assistido por médicos. Até o momento a Nectome coletou US$ 10 mil reembolsáveis para uma lista de espera para o procedimento, caso um dia a oportunidade esteja disponível. Por enquanto, a companhia ainda precisa se esforçar em ensaios clínicos.

A startup já arrecadou um milhão de dólares em financiamento e vinha colaborando com um neurocientista do MIT. Porém, a publicação da história gerou muita polêmica negativa de cientistas e especialistas em ética, e o MIT encerrou o seu contrato com a startup. A repercussão afirmou que o projeto da empresa não é possível de ser realizado. 

Veja a declaração feita pelo MIT na época:

“A neurociência não é suficientemente avançada ao ponto de sabermos se um método de preservação do cérebro é o suficiente para preservar diferentes tipos de biomoléculas relacionadas à memória e à mente. Também não se sabe se é possível recriar a consciência de uma pessoa”, disse a nota ainda em 2018.

Eternização com a realidade aumentada

Enquanto alguns pensam em extrair a mente de um cérebro, outras empresas optam por uma “ressurreição” mais simples, mas não menos invasiva. A empresa Augmented Reality, por exemplo, tem como objetivo ajudar pessoas a viverem em um formato digital, transmitindo conhecimento das pessoas de hoje para as futuras gerações.

O fundador e CEO da empresa de computação FlyBits e professor do MIT Media Lab, Hossein Rahnama, vem tentando construir agentes de software que possam agir como herdeiros digitais. “Os Millennials estão criando gigabytes de dados diariamente e nós estamos alcançando um nível de maturidade em que podemos, realmente, criar uma versão digital de nós mesmos”, conta.

Para colocar o projeto em ação, a Augmented Reality alimenta um mecanismo de aprendizado de máquina com emails, fotos e atividades de redes sociais das pessoas, analisando como ela pensa e age. Assim, é possível fornecer uma cópia digital de uma pessoa real, e ela pode interagir via chatbot, vídeo digitalmente editado ou ainda como um robô humanoide.

Falando em humanoides, no laboratório de robótica Intelligent Robotics, da Universidade de Osaka, no Japão, já existem mais de 30 androides parecidos com humanos, inclusive uma versão robótica de Hiroshi Ishiguro, diretor do setor. O cientista vem inovando no campo de pesquisa de interações entre humanos e robôs, estudando a importância de detalhes, como movimentos sutis dos olhos e expressões faciais.

Reprodução: Hiroshi Ishiguro Laboratory, ATR

Quando Ishiguro morrer, segundo o próprio, ele poderá ser substituído pelo seu robô para dar aulas aos seus alunos, mesmo que esta máquina nunca seja realmente ele e nem possa gerar novas ideias. “Nós não podemos transmitir as nossas consciências aos robôs. Compartilhamos, talvez, as memórias. Um robô pode dizer ‘Eu sou Hiroshi Ishiguro’, mas mesmo assim a consciência é independente”, afirma.

Para Ishiguro, no futuro nada disso será parecido com o que vemos na ficção científica. O download de memória, por exemplo, é algo que não vai acontecer, pois simplesmente não é possível. “Precisamos ter diferentes formas de fazer uma cópia de nossos cérebros, mas nós não sabemos ainda como fazer isso”, completa. 

Mãe “reencontra” filha morta graças a realidade virtual

Para escapar do coronavírus, Yanomami se refugiam no interior da floresta (Amazônia Real)

Artigo original

Por: Ana Amélia Hamdan | 28/04/2020 às 23:41

Os indígenas chamam a pandemia de xawara. Um jovem da etnia morreu de Covid-19, em Boa Vista, Roraima.

A imagem é da Expedição Yanomami Okrapomai (Christian Braga/Midia Ninja/2014)

São Gabriel da Cachoeira (AM) – “A floresta protege porque ela tem um cheiro muito saudável, isso é a proteção que a floresta dá para nós Yanomami. A floresta tem mais proteção porque o ar não é contaminado. Muitos já foram para se proteger na floresta porque evitam de pegar gripe e outras doenças aqui na comunidade. Estão por lá se alimentando com caça, pesca, agora é muito açaí e muita fruta que está tendo na floresta”.

É assim, como se vê na fala da liderança Yanomami, José Mário Pereira Góes, que os indígenas estão se protegendo contra o coronavírus. Ele é presidente da Associação Yanomami do Rio Cauaburis e Afluentes (Ayrca), no Amazonas. Tal como os mais velhos fizeram para fugir de epidemias já enfrentadas no passado, como sarampo, gripes e coqueluche, os indígenas dessa etnia estão se refugiando no interior da floresta amazônica para se afastar do risco de contrair a Covid-19, a doença que causa uma pandemia no mundo e é responsável pela morte de um jovem da etnia.

A Terra Indígena Yanomami tem 9.664.975 hectares, localizada entre os estados do Amazonas e Roraima. São 380 comunidades e uma população de 28.148 pessoas, segundo a Secretaria Especial de Saúde Indígena, do Ministério da Saúde. A nova invasão de garimpeiros, que é um risco eminente da disseminação do novo coronavírus no território, foi denunciada pelo líder Davi Kopenawa Yanomami, em 2019.

Na comunidade Maturacá, localizada em São Gabriel da Cachoeira, no noroeste do Amazonas, pelo menos 12 famílias partiram para o interior da floresta. Outros grupos familiares se preparam para seguir o mesmo caminho. “O nosso povo Yanomami está alerta. A hora que chega em São Gabriel essa doença, vamos nos deslocar e estamos fazendo farinhada para a gente se isolar os 40 dias no mato. E a hora que tiver três casos, quatro casos, não vai ficar ninguém na comunidade. Só vai ficar pelotão, missão. Só isso que vai estar aqui na comunidade”, diz José Góes.

Assembleia para discutir turismo no Pico da Neblina, em Maturacá
(Foto: João Claudio Moreira/Amazônia Real)

Em Boa Vista, capital de Roraima, o vice-presidente da Hutukara Associação Yanomami, Dario Vitório Kopenawa explica que esse movimento de isolamento no interior da floresta amazônica não é uma tarefa fácil para os Yanomami. Muitas das comunidades se fixaram perto de locais onde há posto de saúde. É por isso que há divisão entre quem se refugiou na floresta e quem permaneceu na comunidade. “Algumas minorias foram para o isolado. A maioria ainda está na comunidade, ficando isolado na maloca”, explica.

Dario acompanha a movimentação dos Yanomami para dentro da floresta, recebendo informações via radiofonia, da sede da Hutukara, e relata que a ida para o mato vem acontecendo no Marauiá (região do Rio Marauiá); Parawa-u e Demini, todos no Amazonas. Em Roraima, é o subgrupo Ninam que segue a mesma estratégia. A família de Dario – inclusive seu pai, a liderança e xamã Yanomami Davi Kopenawa -, está na região Demini, buscando proteção na floresta.

Também via rádio, o vice-presidente da Hutukara tem notícias de que os xamãs vêm trabalhando na tentativa de conhecer a doença. “Pandemia coronavírus para nós é xawara. Os Yanomami pajés e médicos da floresta estão trabalhando reconhecendo essa doença. Assim os xamãs me falaram”, diz Dario Kopenawa. 

O isolamento em São Gabriel

Fiscais orientam população em São Gabriel da Cachoeira na terça-feira, 28 de abri
(Foto: Paulo Desana/Dabakuri/Amazônia Real)

A viagem da sede de São Gabriel da Cachoeira para Maturacá leva cerca de 10 horas, dependendo das condições da estrada e de navegação pelo Rio Negro e seus afluentes. No domingo (26), a prefeitura do município confirmou os dois primeiros casos de coronavírus e, no dia seguinte, houve a confirmação outros dois. É grande a possibilidade de já estar havendo a transmissão comunitária. Desses quatro pacientes, três são indígenas e um é militar do Exército.

José Mário Góes, presidente da Associação Yanomami do Rio Cauaburis e Afluentes (Ayrca), está em Maturacá e respondeu à reportagem da Amazônia Real por meio da mensagem de áudio de WhatsApp. O acesso à internet é possível porque durante parte do dia eles conseguem captar o sinal pela proximidade com o 5º Pelotão Especial de Fronteira do Exército.

“Quando uma família vai, outras famílias vão, a vizinhada vai. Porque na comunidade somos todos parentes, então eles levaram toda a família”, disse a liderança indígena. Cada grupo está construindo pequenos abrigos para morar por cerca de 40 dias. Além de se manterem com frutas, caça e pesca, levam alimentos. Se for necessário, voltam à comunidade para reforçar os mantimentos. “Levaram alimentos principais como farinha, banana, tapioca, beiju, e também café, açúcar, arroz, feijão e materiais de caça e pesca. E quando acaba os alimentos eles vêm buscar banana, pegar estoque de farinha”, relata Góes.

“Deixar as casas e ficar por um tempo na floresta é uma estratégia que algumas famílias já estão fazendo. Diferente de nós que estamos enfrentando pela primeira vez uma epidemia, os Yanomami têm experiências recentes que dizimaram comunidades inteiras e os sobreviventes foram os que se isolaram no mato”, explica o assessor do Programa Rio Negro do Instituto Socioambiental (ISA), Marcos Wesley de Oliveira.

Essa estratégia pode ser comparada ao isolamento social recomendado pela Organização Mundial da Saúde (OMS) e pelo Ministério da Saúde, aponta Marcos Wesley. “Os Yanomami sabem que até o momento não há remédio ou vacina eficazes contra a Covid-19”, reforça.

O município de São Gabriel da Cachoeira tem uma população de mais de 45 mil habitantes, a maioria indígenas de 23 etnias, segundo a taxa atualizada do Censo do IBGE. Desse total, 25 mil moram nas aldeias e comunidades, em territórios demarcados, segundo a Federação das Organizações Indígenas do Rio Negro (Foirn). 

Para evitar que os indígenas de Maturacá, cuja população total é de cerca de 2.000 pessoas, façam a viagem até São Gabriel para fazer compras, o ISA e a Foirn enviam cestas básicas e kits de higiene para a comunidade. Esse material será levado por avião do Exército, segundo protocolo de higienização e distribuição para evitar a contaminação da Covid-19. 

Em artigo publicada na Amazônia Real, o antropólogo francês Bruce Albert citou um trecho do livro A queda do Céu, escrito em conjunto por ele e pelo xamã e líder Davi Kopenawa Yanomami, para falar sobre a morte do jovem, em Boa Vista. O adolescente foi sepultado sem o conhecimento dos pais e sem o respeito aos rituais de seu povo. Ao tratar do tema funeral, o antropólogo sugeriu ao leitor “reler A queda do Céu, pp. 267-68, onde Davi Kopenawa conta como sua mãe morreu numa epidemia de sarampo trazida pelos missionários da Novas Tribos do Brasil (aliás, Ethnos360) e como estes sepultaram o cadáver à revelia num lugar até hoje desconhecido: Por causa deles, nunca pude chorar a minha mãe como faziam nossos antigos. Isso é uma coisa muito ruim. Causou-me um sofrimento muito profundo, e a raiva desta morte fica em mim desde então. Foi endurecendo com o tempo, e só terá fim quando eu mesmo acabar. ”

Bruce Albert, que trabalha com os Yanomami desde 1975, também escreveu em sua rede social sobre a saúde do adolescente Yanomami, de 15 anos, da aldeia Helepe, no Rio Uraricoera (RR), antes dele morrer vítima da Covid-19.

O alerta das epidemias do passado

Movimento nas ruas de São Gabriel da Cachoeira na manhã de segunda-feira (27/04/2020) (Foto: Paulo Desana/Dabakuri/Amazônia Real)

A morte do adolescente Yanomami despertou o temor desse povo, inclusive em Maturacá. “Essa morte traz alerta para que isso não acabe com povo Yanomami. Como aconteceu na região do Irokae, morrendo adultos, jovens e crianças, os idosos, como aconteceu isso não queremos que aconteça mais. Por isso estamos alerta por aqui”, afirma José Mário Góes.

Irokae é o primeiro acampamento para o Pico da Neblina, denominado pelos Yanomami de Yaripo, a Montanha de Vento. Essa trilha seria reaberta para o turismo em abril, mas foi adiada devido à pandemia. Anos atrás, na tentativa de fugir da coqueluche, os grupos seguiram por esse caminho, mas alguns acabaram morrendo.

“Essa doença de agora, o coronavírus, aqui em Maturacá, representa epidemia de coqueluche como aconteceu na região de Irokae. O que está acontecendo com os napë (forasteiro, homem branco), isso já aconteceu aqui para nós Yanomami na região do Irokae, onde fica a trilha do Yaripo”, relata José Mário. “Nossos avós já tiveram outra doença, como epidemia de coqueluche, que matou muitas crianças e os mais velhos. Eles não querem que repita essa história. Morreu até um pajé nessa epidemia. Então como fizeram agora, eles foram para a floresta, na região do frio, chegaram até lá no pico. É lá que ficam os restos mortais dos nossos parentes e por isso que nós falamos que temos histórias no caminho do Yaripo”, relata José Góes.

Outro problema enfrentado no passado foi o sarampo. “Aqui na comunidade, em Maturacá, onde está situado o polo base de saúde. Então era um xapono (casa coletiva) onde tivemos epidemia de sarampo. Também nós fizemos o movimento como estamos fazendo hoje aqui, mas não teve jeito. Pessoas fugiram, mas teve óbito nas crianças. Morreu muita criança e adulto. É a mesma história que eles não querem que repita. ”

Para os Yanomami, o vírus é um tipo de envenenamento. “Nós observamos que o próprio napë faz envenenamento no ser humano para dizer que é vírus. Isso é epidemia, é um vírus que afeta qualquer ser humano e acaba com a vida do ser humano. Isso tem na nossa realidade como aconteceu com nossos antepassados o que está acontecendo hoje no mundo inteiro. Até no Brasil e no exterior”, diz José Góes.

Em busca de proteção, os Yanomami recorrem a ensinamentos de seus antepassados. Após a confirmação dos casos em São Gabriel, as lideranças tradicionais iniciaram a chamada “recura’ para que a doença saia do lugar e seja levada pelo vento para onde não tem ser humano.

Expedição Yanomami Okrapomai (Christian Braga/ Midia Ninja/2014)

*Este texto foi atualizado em 29/04/2020 às 11h27 para corrigir o número da população Yonomami.

The Impossible Ethics of Pandemic Triage (The Atlantic)

Original article

Aaron Kheriaty – April 3, 2020

Is there a formula for deciding which patients doctors try to save?

If help does not arrive quickly, several hospitals in New York will soon run out of ventilators. Doctors at these hospitals will then face anguishing choices — if the word “choice” is even applicable when every available option is an awful one.

Imagine that Mr. Jones was intubated yesterday in an NYC hospital. He is not imminently dying, though his chances of surviving Covid-19 are uncertain. Mrs. Smith, another Covid-19 case, now requires intubation in the same hospital’s emergency room. She is twenty years younger than Jones, and without his diabetes and hypertension, so her prognosis for recovery is better. But yesterday Jones took the last ventilator in the ICU. If we leave Mr. Jones on the vent, Mrs. Smith will die. If we take Jones off the vent to give it to Smith, then he will die.

If we choose the younger, healthier Mrs. Smith over the older, sicker Mr. Jones, this might appear to be age discrimination. On the other hand, the coronavirus itself engages in age discrimination, killing those over 70 at a much higher rate — so age itself appears to be a medically relevant prognostic factor in many cases.

Most physicians are not trained as wartime medics. We have never before faced these battlefield triage decisions. And with the coronavirus pandemic, there are additional ethical complications. That NYC hospital is also running out of N95 masks and proper gowns to protect staff from infection. Health care workers certainly have a duty to care for the sick. Just as firefighters run into burning buildings while others run away, so also we treat contagious patients while others are socially distancing.

But just as firefighters never signed up to run into burning buildings in their boxer shorts, so also doctors and nurses did not sign up to treat infectious diseases without basic personal protective equipment — gowns, gloves, and masks that cost pennies apiece yet somehow are in short supply. When this PPE is gone, and doctors lack even the most basic barriers against infection, should the 70-year-old physician have to stay in the game? What about the 28-year-old pregnant medical resident who has an elderly immunocompromised grandfather living at home?

Suppose during this crisis we stretch the duty to treat contagious patients to heroic proportions. This is part of the physician’s job, so it is all hands on deck. After a few weeks of this strategy, and before more N95 masks arrive, half of the emergency and ICU physicians in this NYC hospital are home sick with the cursed virus, and one of the hospital’s docs is sick enough to need — guess what? — a ventilator. So this doctor returns to her hospital as a patient.

Should we then pull Mrs. Jones off the ventilator and offer it to the infected physician, who after all acquired Covid-19 while on the front lines heroically risking her own health to care for patients? If we are not convinced by the argument from reciprocity (that she deserves some reward for these efforts), what about the “multiplier effect”? If our central ethical principle under crisis conditions is to save as many lives as possible, it seems plausible that saving this ICU physician — if she recovers and returns to the fray — could help save the lives of more patients. Doctors are in short supply and cannot be easily replaced.

Okay, fine — perhaps we can prioritize doctors, all other things being equal in terms of prognosis. But many other workers are also critical to the pandemic response. Perhaps we can “replace” food service workers and janitors — as distasteful as it is to put it in those terms and think of our fellow human beings in that way — but what about the lead scientist on a project to develop a coronavirus vaccine? Or the police chief of New York? Or any police officer or firefighter, for that matter? What about a priority nudge for pregnant patients on the basis of this same multiplier effect? How should we draw the line around this category of “critical workers” or others who can get a bump up the triage list?

Draw the line too broadly, encompassing anyone still working during the crisis, and such priority quickly becomes meaningless. Draw it too narrowly and you exclude others who are also essential. In any case, if we consider some to be indispensable in this hour, does this not imply that others — the artists and poets, the homeless and unemployed — are dispensable? How will such practices shape our attitudes and impact social solidarity once the virus is gone and the dust has settled?

Suppose we attempt to resolve these puzzles by sticking only to objective clinical criteria: no special priority for anyone, no triage categories that are not directly related to prognosis. We do our best to predict which patients will have the best short-term survival outcomes, give them first priority on scarce resources like ventilators, and save as many people as possible. This seems sensible enough, until we realize that those Covid-19 patients with the best prognosis are typically the ones without medical conditions like diabetes, hypertension, and cardiac disease. But these people are often healthier because they eat healthy food (which is more expensive than McDonald’s), work out at fancy gyms (also expensive), and have access to good medical care (very expensive).

So a triage system that appears at first glance to be fair and medically objective turns out to have the potential for exacerbating social inequalities. The populations that were most vulnerable before a disaster are likely to be among the most vulnerable during a disaster. On the other hand, our mandate is to save as many lives as possible, not to right all wrongs. If devising a medically fair pandemic triage system is frightfully hard, devising a socially fair system seems impossible.

Triage scenarios are not hypothetical fantasies: they are happening in Italy and they are on the verge of happening here. Even as we hope and pray for the best, we have to plan for the worst — and prepare for it quickly.

For the past several weeks, these and a thousand other bewildering questions have been keeping my colleagues and me awake at night. After working on these issues round the clock with colleagues at my hospital who specialize in ethics, critical care, anesthesiology, emergency medicine, and nursing, I recently joined a task force to devise a pandemic triage protocol for all hospitals in the University of California system. These are some of the most remarkable people I know, and most have skin in the game as physicians on the front lines.

UC hospitals are well prepared for a large coronavirus surge, but many of California’s smaller private and community hospitals may not be so fortunate. These times call for the sharing of resources between hospitals, for transfers of care, for institutional solidarity. Our hospitals’ resources belong not to us, but to the citizens of California, and even to those beyond our state borders.

We are not starting from scratch or reinventing the wheel in our deliberations. Many thoughtful ethicists and dedicated clinicians have examined these questions in the bioethics research literature. And several states have published guidelines on these thorny questions, often with input from citizens. Yet most of this background work was done when these questions were hypothetical, while the guidelines we are producing now may soon be deployed on the ground.

In the few moments when we slow down, we occasionally think about the opportunistic lawyers and prosecutors who will later go after doctors no matter what choices we make. This is not to mention the Monday morning quarterbacks who will second-guess these choices with the benefit of hindsight, limitless time, and much more retrospective data. Well, fine — let armies of graduate students earn their Ph.D.’s in the coming years by telling us what we could have done better.

Honestly, most of the time we just worry about our patients. We picture the droves of sick people, barely able to breathe, who will arrive any day now at our hospital doors in ever expanding numbers. We wonder how we will explain our decision to an anguished daughter when we have to look her in the eye and say, “We are sorry, your father will not be placed on a ventilator but will be transitioned to comfort care only.” How will we explain this when a month ago he would have received treatment without question, and might have recovered?

None of this makes sense and none of us thought we would ever be in this position. Yet here we are.

We have deliberated about duty, justice, equality, fairness, transparency. These principles can never be abandoned even in a crisis. Yet something lingers always in the background of our efforts. There is an inescapably tragic undercurrent to all of this, however upright our intentions. This one unsettling fact always remains to haunt us: If hospitals exceed their surge capacity, patients who otherwise would have lived will die. Lives will be lost simply because we lacked the resources to offer everyone the basics of modern medicine.

T. S. Eliot saw the limits of our ability to rectify all wrongs and balance the scales of justice when he wrote, “For us, there is only the trying. The rest is not our business.” My colleagues and I, like so many others in these strange times, are trying our best. But controlling and managing this pandemic is beyond our abilities, indeed, beyond anyone’s abilities. In the absence of a God’s-eye view, in the absence of unlimited resources, in the absence of a crystal ball that can perfectly prognosticate outcomes, physicians are left to humbly do whatever we can — even as we know that this will not be enough. For us there is only the trying. The rest is marked by tragedy.

Aaron Kheriaty, M.D., is an associate professor of psychiatry and human behavior, and director of the Medical Ethics Program, at the University of California Irvine School of Medicine.

Aaron Kheriaty, “The Impossible Ethics of Pandemic Triage,” TheNewAtlantis.com, April 3, 2020.

Olga Tokarczuk: Coronavírus mostrou que todos sentimos medo e morremos igual (Folha de S.Paulo)

Artigo original

Olga Tokarczuk, 10 de abril de 2020

Da minha janela vejo uma amoreira branca, árvore que me fascina e que foi um dos motivos pelos quais escolhi morar aqui. A amoreira é uma planta generosa —ao longo de toda a primavera e de todo o verão alimenta dezenas de famílias de pássaros com os seus frutos doces e saudáveis. No entanto, agora a amoreira está sem folhas, e assim vejo um pedaço de uma rua quieta ao longo da qual raramente passeia alguém em seu caminho para o parque.

O tempo em Breslávia está quase veranil, brilha um sol que quase ofusca a vista, o céu está azul, e o ar, límpido. Hoje, enquanto passeava com o cachorro, vi duas pegas espantando uma coruja para longe do seu ninho. Nos entreolhamos com a coruja a uma distância de apenas um metro.Tenho a impressão de que os animais também esperam por aquilo que está por vir.

Para mim, já havia um bom tempo, o mundo estava em demasia. Por demais, rápido demais, barulhento demais.

Não passo, portanto, pelo “trauma do isolamento” e não sofro por não poder me encontrar com as pessoas. Não sinto pena que os cinemas não estejam funcionando, estou indiferente ao fechamento dos shoppings. Eu me preocupo apenas quando penso em todas aquelas pessoas que trabalhavam lá e perderam os seus empregos. Quando soube da quarentena preventiva, senti uma espécie de alívio e sei que muitas pessoas sentem o mesmo, embora estejam envergonhadas disso. Minha introversão abafada e maltratada pelo império dos extrovertidos impetuosos se espanou e saiu do armário.

Vejo pela janela o meu vizinho, um advogado esfalfado que eu via, ainda há pouco, saindo de manhã para o tribunal com uma toga pendurada em seu braço. Agora, trajando blusa e calça de moletom folgados, luta com um galho no jardim. Deve estar arrumando as coisas. Vejo um casal de jovens passeando com um cachorro velho que, desde o último inverno, mal consegue andar. O cachorro vacila sobre as patas, e eles o acompanham pacientemente, caminhando a passos lentos. O caminhão de lixo recolhe os despejos provocando um enorme barulho.

Obviamente, a vida continua, só que num ritmo completamente diferente. Arrumei o armário e levei os jornais velhos para fora, para o contêiner dos recicláveis. Transferi as plantas para vasos novos. Levei a bicicleta para o conserto. Sinto prazer em cozinhar.

Voltam até mim, com insistência, imagens da infância, quando havia muito mais tempo e era possível “desperdiçá-lo” olhando pela janela horas a fio, observando as formigas deitada debaixo da mesa, imaginando que era uma arca. Ou estudando a enciclopédia.

Não teríamos, por acaso, voltado para o ritmo normal da vida? O vírus não seria, então, um desvio da norma, muito pelo contrário —aquele mundo frenético antes do vírus teria sido anormal?

Afinal, o vírus trouxe à nossa memória aquilo que reprimimos apaixonadamente —que somos seres frágeis, compostos da matéria mais delicada. E que morremos, que somos mortais. E que a nossa “humanidade” e excepcionalidade não nos separam do mundo. Permanecemos emaranhados nele como numa espécie de rede enorme, interligados aos outros seres através de invisíveis fios de dependências e influências. E que existem correlações entre todos nós. Não importa de que países longínquos provimos, que língua falamos e qual é a cor da nossa pele. Todos, igualmente, contraímos doenças, sentimos o mesmo medo e morremos do mesmo jeito.

O vírus nos conscientizou de que não importa o quanto nos sentimos fracos e vulneráveis perante o perigo, há sempre, ao nosso redor, pessoas ainda mais fracas que precisam de ajuda. Ele nos relembrou quão delicados são os nossos pais e avós idosos e o quanto eles precisam dos nossos cuidados.

Ele nos mostrou que a nossa mobilidade frenética constitui uma ameaça para o mundo. E reavivou a mesma pergunta que poucas vezes tivemos a coragem de nos fazer: de que mesmo estamos à procura?
Então, o medo da doença nos fez retornar do caminho enredado e, por necessidade, evocou a existência dos ninhos de onde provimos e onde nos sentimos seguros. E, mesmo se fôssemos viajantes incansáveis, numa situação como esta o nosso destino seria uma casa.

Assim, se revelaram diante de nós tristes verdades —que em um momento de perigo volta o raciocínio que fecha e exclui por meio de categorias como nação e fronteiras. Neste momento difícil se descobriu quão fraca, em prática, é a ideia da comunidade europeia. A União Europeia basicamente entregou os pontos, passando as decisões no tempo de crise aos Estados. Considero o fechamento das fronteiras nacionais como a maior derrota deste tempo vago em que voltaram os velhos egoísmos e categorias como “os nossos” e “os estranhos”, ou seja, aquilo que ao longo dos últimos anos tentávamos combater com a esperança de que esses conceitos jamais formatassem nossas mentes. O medo do vírus automaticamente trouxe à memória a mais simples convicção atávica –que a culpa é dos estranhos e que eles sempre trazem o perigo de algum lugar. Na Europa, o vírus veio “de algures”, não é nosso, é alheio. Na Polônia, todas as pessoas vindas do estrangeiro se tornaram suspeitas.

Para muitos jovens, uma onda de fronteiras trancadas impetuosamente e filas monstruosas nas passagens fronteiriças devem ter sido um choque. O vírus nos relembra –as fronteiras continuam existindo e estão bem.

Receio também que o vírus evoque rapidamente outra antiga verdade –o quanto somos desiguais. Alguns de nós vão partir em seus aviões para a sua casa localizada numa ilha ou num aconchego silvestre, outros vão permanecer nas cidades operando termoelétricas ou estações de abastecimento de água. Outros ainda vão pôr a sua saúde em risco trabalhando nas lojas e hospitais. Uns vão enriquecer com a epidemia, outros vão perder tudo o que ganharam na vida. A crise que está se aproximando vai certamente abalar os princípios que nos pareciam estáveis. Muitos países não vão conseguir lidar com ela e em face de sua decomposição nascerá uma nova ordem, assim como muitas vezes acontece depois das crises.

Permanecemos em casa lendo livros e assistindo a séries, mas na realidade nos preparamos para uma grande batalha pela nova realidade que nem sequer conseguimos imaginar, percebendo, aos poucos, que nada será como antes. A situação da quarentena obrigatória e do enquartelamento da família em casa pode nos revelar algo que jamais queríamos admitir –que a família nos cansa e que os laços matrimoniais há muito tempo afrouxaram. Nossos filhos vão sair da quarentena viciados na internet e muitos de nós vão perceber o absurdo e a vagueza da situação em que permanecem mecanicamente e por força de inércia. E se o número de assassinatos, suicídios e doenças mentais crescer?

Diante dos nossos olhos se esvanece, feito fumaça, o paradigma civilizatório que nos moldou ao longo dos últimos 200 anos –que somos os senhores da criação, podemos fazer tudo e o mundo nos pertence.

Novos tempos estão por vir.

Tradução do polonês de Olga Bagińska-Shinzato

Olga Tokarczuk é autora de ‘Sobre os Ossos dos Mortos’ (Todavia) e venceu o prêmio Nobel de Literatura em 2019

Esse desconforto que você está sentindo é luto (HBR/Medium)

Por Scott Berinato, da Harvard Business Review. Traduzido por Ana Marcela Sarria (aqui); revisado por Renzo Taddei.

Texto original em inglês

HBR Staff/d3sign/Getty Images

Parte da equipe da HBR se reuniu virtualmente outro dia — uma tela cheia de rostos, numa cena que está se tornando cada vez mais comum por todos lados. Falamos sobre o conteúdo que estamos produzindo nestes tempos angustiantes e como podemos ajudar as pessoas. Mas também falamos sobre como estamos nos sentindo. Uma colega mencionou que o que ela sentia era luto. Cabeças acenaram em concordância na tela.

Se podemos nomeá-lo, talvez possamos lidar com ele. Conversamos com David Kessler sobre ideias de como fazer isso. Kessler é um grande especialista em luto. Ele co-escreveu, com Elisabeth Kübler-Ross, o livro On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss. Seu novo livro adiciona outro estágio no processo, Finding Meaning: The Sixth Stage of Grief. Kessler também trabalhou por uma década no sistema hospitalar de Los Angeles. Ele participou da equipe de risco biológico. Seu trabalho voluntário inclui ser membro da Reserva de Especialistas da polícia de Los Angeles para eventos traumáticos, assim como ter servido na equipe de serviços em situação de desastre da Cruz Vermelha. Ele é o fundador do www.grief.com, que tem mais de 5 milhões de visitas anuais advindas de 167 países.

Kessler compartilhou seus pensamentos sobre por que é importante reconhecer o luto que você pode estar sentindo, como controlá-lo, e por que ele acredita que vamos encontrar um sentido nele. A conversa está levemente editada para garantir maior clareza.

HBR: As pessoas estão sentindo muitas coisas agora. Écorreto chamar algumas das coisas que elas estão sentindo de luto?

Kessler: Sim, e estamos sentindo vários lutos diferentes. Estamos sentindo que o mundo mudou, e ele mudou mesmo. Sabemos que é temporário, mas não sentimos que seja, e compreendemos que as coisas vão ser diferentes. Assim como ir ao aeroporto mudou para sempre depois do 11 de setembro, as coisas vão mudar e este é o ponto no qual mudaram. A perda da normalidade; o medo do estrago econômico; a perda de conexão. Estamos sendo afetados por essas coisas, e estamos em luto. Não estamos acostumados a este tipo de luto coletivo no ar.

Você disse que estamos sentindo mais de um tipo de luto?

Sim, estamos sentindo, também, luto antecipado. Luto antecipado é esse sentimento que temos sobre o que o futuro nos reserva quando estamos incertos a respeito. Normalmente se centra na morte. Sentimos isso quando alguém tem um diagnóstico ruim, ou quando pensamos a respeito do fato de que vamos perder nosso pais em algum momento. Luto antecipado é também, mais maneira mais geral, sobre futuros imaginados. Tem uma tempestade chegando. Tem algo ruim lá fora. Com um vírus, este tipo de luto é muito confuso para as pessoas. Nossa cognição sabe que algo ruim está acontecendo, mas não podemos vê-lo. Isso rompe nosso sentido de segurança. Estamos sentindo a perda da segurança. Eu acho que jamais havíamos perdido coletivamente nosso senso geral de segurança desta forma. Indivíduos ou grupos específicos passaram por isso, mas isso é inédito em escala planetária. Estamos em luto nos níveis micro e macro.

O quê podemos fazer para lidar com o luto?

Entender os estágios do luto é um começo. Mas sempre que falo sobre os estágios do luto, eu lembro as pessoas de que os estágios não são lineares e podem não acontecer nessa ordem. Não é um mapa, mas nos fornece uma plataforma para acessar este mundo desconhecido. Existe a negação, que acontece bastante no início: “este vírus não vai nos afetar”. Existe a raiva: “vocês estão nos fazendo ficar em casa e tirando nossos trabalhos”. Existe a barganha: “ok, se estabelecemos o distanciamento social por duas semanas, tudo vai melhorar, certo?”. Existe a tristeza: “eu não sei quando isto vai terminar”. E, finalmente, a aceitação: “isto está acontecendo; eu tenho que descobrir como seguir adiante”.

A aceitação, como você pode imaginar, é onde está nosso poder. Encontramos o controle quando chegamos na fase da aceitação. “Eu posso lavar minhas mãos. Eu posso manter uma distância segura. Eu posso aprender a trabalhar virtualmente.”

Quando estamos sentindo luto, existe uma dor física. E a mente acelerada. Existem técnicas para lidar com isso e fazer com que seja menos intenso?

Vamos voltar para o luto antecipado. Luto antecipado não-saudável é, na verdade, ansiedade; esse é o sentimento sobre o qual você está falando. Nossa mente começa a nos mostrar imagens. Meus pais ficando doentes. Vemos os piores cenários. Essa é nossa mente sendo protetiva. Nosso objetivo é não ignorar essas imagens ou tentar fazê-las ir embora — sua mente não vai deixar você fazer isso e pode ser doloroso se você forçar. O objetivo é encontrar o equilíbrio nas coisas que você está pensando. Se você sente que imagens ruins estão tomando forma, mude o seu pensamento para imagens positivas. Todos nós ficamos doentes e o mundo segue adiante. Nem todo mundo que eu amo morre. Talvez não morram porque estamos todos fazendo as coisas certas. Nenhum cenário deve ser ignorado, mas nenhum deve dominar também.

Luto antecipado é a mente projetando-se para o futuro e imaginando o pior. Para se acalmar, você quer voltar para o presente. Este conselho vai soar familiar para qualquer pessoa que já meditou ou praticou mindfulness, mas as pessoas podem sempre se surpreender com o quão simples isto pode ser. Você pode nomear cinco coisas que estão na sala onde você está. Existe um computador, uma cadeira, uma foto de um cachorro, um tapete velho e uma xícara de café. É simples assim. Respire. Perceba que, no momento presente, nada do que você tinha antecipado aconteceu. Neste momento, você está bem. Você tem comida. Você não está doente. Use seus sentidos e pense sobre o que eles sentem. A mesa é dura. O cobertor é macio. Eu consigo sentir o ar entrando em minhas narinas. Isto efetivamente funciona para reduzir a dor.

Você também pode pensar sobre como abrir mão do que você não tem controle. O que seu vizinho está fazendo está fora do seu controle. O que está no seu controle é ficar a um metro de distância dele, e lavar suas mãos. Foque nisso.

Finalmente, é um bom momento para multiplicar a compaixão. As pessoas vão ter níveis diferentes de medo e luto e isso se manifesta de formas diferentes. Uma pessoa com quem trabalho ficou muito rude comigo outro dia e eu pensei: “não parece a mesma pessoa; essa é a forma como a pessoa está lidando com a situação. Estou vendo seu medo e ansiedade”. Então seja paciente. Pense sobre como as pessoas geralmente são e não quem elas parecem ser neste momento.

Um aspecto particularmente perturbador nesta pandemia é não saber quando ela acaba.

Isto é um estado temporário. Ajuda falar sobre isso. Eu trabalhei 10 anos no sistema hospitalar. Eu fui treinado para situações como esta. Eu também estudei a pandemia da gripe de 1918. As precauções que estamos tomando são corretas. A história nos conta isso. Isto se chama sobrevivência. Vamos sobreviver. Este é um tempo de se superproteger, mas não se reagir de forma desmedida.

E acredito que vamos encontrar sentido nisto. Eu fiquei honrado que a família de Elisabeth Kübler-Ross me deu permissão para acrescentar um sexto estado ao luto: significado. Eu tinha falado bastante com Elisabeth sobre o que viria depois da aceitação. Eu não quis parar na aceitação quando experimentei o luto pessoal. Eu quis significado naquelas horas mais difíceis. E efetivamente acredito que encontramos iluminação nestes momentos. Agora mesmo as pessoas estão percebendo que elas podem se conectar através da tecnologia. Elas não estão tão distantes quanto imaginavam. Elas estão percebendo que podem usar seus telefones para conversas longas. Estão apreciando caminhadas. Eu acredito que vamos continuar encontrando significado agora e quando isso tiver acabado.

O que você diria para alguém que lê tudo isto e ainda assim se sente sobrecarregado com o luto?

Continue tentando. Há algo poderoso em nomear o luto. Isso nos ajuda a sentir o que está dentro de nós. Tantas pessoas me disseram na última semana: “estou dizendo para meus colegas de trabalho que estou tendo dificuldades” ou “chorei na noite passada”. Quando você nomeia o luto, você é mais capaz de senti-lo e ele se move através de você. Emoções precisam de movimento. É importante que entendamos o que estamos passando. Um produto infeliz do movimento de autoajuda é que somos a primeira geração que tem emoções sobre suas emoções. Falamos para nós mesmos: “estou me sentindo triste, mas não deveria sentir isso; outras pessoas se sentem pior”. Nós podemos — devemos — parar no primeiro sentimento. “Eu me sinto triste. Vou me deixar sentir triste, por cinco minutos”. Seu objetivo nesse momento é sentir sua tristeza e medo e raiva, independente do que estejam sentindo as demais pessoas. Lutar contra isso não ajuda porque seu corpo está produzindo o sentimento. Se permitimos que os sentimentos aconteçam, eles vão acontecer de uma maneira ordenada, e nos empoderar. Então não seremos vítimas.

Numa maneira ordenada?

Sim. às vezes tentamos não sentir o que estamos sentindo porque temos essa imagem de um “bando de emoções”. Se eu me sentir triste e acolher a tristeza, ela não irá embora. O bando de emoções ruins vai me dominar. A verdade é que uma emoção se move através de nós. Não existe um bando de emoções que vai nos pegar. É absurdo pensar que não deveríamos sentir luto agora. Permita-se sentir o luto e siga adiante.

That Discomfort You’re Feeling Is Grief (HBR)

Scott Berinato

March 23, 2020

HBR Staff/d3sign/Getty Images

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Some of the HBR edit staff met virtually the other day — a screen full of faces in a scene becoming more common everywhere. We talked about the content we’re commissioning in this harrowing time of a pandemic and how we can help people. But we also talked about how we were feeling. One colleague mentioned that what she felt was grief. Heads nodded in all the panes.

If we can name it, perhaps we can manage it. We turned to David Kessler for ideas on how to do that. Kessler is the world’s foremost expert on grief. He co-wrote with Elisabeth Kübler-Ross On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss. His new book adds another stage to the process, Finding Meaning: The Sixth Stage of Grief. Kessler also has worked for a decade in a three-hospital system in Los Angeles. He served on their biohazards team. His volunteer work includes being an LAPD Specialist Reserve for traumatic events as well as having served on the Red Cross’s disaster services team. He is the founder of www.grief.com, which has over 5 million visits yearly from 167 countries.

Kessler shared his thoughts on why it’s important to acknowledge the grief you may be feeling, how to manage it, and how he believes we will find meaning in it. The conversation is lightly edited for clarity.

HBR: People are feeling any number of things right now. Is it right to call some of what they’re feeling grief?

Kessler: Yes, and we’re feeling a number of different griefs. We feel the world has changed, and it has. We know this is temporary, but it doesn’t feel that way, and we realize things will be different. Just as going to the airport is forever different from how it was before 9/11, things will change and this is the point at which they changed. The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving. Collectively. We are not used to this kind of collective grief in the air.

You said we’re feeling more than one kind of grief?

Yes, we’re also feeling anticipatory grief. Anticipatory grief is that feeling we get about what the future holds when we’re uncertain. Usually it centers on death. We feel it when someone gets a dire diagnosis or when we have the normal thought that we’ll lose a parent someday. Anticipatory grief is also more broadly imagined futures. There is a storm coming. There’s something bad out there. With a virus, this kind of grief is so confusing for people. Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety. We’re feeling that loss of safety. I don’t think we’ve collectively lost our sense of general safety like this. Individually or as smaller groups, people have felt this. But all together, this is new. We are grieving on a micro and a macro level.

What can individuals do to manage all this grief?

Understanding the stages of grief is a start. But whenever I talk about the stages of grief, I have to remind people that the stages aren’t linear and may not happen in this order. It’s not a map but it provides some scaffolding for this unknown world. There’s denial, which we say a lot of early on: This virus won’t affect us. There’s anger: You’re making me stay home and taking away my activities. There’s bargaining: Okay, if I social distance for two weeks everything will be better, right? There’s sadness: I don’t know when this will end. And finally there’s acceptance. This is happening; I have to figure out how to proceed.

Acceptance, as you might imagine, is where the power lies. We find control in acceptance. I can wash my hands. I can keep a safe distance. I can learn how to work virtually.

When we’re feeling grief there’s that physical pain. And the racing mind. Are there techniques to deal with that to make it less intense?

Let’s go back to anticipatory grief. Unhealthy anticipatory grief is really anxiety, and that’s the feeling you’re talking about. Our mind begins to show us images. My parents getting sick. We see the worst scenarios. That’s our minds being protective. Our goal is not to ignore those images or to try to make them go away — your mind won’t let you do that and it can be painful to try and force it. The goal is to find balance in the things you’re thinking. If you feel the worst image taking shape, make yourself think of the best image. We all get a little sick and the world continues. Not everyone I love dies. Maybe no one does because we’re all taking the right steps. Neither scenario should be ignored but neither should dominate either.

Anticipatory grief is the mind going to the future and imagining the worst. To calm yourself, you want to come into the present. This will be familiar advice to anyone who has meditated or practiced mindfulness but people are always surprised at how prosaic this can be. You can name five things in the room. There’s a computer, a chair, a picture of the dog, an old rug, and a coffee mug. It’s that simple. Breathe. Realize that in the present moment, nothing you’ve anticipated has happened. In this moment, you’re okay. You have food. You are not sick. Use your senses and think about what they feel. The desk is hard. The blanket is soft. I can feel the breath coming into my nose. This really will work to dampen some of that pain.

You can also think about how to let go of what you can’t control. What your neighbor is doing is out of your control. What is in your control is staying six feet away from them and washing your hands. Focus on that.

Finally, it’s a good time to stock up on compassion. Everyone will have different levels of fear and grief and it manifests in different ways. A coworker got very snippy with me the other day and I thought, That’s not like this person; that’s how they’re dealing with this. I’m seeing their fear and anxiety. So be patient. Think about who someone usually is and not who they seem to be in this moment.

One particularly troubling aspect of this pandemic is the open-endedness of it.

This is a temporary state. It helps to say it. I worked for 10 years in the hospital system. I’ve been trained for situations like this. I’ve also studied the 1918 flu pandemic. The precautions we’re taking are the right ones. History tells us that. This is survivable. We will survive. This is a time to overprotect but not overreact.

And, I believe we will find meaning in it. I’ve been honored that Elisabeth Kübler-Ross’s family has given me permission to add a sixth stage to grief: Meaning. I had talked to Elisabeth quite a bit about what came after acceptance. I did not want to stop at acceptance when I experienced some personal grief. I wanted meaning in those darkest hours. And I do believe we find light in those times. Even now people are realizing they can connect through technology. They are not as remote as they thought. They are realizing they can use their phones for long conversations. They’re appreciating walks. I believe we will continue to find meaning now and when this is over.

What do you say to someone who’s read all this and is still feeling overwhelmed with grief?

Keep trying. There is something powerful about naming this as grief. It helps us feel what’s inside of us. So many have told me in the past week, “I’m telling my coworkers I’m having a hard time,” or “I cried last night.” When you name it, you feel it and it moves through you. Emotions need motion. It’s important we acknowledge what we go through. One unfortunate byproduct of the self-help movement is we’re the first generation to have feelings about our feelings. We tell ourselves things like, I feel sad, but I shouldn’t feel that; other people have it worse. We can — we should — stop at the first feeling. I feel sad. Let me go for five minutes to feel sad. Your work is to feel your sadness and fear and anger whether or not someone else is feeling something. Fighting it doesn’t help because your body is producing the feeling. If we allow the feelings to happen, they’ll happen in an orderly way, and it empowers us. Then we’re not victims.

In an orderly way?

Yes. Sometimes we try not to feel what we’re feeling because we have this image of a “gang of feelings.” If I feel sad and let that in, it’ll never go away. The gang of bad feelings will overrun me. The truth is a feeling that moves through us. We feel it and it goes and then we go to the next feeling. There’s no gang out to get us. It’s absurd to think we shouldn’t feel grief right now. Let yourself feel the grief and keep going.

Original post

Italians over 80 ‘will be left to die’ as country overwhelmed by coronavirus (The Telegraph)

Hardest-hit region drafts new proposals saying who will live and who will die

By Erica Di Blasi Turin 14 March 2020 • 4:38pm

Coronavirus victims in Italy will be denied access to intensive care if they are aged 80 or more or in poor health should pressure on beds increase, a document prepared by a crisis management unit in Turin proposes.

Some patients denied intensive care will in effect be left to die, doctors fear.

The unit has drawn up a protocol, seen by The Telegraph, that will determine which patients receive treatment in intensive care and which do not if there are insufficient spaces. Intensive care capacity is running short in Italy as the coronavirus continues to spread.

The document, produced by the civil protection deparment of the Piedmont region, one of those hardest hit, says: “The criteria for access to intensive therapy in cases of emergency must include age of less than 80 or a score on the Charlson comorbidity Index [which indicates how many other medical conditions the patient has] of less than 5.”

The ability of the patient to recover from resuscitation will also be considered.

One doctor said: “[Who lives and who dies] is decided by age and by the [patient’s] health conditions. This is how it is in a war.”

The document says: “The growth of the current epidemic makes it likely that a point of imbalance between the clinical needs of patients with COVID-19 and the effective availability of intensive resources will be reached.

“Should it become impossible to provide all patients with intensive care services, it will be necessary to apply criteria for access to intensive treatment, which depends on the limited resources available.”

It adds: “The criteria set out guidelines if the situation becomes of such an exceptional nature as to make the therapeutic choices on the individual case dependent on the availability of resources, forcing [hospitals] to focus on those cases in which the cost/benefit ratio is more favorable for clinical treatment.”

Luigi Icardi, a councilor for health in Piedmont, said: “I never wanted to see such a moment. It [the document] will be binding and will establish in the event of saturation of the wards a precedence code for access to intensive care, based on certain parameters such as potential survival.”

The document is already complete and only approval from a technical-scientific committee is needed before it is sent to hospitals. The criteria are expected to apply throughout Italy, government sources said.

More than 1,000 people in Italy have now died from the virus and the number is growing every day. More than 15,000 are infected.

Italy has 5,090 intensive care beds, which for the moment exceeds the number of patients who need them. It is also working to create new bed capacity in private clinics, nursing homes and even in tents. However, the country also needs also doctors and nurses – the government wants to hire them – and equipment.

Lombardy remains the most critical region. However, the situation is also serious in neighboring Piedmont. Here, in just one day, 180 new cases were recorded, while deaths numbered 27. The trend suggests that the situation is not about to improve.

Roberto Testi, president of the coranavirus technical-scientific committee for Piedmont, told The Telegraph: “Here in Piedmont we aim to delay as long as possible the use of these criteria. At the moment there are still intensive care places available and we are working to create more.

“We want to arrive as late as possible at the point where we have to decide who lives and who dies. The criteria relate only to access to intensive care – those who do not get access to intensive care will still receive all the treatment possible. In medicine we sometimes have to make difficult choices but it’s important to have a system about how to make them.”

Poor air quality kills 5.5 million worldwide annually (Science Daily)

Date: February 12, 2016

Source: University of British Columbia

Summary: New research shows that more than 5.5 million people die prematurely every year due to household and outdoor air pollution. More than half of deaths occur in two of the world’s fastest growing economies, China and India.

New research shows that more than 5.5 million people die prematurely every year due to household and outdoor air pollution. More than half of deaths occur in two of the world’s fastest growing economies, China and India. Credit: Institute for Health Metrics and Evaluation (IHME), University of Washington

New research shows that more than 5.5 million people die prematurely every year due to household and outdoor air pollution. More than half of deaths occur in two of the world’s fastest growing economies, China and India.

Power plants, industrial manufacturing, vehicle exhaust and burning coal and wood all release small particles into the air that are dangerous to a person’s health. New research, presented today at the 2016 annual meeting of the American Association for the Advancement of Science (AAAS), found that despite efforts to limit future emissions, the number of premature deaths linked to air pollution will climb over the next two decades unless more aggressive targets are set.

“Air pollution is the fourth highest risk factor for death globally and by far the leading environmental risk factor for disease,” said Michael Brauer, a professor at the University of British Columbia’s School of Population and Public Health in Vancouver, Canada. “Reducing air pollution is an incredibly efficient way to improve the health of a population.”

For the AAAS meeting, researchers from Canada, the United States, China and India assembled estimates of air pollution levels in China and India and calculated the impact on health.

Their analysis shows that the two countries account for 55 per cent of the deaths caused by air pollution worldwide. About 1.6 million people died of air pollution in China and 1.4 million died in India in 2013.

In China, burning coal is the biggest contributor to poor air quality. Qiao Ma, a PhD student at the School of Environment, Tsinghua University in Beijing, China, found that outdoor air pollution from coal alone caused an estimated 366,000 deaths in China in 2013.

Ma also calculated the expected number of premature deaths in China in the future if the country meets its current targets to restrict coal combustion and emissions through a combination of energy policies and pollution controls. She found that air pollution will cause anywhere from 990,000 to 1.3 million premature deaths in 2030 unless even more ambitious targets are introduced.

“Our study highlights the urgent need for even more aggressive strategies to reduce emissions from coal and from other sectors,” said Ma.

In India, a major contributor to poor air quality is the practice of burning wood, dung and similar sources of biomass for cooking and heating. Millions of families, among the poorest in India, are regularly exposed to high levels of particulate matter in their own homes.

“India needs a three-pronged mitigation approach to address industrial coal burning, open burning for agriculture, and household air pollution sources,” said Chandra Venkataraman, professor of Chemical Engineering at the Indian Institute of Technology Bombay, in Mumbai, India.

In the last 50 years, North America, Western Europe and Japan have made massive strides to combat pollution by using cleaner fuels, more efficient vehicles, limiting coal burning and putting restrictions on electric power plants and factories.

“Having been in charge of designing and implementing strategies to improve air in the United States, I know how difficult it is. Developing countries have a tremendous task in front of them,” said Dan Greenbaum, president of Health Effects Institute, a non-profit organization based in Boston that sponsors targeted efforts to analyze the health burden from different air pollution sources. “This research helps guide the way by identifying the actions which can best improve public health.”

Video: https://youtu.be/Kwoqa84npsU


The research is an extension of the Global Burden of Disease study, an international collaboration led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington that systematically measured health and its risk factors, including air pollution levels, for 188 countries between 1990 and 2013. The air pollution research is led by researchers at the University of British Columbia and the Health Effects Institute.

Additional facts about air pollution:

  • World Health Organization (WHO) air quality guidelines set daily particulate matter at 25 micrograms per cubic metre.
  • At this time of year, Beijing and New Delhi will see daily levels at or above 300 micrograms per cubic meter metre; 1,200 per cent higher than WHO guidelines.
  • While air pollution has decreased in most high-income countries in the past 20 years, global levels are up largely because of South Asia, Southeast Asia, and China. More than 85 per cent of the world’s population now lives in areas where the World Health Organization Air Quality Guideline is exceeded.
  • The researchers say that strict control of particulate matter is critical because of changing demographics. Researchers predict that if air pollution levels remain constant, the number of deaths will increase because the population is aging and older people are more susceptible to illnesses caused by poor air quality.
  • According to the Global Burden of Disease study, air pollution causes more deaths than other risk factors like malnutrition, obesity, alcohol and drug abuse, and unsafe sex. It is the fourth greatest risk behind high blood pressure, dietary risks and smoking.
  • Cardiovascular disease accounts for the majority of deaths from air pollution with additional impacts from lung cancer, chronic obstructive pulmonary disease (COPD) and respiratory infections.

Theorizing Embodiment and Making Bodies ‘Matter’ (The Disorder of Things)


Bringing to a close our symposium on Bodies of Violence is Lauren’s rejoinder to all our contributors, Kevin McSorleyAli HowellPablo and Antoine.

First, a huge thank you to the (Dis)order of Things and especially Antoine for organizing this forum and to each of the contributors. It’s been a huge honor to have my work read so carefully and responded to so thoughtfully and I welcome the opportunity to try to clarify some of my work and acknowledge where the contributors have pointed out helpful areas for future research.

As Pablo K and others noticed, Bodies of Violence it is not meant to be a general theory of embodiment in IR (I’m not sure such a project is feasible or politically desirable in any event).  It is a more specific intervention with a different ambition: both to speak to ‘mainstream’ concerns about theorizing violence, particularly forms of political violence associated with the ‘war on terror’ and to make not only a theoretical argument about how we might or should theorize embodiment and violence, but also to show that understanding these different ‘modes of violence’ necessitates such an understanding of the relationship between bodies, subjects and violence.  My rationale for using feminist theory to think about the relationship between bodies, subjects and violence in IR was not meant to be exclusive: certainly (other) people working with concepts of biopolitics as well as anti-colonial/anti-racist theorists, disability theorists, phenomenologists and more also have much to say on this topic, some insights of which have been very important in my analysis, if not as fully fleshed out (if you will) as my engagement with feminist theory is.[i] For me, it was a particular reading of feminist theories of embodiment, not solely based on Butler, but on a particular feminist problematic in which women, as a category of those constituted, as Pablo K put it, the “improperly bodied”, are politically disenfranchised and generally excluded from their status as a fully human subject that served as a starting point, but far from an ‘ending’ for thinking about the subject of embodiment.  Rather, it is, as Kevin noted, “the specific tradition of trying to think through women’s subordination in terms of the relationship between bodies, subjects and power” that feminist theory entails that I wanted to use to think about violence and embodiment in ways that I hope will speak not only to feminists in IR but also to other critical and the more pluralistically and trans-disciplinarily minded scholars in IR and beyond as well.

Ana Mendieta, Body Tracks

However, this brings us to some of the drawbacks of feminist approaches to violence and embodiment. Ali’s point about the violence of feminist theory is a particularly good one. Feminists working in IR tend to be quite aware of the uses of feminism for violent aims: the Taliban’s oppression and abuse of women in Afghanistan as a rationale for war by the US and its allies being supported by NOW and the Feminist Majority is a well-known example. Ali’s point about the violence of some feminism(s) against trans-people is also well-taken; though Butler is hardly a ‘TERF’ by any means, her work has been critiqued by trans-theorists for a number of reasons. For the purposes of this book, I don’t necessarily see a conflict between trans-theory and Butler’s theory of the materialization of bodies and the limits of intelligibility as being relevant to the ways in which security practices work to materialize only certain bodies as ‘real,’ often excluding trans- people and constituting them as threats. In general, I agree with Ali that we should welcome feminist scholarship and practice that is less defensive in regards to the ‘mainstream’ of the discipline and more willing to seek alliances and interlocutors from a broader range of scholars, both in the spaces of IR and outside doing work on violence, power and embodiment.[ii]

Forum contributors also provided some excellent provocations for thinking about aspects of embodiment or ways of addressing the thorny question of embodiment that my book did not focus on. Pablo writes, “It is a book thoroughly about bodies, but not therefore necessarily a theory of bodies and embodiment. And it is theory of em-bodies-ment that we may in need of.” On a somewhat different note, Kevin wonders what might happened if the embodied subjects of which I write “could have a more audible place in the analysis.” Of course, it (should) hardly need mentioning the great amount of work influenced by feminist and postcolonial theory that strives to bring the voices and experiences of embodied subjects, particularly of marginalized peoples, into IR as a disciplinary space. I would point, for one example, to the work of Christine Sylvester and others on experience as an embodied concept for theorizing war. However, as Kevin points out, my book has a different, and I would hope, complementary aim: to show the explanatory and critical value of theorizing bodies as both produced by, and productive of, practices of violence in international politics.  It is the last point, that bodies are productive of violence, which speaks more to Pablo’s concern about bodies ‘mattering’.

While Bodies of Violence is perhaps most influenced by Butler’s project, as Kevin, Ali and Pablo K have all noted, theories of embodiment (or at least the relationship between discourse and materiality) such as Elizabeth Grosz’s Volatile Bodiesand Barad’s ‘posthumanist performativity’ as well as Donna Haraway’s work are perhaps more of an influence than appears in the published version of the book, which takes as an overarching frame Butler’s concepts of normative violence and ontological precarity. These other works are concerned, in their own way, with the ways in which matter ‘matters’ or the ways in which embodied subjects exceed their materializations in discourse.[iii]

Marlene Dumas, Measuring Your Own Grave

It is the ‘generative’ or ‘productive’ capacities of bodies that is an engagement with ‘new materialisms’ or ‘feminist materialisms’ if you like. One of the aspects of Barad’s work, whom Pablo mentions, that is most appealing is the insistence of intra-activity, with the implication that we cannot meaningfully separate matter from the discursive, as phenomena only exist by virtue of ongoing assemblages and reassemblages of matter and discourse.  Bodies ‘matter,’ they do things, they have what Diana Coole refers to as ‘agentic capacities’ One reason that Bodies of Violence focuses on actual instances of violence perpetrated on and by bodies in international politics is precisely to take bodies seriously as something other than ‘representations’ or ‘abstractions’ in IR. An example of bodies being ‘productive’ in the book are the ways that bodies ‘speak’ which might exceed the intentions of ‘speaking subjects’. Antoine’s discussion of my work on the hunger striking body in Guantanamo Bay (which I also discussed earlier here on the blog) makes reference to this point: the body in pain as a call for recognition. This is something the body ‘does’ that is not reducible to the intentions of a fully constituted subject nor the words spoken by such subjects (this is in addition to the ways in which hunger striking prisoners such as Samir Naji al Hasan Moqbel have spoken eloquently about their experiences). And yet, while this body’s actions may have certain implications, enable certain politics, etc, this cannot be understood without understanding that the body’s capacities are already subject to prior materializations and their reception will also bear the marks of prior political assemblages as well.

A key example of this from the book is the embodiment of drone operators, or perhaps more accurately, the legal/technological drone assemblage.  While this form of embodiment is what might be termed, following Haraway, a ‘material-semiotic actor’, it is a body, or form of embodiment, that is necessary for the kind of ‘death-world’ that enables the killing of suspected militants as well as those people who can only be named innocent or militant in the aftermath. Both bodies of drone operators and the people who are killed by drone strikes are intimately connected in this way: the embodiment of drone pilots is productive of the bodies of targets and the ‘uncountable’ bodies whose deaths remain outside of the epistemological framework enabled by this drone assemblage. Thus, there is less of an explicit engagement with ‘new materialisms’ per se than an acknowledgement (one that has been part of feminist theory for decades) that one cannot determine or write bodies ‘all the way down’ and that, in the words of Samantha Frost and Diana Coole,’ nature ‘pushes back’ in sometimes unexpected ways, but in ways that are nonetheless subject to human interpretation.

Insect swarm picture from wired.com, Lukas Felzmann

Antoine concludes the forum on a forward-looking note that also recalls Ali’s point of the various forms of critical literatures that have much to offer our thinking about bodies and violence beyond feminist literatures: “a growing task of critical scholars in the future may therefore also be that of attentiveness to new forms for the sorting and hierarchizing of bodies, human and otherwise, that are emerging from the production of scientific knowledges.” I agree and (some of) my current research is aimed precisely at the question of gender, queer theory and ‘the posthuman’. While I am wary of certain tendencies within some of the critical literatures of affect theory, ‘new materialisms’ and the like that suggest either explicitly or implicitly that feminist, anti-racial or other such critiques are outmoded, scholars like Rosi Braidotti and Donna Haraway have read the feminist politics the ‘posthuman’ in ways that engage the shifting materialities and discursive constructions of gendered and sexualized bodies. I’m working on a project now that pursues the question of embodiment and ‘drone warfare’ future to consider the politics of the insect and the swarm as inspirations for military technological developments, in the manner that Katherine Hayles describes as a double vision that “looks simultaneously at the power of simulation and at the materialities that produce it” in order to “better understand the implication of articulating posthuman constructions together with embodied actualities” (Hayles 1999, 47). This is to say both discursive constructions of insects/swarms in culture (particularly their association with death, abjection and the feminine) as well as the material capabilities of insects and their role in the earth’s eco-system and its own set of ‘death-worlds’ can and should be thought in tandem. The parameters of this project are yet not fixed (are they ever?) and so I’m grateful for this conversation around Bodies of Violence as I work to further the project of taking embodiment and its relationships with subjectivity and violence seriously in thinking about international political violence in its myriad forms. These contributions are evidence that work on embodiment in IR and related disciplines is becoming a robust research area in which many possibilities exist for dialogue, critique and collaboration.

[i] Also, feminist theorists such as Butler, Grosz, Haraway and Ahmed all engage in a variety of traditions as well, from psychoanalysis, Foucauldian theory, phenomenology, postcolonial theory, and more, so the divisions between ‘feminist theory’ and other kinds of critical theory is far from given, and a much longer piece could be written about this.

[ii] Although see recent work by Rose McDermott and Dan Reiter that seems determined to ignore the advances of decades of scholarship on gender, feminism, and war.

[iii] I agree with Pablo K that Butler’s work is ambiguously situated in relationship to the so-called ‘new materialisms’: I make a brief case in the book that it is not incompatible with her approach at times, but I don’t explore this at length in the final version of the text.

The Skeleton Trade: Life, Death, and Commerce in Early Modern Europe (Objects in Motion: Material Culture in Transition)

JULY 9, 2015

Anita Guerrini, Horning Professor of the Humanities and Professor of History at Oregon State University, discusses the fascinating research which she presented at Objects in Motion: Material Culture in Transition.

Although the human skeleton was well known as a symbol before 1500, the articulated skeleton does not seem to have come into its own as an object – scientific and artistic as well as symbolic – until the time of Vesalius. Curiously ubiquitous, since everyone has one, but yet largely invisible, anatomists revealed the skeleton to view. The well-known illustrations of Vesalius were plagiarized over and over for two centuries after their publication in 1543.

Vesalius, "De humani corporis fabrica", 1543. Credit: Wellcome Library, London.

Vesalius was the first to give detailed instructions on how to make a skeleton, for although it was a natural object, it was also a crafted object whose construction entailed a lot of work. The human body became an object in motion as it travelled from the scaffold to the dissection table to the grisly cauldron where the bones were boiled to remove their flesh. While artists and anatomists employed skeletons for instruction, little evidence of their collection appears before the mid-seventeenth century, when they begin to appear in cabinets and collections. Both the Royal Society and the Paris Academy of Sciences owned several. At the Paris Academy, André Colson, described as an “ébeniste” or furniture maker, was charged with the making and maintenance of the skeleton room, while the physician Nehemiah Grew, who catalogued the Royal Society’s collections in 1681, may also have made its skeletons. By the end of the seventeenth century, a vigorous skeleton trade flourished across Europe, and they often appear in auction catalogues alongside books, works of art, and scientific instruments. At the same time, relics, both old and new, retained their potency in both Catholic and Protestant countries.

After Vesalius, detailed instructions for making a skeleton appeared in many anatomical texts and manuals as part of the education of a physician or surgeons; in the eighteenth century, William Hunter took it for granted that each of his students would need to construct a skeleton for his own use and in addition procure “several skulls.” While such a process would seem to confer anonymity to the finished skeleton, provenance and even identity often clung to the bones along with religious resonances. Most skeletons were of executed criminals, some of them widely known. The skeleton of the “Thief-taker General” Jonathan Wild, executed in 1725, still hangs in the gallery of the College of Surgeons in London, and Hogarth’s famous 1751 “Fourth Stage of Cruelty” shows the skeletons of other malefactors on display in niches at Surgeons’ Hall while a cauldron awaits the bones of Tom Nero, who is being dissected by the surgeons after his conviction for murder.

William Hogarth's "The Fourth Stage of Cruelty", 1751. Credit: Wikimedia.

Widespread demand and changing scientific contexts expanded the market for skeletons (as well as skulls) beyond Europe to encompass much of the known world by the mid-eighteenth century. The prodigious collector Hans Sloane received skulls and bones from contacts throughout the world, including native bones that his Jamaican contacts apparently stumbled across in caves. Sloane’s meticulous catalogues of his collections allow one to trace the provenance of many of his human specimens though other collectors and agents. Such catalogues, along with account books, advertisements, and illustrations, reveal this worldwide commerce in skeletons alongside a continued trade in skeletal relics. Traveling across time and place, skeletons embodied beauty and deformity, crime and punishment, sin and sanctity, science and colonial power, often simultaneously.

18th-century trade card for the skeleton seller and preparator Nathaniel Longbottom of London. Credit: Wellcome Library, London.

Médicos que ‘ressuscitam mortos’ querem testar técnica em humanos (BBC)

Técnica para estender vidas por algumas horas nunca foi testada em humanos

“Quando seu corpo está com temperatura de 10 graus, sem atividade cerebral, batimento cardíaco e sangue – é um consenso que você está morto”, diz o professor Peter Rhee, da universidade do Arizona. “Mas ainda assim, nós conseguimos trazer você de volta.”

Rhee não está exagerando. Com Samuel Tisherman, da Universidade de Maryland, nos Estados Unidos, ele comprovou que é possível manter o corpo em estado “suspenso” por horas.

O procedimento já foi testado com animais e é o mais radical possível. Envolve retirar todo o sangue do corpo e esfriá-lo até 20 graus abaixo da sua temperatura normal.

Quando o problema no corpo do paciente é resolvido, o sangue volta a ser bombeado, reaquecendo lentamente o sistema. Quando a temperatura do sangue chega a 30 graus, o coração volta a bater.

Os animais submetidos a esse teste tiveram poucos efeitos colaterais ao despertar. “Eles ficam um pouco grogue por um tempo, mas no dia seguinte já estão bem”, diz Tisherman.

Testes com humanos

Tisherman causou um frisson internacional este ano quando anunciou que está pronto para fazer testes com humanos. As primeiras cobaias seriam vítimas de armas de fogo em Pittsburgh, na Pensilvânia.

Nesse caso, são pacientes cujos corações já pararam de bater e que não teriam mais chances de sobreviver, pelas técnicas convencionais. O médico americano teme que, por conta de manchetes imprecisas na imprensa, tenha-se criado uma ideia equivocada da sua pesquisa

Peter Rhee ajudou a criar técnica inovadora que envolve retirar o sangue do paciente

“Quando as pessoas pensam no assunto, elas pensam em viajantes espaciais sendo congelados e acordados em Júpiter, ou no [personagem] Han Solo, de Guerra nas Estrelas”, diz Tisherman.

“Isso não ajuda, porque é importante que as pessoas saibam que não se trata de ficção científica.”

Os esforços para trazer as pessoas de volta do que se acredita ser a morte já existem há décadas. Tisherman começou seus estudos com Peter Safar, que nos anos 1960 criou a técnica pioneira de reanimação cardiorrespiratória. Com uma massagem cardíaca, é possível manter o coração artificialmente ativo por um tempo.

“Sempre fomos criados para acreditar que a morte é um momento absoluto, e que quando morremos não tem mais volta”, diz Sam Parnia, da Universidade Estadual de Nova York.

“Com a descoberta básica da reanimação cardiorrespiratória nós passamos a entender que as células do corpo demoram horas para atingir uma morte irreversível. Mesmo depois que você já virou um cadáver, ainda existe como resgatá-lo.”

Recentemente, um homem de 40 anos no Texas sobreviveu por três horas e meia com a reanimação cardiorrespiratória.

Segundo os médicos de plantão, “todo mundo com dois braços foi chamado para se revezar fazendo as compressões no peito do paciente”.

Durante a massagem, ele continuava consciente e conversando com os médicos, mas caso o procedimento fosse interrompido, ele morreria. Eventualmente ele se recuperou e acabou sobrevivendo.

Esse caso de rescucitação ao longo de um grande período só funcionou porque não havia uma grande lesão no corpo do paciente. Mas isso é raro.


A técnica desenvolvida agora por Tisherman é baseada na ideia de que baixas temperaturas mantêm o corpo vivo por mais tempo – cerca de uma ou duas horas.

O sangue é retirado e no seu lugar é colocada uma solução salina que ajuda a rebaixar a temperatura do corpo para algo como 10 a 15 graus Celsius.

Em experiência com porcos, cerca de 90% deles se recuperaram quando o sangue foi bombeado de volta. Cada animal passou mais de uma hora no “limbo”.

Técnica de massagem cardíaca já ajuda a estender a vida de pessoas com paradas

“É uma das coisas mais incríveis de se observar: quando o coração começa a bater de novo”, diz Rhee.

Após a operação, foram realizados vários testes para avaliar se houve dano cerebral. Aparentemente nenhum porco apresentou problemas.

O desafio de obter permissão para testar em humanos tem sido enorme até agora. Tisherman e Rhee finalmente receberam permissão para testar sua técnica com vítimas de tiros em Pittsburgh.

Um dos problemas a ser contornado é ver como os pacientes se adaptam com o sangue de outra pessoa. Os porcos receberam o próprio sangue congelado, mas no caso dos humanos será necessário usar o estoque do banco de sangues.

Se der certo, os médicos acreditam que a técnica poderia ser aplicada não só vítimas de lesões, como tiros e facadas, mas em pessoas com ataque cardíaco.

A pesquisa também está levando a outros estudos sobre qual seria a melhor solução química para reduzir o metabolismo do corpo humano.

Leia a versão desta reportagem original em inglês no site BBC Future.

Scientists find ‘hidden brain signatures’ of consciousness in vegetative state patients (Science Daily)

Date: October 16, 2014

Source: University of Cambridge

Summary: Scientists in Cambridge have found hidden signatures in the brains of people in a vegetative state, which point to networks that could support consciousness even when a patient appears to be unconscious and unresponsive. The study could help doctors identify patients who are aware despite being unable to communicate.

These images show brain networks in two behaviorally similar vegetative patients (left and middle), but one of whom imagined playing tennis (middle panel), alongside a healthy adult (right panel). Credit: Srivas Chennu

Scientists in Cambridge have found hidden signatures in the brains of people in a vegetative state, which point to networks that could support consciousness even when a patient appears to be unconscious and unresponsive. The study could help doctors identify patients who are aware despite being unable to communicate.

There has been a great deal of interest recently in how much patients in a vegetative state following severe brain injury are aware of their surroundings. Although unable to move and respond, some of these patients are able to carry out tasks such as imagining playing a game of tennis. Using a functional magnetic resonance imaging (fMRI) scanner, which measures brain activity, researchers have previously been able to record activity in the pre-motor cortex, the part of the brain which deals with movement, in apparently unconscious patients asked to imagine playing tennis.

Now, a team of researchers led by scientists at the University of Cambridge and the MRC Cognition and Brain Sciences Unit, Cambridge, have used high-density electroencephalographs (EEG) and a branch of mathematics known as ‘graph theory’ to study networks of activity in the brains of 32 patients diagnosed as vegetative and minimally conscious and compare them to healthy adults. The findings of the research are published today in the journal PLOS Computational Biology. The study was funded mainly by the Wellcome Trust, the National Institute of Health Research Cambridge Biomedical Research Centre and the Medical Research Council (MRC).

The researchers showed that the rich and diversely connected networks that support awareness in the healthy brain are typically — but importantly, not always — impaired in patients in a vegetative state. Some vegetative patients had well-preserved brain networks that look similar to those of healthy adults — these patients were those who had shown signs of hidden awareness by following commands such as imagining playing tennis.

Dr Srivas Chennu from the Department of Clinical Neurosciences at the University of Cambridge says: “Understanding how consciousness arises from the interactions between networks of brain regions is an elusive but fascinating scientific question. But for patients diagnosed as vegetative and minimally conscious, and their families, this is far more than just an academic question — it takes on a very real significance. Our research could improve clinical assessment and help identify patients who might be covertly aware despite being uncommunicative.”

The findings could help researchers develop a relatively simple way of identifying which patients might be aware whilst in a vegetative state. Unlike the ‘tennis test’, which can be a difficult task for patients and requires expensive and often unavailable fMRI scanners, this new technique uses EEG and could therefore be administered at a patient’s bedside. However, the tennis test is stronger evidence that the patient is indeed conscious, to the extent that they can follow commands using their thoughts. The researchers believe that a combination of such tests could help improve accuracy in the prognosis for a patient.

Dr Tristan Bekinschtein from the MRC Cognition and Brain Sciences Unit and the Department of Psychology, University of Cambridge, adds: “Although there are limitations to how predictive our test would be used in isolation, combined with other tests it could help in the clinical assessment of patients. If a patient’s ‘awareness’ networks are intact, then we know that they are likely to be aware of what is going on around them. But unfortunately, they also suggest that vegetative patients with severely impaired networks at rest are unlikely to show any signs of consciousness.”

Journal Reference:

  1. Chennu S, Finoia P, Kamau E, Allanson J, Williams GB, et al. Spectral Signatures of Reorganised Brain Networks in Disorders of Consciousness. PLOS Computational Biology, 2014; 10 (10): e1003887 DOI:10.1371/journal.pcbi.1003887

‘El rayo fue un castigo’: Mamo que sobrevivió a tragedia de la Sierra (El Tiempo)

EL TIEMPO visitó el pueblo donde murieron 11 indígenas y habló con su máxima autoridad.

Por:   |

2:29 p.m. | 7 de octubre de 2014

En la foto, el mamo Ramón Gil, que perdió a su hijo Juan Ramón Gil cuando cayó el rayo que mató a 11 indígenas.

Foto: Carlos Capella / EL TIEMPO. En la foto, el mamo Ramón Gil, que perdió a su hijo Juan Ramón Gil cuando cayó el rayo que mató a 11 indígenas.

El mamo Ramón Gil, la máxima autoridad de los wiwa y uno de los indígenas tradicionales más conocidos de la Sierra Nevada, dice que hace dos años la naturaleza le había advertido que debían pagar por tantas talas y saqueos que se han realizado en estas montañas. (Lea también: Llegan ayudas a comunidad wiwa tras caída de rayo en Sierra Nevada)

Esa advertencia se hizo realidad cuando en la madrugada de este lunes, asegura el mamo, un rayo cayó sobre la unguma, choza ceremonial donde estaban reunidos unos 50 wiwas de la cuenca media del río Guachaca, y mató a 11 indígenas y dejó a otros 20 con heridas.

La comunidad wiwa de la sierra nevada de Santa Marta se repone de la tragedia que ocasionó la caída de un rayo que mató 11 personas y dejó 20 heridos. Foto: CEET

Luego de la tragedia, en la noche del lunes, los indígenas se fueron del pueblo por temor a que otro rayo volviera a castigarlos. Los cadáveres fueron recogidos en una choza y acomodados en el piso, donde pasaron la noche. Hoy, en la mañana, cuando escucharon el sonido del helicóptero volvieron a bajar de las montañas al pueblo. (Lea también: ‘Un trueno retumbó en la Sierra y en segundos se prendió la choza’)

“El domingo a las seis de la tarde, cuando cayeron los primeros relámpagos, sentí que estaban molestos, pidiendo que le devuelvan a la naturaleza todo lo que se han llevado de la Sierra”, contó el hombre ayer entre las cenizas de la choza ceremonial, de donde aún, pese a los últimos aguaceros, se levantan pequeñas columnas de humo que salen de la tierra y el olor a quemado invade las 40 chozas de kemakúmake, el pueblo ancestral que llora por la tragedia. (Vea las fotos de la zona donde cayó el rayo y la operación para evacuar a los heridos)

En su relato, Ramón, que perdió a su hijo, recuerda que le dijo a la comunidad que el relámpago necesitaba un pago, por tantos árboles talados y cuarzo saqueado. También les había dicho que desde hace tiempo la naturaleza le estaba pidiendo que le cobrara a todos aquellos que habían profanado esos lugares sagrados y él no lo había hecho. (Vea en un mapa los 2.900 rayos que cayeron en la zona de la Sierra Nevada)

“Le dije a la comunidad, el trueno está bravo, dice que nos mandó el primer castigo el verano, pero como suplicamos mucho, manda el aguacero, pero no pagamos y ahora va a venir guerra de la naturaleza y de la humanidad”, asegura el viejo mamo que le dijo la naturaleza.

Esa noche, él estaba hablando con los hombres del pueblo en la choza ceremonial, cuando sintió como la luz iluminó el lugar y todos fueron cayendo lentamente. “Cuando la candela vino hacia mí se me nubló la vista. Me levanté, me dio rabia y lo insulté. A los pocos minutos solo hubo caos y el fuego se apoderó del lugar”, recuerda . Los indígenas que llegaron de las otras chozas tuvieron que sacar los cuerpos para evitar que las llamas los consumieran. (Lea también: Unas 100 personas mueren por rayos en Colombia cada año)

“Le quitamos 11 para que reflexione, analice y hable con los hermanitos menores y les advierta también”, dice Ramón que es el mensaje de la naturaleza.

Pide reunión con mamos

El mamo Ramón le pidió al Gobierno que los ayude para citar un encuentro de por lo menos un mes con los mamos ancestrales y espirituales de los cuatro pueblos indígenas de la Sierra Nevada: koguis, arhuacos, kankuamos y wiwas, para que analicen como autoridades todas las problemáticas que se viven en estos momentos en los resguardos.

Luego de la tragedia, en la noche del lunes, los indígenas se fueron del pueblo por temor a que otro rayo volviera a castigarlos. Foto CEET

También reconoció que los cabildos gobernadores de estos pueblos se han convertido en una especie de talanquera para que las autoridades espirituales y guías de estos pueblos se reúnan. “Necesitamos analizar y unificar un criterio, interna y espiritualmente, ya que los cabildos gobernadores no se ponen de acuerdo”, dijo.

Ayer, Ramón se lamentó de no saber leer ni escribir en español para poder hacer una cartilla para que todos entiendan y comprendan cuál es el mensaje que la naturaleza les da a los mamos y así respeten los últimos recursos que quedan en la Sierra Nevada.

Siguen llegando ayudas

A las 6:30 a.m. de hoy salió el primer helicóptero con alimentos, frazadas, medicamentos y hamacas recogidos por la Defensa Civil y enviados por la Unidad Nacional de Riesgo.

Desde la primera División del Ejército, entre ayer hoy, unos nueve viajes se hicieron en helicópteros sacando heridos, llevando ayudas y periodistas. “No solamente estamos para la guerra, también para ayudas humanitarias”, dijo el capitán del Ejército, Ómar Pardo, quien está al frente de los vuelos.

Ejército y Policía acompañados de la Defensa Civil llevan ayudas. Foto: CEET

A su turno, el coronel Luis Alfonso Quintero Parada, comandante de la Policía Metropolitana de Santa Marta, encabezó con la Policía Judicial la última inspección a los cadáveres, que hoy mismo serán entregados a la comunidad.

“Tenemos un equipo medico revisando a los indígenas, tal como lo solicitaron, para brindarles un apoyo con medicamento y curación, al equipo de Policía judicial se les sumaron dos médicos forenses de Barranquilla, para apoyar el trabajo”, dijo el oficial.

L​eonardo Herrera Delghams
Enviado especial de EL TIEMPO
Sierra Nevada de Santa Marta

Consciência pode permanecer por até três minutos após a morte, diz estudo (O Globo)

Cientistas entrevistaram pacientes que chegaram a ter morte clínica, mas voltaram à vida


Cena da novela "Amor Eterno Amor" da Rede Globo retrata a experiência de quase morte estudadas pelos cientistas da Universidade de Southampton Foto: ReproduçãoCena da novela “Amor Eterno Amor” da Rede Globo retrata a experiência de quase morte estudadas pelos cientistas da Universidade de Southampton – Reprodução

RIO – Aquele túnel com uma luz brilhante no fundo e uma sensação de paz descritos por filmes e outras pessoas que alegaram ter passado por experiência de quase morte podem ser reais. No maior estudo já feito sobre o tema, cientistas da Universidade de Southampton disseram ter comprovado que a consciência humana permanece por ao menos três minutos após o óbito biológico. Durante esse meio tempo, pacientes conseguiriam testemunhar e lembrar depois de eventos como a saída do corpo e os movimentos ao redor do quarto do hospital.

Ao longo de quatro anos, os especialistas examinaram mais de duas mil pessoas que sofreram paradas cardíacas em 15 hospitais no Reino Unido, Estados Unidos e Áustria. Cerca de 16% sobreviveram. E destes, mais de 40% descreveram algum tipo de “consciência” durante o tempo em que eles estavam clinicamente mortos, antes de seus corações voltarem a bater.

O caso mais emblemático foi de um homem ainda lembrou ter deixado seu corpo totalmente e assistindo sua reanimação do canto da sala. Apesar de ser inconsciente e “morto” por três minutos, o paciente narrou com detalhes as ações da equipe de enfermagem e descreveu o som das máquinas.

– Sabemos que o cérebro não pode funcionar quando o coração parou de bater. Mas neste caso, a percepção consciente parece ter continuado por até três minutos no período em que o coração não estava batendo, mesmo que o cérebro normalmente encerre as atividades dentro de 20 a 30 segundos após o coração – explicou ao jornal inglês The Telegraph o pesquisador Sam Parnia.

Dos 2.060 pacientes com parada cardíaca estudados, 330 sobreviveram e 140 disseram ter experimentado algum tipo de consciência ao ser ressuscitado. Embora muitos não se lembrassem de detalhes específicos, alguns relatos coincidiram. Um em cada cinco disseram que tinha sentido uma sensação incomum de tranquilidade, enquanto quase um terço disse que o tempo tinha se abrandado ou se acelerado.

Alguns lembraram de ter visto uma luz brilhante, um flash de ouro ou o sol brilhando. Outros relataram sentimentos de medo, afogamento ou sendo arrastado pelas águas profundas. Cerca de 13% disseram que se sentiam separados de seus corpos.

De acordo com Parnia, muito mais pessoas podem ter experiências quando estão perto da morte, mas as drogas ou sedativos utilizados no processo de ressuscitação podem afetar a memória:

– As estimativas sugerem que milhões de pessoas tiveram experiências vivas em relação à morte. Muitas assumiram que eram alucinações ou ilusões, mas os relatos parecem corresponder a eventos reais. E uma proporção maior de pessoas pode ter experiências vivas de morte, mas não se lembrarem delas devido aos efeitos da lesão cerebral ou sedativos em circuitos de memória.


Read more: http://oglobo.globo.com/sociedade/saude/consciencia-pode-permanecer-por-ate-tres-minutos-apos-morte-diz-estudo-14166762#ixzz3FaJap9ny

Near-death experiences? Results of the world’s largest medical study of the human mind and consciousness at time of death (Science Daily)

Date: October 7, 2014

Source: University of Southampton

Summary: The results of a four-year international study of 2060 cardiac arrest cases across 15 hospitals concludes the following. The themes relating to the experience of death appear far broader than what has been understood so far, or what has been described as so called near-death experiences. In some cases of cardiac arrest, memories of visual awareness compatible with so called out-of-body experiences may correspond with actual events. A higher proportion of people may have vivid death experiences, but do not recall them due to the effects of brain injury or sedative drugs on memory circuits. Widely used yet scientifically imprecise terms such as near-death and out-of-body experiences may not be sufficient to describe the actual experience of death. The recalled experience surrounding death merits a genuine investigation without prejudice.

The results of a four-year international study of 2060 cardiac arrest cases across 15 hospitals are in. Among those who reported a perception of awareness and completed further interviews, 46 per cent experienced a broad range of mental recollections in relation to death that were not compatible with the commonly used term of near death experiences. Credit: © sudok1 / Fotolia

The results of a four-year international study of 2060 cardiac arrest cases across 15 hospitals concludes the following. The themes relating to the experience of death appear far broader than what has been understood so far, or what has been described as so called near-death experiences. In some cases of cardiac arrest, memories of visual awareness compatible with so called out-of-body experiences may correspond with actual events. A higher proportion of people may have vivid death experiences, but do not recall them due to the effects of brain injury or sedative drugs on memory circuits. Widely used yet scientifically imprecise terms such as near-death and out-of-body experiences may not be sufficient to describe the actual experience of death.

Recollections in relation to death, so-called out-of-body experiences (OBEs) or near-death experiences (NDEs), are an often spoken about phenomenon which have frequently been considered hallucinatory or illusory in nature; however, objective studies on these experiences are limited.

In 2008, a large-scale study involving 2060 patients from 15 hospitals in the United Kingdom, United States and Austria was launched. The AWARE (AWAreness during REsuscitation) study, sponsored by the University of Southampton in the UK, examined the broad range of mental experiences in relation to death. Researchers also tested the validity of conscious experiences using objective markers for the first time in a large study to determine whether claims of awareness compatible with out-of-body experiences correspond with real or hallucinatory events.

Results of the study have been published in the journal Resuscitation.

Dr Sam Parnia, Assistant Professor of Critical Care Medicine and Director of Resuscitation Research at The State University of New York at Stony Brook, USA, and the study’s lead author, explained: “Contrary to perception, death is not a specific moment but a potentially reversible process that occurs after any severe illness or accident causes the heart, lungs and brain to cease functioning. If attempts are made to reverse this process, it is referred to as ‘cardiac arrest’; however, if these attempts do not succeed it is called ‘death’. In this study we wanted to go beyond the emotionally charged yet poorly defined term of NDEs to explore objectively what happens when we die.”

Thirty-nine per cent of patients who survived cardiac arrest and were able to undergo structured interviews described a perception of awareness, but interestingly did not have any explicit recall of events.

“This suggests more people may have mental activity initially but then lose their memories after recovery, either due to the effects of brain injury or sedative drugs on memory recall,” explained Dr Parnia, who was an Honorary Research Fellow at the University of Southampton when he started the AWARE study.

Among those who reported a perception of awareness and completed further interviews, 46 per cent experienced a broad range of mental recollections in relation to death that were not compatible with the commonly used term of NDE’s. These included fearful and persecutory experiences. Only 9 per cent had experiences compatible with NDEs and 2 per cent exhibited full awareness compatible with OBE’s with explicit recall of ‘seeing’ and ‘hearing’ events.

One case was validated and timed using auditory stimuli during cardiac arrest. Dr Parnia concluded: “This is significant, since it has often been assumed that experiences in relation to death are likely hallucinations or illusions, occurring either before the heart stops or after the heart has been successfully restarted, but not an experience corresponding with ‘real’ events when the heart isn’t beating. In this case, consciousness and awareness appeared to occur during a three-minute period when there was no heartbeat. This is paradoxical, since the brain typically ceases functioning within 20-30 seconds of the heart stopping and doesn’t resume again until the heart has been restarted. Furthermore, the detailed recollections of visual awareness in this case were consistent with verified events.

“Thus, while it was not possible to absolutely prove the reality or meaning of patients’ experiences and claims of awareness, (due to the very low incidence (2 per cent) of explicit recall of visual awareness or so called OBE’s), it was impossible to disclaim them either and more work is needed in this area. Clearly, the recalled experience surrounding death now merits further genuine investigation without prejudice.”

Further studies are also needed to explore whether awareness (explicit or implicit) may lead to long term adverse psychological outcomes including post-traumatic stress disorder.

Dr Jerry Nolan, Editor-in-Chief of Resuscitation, stated: “The AWARE study researchers are to be congratulated on the completion of a fascinating study that will open the door to more extensive research into what happens when we die.”

Journal Reference:

  1. Parnia S, et al. AWARE—AWAreness during REsuscitation—A prospective study. Resuscitation, 2014 DOI: 10.1016/j.resuscitation.2014.09.004

Deadly Algorithms (Radical Philosophy)

Can legal codes hold software accountable for code that kills?

RP 187 (Sept/Oct 2014)

Schuppli web-web

Algorithms have long adjudicated over vital processes that help to ensure our well-being and survival, from pacemakers that maintain the natural rhythms of the heart, and genetic algorithms that optimise emergency response times by cross-referencing ambulance locations with demographic data, to early warning systems that track approaching storms, detect seismic activity, and even seek to prevent genocide by monitoring ethnic conflict with orbiting satellites. [1] However, algorithms are also increasingly being tasked with instructions to kill: executing coding sequences that quite literally execute.

Guided by the Obama presidency’s conviction that the War on Terror can be won by ‘out-computing’ its enemies and pre-empting terrorists’ threats using predictive software, a new generation of deadly algorithms is being designed that will both control and manage the ‘kill-list,’ and along with it decisions to strike. [2] Indeed, the recently terminated practice of ‘signature strikes’, in which data analytics was used to determine emblematic ‘terrorist’ behaviour and match these patterns to potential targets on the ground, already points to a future in which intelligence-gathering, assessment and military action, including the calculation of who can legally be killed, will largely be performed by machines based upon an ever-expanding database of aggregated information. As such, this transition to execution by algorithm is not simply a continuation of killing at ever greater distances inaugurated by the invention of the bow and arrow that separated warrior and foe, as many have suggested. [3] It is also a consequence of the ongoing automation of warfare, which can be traced back to the cybernetic coupling of Claude Shannon’s mathematical theory of information with Norbert Wiener’s wartime research into feedback loops and communication control systems. [4] As this new era of intelligent weapons systems progresses, operational control and decision-making are increasingly being outsourced to machines.

Computing terror

In 2011 the US Department of Defense (DOD) released its ‘roadmap’ forecasting the expanded use of unmanned technologies, of which unmanned aircraft systems – drones – are but one aspect of an overall strategy directed towards the implementation of fully autonomous Intelligent Agents. It projects its future as follows:

The Department of Defense’s vision for unmanned systems is the seamless integration of diverse unmanned capabilities that provide flexible options for Joint Warfighters while exploiting the inherent advantages of unmanned technologies, including persistence, size, speed, maneuverability, and reduced risk to human life. DOD envisions unmanned systems seamlessly operating with manned systems while gradually reducing the degree of human control and decision making required for the unmanned portion of the force structure. [5]

The document is a strange mix of Cold War caricature and Fordism set against the backdrop of contemporary geopolitical anxieties, which sketches out two imaginary vignettes to provide ‘visionary’ examples of the ways in which autonomy can improve efficiencies through inter-operability across military domains, aimed at enhancing capacities and flexibility between manned and unmanned sectors of the US Army, Air Force and Navy. In these future scenarios, the scripting and casting are strikingly familiar, pitting the security of hydrocarbon energy supplies against rogue actors equipped with Russian technology. One concerns an ageing Russian nuclear submarine deployed by a radicalized Islamic nation-state that is beset by an earthquake in the Pacific, thus contaminating the coastal waters of Alaska and threatening its oil energy reserves. The other involves the sabotaging of an underwater oil pipeline in the Gulf of Guinea off the coast of Africa, complicated by the approach of a hostile surface vessel capable of launching a Russian short-range air-to-surface missile. [6]

These Hollywood-style action film vignettes – fully elaborated across five pages of the report – provide an odd counterpoint to the claims being made throughout the document as to the sober science, political prudence and economic rationalizations that guide the move towards fully unmanned systems. On what grounds are we to be convinced by these visions and strategies? On the basis of a collective cultural imaginary that finds its politics within the CGI labs of the infotainment industry? Or via an evidence-based approach to solving the complex problems posed by changing global contexts? Not surprisingly, the level of detail (and techno-fetishism) used to describe unmanned responses to these risk scenarios is far more exhaustive than that devoted to the three primary challenges which the report identifies as specific to the growing reliance upon and deployment of automated and autonomous systems:

1. Investment in science and technology (S&T) to enable more capable autonomous operations.

2. Development of policies and guidelines on what decisions can be safely and ethically delegated and under what conditions.

3. Development of new Verification and Validation (V&V) and T&E techniques to enable verifiable ‘trust’ in autonomy. [7]

As the second of these ‘challenges’ indicates, the delegation of decision-making to computational regimes is particularly crucial here, in so far as it provokes a number of significant ethical dilemmas but also urgent questions regarding whether existing legal frameworks are capable of attending to the emergence of these new algorithmic actors. This is especially concerning when the logic of precedent that organizes much legal decision-making (within common law systems) has followed the same logic that organized the drone programme in the first place: namely, the justification of an action based upon a pattern of behaviour that was established by prior events.

The legal aporia intersects with a parallel discourse around moral responsibility; a much broader debate that has tended to structure arguments around the deployment of armed drones as an antagonism between humans and machines. As the authors of the entry on ‘Computing and Moral Responsibility’ in the Stanford Encyclopedia of Philosophy put it:

Traditionally philosophical discussions on moral responsibility have focused on the human components in moral action. Accounts of how to ascribe moral responsibility usually describe human agents performing actions that have well-defined, direct consequences. In today’s increasingly technological society, however, human activity cannot be properly understood without making reference to technological artifacts, which complicates the ascription of moral responsibility. [8]

When one poses the question, under what conditions is it morally acceptable to deliberately kill a human being, one is not, in this case, asking whether the law permits such an act for reasons of imminent threat, self-defence or even empathy for someone who is in extreme pain or in a non-responsive vegetative state. The moral register around the decision to kill operates according to a different ethical framework: one that doesn’t necessarily bind the individual to a contract enacted between the citizen and the state. Moral positions can be specific to individual values and beliefs whereas legal frameworks permit actions in our collective name as citizens contracted to a democratically elected body that acts on our behalf but with which we might be in political disagreement. While it is, then, much easier to take a moral stance towards events that we might oppose – US drone strikes in Pakistan – than to justify a claim as to their specific illegality given the anti-terror legislation that has been put in place since 9/11, assigning moral responsibility, proving criminal negligence or demonstrating legal liability for the outcomes of deadly events becomes even more challenging when humans and machines interact to make decisions together, a complication that will only intensify as unmanned systems become more sophisticated and act as increasingly independent legal agents. Moreover, the outsourcing of decision-making to the judiciary as regards the validity of scientific evidence, which followed the 1993 Daubertruling – in the context of a case brought against Merrell Dow Pharmaceuticals – has, in addition, made it difficult for the law to take an activist stance when confronted with the limitations of its own scientific understandings of technical innovation. At present it would obviously be unreasonable to take an algorithm to court when things go awry, let alone when they are executed perfectly, as in the case of a lethal drone strike.

By focusing upon the legal dimension of algorithmic liability as opposed to more wide-ranging moral questions I do not want to suggest that morality and law should be consigned to separate spheres. However, it is worth making a preliminary effort to think about the ways in which algorithms are not simply reordering the fundamental principles that govern our lives, but might also be asked to provide alternate ethical arrangements derived out of mathematical axioms.

Algorithmic accountability

Law, which has already expanded the category of ‘legal personhood’ to include non-human actors such as corporations, also offers ways, then, to think about questions of algorithmic accountability. [9] Of course many would argue that legal methods are not the best frameworks for resolving moral dilemmas. But then again nor are the objectives of counter-terrorism necessarily best serviced by algorithmic oversight. Shifting the emphasis towards a juridical account of algorithmic reasoning might, at any rate, prove useful when confronted with the real possibility that the kill list and other emergent matrices for managing the war on terror will be algorithmically derived as part of a techno-social assemblage in which it becomes impossible to isolate human from non-human agents. It does, however, raise the ‘bar’ for what we would now need to ask the law to do. The degree to which legal codes can maintain their momentum alongside rapid technological change and submit ‘complicated algorithmic systems to the usual process of checks-and-balances that is generally imposed on powerful items that affect society on a large scale’ is of considerable concern. [10] Nonetheless, the stage has already been set for the arrival of a new cast of juridical actors endowed not so much with free will in the classical sense (that would provide the conditions for criminal liability), but intelligent systems which are wilfully free in the sense that they have been programmed to make decisions based upon their own algorithmic logic.[11] While armed combat drones are the most publicly visible of the automated military systems that the DOD is rolling out, they are only one of the many remote-controlled assets that will gather, manage, analyse and act on the data that they acquire and process.

Proponents of algorithmic decision-making laud the near instantaneous response time that allows Intelligent Agents – what some have called ‘moral predators’ – to make micro-second adjustments to avert a lethal drone strike should, for example, children suddenly emerge out of a house that is being targeted as a militant hideout. [12] Indeed robotic systems have long been argued to decrease the error margin of civilian casualties that are often the consequence of actions made by tired soldiers in the field. Nor are machines overly concerned with their own self-preservation, which might likewise cloud judgement under conditions of duress. Yet, as Sabine Gless and Herbert Zech ask, if these ‘Intelligent Agents are often used in areas where the risk of failure and error can be reduced by relying on machines rather than humans … the question arises: Who is liable if things go wrong?’[13]

Typically when injury and death occur to humans, the legal debate focuses upon the degree to which such an outcome was foreseeable and thus adjudicates on the basis of whether all reasonable efforts and pre-emptive protocols had been built into the system to mitigate against such an occurrence. However, programmers cannot of course run all the variables that combine to produce machinic decisions, especially when the degree of uncertainty as to conditions and knowledge of events on the ground is as variable as the shifting contexts of conflict and counter-terrorism. Werner Dahm, chief scientist at the United States Air Force, typically stresses the difficulty of designing error-free systems: ‘You have to be able to show that the system is not going to go awry – you have to disprove a negative.’ [14] Given that highly automated decision-making processes involve complex and rapidly changing contexts mediated by multiple technologies, can we then reasonably expect to build a form of ethical decision-making into these unmanned systems? And would an algorithmic approach to managing the ethical dimensions of drone warfare – for example, whether to strike 16-year-old Abdulrahman al-Awlaki in Yemen because his father was a radicalized cleric; a role that he might inherit – entail the same logics that characterized signature strikes, namely that of proximity to militant-like behaviour or activity? [15] The euphemistically rebranded kill list known as the ‘disposition matrix’ suggests that such determinations can indeed be arrived at computationally. As Greg Miller notes: ‘The matrix contains the names of terrorism suspects arrayed against an accounting of the resources being marshaled to track them down, including sealed indictments and clandestine operations.’ [16]

Intelligent systems are arguably legal agents but not as of yet legal persons, although precedents pointing to this possibility have already been set in motion. The idea that an actual human being or ‘legal person’ stands behind the invention of every machine who might ultimately be found responsible when things go wrong, or even when they go right, is no longer tenable and obfuscates the fact that complex systems are rarely, if ever, the product of single authorship; nor do humans and machines operate in autonomous realms. Indeed, both are so thoroughly entangled with each other that the notion of a sovereign human agent functioning outside the realm of machinic mediation seems wholly improbable. Consider for a moment only one aspect of conducting drone warfare in Pakistan – that of US flight logistics – in which we find that upwards of 165 people are required just to keep a Predator drone in the air for twenty-four hours, the half-life of an average mission. These personnel requirements are themselves embedded in multiple techno-social systems composed of military contractors, intelligence officers, data analysts, lawyers, engineers, programmers, as well as hardware, software, satellite communication, and operation centres (CAOC), and so on. This does not take into account the R&D infrastructure that engineered the unmanned system, designed its operating procedures and beta-tested it. Nor does it acknowledge the administrative apparatus that brought all of these actors together to create the event we call a drone strike. [17]

In the case of a fully automated system, decision-making is reliant upon feedback loops that continually pump new information into the system in order to recalibrate it. But perhaps more significantly in terms of legal liability, decision-making is also governed by the system’s innate ability to self-educate: the capacity of algorithms to learn and modify their coding sequences independent of human oversight. Isolating the singular agent who is directly responsible – legally – for the production of a deadly harm (as currently required by criminal law) suggests, then, that no one entity beyond the Executive Office of the President might ultimately be held accountable for the aggregate conditions that conspire to produce a drone strike and with it the possibility of civilian casualties. Given that the USA doesn’t accept the jurisdiction of the International Criminal Court and Article 25 of the Rome Statute governing individual criminal responsibility, what new legal formulations could, then, be created that would be able to account for indirect and aggregate causality born out of a complex chain of events including so called digital perpetrators? American tort law, which adjudicates over civil wrongs, might be one such place to look for instructive models. In particular, legal claims regarding the use of environmental toxins, which are highly distributed events whose lethal effects often take decades to appear, and involve an equally complex array of human and non-human agents, have been making their way into court, although not typically with successful outcomes for the plaintiffs. The most notable of these litigations have been the mass toxic tort regarding the use of Agent Orange as a defoliant in Vietnam and the Bhopal disaster in India. [18] Ultimately, however, the efficacy of such an approach has to be considered in light of the intended outcome of assigning liability, which in the cases mentioned was not so much deterrence or punishment, but, rather, compensation for damages.

Recoding the law

While machines can be designed with a high degree of intentional behaviour and will out-perform humans in many instances, the development of unmanned systems will need to take into account a far greater range of variables, including shifting geopolitical contexts and murky legal frameworks, when making the calculation that conditions have been met to execute someone. Building in fail-safe procedures that abort when human subjects of a specific size (children) or age and gender (males under the age of 18) appear, sets the stage for a proto-moral decision-making regime. But is the design of ethical constraints really where we wish to push back politically when it comes to the potential for execution by algorithm? Or can we work to complicate the impunity that certain techno-social assemblages currently enjoy? As a 2009 report by the Royal Academy of Engineering on autonomous systems argues,

Legal and regulatory models based on systems with human operators may not transfer well to the governance of autonomous systems. In addition, the law currently distinguishes between human operators and technical systems and requires a human agent to be responsible for an automated or autonomous system. However, technologies which are used to extend human capabilities or compensate for cognitive or motor impairment may give rise to hybrid agents … Without a legal framework for autonomous technologies, there is a risk that such essentially human agents could not be held legally responsible for their actions – so who should be responsible? [19]

Implicating a larger set of agents including algorithmic ones that aid and abet such an act might well be a more effective legal strategy, even if expanding the limits of criminal liability proves unwieldy. As the 2009 ECCHR Study on Criminal Accountability in Sri Lanka put it: ‘Individuals, who exercise the power to organise the pattern of crimes that were later committed, can be held criminally liable as perpetrators. These perpetrators can usually be found in civil ministries such as the ministry of defense or the office of the president.’ [20] Moving down the chain of command and focusing upon those who participate in the production of violence by carrying out orders has been effective in some cases (Sri Lanka), but also problematic in others (Abu Ghraib) where the indictment of low-level officers severed the chain of causal relations that could implicate more powerful actors. Of course prosecuting an algorithm alone for executing lethal orders that the system is in fact designed to make is fairly nonsensical if the objective is punishment. The move must, then, be part of an overall strategy aimed at expanding the field of causality and thus broadening the reach of legal responsibility.

My own work as a researcher on the Forensic Architecture project, alongside Eyal Weizman and several others, in developing new methods of spatial and visual investigation for the UN inquiry into the use of armed drones, provides one specific vantage point for considering how machinic capacities are reordering the field of political action and thus calling forth new legal strategies.[21] In taking seriously the agency of things, we must also take seriously the agency of things whose productive capacities are enlisted in the specific decision to kill. Computational regimes, in operating largely beyond the thresholds of human perception, have produced informatic conjunctions that have redistributed and transformed the spaces in which action occurs, as well as the nature of such consequential actions themselves. When algorithms are being enlisted to out-compute terrorism and calculate who can and should be killed, do we not need to produce a politics appropriate to these radical modes of calculation and a legal framework that is sufficiently agile to deliberate over such events?

Decision-making by automated systems will produce new relations of power for which we have as yet inadequate legal frameworks or modes of political resistance – and, perhaps even more importantly, insufficient collective understanding as to how such decisions will actually be made and upon what grounds. Scientific knowledge about technical processes does not belong to the domain of science alone, as the Daubert ruling implies. However, demands for public accountability and oversight will require much greater participation in the epistemological frameworks that organize and manage these new techno-social systems, and that may be a formidable challenge for all of us. What sort of public assembly will be able to prevent the premature closure of a certain ‘epistemology of facts’, as Bruno Latour would say, that are at present cloaked under a veil of secrecy called ‘national security interests’ – the same order of facts that scripts the current DOD roadmap for unmanned systems?

In a recent ABC Radio interview, Sarah Knuckey, director of the Project on Extrajudicial Executions at New York University Law School, emphasized the degree to which drone warfare has strained the limits of international legal conventions and with it the protection of civilians. [22] The ‘rules of warfare’ are ‘already hopelessly out-dated’, she says, and will require ‘new rules of engagement to be drawn up’: ‘There is an enormous amount of concern about the practices the US is conducting right now and the policies that underlie those practices. But from a much longer-term perspective and certainly from lawyers outside the US there is real concern about not just what’s happening now but what it might mean 10, 15, 20 years down the track.’ [23] Could these new rules of engagement – new legal codes – assume a similarly preemptive character to the software codes and technologies that are being evolved – what I would characterize as a projective sense of the law? Might they take their lead from the spirit of the Geneva Conventions protecting the rights of noncombatants, rather than from those protocols (the Hague Conventions of 1899, 1907) that govern the use of weapons of war, and are thus reactive in their formulation and event-based? If so, this would have to be a set of legal frameworks that is not so much determined by precedent – by what has happened in the past – but, instead, by what may take place in the future.


1. ^ See, for example, the satellite monitoring and atrocity evidence programmes: ‘Eyes on Darfur’ (www.eyesondarfur.org) and ‘The Sentinel Project for Genocide Prevention’ (http://thesentinelproject.org).

2. ^ Cori Crider, ‘Killing in the Name of Algorithms: How Big Data Enables the Obama Administration’s Drone War’, Al Jazeera America, 2014, http://america.aljazeera.com/opinions/2014/3/drones-big-data-waronterror
obama.html; accessed 18 May 2014. See also the flow chart in Daniel Byman and Benjamin Wittes, ‘How Obama Decides Your Fate if He Thinks You’re a Terrorist,’ The Atlantic, 3 January 2013, http://www.theatlantic.com/

3. ^ For a recent account of the multiple and compound geographies through which drone operations are executed, see Derek Gregory, ‘Drone Geographies’, Radical Philosophy 183 (January/February 2014), pp. 7–19.

4. ^ Contemporary information theorists would argue that the second-order cybernetic model of feedback and control, in which external data is used to adjust the system, doesn’t take into account the unpredictability of evolutive data internal to the system resulting from crunching ever-larger datasets. See Luciana Parisi’s Introduction to Contagious Architecture: Computation, Aesthetics, and Space, MIT Press, Cambridge MA, 2013. For a discussion of Weiner’s cybernetics in this context, see Reinhold Martin, ‘The Organizational Complex: Cybernetics, Space, Discourse’, Assemblage 37, 1998, p. 110.

5. ^ DOD, Unmanned Systems Integrated Roadmap Fy2011–2036, Office of the Undersecretary of Defense for Acquisition, Technology, & Logistics, Washington, DC, 2011, p. 3, http://www.defense.gov/pubs/DOD-USRM-

6. ^ Ibid., pp. 1–10.

7. ^ Ibid., p. 27.

8. ^ Merel Noorman and Edward N. Zalta, ‘Computing and Moral Responsibility,’ The Stanford Encyclopedia of Philosophy(2014), http://plato.stanford.edu/archives/sum2014/entries/computing-responsibility.

9. ^ See John Dewey, ‘The Historic Background of Corporate Legal Personality’, Yale Law Journal, vol. 35, no. 6, 1926, pp. 656, 669.

10. ^ Data & Society Research Institute, ‘Workshop Primer: Algorithmic Accountability’, The Social, Cultural & Ethical Dimensions of ‘Big Data’ workshop, 2014, p. 3.

11. ^ See Gunther Teubner, ‘Rights of Non-Humans? Electronic Agents and Animals as New Actors in Politics and Law,’ Journal of Law & Society, vol. 33, no.4, 2006, pp. 497–521.

12. ^ See Bradley Jay Strawser, ‘Moral Predators: The Duty to Employ Uninhabited Aerial Vehicles,’ Journal of Military Ethics, vol. 9, no. 4, 2010, pp. 342–68.

13. ^ Sabine Gless and Herbert Zech, ‘Intelligent Agents: International Perspectives on New Challenges for Traditional Concepts of Criminal, Civil Law and Data Protection’, text for ‘Intelligent Agents’ workshop, 7–8 February 2014, University of Basel, Faculty of Law, http://www.snis.ch/sites/default/files/workshop_intelligent_agents.pdf.

14. ^ Agence-France Presse, ‘The Next Wave in U.S. Robotic War: Drones on Their Own’, Defense News, 28 September 2012, p. 2, http://www.defensenews.com/article/20120928/DEFREG02/309280004/The-Next-Wave-

15. ^ When questioned about the drone strike that killed 16-year old American-born Abdulrahman al-Awlaki, teenage son of radicalized cleric Anwar Al-Awlaki, in Yemen in 2011, Robert Gibbs, former White House press secretary and senior adviser to President Obama’s re-election campaign, replied that the boy should have had ‘a more responsible father’.

16. ^ Greg Miller, ‘Plan for Hunting Terrorists Signals U.S. Intends to Keep Adding Names to Kill Lists’, Washington Post, 23 October 2012, http://www.washingtonpost.com/world/national-security/plan-for-hunting-terrorists-signals-us-intends-to-keep-adding-names-to-kill-lists/2012/10/23/4789b2ae-18b3–11e2–a55c-39408fbe6a4b_story.html.

17. ^ ‘While it might seem counterintuitive, it takes significantly more people to operate unmanned aircraft than it does to fly traditional warplanes. According to the Air Force, it takes a jaw-dropping 168 people to keep just one Predator aloft for twenty-four hours! For the larger Global Hawk surveillance drone, that number jumps to 300 people. In contrast, an F-16 fighter aircraft needs fewer than one hundred people per mission.’ Medea Benjamin, Drone Warfare: Killing by Remote Control, Verso, London and New York, 2013, p. 21.

18. ^ See Peter H. Schuck, Agent Orange on Trial: Mass Toxic Disasters in the Courts, Belknap Press of Harvard University Press, Cambridge MA, 1987. See also: http://www.bhopal.com/bhopal-litigation.

19. ^ Royal Academy of Engineering, Autonomous Systems: Social, Legal and Ethical Issues, RAE, London, 2009, p. 3, http://www.raeng.org.uk/societygov/engineeringethics/pdf/Autonomous_Systems_Report_09.pdf.

20. ^ European Center for Constitutional and Human Rights, Study on Criminal Accountability in Sri Lanka as of January 2009, ECCHR, Berlin, 2010, p. 88.

21. ^ Other members of the Forensic Architecture drone investigative team included Jacob Burns, Steffen Kraemer, Francesco Sebregondi and SITU Research. See http://www.forensic-architecture.org/case/drone-strikes.

22. ^ Bureau of Investigative Journalism, ‘Get the Data: Drone Wars’, http://www.thebureauinvestigates.com/category/projects/drones/drones-graphs.

23. ^ Annabelle Quince, ‘Future of Drone Strikes Could See Execution by Algorithm’, Rear Vision, ABC Radio, edited transcript, pp. 2–3.

Murder Machines: Why Cars Will Kill 30,000 Americans This Year (Collectors Weekly)

By Hunter Oatman-Stanford — March 10th, 2014

boston fatalities

There’s an open secret in America: If you want to kill someone, do it with a car. As long as you’re sober, chances are you’ll never be charged with any crime, much less manslaughter. Over the past hundred years, as automobiles have been woven into the fabric of our daily lives, our legal system has undermined public safety, and we’ve been collectively trained to think of these deaths as unavoidable “accidents” or acts of God. Today, despite the efforts of major public-health agencies and grassroots safety campaigns, few are aware that car crashes are the number one cause of death for Americans under 35. But it wasn’t always this way.

“At some point, we decided that somebody on a bike or on foot is not traffic, but an obstruction to traffic.”

“If you look at newspapers from American cities in the 1910s and ’20s, you’ll find a lot of anger at cars and drivers, really an incredible amount,” says Peter Norton, the author of Fighting Traffic: The Dawn of the Motor Age in the American City. “My impression is that you’d find more caricatures of the Grim Reaper driving a car over innocent children than you would images of Uncle Sam.”

Though various automobiles powered by steam, gas, and electricity were produced in the late 19th century, only a handful of these cars actually made it onto the roads due to high costs and unreliable technologies. That changed in 1908, when Ford’s famous Model T standardized manufacturing methods and allowed for true mass production, making the car affordable to those without extreme wealth. By 1915, the number of registered motor vehicles was in the millions.

Top: A photo of a fatal car wreck in Somerville, Massachusetts, in 1933. Via the Boston Public Library. Above: The New York Times coverage of car violence from November 23, 1924.

Top: A photo of a fatal car wreck in Somerville, Massachusetts, in 1933. Via the Boston Public Library. Above: The New York Times coverage of car violence from November 23, 1924.

Within a decade, the number of car collisions and fatalities skyrocketed. In the first four years after World War I, more Americans died in auto accidents than had been killed during battle in Europe, but our legal system wasn’t catching on. The negative effects of this unprecedented shift in transportation were especially felt in urban areas, where road space was limited and pedestrian habits were powerfully ingrained.

For those of us who grew up with cars, it’s difficult to conceptualize American streets before automobiles were everywhere. “Imagine a busy corridor in an airport, or a crowded city park, where everybody’s moving around, and everybody’s got business to do,” says Norton. “Pedestrians favored the sidewalk because that was cleaner and you were less likely to have a vehicle bump against you, but pedestrians also went anywhere they wanted in the street, and there were no crosswalks and very few signs. It was a real free-for-all.”

A typical busy street scene on Sixth Avenue in New York City shows how pedestrians rules the roadways before automobiles arrived, circa 1903. Via Shorpy.

A typical busy street scene on Sixth Avenue in New York City shows how pedestrians ruled the roadways before automobiles arrived, circa 1903. Via Shorpy.

Roads were seen as a public space, which all citizens had an equal right to, even children at play. “Common law tended to pin responsibility on the person operating the heavier or more dangerous vehicle,” says Norton, “so there was a bias in favor of the pedestrian.” Since people on foot ruled the road, collisions weren’t a major issue: Streetcars and horse-drawn carriages yielded right of way to pedestrians and slowed to a human pace. The fastest traffic went around 10 to 12 miles per hour, and few vehicles even had the capacity to reach higher speeds.

“The real battle is for people’s minds, and this mental model of what a street is for.”

In rural areas, the car was generally welcomed as an antidote to extreme isolation, but in cities with dense neighborhoods and many alternate methods of transit, most viewed private vehicles as an unnecessary luxury. “The most popular term of derision for a motorist was a ‘joyrider,’ and that was originally directed at chauffeurs,” says Norton. “Most of the earliest cars had professional drivers who would drop their passengers somewhere, and were expected to pick them up again later. But in the meantime, they could drive around, and they got this reputation for speeding around wildly, so they were called joyriders.”

Eventually, the term spread to all types of automobile drivers, along with pejoratives like “vampire driver” or “death driver.” Political cartoons featured violent imagery of so-called “speed demons” murdering innocents as they plowed through city streets in their uncontrollable vehicles. Other editorials accused drivers of being afflicted with “motor madness” or “motor rabies,” which implied an addiction to speed at the expense of human life.

This cartoon from 1909 shows the outrage felt by many Americans that wealthy motorists could hurt others without consequence. Via the Library of Congress.

This cartoon from 1909 shows the outrage felt by many Americans that wealthy motorists could hurt others without consequence. Via the Library of Congress.

In an effort to keep traffic flowing and solve legal disputes, New York City became the first municipality in America to adopt an official traffic code in 1903, when most roadways had no signage or traffic controls whatsoever. Speed limits were gradually adopted in urban areas across the country, typically with a maximum of 10 mph that dropped to 8 mph at intersections.

By the 1910s, many cities were working to improve their most dangerous crossings. One of the first tactics was regulating left-turns, which was usually accomplished by installing a solid column or “silent policeman” at the center of busy intersections that forced vehicles to navigate around it. Cars had to pass this mid-point before turning left, preventing them from cutting corners and speeding recklessly into oncoming traffic.

Left, a patent for a Silent Policeman traffic post, and right, an ad for the Cutter Company's lighted post, both from 1918.

Left, a patent for a Silent Policeman traffic post, and right, an ad for the Cutter Company’s lighted post, both from 1918.

A variety of innovative street signals and markings were developed by other cities hoping to tame the automobile. Because they were regularly plowed over by cars, silent policemen were often replaced by domed, street-level lights called “traffic turtles” or “traffic mushrooms,” a style popularized in Milwaukee, Wisconsin. Detroit reconfigured a tennis court line-marker as a street-striping device for dividing lanes. In 1914, Cleveland installed the first alternating traffic lights, which were manually operated by a police officer stationed at the intersection. Yet these innovations did little to protect pedestrians.

“What evil bastard would drive their speeding car where a kid might be playing?”

By the end of the 1920s, more than 200,000 Americans had been killed by automobiles. Most of these fatalities were pedestrians in cities, and the majority of these were children. “If a kid is hit in a street in 2014, I think our first reaction would be to ask, ‘What parent is so neglectful that they let their child play in the street?,’” says Norton.

“In 1914, it was pretty much the opposite. It was more like, ‘What evil bastard would drive their speeding car where a kid might be playing?’ That tells us how much our outlook on the public street has changed—blaming the driver was really automatic then. It didn’t help if they said something like, ‘The kid darted out into the street!,’ because the answer would’ve been, ‘That’s what kids do. By choosing to operate this dangerous machine, it’s your job to watch out for others.’ It would be like if you drove a motorcycle in a hallway today and hit somebody—you couldn’t say, ‘Oh, well, they just jumped out in front of me,’ because the response would be that you shouldn’t operate a motorcycle in a hallway.”

Left, an ad for the Milwaukee-style traffic mushroom, and right, the device in action on Milwaukee's streets, circa 1926. Via the Milwaukee Public Library.

Left, an ad for the Milwaukee-style traffic mushroom, and right, the device in action on Milwaukee streets, circa 1926. Via the Milwaukee Public Library.

In the face of this traffic fatality epidemic, there was a fierce public outcry including enormous rallies, public memorials, vehement newspaper editorials, and even a few angry mobs that attacked motorists following a collision. “Several cities installed public memorials to the children hit by cars that looked like war monuments, except that they were temporary,” says Norton. “To me, that says a lot, because you collectively memorialize people who are considered a public loss. Soldiers killed in battle are mourned by the whole community, and they were doing that for children killed in traffic, which really captures how much the street was considered a public space. People killed in it were losses to the whole community.”

As early as 1905, newspapers were printing cartoons that criticized motor-vehicle drivers.

As early as 1905, newspapers were printing cartoons that criticized motor-vehicle drivers.

As the negative press increased and cities called for lower speed limits and stricter enforcement, the burgeoning auto industry recognized a mounting public-relations disaster. The breaking point came in 1923, when 42,000 citizens of Cincinnati signed a petition for a referendum requiring any driver in the city limits to have a speed governor, a mechanical device that would inhibit the fuel supply or accelerator, to keep vehicles below 25 miles per hour. (Studies show that around five percent of pedestrians are killed when hit by vehicles traveling under 20 miles per hour, versus 80 percent for cars going 40 miles an hour or more.)

The Cincinnati referendum logically equated high vehicle speeds with increasing danger, a direct affront to the automobile industry. “Think about that for a second,” Norton says. “If you’re in the business of selling cars, and the public recognizes that anything fast is dangerous, then you’ve just lost your number-one selling point, which is that they’re faster than anything else. It’s amazing how completely the auto industry joined forces and mobilized against it.”

One auto-industry response to the Cincinnati referendum of 1923 was to conflate speed governors with negative stereotypes about China. Via the Cincinnati Post.

One auto-industry response to the Cincinnati referendum of 1923 was to conflate speed governors with negative stereotypes about China. Via the Cincinnati Post.

“Motordom,” as the collective of special interests including oil companies, auto makers, auto dealers, and auto clubs dubbed itself, launched a multi-pronged campaign to make city streets more welcoming to drivers, though not necessarily safer. Through a series of social, legal, and physical transformations, these groups reframed arguments about vehicle safety by placing blame on reckless drivers and careless pedestrians, rather than the mere presence of cars.

In 1924, recognizing the crisis on America’s streets, Herbert Hoover launched the National Conference on Street and Highway Safety from his position as Commerce Secretary (he would become President in 1929). Any organizations interested or invested in transportation planning were invited to discuss street safety and help establish standardized traffic regulations that could be implemented across the country. Since the conference’s biggest players all represented the auto industry, the group’s recommendations prioritized private motor vehicles over all other transit modes.

A woman poses with a newly installed stop sign in Los Angeles in 1925, built to the specifications recommended at the first National Conference on Street Safety. Via USC Libraries.

A woman poses with a newly installed stop sign in Los Angeles in 1925, built to the specifications recommended at the first National Conference on Street Safety. Via USC Libraries.

Norton suggests that the most important outcome of this meeting was a model municipal traffic ordinance, which was released in 1927 and provided a framework for cities writing their own street regulations. This model ordinance was the first to officially deprive pedestrians access to public streets. “Pedestrians could cross at crosswalks. They could also cross when traffic permitted, or in other words, when there was no traffic,” explains Norton. “But other than that, the streets were now for cars. That model was presented to the cities of America by the U.S. Department of Commerce, which gave it the stamp of official government recommendation, and it was very successful and widely adopted.” By the 1930s, this legislation represented the new rule of the road, making it more difficult to take legal recourse against drivers.

Meanwhile, the auto industry continued to improve its public image by encouraging licensing to give drivers legitimacy, even though most early licenses required no testing. Norton explains that in addition to the revenue it generated, the driver’s license “would exonerate the average motorist in the public eye, so that driving itself wouldn’t be considered dangerous, and you could direct blame at the reckless minority.” Working with local police and civic groups like the Boy Scouts, auto clubs pushed to socialize new pedestrian behavior, often by shaming or ostracizing people who entered the street on foot. Part of this effort was the adoption of the term “jaywalker,” which originally referred to a clueless person unaccustomed to busy city life (“jay” was slang for a hayseed or country bumpkin).

Left, a cartoon from 1923 mocks jaywalking behavior. Via the National Safety Council. Right, a 1937 WPA poster emphasizes jaywalking dangers.

Left, a cartoon from 1923 mocks jaywalking behavior. Via the National Safety Council. Right, a 1937 WPA poster emphasizes jaywalking dangers.

“Drivers first used the word ‘jaywalker’ to criticize pedestrians,” says Norton, “and eventually, it became an organized campaign by auto dealers and auto clubs to change attitudes about walking in the street wherever you wanted to. They had people dressed up like idiots with sandwich board signs that said ‘jaywalker’ or men wearing women’s dresses pretending to be jaywalkers. They even had a parade where a clown was hit by a Model T over and over again in front of the crowd. Of course, the message was that you’re stupid if you walk in the street.” Eventually, cities began adopting laws against jaywalking of their own accord.

In 1928, the American Automobile Association (AAA) took charge of safety education for children by sending free curricula to every public school in America. “Children would illustrate posters with slogans like, ‘Why I should not play in the street’ or ‘Why the street is for cars’ and so on,” explains Norton. “They took over the school safety patrols at the same time. The original patrols would go out and stop traffic for other kids to cross the street. But when AAA took over, they had kids sign pledges that said, ‘I will not cross the street except at the intersection,’ and so on. So a whole generation of kids grew up being trained that the streets were for cars only.” Other organizations like the Automobile Safety Foundation and the National Safety Council also helped to educate the public on the dangers of cars, but mostly focused on changing pedestrian habits or extreme driver behaviors, like drunk driving.

Street-safety posters produced by AAA in the late 1950s focused on changing behavior of children, rather than drivers.

Street-safety posters produced by AAA in the late 1950s focused on changing behavior of children, rather than drivers.

Once the social acceptance of private cars was ensured, automobile proponents could begin rebuilding the urban environment to accommodate cars better than other transit modes. In the 1920s, America’s extensive network of urban railways was heavily regulated, often with specific fare and route restrictions as well as requirements to serve less-profitable areas. As motor vehicles began invading streetcar routes, these companies pushed for equal oversight of private cars.

“Automobiles could drive on the tracks,” explains Norton, “so this meant that as soon as just five percent of the people in cities were going around by car, they slowed the street railways down significantly, and streetcars couldn’t make their schedules anymore. They could ring a bell and try to make drivers get off their tracks, but if the driver couldn’t move because of other traffic, they were stuck. So the streetcars would just stand in traffic like automobiles.”

GE streetcar ads from 1928, left, and the early 1940s, right, emphasize the efficiency of mass transit over private automobiles.

GE streetcar ads from 1928, left, and the early 1940s, right, emphasize the efficiency of mass transit over private automobiles.

The final blow was delivered in 1935 with the Public Utility Holding Company Act, which forced electric-utility companies to divest their streetcar businesses. Though intended to reduce corruption and regulate these growing electric utilities, this law removed the subsidies supporting many streetcar companies, and as a result, more than 100 transit companies failed over the next decade.

Even as government assistance was removed from these mass-transit systems, the growing network of city streets and highways was receiving ever more federal funding. Many struggling metro railways were purchased by a front company (operated by General Motors, Firestone Rubber, Standard Oil, and Phillips Petroleum), that ripped up their tracks to make way for fleets of buses, furthering America’s dependency on motor vehicles.

Meanwhile, traffic engineers were reworking city streets to better accommodate motor vehicles, even as they recognized cars as the least equitable and least efficient form of transportation, since automobiles were only available to the wealthy and took up 10 times the space of a transit rider. Beginning in Chicago, traffic engineers coordinated street signals to keep motor vehicles moving smoothly, while making crossing times unfriendly to pedestrians.

An aerial view from 1939 of 14th Street and Pennsylvania Avenue, in Washington, D.C., shows early street markings. Via shorpy.com.

An aerial view from 1939 of 14th Street and Pennsylvania Avenue, in Washington, D.C., shows early street markings. Via shorpy.com.

“Long after its victory, Motordom fought to keep control of traffic problems. Its highway engineers defined a good thoroughfare as a road with a high capacity for motor vehicles; they did not count the number of persons moved,” Norton writes in Fighting Traffic. Today our cities still reflect this: The Level of Service (LOS) measurement by which most planners use to gauge intersection efficiency is based only on motor-vehicle delays, rather than the impact to all modes of transit.

As in other American industries ranging from health care to education, those with the ability to pay for the best treatment were prioritized over all others. One 1941 traffic-control textbook read: “If people prefer to drive downtown and can afford it, then facilities must be built for them up to their ability to pay. The choice of mode of travel is their own; they cannot be forced to change on the strength of arguments of efficiency or economy.”

All the while, traffic violence continued unabated, with fatalities increasing every year. The exception was during World War II, when fuel shortages and resource conservation led to less driving, hence a drop in the motor-vehicle death rates, which spiked again following the war’s conclusion. By the time the National Interstate and Defense Highways Act was passed in 1956, the U.S. was fully dependent on personal automobiles, favoring the flexibility of cars over the ability of mass transit to carry more people with less energy in a safer manner.

In 1962, Boston formally adopted jaywalking laws to penalize pedestrians, as this photo of city officials shows.

In 1962, Boston formally adopted jaywalking laws to penalize pedestrians.

In 1966, Ralph Nader published his best-selling book, Unsafe At Any Speed, which detailed the auto industry’s efforts to suppress safety improvements in favor of profits. In the preface to his book, Naderpointed out the huge costs inflicted by private vehicle collisions, noting that “…these are not the kind of costs which fall on the builders of motor vehicles (excepting a few successful lawsuits for negligent construction of the vehicle) and thus do not pinch the proper foot. Instead, the costs fall to users of vehicles, who are in no position to dictate safer automobile designs.” Instead of directing money at prevention, like vehicle improvements, changing behaviors, and road design, money is spent on treating the symptoms of road violence. Today, the costs of fatal crashes are estimated at over $99 billion in the U.S., or around $500 for every licensed driver, according to the Center for Disease Control (CDC).

Nader suggested that the protection of our “body rights,” or physical safety, needed the same broad support given to civil rights, even in the face of an industry with so much financial power. “A great problem of contemporary life is how to control the power of economic interests which ignore the harmful effects of their applied science and technology. The automobile tragedy is one of the most serious of these man-made assaults on the human body,” Nader wrote.

Dr. David Sleet, who works in the Division of Unintentional Injury Prevention at the CDC, says Nader’s book was a game-changer. “That really started this whole wave of improvements in our highway-safety problem,” says Sleet. “The death rates from vehicle crashes per population just kept steadily increasing from the 1920s until 1966. Two acts of Congress were implemented in 1966, which initiated a national commitment to reducing injuries on the road by creating agencies within the U.S. Department of Transportation to set standards and regulate vehicles and highways. After that, the fatalities started to decline.”

Ralph Nader's book, "Unsafe at Any Speed," brought a larger awareness to America's traffic fatalities, and targeted design issues with the Corvair. A few years prior, in 1962, comedian Ernie Kovacs was killed in a Corvair wagon, seen at right wrapped around a telephone pole.

Ralph Nader’s book, “Unsafe at Any Speed,” brought a larger awareness to America’s traffic fatalities, and targeted design issues with the Corvair. A few years prior, in 1962, comedian Ernie Kovacs was killed in a Corvair wagon, seen at right wrapped around a telephone pole.

The same year Nader’s book was published, President Lyndon Johnson signed the National Traffic and Motor Vehicle Safety Act and the Highway Safety Act. This legislation led to the creation of the National Highway Traffic Safety Administration (NHTSA), which set new safety standards for cars and highways. A full 50 years after automobiles had overtaken city streets, federal agencies finally began addressing the violence as a large-scale, public-health issue. In 1969, NHTSA director Dr. William Haddon, a public-health physician and epidemiologist, recognized that like infectious diseases, motor-vehicle deaths were the result of interactions between a host (person), an agent (motor vehicle), and their environment (roadways). As directed by Haddon, the NHTSA enforced changes to features like seat belts, brakes, and windshields that helped improve the country’s fatality rate.

Following the release of Nader’s book, grassroots organizations like Mothers Against Drunk Driving (MADD, 1980) formed to combat car-safety issues that national legislators were not addressing. The CDC began adapting its public-health framework to the issue of motor-vehicle injury prevention in 1985, focusing on high-risk populations like alcohol-impaired drivers, motorcyclists, and teenagers.

In the late 1970s, the NHTSA standardized crash tests, like this 90 mph test of two Volvos.

In the late 1970s, the NHTSA standardized crash tests, like this 90 mph test of two Volvos.

“I think the perennial problem for us, as a culture, is recognizing that these injuries are both predictable and preventable,” says Sleet. “The public still has not come around to thinking of motor-vehicle crashes as something other than ‘accidents.’ And as long as you believe they’re accidents or acts of fate, then you won’t do anything to prevent them. The CDC continues to stress that motor-vehicle injuries, like diseases, are preventable.”

Sleet says the CDC’s approach is similar to its efforts against smoking: The first step is understanding the magnitude of the problem or threat, the second is identifying risk factors, and the third is developing interventions that can reduce these factors. “The last stage is getting widespread adoption of these known and effective interventions,” explains Sleet. “The reason we think motor-vehicle injuries represent a winnable battle is that there are lots of effective interventions that are just not used by the general public. We’ve been fighting this battle of increasing injuries since cars were first introduced into society, and we still haven’t solved it.

“Public health is a marathon, not a sprint,” adds Sleet. “It’s taken us 50 years since the first surgeon general’s report on smoking to make significant progress against tobacco. We need to stay the course with vehicle injuries.”

Though their advocacy is limited to drunk driving, MADD is one of the few organizations to use violent imagery to promote road safety, as seen in this ad from 2007.

Though their advocacy is limited to drunk driving, MADD is one of the few organizations to use violent imagery to promote road safety, as seen in this ad from 2007.

Although organizations like the CDC have applied this public-health approach to the issue for decades now, automobiles remain a huge danger. While the annual fatality rate has dropped significantly from its 1930s high at around 30 deaths for every 100,000 persons to 11 per 100,000 in recent years, car crashes are still a top killer of all Americans. For young people, motor-vehicle collisions remain the most common cause of death. In contrast, traffic fatalities in countries like the United Kingdom, where drivers are presumed to be liable in car crashes, are about a third of U.S. rates.

In 2012, automobile collisions killed more than 34,000 Americans, but unlike our response to foreign wars, the AIDS crisis, or terrorist attacks—all of which inflict fewer fatalities than cars—there’s no widespread public protest or giant memorial to the dead. We fret about drugs and gun safety, but don’t teach children to treat cars as the loaded weapons they are.

“These losses have been privatized, but in the ’20s, they were regarded as public losses,” says Norton. After the auto industry successfully altered street norms in the 1920s, most state Departments of Transportation actually made it illegal to leave roadside markers where a loved one was killed. “In recent years, thanks to some hard work by grieving families, the rules have changed in certain states, and informal markers are now allowed,” Norton adds. “Some places are actually putting in DOT-made memorial signs with the names of victims. The era of not admitting what’s going on is not quite over, but the culture is changing.”

Ghost bikes have been installed on roadways across the country where cyclists were killed by motorists, like this bike in Boulder, Colorado, in memory of Matthew Powell in 2008.

In recent years, white Ghost Bikes have been installed on roadways across the country where cyclists were killed by motorists, like this bike in Boulder, Colorado, in memory of Matthew Powell.

“Until recently, there wasn’t any kind of concerted public message around the basic danger of driving,” says Ben Fried, editor of the New York branch of Streetsblog, a national network of journalists chronicling transportation issues. “Today’s street safety advocates look to MADD and other groups that changed social attitudes toward drunk driving in the late ’70s and early ’80s as an example of how to affect these broad views on how we drive. Before you had those organizations advocating for victims’ families, you would hear the same excuses for drunk driving that you hear today for reckless driving.”

Though drunk driving has long been recognized as dangerous, seen in this WPA poster from 1937, reckless driving has been absent from most safety campaigns.

Though drunk driving has long been recognized as dangerous, seen in this WPA poster from 1937, reckless driving has been absent from most safety campaigns.

Though anti-drunk-driving campaigns are familiar to Americans, fatalities involving alcohol only account for around a third of all collisions, while the rest are caused by ordinary human error. Studies also show that reckless drivers who are sober are rarely cited by police, even when they are clearly at fault. In New York City during the last five years, less than one percent of drivers who killed or injured pedestrians and cyclists were ticketed for careless driving. (In most states, “negligent” driving, which includes drunk driving, has different legal consequences than “reckless” driving, though the jargon makes little difference to those hurt by such drivers.)

Increasingly, victims and their loved ones aremaking the case that careless driving is as reprehensible as drunk driving, advocating a cultural shift that many drivers are reluctant to embrace. As with auto-safety campaigns in the past, this grassroots effort is pushing cities to adopt legislation that protects against reckless drivers, including laws inspired by Sweden’s Vision Zerocampaign. First implemented in 1997, Vision Zero is an effort to end all pedestrian fatalities and serious injuries; recently, cities like New York, Chicago, and San Francisco also announced their goals of eliminating traffic deaths within 10 years. Other initiatives are being introduced at the state level, including “vulnerable user laws,” which pin greater responsibility on road users who wield the most power whether a car compared to a bicyclist, or a biker to a pedestrian.

Fried says that most people are aware of the dangers behind the wheel, but are accustomed to sharing these risks, rather than taking individual responsibility for careless behavior. “So many of us drive and have had the experience of not following the law to a T—going a little bit over the speed limit or rolling through a stop sign,” he explains. “So there’s this tendency to deflect our own culpability, and that’s been institutionalized by things like no-fault laws and car insurance, where we all share the cost for the fact that driving is a dangerous thing.”

This dark political cartoon from "Puck" magazine in 1907 suggested that speeding motorists were chasing death. Via the Library of Congress.

This dark political cartoon from “Puck” magazine in 1907 suggested that speeding motorists were chasing death. Via the Library of Congress.

As cities attempt to undo years of car-oriented development by rebuilding streets that better incorporate public transit, bicycle facilities, and pedestrian needs, the existing bias towards automobiles is making the fight to transform streets just as intense as when cars first arrived in the urban landscape. “The fact that changes like redesigning streets for bike lanes set off such strong reactions today is a great analogy to what was going on in the ’20s,” says Fried. “There’s a huge status-quo bias that’s inherent in human nature. While I think the changes today are much more beneficial than what was done 80 years ago, the fact that they’re jarring to people comes from the same place. People are very comfortable with things the way they are.”

However, studies increasingly show that most young people prefer to live in dense, walkable neighborhoods, and are more attuned to the environmental consequences of their transportation than previous generations. Yet in the face of clear evidence that private automobiles are damaging to our health and our environment, most older Americans still cling to their cars. Part of this impulse may be a natural resistance to change, but it’s also reinforced when aging drivers have few viable transportation alternatives, particularly in suburban areas or sprawling cities with terrible public transit.

“People don’t have to smoke,” Sleet says, “whereas people might feel they do need a car to get to work. Our job is to try and make every drive a safe drive. I think we can also reduce the dependency we have on motor vehicles, but that’s not going to happen until we provide other alternatives for people to get from here to there.”

Gory depictions of car violence became rare in the United States after the 1920s, though they persisted in Europe, as seen in his German safety poster from 1930 that reads, "Motorist! Be Careful!"

Gory depictions of car violence became rare in the United States after the 1920s, though they persisted in Europe, as seen in his German safety poster from 1930 that reads, “Motorist! Be Careful!” Via the Library of Congress.

Fried says that unlike campaigns for smoking and HIV reduction, American cities aren’t directly pushing people to change their behavior. “You don’t see cities saying outright that driving is bad, or asking people to take transit or ride a bike, in part because they’re getting flack from drivers. No one wants to be seen as ‘anti-car,’ so their message has mostly been about designing streets for greater safety. I think, by and large, this has been a good choice.”

“The biggest reductions in traffic injuries that the New York City DOT has been able to achieve are all due to reallocating space from motor vehicles to pedestrians and bikes,” says Fried. “The protected bike-lane redesigns in New York City are narrowing the right of way for vehicles by at least 8 feet, and sometimes more. If you’re a pedestrian, that’s 8 more feet that you don’t have to worry about when you’re crossing the street. And if you’re driving, the design gives you cues to take it a bit slower because the lanes are narrower. You’re more aware of how close you are to other moving objects, so the incidence of speeding isn’t as high as it used to be. All these changes contribute to a safer street environment.”

Like in the 1920s, these infrastructure changes really start with a new understanding of acceptable street behavior. “That battle for street access of the 1910s and ’20s, while there was a definite winner, it never really ended,” says Norton. “It’s a bit like the street became an occupied country, and you have a resistance movement. There have always been pedestrians who are like, ‘To hell with you, I’m crossing anyway.’

“The people who really get it today, in 2014, know that the battle isn’t to change rules or put in signs or paint things on the pavement,” Norton continues. “The real battle is for people’s minds, and this mental model of what a street is for. There’s a wonderful slogan used by some bicyclists that says, ‘We are traffic.’ It reveals the fact that at some point, we decided that somebody on a bike or on foot is not traffic, but an obstruction to traffic. And if you look around, you’ll see a hundred other ways in which that message gets across. That’s the main obstacle for people who imagine alternatives—and it’s very much something in the mind.”

This 1935 Chevy safety film made the misleading argument that their vehicles were "the safest place to be," and that all danger was created by careless drivers.

This 1935 Chevy safety film made the argument that motor vehicles were “the safest place to be,” and that danger was only created by careless drivers.

(This article is dedicated to my uncle, Jim Vic Oatman, and friend, Chris Webber, both of whom were killed by car collisions. Learn more about the CDC’s battle against motor-vehicle injuries here, find out how to bring Vision Zero to your city, or scare yourself with the Boston Public Library’s archive of historic car wreck images.)