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China tightens its grip on freedom in academics
Scholars often debate risking their livelihoods and personal safety in order to conduct research in certain areas.
- Authoritarian governments that rely heavily on coercion must be more intrusive about how education shapes the personality and character of its members.
- In China, there are topics that scholars know to avoid — especially, the Three Ts: Taiwan, Tibet, and Tiananmen Square.
- While the majority of scholars are likely toeing the party line when it comes to their research, some are working toward encouraging academic freedom in the country, often at significant risk to themselves and their families.
In March of 2019, Chinese President Xi Jinping called on Chinese educators to "nurture generation after generation [of young people] who support Chinese Communist Party rule and China's socialist system." What does this mean for the state of scholarship in China? Toeing the line between the right and wrong viewpoint is a serious matter for scholars in that country. It can be the difference between a fulfilling career and being barred from research, removed from the country, or even imprisoned.
This interconnection between government and education is ancient — think, Plato's "Republic." Any society needs to bring new members into conformity with the order that society aims at. In the U.S. this is called civics education and comprises understanding the rules under which our society is structured. These rules allow a wide degree of individual freedom rooted in individual rights. Citizens must understand those rights and how those rights constrain and protect us in our interactions with each other and the government. Traditionally in the US many of these rights are also not seen to be the sole privilege of citizens but what are owed to humans as many are extended to non-citizen residents and visitors.
Authoritarian governments that rely heavily on coercion must be more intrusive about how education shapes the personality and character of its members. The system erected by the Chinese Communist Party's (CCP) rests on control by the party. As such, the government looks to prohibit thoughts and actions that would undermine party control.
Consider the case of Liu Xiaobo, the scholar and human rights activist who, along with more than 300 other Chinese citizens, signed Charter 08, a political manifesto demanding freedom of expression, human rights, and economic liberalism in China. According to Chinese officials, signatories of this statement were guilty of "inciting subversion of state power." Liu was sentenced to 11 years of imprisonment though he died of liver cancer after serving eight.
While this incident might have made international headlines, it is not a wholly unique one in the age of the internet garnering easier access than ever to liberal values. Scholars across China are regularly targeted for working on subjects that upset the CCP or are coerced into restricting their research to acceptable topics.
President Xi Jinping inspects the Chinese People's Liberation Army Garrison In Hong Kong.
Lessons in the wrong ideology
In China, there are topics that scholars know to avoid. First are the Three Ts: Taiwan, Tibet, and Tiananmen Square. There are also seven additional subjects that educators are forbidden from teaching that are listed in the so-called Document Number Nine, a document circulated amongst the CCP that was leaked in July 2013. These seven forbidden subjects are those that promote Western constitutional democracy, universal values, civil society, neoliberalism, Western-style journalism, "historical nihilism," and questioning China's reforms and socialist nature.
This document was first leaked in 2013, the same year that Xi came to power, and it is believed to have been developed or at least approved by Xi. Since its publication and Xi's assumption of power, the CCP has wielded increasingly forceful influence over what is and is not permissible in China's higher education system.
Being 'taken for tea'
While studying the actions of the CCP against scholars in mainland Chinese universities is challenging for obvious reasons, studies from universities in Hong Kong, Australia, North America, and other regions conducting research in mainland China have recently been published.
Chestnut Greitens and colleagues conducted such a study on over 500 researchers. They found that nearly 10 percent of their sample had been approached by authorities and "taken for tea," a euphemism for when scholars are interrogated and intimidated. As one scholar relayed:
Our research group, consisting of Chinese and foreign scholars, were conducting survey research in [redacted]. Some elements of the research topic were considered politically sensitive. We were contacted by the county government, spent a full day "having tea" and discussing the project, and finally asked to leave the county. We complied.
A further 12 percent said their Chinese colleagues had been approached and asked about their work, roughly a quarter were denied access to archival records, and 17 percent had interview subjects withdraw in a suspicious or unexplained manner. The primary concern of these researchers, however, was not their own safety but rather that of their Chinese colleagues or informants. Researchers recommended paying attention to how mainland Chinese collaborators reacted, as they were far more likely to face the consequences of any politically sensitive research project. One researcher said, "This is more important than your publication or your tenure or your degree. If you think in these terms and observe cues of whether people are comfortable or want to cooperate, you should be OK."
But these concerns can also persuade researchers to engage in self-censorship. In an interview with Big Think, Robert Quinn, the founder of the Scholars at Risk Network, discussed how researchers can be persuaded to do the CCP's work for them:
We don't understand how much our thoughts, our very thoughts and therefore our identities, are shaped by implicit permission to think that or ask that or say that. … When they come and haul away the professor in the office next to yours to prison, that affects whether you're going to publish the next article. How do we measure that?
The right to know: How does censorship affect academics?
Consequences for mainland Chinese scholars
While statistics on the nature of academic freedom within mainland China are limited, the Scholars at Risk network has assembled a report detailing the experiences of several Chinese scholars, titled Obstacles to Excellence.
The report describes several features of Chinese academia with chilling effects on research, such as the use of student informants. These informants report on other students' and teachers' comments and activities for the CCP. Dezhou University in Shandong Province reportedly issued a directive to set up a student informant network intended to "destroy the seeds of discord that may affect security and stability before they sprout."
Scholars that are perceived to sow "the seeds of discord" often face serious consequences. Some Chinese scholars reported having their travel restricted, being fired from their positions, being followed by plainclothes police, having their communications monitored, and having other measures taken up against them. For example, legal scholar Teng Biao, a signatory of Charter 08, was forbidden from publishing books and banned from teaching. In 2011, plainclothes police officers detained Teng, throwing a sack over his head, and held him for 70 days while he was beaten and tortured.
These actions by the CCP tend to be more severe in the more politically sensitive regions of China, such as Xinjiang, Inner Mongolia, and Tibet. In the Xinjiang province, for instance, where the persecuted Uighur minority primarily resides, residents are made to install surveillance software on their mobile phones. The province also hosts a number of re-education camps where Uighur Muslims are made to eat pork and drink alcohol, recite CCP anthems, and attend indoctrination classes.
While the majority of scholars are likely toeing the party line when it comes to their research, some are working toward encouraging academic freedom in the country, often at significant risk to themselves and their families. For this reason, acceptance of scholars fleeing persecution is imperative for nations with more fortunate attitudes toward academic freedom. Even so, this fear of displacement will historically affect the scope of knowledge in a country like China, making the pursuit of academic freedom more important than ever.
So far, 30 student teams have entered the Indy Autonomous Challenge, scheduled for October 2021.
- The Indy Autonomous Challenge will task student teams with developing self-driving software for race cars.
- The competition requires cars to complete 20 laps within 25 minutes, meaning cars would need to average about 110 mph.
- The organizers say they hope to advance the field of driverless cars and "inspire the next generation of STEM talent."
Indy Autonomous Challenge<p>Completing the race in 25 minutes means the cars will need to average about 110 miles per hour. So, while the race may end up being a bit slower than a typical Indy 500 competition, in which winners average speeds of over 160 mph, it's still set to be the fastest autonomous race featuring full-size cars.</p><p style="margin-left: 20px;">"There is no human redundancy there," Matt Peak, managing director for Energy Systems Network, a nonprofit that develops technology for the automation and energy sectors, told the <a href="https://www.post-gazette.com/business/tech-news/2020/06/01/Indy-Autonomous-Challenge-Indy-500-Indianapolis-Motor-Speedway-Ansys-Aptiv-self-driving-cars/stories/202005280137" target="_blank">Pittsburgh Post-Gazette</a>. "Either your car makes this happen or smash into the wall you go."</p>
Illustration of the Indy Autonomous Challenge
Indy Autonomous Challenge<p>The Indy Autonomous Challenge <a href="https://www.indyautonomouschallenge.com/rules" target="_blank">describes</a> itself as a "past-the-post" competition, which "refers to a binary, objective, measurable performance rather than a subjective evaluation, judgement, or recognition."</p><p>This competition design was inspired by the 2004 DARPA Grand Challenge, which tasked teams with developing driverless cars and sending them along a 150-mile route in Southern California for a chance to win $1 million. But that prize went unclaimed, because within a few hours after starting, all the vehicles had suffered some kind of critical failure.</p>
Indianapolis Motor Speedway
Indy Autonomous Challenge<p>One factor that could prevent a similar outcome in the upcoming race is the ability to test-run cars on a virtual racetrack. The simulation software company Ansys Inc. has already developed a model of the Indianapolis Motor Speedway on which teams will test their algorithms as part of a series of qualifying rounds.</p><p style="margin-left: 20px;">"We can create, with physics, multiple real-life scenarios that are reflective of the real world," Ansys President Ajei Gopal told <a href="https://www.wsj.com/articles/autonomous-vehicles-to-race-at-indianapolis-motor-speedway-11595237401?mod=e2tw" target="_blank">The Wall Street Journal</a>. "We can use that to train the AI, so it starts to come up to speed."</p><p>Still, the race could reveal that self-driving cars aren't quite ready to race at speeds of over 110 mph. After all, regular self-driving cars already face enough logistical and technical roadblocks, including <a href="https://www.bbc.com/news/technology-53349313#:~:text=Tesla%20will%20be%20able%20to,no%20driver%20input%2C%20he%20said." target="_blank">crumbling infrastructure, communication issues</a> and the <a href="https://bigthink.com/paul-ratner/would-you-ride-in-a-car-thats-programmed-to-kill-you" target="_self">fateful moral decisions driverless cars will have to make in split seconds</a>.</p>But the Indy Autonomous Challenge <a href="https://static1.squarespace.com/static/5da73021d0636f4ec706fa0a/t/5dc0680c41954d4ef41ec2b2/1572890638793/Indy+Autonomous+Challenge+Ruleset+-+v5NOV2019+%282%29.pdf" target="_blank">says</a> its main goal is to advance the industry, by challenging "students around the world to imagine, invent, and prove a new generation of automated vehicle (AV) software and inspire the next generation of STEM talent."
A new Harvard study finds that the language you use affects patient outcome.
- A study at Harvard's McLean Hospital claims that using the language of chemical imbalances worsens patient outcomes.
- Though psychiatry has largely abandoned DSM categories, professor Joseph E Davis writes that the field continues to strive for a "brain-based diagnostic system."
- Chemical explanations of mental health appear to benefit pharmaceutical companies far more than patients.
Challenging the Chemical Imbalance Theory of Mental Disorders: Robert Whitaker, Journalist<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="41699c8c2cb2aee9271a36646e0bee7d"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/-8BDC7i8Yyw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>This is a far cry from Howard Rusk's 1947 <em>NY Times </em>editorial calling for mental health disorders to be treated similarly to physical disease (such as diabetes and cancer). This mindset—not attributable to Rusk alone; he was merely relaying the psychiatric currency of the time—has dominated the field for decades: mental anguish is a genetic and/or chemical-deficiency disorder that must be treated pharmacologically.</p><p>Even as psychiatry untethered from DSM categories, the field still used chemistry to validate its existence. Psychotherapy, arguably the most efficient means for managing much of our anxiety and depression, is time- and labor-intensive. Counseling requires an empathetic and wizened ear to guide the patient to do the work. Ingesting a pill to do that work for you is more seductive, and easier. As Davis writes, even though the industry abandoned the DSM, it continues to strive for a "brain-based diagnostic system." </p><p>That language has infiltrated public consciousness. The team at McLean surveyed 279 patients seeking acute treatment for depression. As they note, the causes of psychological distress have constantly shifted over the millennia: humoral imbalance in the ancient world; spiritual possession in medieval times; early childhood experiences around the time of Freud; maladaptive thought patterns dominant in the latter half of last century. While the team found that psychosocial explanations remain popular, biogenetic explanations (such as the chemical imbalance theory) are becoming more prominent. </p><p>Interestingly, the 80 people Davis interviewed for his book predominantly relied on biogenetic explanations. Instead of doctors diagnosing patients, as you might expect, they increasingly serve to confirm what patients come in suspecting. Patients arrive at medical offices confident in their self-diagnoses. They believe a pill is the best course of treatment, largely because they saw an advertisement or listened to a friend. Doctors too often oblige without further curiosity as to the reasons for their distress. </p>
Image: Illustration Forest / Shutterstock<p>While medicalizing mental health softens the stigma of depression—if a disorder is inheritable, it was never really your fault—it also disempowers the patient. The team at McLean writes,</p><p style="margin-left: 20px;">"More recent studies indicate that participants who are told that their depression is caused by a chemical imbalance or genetic abnormality expect to have depression for a longer period, report more depressive symptoms, and feel they have less control over their negative emotions."</p><p>Davis points out the language used by direct-to-consumer advertising prevalent in America. Doctors, media, and advertising agencies converge around common messages, such as everyday blues is a "real medical condition," everyone is susceptible to clinical depression, and drugs correct underlying somatic conditions that you never consciously control. He continues,</p><p style="margin-left: 20px;">"Your inner life and evaluative stance are of marginal, if any, relevance; counseling or psychotherapy aimed at self-insight would serve little purpose." </p><p>The McLean team discovered a similar phenomenon: patients expect little from psychotherapy and a lot from pills. When depression is treated as the result of an internal and immutable essence instead of environmental conditions, behavioral changes are not expected to make much difference. Chemistry rules the popular imagination.</p>
Why Depression Isn't Just a Chemical Imbalance<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fbc027c9358dad4a6d9e2704fc9ddb04"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/GAC9ODvSxh0?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Many years ago, my best friend tried to quit smoking. He asked for help. While I'm no addiction expert, I offered what I knew from my fitness toolkit: breathing exercises and cardiovascular training, methods for strengthening his body and mind that could, I hoped, inspire him to take better care of himself in general. He replied, "No, I meant something like a pill."</p><p>A few years later, he quit for good. After failing the cold turkey method a number of times, it finally stuck. Maybe it was watching his children grow up—the reason my parents quit when I was young. This method is not easy, however. It challenges you; it forces you to confront your demons; it drastically affects your brain chemistry. Yet, in the long run, it sometimes works. </p><p>Sometimes pills work, too. But often they do not. The journalist Robert Whitaker, author of <em>Anatomy of an Epidemic</em>, discussed the clinical trial process <a href="https://bigthink.com/mind-brain/antidepressants-dangers" target="_self">during our recent conversation</a>. While the FDA process appears thorough from the outside, pharmaceutical companies only need to prove that a drug works better than placebo, not that it works for the most amount of people. He continues, </p><p style="margin-left: 20px;">"Let's say you have a drug that provides a relief of symptoms in 20 percent of people. In placebo, it's 10 percent. How many people in that study do not benefit from the drug? Nine out of 10. How many people are exposed to the adverse effects of the drug? 100 percent."</p><p>Even though some pharmacological interventions show little efficacy, and even though Xanax, an addictive and destructive benzodiazepine that only showed <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/" target="_blank">short-term (four weeks) efficacy</a> in clinical trials, is being prescribed for many months and years, doctors continue to use the language of clinical neuroscience to describe mental health issues. If chemistry is the problem, people will turn to chemistry for the solution. </p><p>Perhaps we should, as psychiatrist Dean Schuyler <a href="https://bigthink.com/surprising-science/antidepressant-effects" target="_self">writes</a> in a 1974 book, recognize that most depressive episodes "will run their course and terminate with virtually complete recovery without specific intervention." The problem is that idea isn't profitable. As long as the gatekeepers continue to use the language of chemical imbalances to describe what for many is just an episodic case of the "blahs," we'll continue creating more problems than we solve.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
Is focusing solely on body mass index the best way for doctor to frame obesity?
- New guidelines published in the Canadian Medical Association Journal argue that obesity should be defined as a condition that involves high body mass index along with a corresponding physical or mental health condition.
- The guidelines note that classifying obesity by body mass index alone may lead to fat shaming or non-optimal treatments.
- The guidelines offer five steps for reframing the way doctors treat obesity.
A new 5-step system for treating obesity<p>To help primary care practitioners better treat obesity, the doctors outlined five steps:</p><ol><li>Recognition of obesity as a chronic disease by health care providers, who should ask the patient permission to offer advice and help treat this disease in an unbiased manner.</li><li>Assessment of an individual living with obesity, using appropriate measurements, and identifying the root causes, complications and barriers to obesity treatment.</li><li>Discussion of the core treatment options (medical nutrition therapy and physical activity) and adjunctive therapies that may be required, including psychological, pharmacologic and surgical interventions.</li><li>Agreement with the person living with obesity regarding goals of therapy, focusing mainly on the value that the person derives from health-based interventions.</li><li>Engagement by health care providers with the person with obesity in continued follow-up and reassessments, and encouragement of advocacy to improve care for this chronic disease.</li></ol><p>Insider noted that some health professionals and body-positive advocates don't think the guidelines go far enough in reframing obesity treatment. The update still points "to individual bodies as the problem, not culture," registered dietitian <a href="https://www.bodykindnessbook.com/" target="_blank">Rebecca Scritchfield</a>, told <a href="https://www.insider.com/canada-doctors-obesity-should-be-defined-by-health-not-weight-2020-8" target="_blank">Insider</a>.</p><p>But it's also possible to see how some health professionals may worry this new model could discourage patients from taking the initiative to tackle weight-loss on their own, through exercise and dieting.</p><p>In a 2020 opinion piece published in <a href="https://www.frontiersin.org/articles/10.3389/fnut.2020.00002/full" target="_blank">Frontiers in Nutrition</a>, Dr. <a href="https://www.frontiersin.org/people/u/69229" target="_blank">Elliot M. Berry</a> argued that misplaced "medical and political correctness" may lead to the abrogation of the physician's responsibility to properly care for patients.</p><p style="margin-left: 20px;">"For example, some doctors are now even reluctant to raise the issue of obesity lest they be accused of fat shaming by not accepting their patients' proportions (despite the quote at the head of this opinion piece), and thereby receive poor approval ratings in an atmosphere where popularity is equated with good healthcare."</p><p>Berry offers a list of nine steps that he thinks could help the healthcare industry better treat obesity, without shaming patients or falling prey to political correctness.</p>
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