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At times of suffering, the greatest gift is accompaniment by another
How do you overcome the tension between autonomy and solidarity?
Concerned about her risk, the woman sought testing for BRCA1 and BRCA2 inherited mutations, which increase the risk of female breast and ovarian cancers. When the testing came back positive and she decided to undergo a double mastectomy, her doctor asked her how she wanted to tell her siblings. But the patient insisted upon her privacy, and chose not to inform them of her test result. This meant the doctor was torn between respecting his patient's confidentiality and a duty of benevolence toward her at-risk relatives.
This case, and many others like it, exhibits a tension between autonomy and solidarity. Valuing autonomy guides one to let others make their own choices, and to respect those choices. Valuing solidarity guides one to take responsibility for the wellbeing of others, and to intervene on their behalf. Situations in which these values conflict prompt searching for balance, where possible, perhaps by restricting the scope of rights to privacy for the sake of justice, or by defining exceptions that merit disclosing information without consent. In the case of the patient with the breast cancer gene, her doctor's decision about how to balance autonomy and solidarity is difficult, and whatever decision he makes is far from straightforward.
Some cases, however, are more difficult still. Consider the one reported by the sociologist Arthur Frank in 2016 of Faith, a 28-year-old woman with cystic fibrosis whose lungs are failing and whose doctor informs her that a transplant is likely futile. A surgeon from another hospital is touting a new technique that, while very risky, might be successful. There are doubts about the surgeon's motives. Because her condition is deteriorating, Faith has only two weeks to make a decision. What does it mean to counsel Faith in this situation? She has no real autonomy, because her extreme vulnerability and uncertainty about the proffered technique preclude her giving informed consent. But valuing solidarity is inappropriate too, because the right decision on her behalf is impossible in a position of such uncertainty about the outcome.
Faith's life-limiting condition is difficult because it induces despair, dissonance and desolation: despair as hopes for the future confront the inevitability of fate; dissonance between an imagined future and present reality; and the desolation of being alienated and isolated when others withdraw from her tragedy and retreat from her subjectivity. In such situations, the often-neglected strategy of 'accompaniment' might be the best available option.
Let me explain what accompaniment means in this context. The performing arts offer a variety of examples that help to clarify this. In music, the accompaniment is the musical part that supports the melody or main themes of a musical performance, as when an organist or guitarist accompanies a choir, or a drummer and bass player accompany a lead singer. In a dramatic film, the accompaniment is the part that supports the dramatic action, as when a musical soundtrack accompanies dialogue between actors. These examples indicate that accompanying another involves lending support to the other in ways that amplify or strengthen their efforts. Like solidarity, accompaniment involves one uniting with another. But unlike solidarity, which typically aims to correct some injustice or satisfy some need, accompaniment aims to acknowledge and engage with the efforts of another – not for the sake of helping the other achieve some goal that's impossible to achieve on one's own, but for the sake of enriching, and making manifest the value of, the other's efforts. This difference in emphasis is important.
The School Kids Investigating Language in Life and Society (SKILLS) programme at the University of California, Santa Barbara (USCB) exemplifies the practice of accompaniment. Students in the programme are second-generation immigrant Latinx from working-class homes who intend to pursue higher education. Mary Bucholtz, Dolores Inés Casillas and Jin Sook Lee, all scholars at USCB, report that one of the main obstacles these students face is linguistic. Cultural demands to speak English isolate the students from communicating with their Spanish-speaking grandparents, and their English-language dialects tend to marginalise them in academic contexts. SKILLS teachers accompany these students by engaging them in research projects designed to help them see their linguistic skills as assets, and to reframe their linguistic capability as a virtue rather than a hindrance.
To accompany another is to give companionship against despair, dissonance and desolation. Against desolation, one who accompanies offers consolation, being with another in their solitude by creating opportunities for testimony, listening and hearing without judgment, and reinforcing the other's dignity by acknowledging their experience and struggle. Against dissonance and despair, one who accompanies also fosters reconciliation by affirming strength and resilience, bringing one's presence to the other's difficulties, validating ways that the past pulls upon the present, and participating in efforts to imagine ways of transforming or reframing the affective significance of the other's reality.
Consider the case of Samuel, Alisha and Aaron Cobb's son, who had a severe abdominal wall defect and the chromosomal abnormality trisomy 18. Samuel died five hours after his birth. His parents had learned of his condition five months before he was born. Three months before his birth, they learned it would be fatal, and his mother spent the remainder of her pregnancy enduring the typical curious enquiries, idle comments and congratulations. Some years later, reflecting upon his grief, Samuel's father writes, in Loving Samuel: Suffering, Dependence, and the Calling of Love (2014):
There are days now where it is easier to carry the sorrow of our loss, but it is not because the burden is lighter. At times, it is because one of us is carrying the other, or, perhaps, we all are being carried by others.
The carryings by others of which Cobb writes are acts of accompaniment. The acts demand, of those who accompany, foregoing fears and strategies for self-protection for the sake of giving witness to an unavoidably difficult present and an irreparably uncertain future. They demand companionship, rather than distancing, directed toward helping another bear what seems to be unbearable.
When compassion opens us to the struggles of another in situations that induce despair, dissonance and desolation, it can be difficult to discern an appropriate response. The temptation is to manage the other's condition – to offer solutions or platitudes, to approach the other objectively. But despair, dissonance and desolation are not faults to be managed, and efforts to the contrary deny our powerlessness against the other's vulnerability. Adopting the stance of accompaniment, by contrast, embraces the truth the other knows all too well and, in doing so, embraces the other. It succeeds not by resolving problems but by aligning with the other – experiencing the other's suffering in common, allowing the other's struggle to matter and affect one's own experience, and responding, with speech or action or silence, in ways that don't obstruct the other's efforts to confront their situation.
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Certain water beetles can escape from frogs after being consumed.
- A Japanese scientist shows that some beetles can wiggle out of frog's butts after being eaten whole.
- The research suggests the beetle can get out in as little as 7 minutes.
- Most of the beetles swallowed in the experiment survived with no complications after being excreted.
In what is perhaps one of the weirdest experiments ever that comes from the category of "why did anyone need to know this?" scientists have proven that the Regimbartia attenuata beetle can climb out of a frog's butt after being eaten.
The research was carried out by Kobe University ecologist Shinji Sugiura. His team found that the majority of beetles swallowed by black-spotted pond frogs (Pelophylax nigromaculatus) used in their experiment managed to escape about 6 hours after and were perfectly fine.
"Here, I report active escape of the aquatic beetle R. attenuata from the vents of five frog species via the digestive tract," writes Sugiura in a new paper, adding "although adult beetles were easily eaten by frogs, 90 percent of swallowed beetles were excreted within six hours after being eaten and, surprisingly, were still alive."
One bug even got out in as little as 7 minutes.
Sugiura also tried putting wax on the legs of some of the beetles, preventing them from moving. These ones were not able to make it out alive, taking from 38 to 150 hours to be digested.
Naturally, as anyone would upon encountering such a story, you're wondering where's the video. Thankfully, the scientists recorded the proceedings:
The Regimbartia attenuata beetle can be found in the tropics, especially as pests in fish hatcheries. It's not the only kind of creature that can survive being swallowed. A recent study showed that snake eels are able to burrow out of the stomachs of fish using their sharp tails, only to become stuck, die, and be mummified in the gut cavity. Scientists are calling the beetle's ability the first documented "active prey escape." Usually, such travelers through the digestive tract have particular adaptations that make it possible for them to withstand extreme pH and lack of oxygen. The researchers think the beetle's trick is in inducing the frog to open a so-called "vent" controlled by the sphincter muscle.
"Individuals were always excreted head first from the frog vent, suggesting that R. attenuata stimulates the hind gut, urging the frog to defecate," explains Sugiura.
For more information, check out the study published in Current Biology.
New research from the University of Granada found that stress could help determine sex.
Stress in the modern world is generally viewed as a hindrance to a healthy life.
Indeed, excess stress is associated with numerous problems, including cardiovascular disease, high blood pressure, insomnia, depression, obesity, and other conditions. While the physiological mechanisms associated with stress can be beneficial, as Kelly McGonigal points out in The Upside of Stress, the modern wellness industry is built on the foundation of stress relief.
The effects of stress on pregnant mothers is another longstanding area of research. For example, what potential negative effects do elevated levels of cortisol, epinephrine, and norepinephrine have on fetal development?
A new study, published in the Journal of Developmental Origins of Health and Disease, investigated a very specific aspect of stress on fetuses: does it affect sex? Their findings reveal that women with elevated stress are twice as likely to give birth to a girl.
For this research, the University of Granada scientists recorded the stress levels of 108 women before, during, and after conception. By testing cortisol concentration in their hair and subjecting the women to a variety of psychological tests, the researchers discovered that stress indeed influences sex. Specifically, stress made women twice as likely to deliver a baby girl.
The team points out that their research is consistent with other research that used saliva to show that stress resulted in a decreased likelihood of delivering a boy.
Maria Isabel Peralta RamírezPhoto courtesy of University of Granada
Lead author María Isabel Peralta Ramírez, a researcher at the UGR's Department of Personality, Evaluation and Psychological Treatment, says that prior research focused on stress levels leading up to and after birth. She was interested in stress's impact leading up to conception. She says:
"Specifically, our research group has shown in numerous publications how psychological stress in the mother generates a greater number of psychopathological symptoms during pregnancy: postpartum depression, a greater likelihood of assisted delivery, an increase in the time taken for lactation to commence (lactogenesis), or inferior neurodevelopment of the baby six months after birth."
While no conclusive evidence has been rendered, the research team believes that activation of the mother's endogenous stress system during conception sets the concentration of sex hormones that will be carried throughout development. As the team writes, "there is evidence that testosterone functions as a mechanism when determining the baby's sex, since the greater the prenatal stress levels, the higher the levels of female testosterone." Levels of paternal stress were not factored into this research.
Previous studies show that sperm carrying an X chromosome are better equipped to reach the egg under adverse conditions than sperm carrying the Y chromosome. Y fetuses also mature slowly and are more likely to produce complications than X fetuses. Peralta also noted that there might be more aborted male fetuses during times of early maternal stress, which would favor more girls being born under such circumstances.
In the future, Peralta and her team say an investigation into aborted fetuses should be undertaken. Right now, the research was limited to a small sample size that did not factor in a number of elements. Still, the team concludes, "the research presented here is pioneering to the extent that it links prenatal stress to the sex of newborns."
Stay in touch with Derek on Twitter and Facebook. His most recent book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."
The world's 10 most affected countries are spending up to 59% of their GDP on the effects of violence.
- Conflict and violence cost the world more than $14 trillion a year.
- That's the equivalent of $5 a day for every person on the planet.
- Research shows that peace brings prosperity, lower inflation and more jobs.
- Just a 2% reduction in conflict would free up as much money as the global aid budget.
- Report urges governments to improve peacefulness, especially amid COVID-19.
What is the price of peace?
Or put another way, how much better off would we all be in a world where armed conflict was avoided?
To give some context, 689 million people - more than 9% of the world's population - live on less than $1.90 a day, according to World Bank figures, underscoring the potential impact peace-building activities could have.
Just over 10% of global GDP is being spent on containing, preventing and dealing with the consequences of violence. As well as the 1.4 million violent deaths each year, conflict holds back economic development, causes instability, widens inequality and erodes human capital.
Putting a price tag on peace and violence helps us see the disproportionately high amounts spent on creating and containing violent acts compared to what is spent on building resilient, productive, and peaceful societies.
—Steve Killelea, founder and executive chairman, Institute for Economics & Peace (IEP)
The cost of violence
In a report titled "The Economic Value of Peace 2021", the IEP says that for every death from violent conflict, 40 times as many people are injured. The world's 10 most affected countries are spending up to 59% of their GDP on the effects of violence.
Grounds for hope
But the picture is not all bleak. The economic impact of violence fell for the second year in a row in 2019, as parts of the world became more peaceful.
The global cost dropped by $64 billion between 2018 and 2019, even though it was still $1.2 trillion higher than in 2012.
In five regions of the world the costs increased in 2019. The biggest jump was in Central America and the Caribbean, where a rising homicide rate pushed the cost up 8.3%.
Syria, with its ongoing civil war, suffered the greatest economic impact with almost 60% of its GDP lost to conflict in 2019. That was followed by Afghanistan (50%) and South Sudan (46%).
The report makes a direct link between peace and prosperity. It says that, since 2000, countries that have become more peaceful have averaged higher GDP growth than those which have become more violent.
"This differential is significant and represents a GDP per capita that is 30% larger when compounded over a 20-year period," the report says adding that peaceful countries also have substantially lower inflation and unemployment.
"Small improvements in peace can have substantial economic benefits," it adds. "For example, a 2% reduction in the global impact of violence is roughly equivalent to all overseas development aid in 2019."
Equally, the total value of foreign direct investment globally only offsets 10% of the economic impact of violence. Authoritarian regimes lost on average 11% of GDP to the costs of violence while in democracies the cost was just 4% of GDP.
And the gap has widened over time, with democracies reducing the cost of violence by almost 16% since 2007 while in authoritarian countries it has risen by 27% over the same period.
The report uses 18 economic indicators to evaluate the cost of violence. The top three are military spending (which was $5.9 trillion globally in 2019), the cost of internal security which makes up over a third of the total at $4.9 trillion and homicide.
Peace brings prosperity
The formula also contains a multiplier effect because as peace increases, money spent containing violence can instead be used on more productive activities which drive growth and generate higher monetary and social returns.
"Substantial economic improvements are linked to improvements in peace," says the report. "Therefore, government policies should be directed to improving peacefulness, especially in a COVID-19 environment where economic activity has been subdued."
The IEP says what it terms "positive peace" is even more beneficial than "negative peace" which is simply the absence of violence or the fear of violence. Positive peace involves fostering the attitudes, institutions & structures that create and sustain peaceful societies.
The foundations of a positively peaceful society, it says, are: a well functioning government, sound business environment, acceptance of the rights of others, good relations with neighbours, free flow of information, high levels of human capital, low levels of corruption and equitable distribution of resources.
The World Economic Forum's report Mobilizing the Private Sector in Peace and Reconciliation urged companies large and small to recognise their potential to work for peace quoting the former Goldman Sachs chair, the late Peter Sutherland, who said: "Business thrives where society thrives."
The lush biodiversity of South America's rainforests is rooted in one of the most cataclysmic events that ever struck Earth.