Court rules that patients have a right to disbelieve doctors

There is a clear ethical and legal principle that adults have a right to make decisions about their health. This is sometimes called the principle of patient autonomy. That is, of course, why doctors need patients’ consent before providing the treatment they recommend.

But we only really notice the ethical significance of this principle when patients make choices that go against medical advice and that doctors think are unwise or even dangerous. If we respect autonomy, those choices, too, must be respected.

There is an important proviso: if the adult has or appears to have a physical or mental disorder that seriously impairs their ability to make decisions (their “capacity” to use the language used by English law), it may not be right to do as the adult wishes. In such cases, there are important legal processes to potentially make decisions for the adult patient.

But what if a patient simply does not believe the information that a doctor is telling them? Could that affect the patient’s capacity to make decisions? A recent court case focused on this question.

In 2023, 19-year-old Sudiksha Thirumalesh became the focus of a legal dispute regarding her capacity to make decisions.

Thirumalesh suffered from a rare mitochondrial disorder and spent over a year in hospital in the UK in an intensive care unit. She depended on a breathing machine, artificial nutrition and kidney dialysis for her survival. The doctors caring for Thirumalesh judged that her disease had progressed, and she was dying.

They proposed transitioning her to a palliative treatment plan. Thirumalesh, along with her family, opposed the recommendation. While she accepted that her chances of recovery were “no more than 50%”, she did not believe the situation was as grave as the doctors were making it out to be. She wished to explore the possibility of experimental treatment overseas.

The key issue brought before the Court of Protection in September 2023 (and then the Court of Appeal earlier this year) was whether Thirumalesh’s capacity to make decisions about her care was compromised by her refusal to believe her doctors.

In a controversial ruling, Justice Roberts held that Sudiksha Thirumalesh lacked decision-making capacity because she could not appropriately weigh or use the information provided by her medical team.

Ethical issues

Imagine that someone is trying to find their way to a distant destination in a strange city. To navigate, they have a map, they have received some directions and they draw on information they see around them (such as street signs).

Of course, the person might get lost or take a long time to get there. But in some cases, the person might be literally incapable of finding their way. For example, they might be unable to read the map, comprehend the directions or read the street signs.

Or they might have such severe memory problems that they can’t remember where they are going, or whether they were told to turn left or right at the traffic lights. In those cases, we might think that it is important that someone else takes over the driving.

But what if they don’t believe in what the map is telling them, or the directions?

As we outline in a recent paper, there are several reasons to be sceptical about belief as a basis for judging a patient to lack capacity.

First, a patient’s values (the things to which they attach importance) can affect what they believe and even who they are able to believe. Factors like hope can play an influential role in shaping beliefs. But values are not the sort of thing that justify overruling a patient’s choices.

Indeed, respecting autonomy fundamentally requires allowing patients to develop beliefs and make choices in line with their values. If someone values the challenge of finding their way without a map, that wouldn’t give us a reason to navigate for them.

Second, it is important to distinguish between situations where someone is (a) capable of believing X but chooses not to do so and (b) where they are (literally) incapable of believing X.

The latter would arguably ground a judgment of incapacity. That might apply in the case of a person who is suffering from delusions of persecution and thinks that the map is fake and the people offering directions are all imposters. But chosen beliefs (or disbelief) are different.

A vaccine sceptic, for example, may disbelieve the information offered by all health professionals, but that does not make them incapable of deciding to have (or, more likely, refuse) a vaccine.

Based on the available evidence and expert testimony, Thirumalesh showed some understanding of the information provided to her and an appreciation of its significance.

Her stated desire to “die trying to live” appeared to indicate a recognition that at some point in the future, she may succumb to her condition. Her beliefs were motivated by her desire to survive and, therefore, an expression of her autonomy, not a threat to it.

Finally, to impose the beliefs of doctors on patients undermines the importance of partnership with patients and families, taking into consideration their values and preferences.

The family of Sudiksha Thirumalesh stand with another family outside the Supreme Court in London, while judges considered lifting the naming restrictions for the doctors involved in care of two deceased children.
PA Images / Alamy Stock Photo

The appeal

Tragically, Sudiksha Thirumalesh died in September 2023 following a cardiac arrest, after an appeal was filed by her family (but before any stopping of the medical treatments keeping her alive).

Although the results of the appeal could not benefit Thirumalesh, the Court of Appeal agreed to hear it because of the wider significance of the issues raised. In a landmark ruling in July 2024, the Court of Appeal reversed the previous decision, affirming that while Thirumalesh’s beliefs entailed a mistaken understanding of the clinical reality, they were not grounds for finding her to lack capacity.

In retrospect, it appears clear that Thirumalesh’s doctors were right that she was reaching the end of the road in her illness. She did not believe this, but she retained the right to make choices about her medical treatment – at least for treatments that were available and appropriate.

This case demonstrates some of the difficulties, but also the important ethical principles in decision-making for seriously ill patients. When doctors assess “capacity” to make decisions, they ought to focus on the technical (cognitive) elements and not the evaluative elements. It is inherently risky to include someone’s beliefs and values in capacity determinations.

A doctor, like a guide, should offer directions. They should try to help patients make good decisions about their health, including correcting, where possible, any misconceptions or misunderstandings. Ultimately, though, they should allow travellers (patients) to ignore that advice and walk in what looks like the wrong direction. Läs mer…

Companies won’t survive in a nature-depleted world – I’ve met the business owners who are taking action

After the conclusion of UN biodiversity conference Cop16, it was easy to feel disappointed. In Cali, Colombia, discussions fell short on how to monitor targets and progress remains slow. Despite agreements, Cop16 lacked urgency from governments and the UN on how to halt the crisis in the natural world.

Like many others, the UK government remains focused on net zero targets for greenhouse gas emissions. It can feel like biodiversity – the thing that makes our world a vibrant and beautiful place – has been left behind.

So it should come as good news that in my research I have heard stories from business owners who are taking it upon themselves to make a change. These are owners of small and medium-sized enterprises (SMEs) who are going from business as usual to business with nature as an equal partner.

We all connect with nature in different ways, from the joy of hearing a robin singing to the annoyance of having a seagull steal your lunch. This is the same for business – there are negative and positive interactions.

My ongoing research is finding that business owners often take their environmental passions and turn them into company values. The business managers, creators and entrepreneurs I spoke to are putting nature at the centre of their actions and decisions. And the markets they operate in are changing as customers see past simply using nature as a brand image. I found that it’s no longer acceptable to only think about nature for advertisements. It should also be the focus of the product.

This consumer expectation has resulted in many small businesses evolving their supply chain, industry and services to reflect their nature-dependent branding – the very opposite of greenwashing.

What does it mean to trade on nature?

Take an outdoor clothing company. Its adverts would likely feature rugged footpaths, wild hillsides and beautiful sandy beaches.

A world without diverse flora and fauna would probably ruin the outdoor clothing market – very few people will want to explore a polluted forest. So biodiversity is an important aspect of the success of their product in both advertisement and use.

Or a more complex example might be a company that produces high-end kitchen units. Most of their product is sold locally, and the area is renowned for its landscape. This environment draws both potential customers and potential employees to live in the area – so threats to the landscape also present a long-term risk to the business.

Both of these examples show how businesses depend on biodiversity. Despite the shortcomings of Cop16, those businesses that are already taking action can offer valuable lessons to governments and to bigger corporations.

The key ideas emerging from this research include understanding that businesses depend on biodiversity; that now is the time to innovate and adapt; and that individual connections with nature can be the trigger to create change.

As an example of this third point, one interviewee from a business selling Cornish food hampers talked about how they had noticed the lack of bees. This prompted them to talk to their team about how they manage their land. And after consulting a wildlife volunteer, they turned half of their land over to meadow and created a pond. They are continuing to review the environmental impact of their hampers, reviewing the supply chain and are now creating a decarbonisation plan.

These owners are connecting with nature locally and bringing this to their brand values. For some owners this has meant difficult conversations with customers. Tourists usually would not appreciate a hornets’ nest in their holiday home, but at one venue staff took the time to share their passion for insects with the guests, who then understood that they could actually co-exist.

Once inspired, however, it can be difficult to know what to do next. Another interviewee said that they knew what they were doing wrong but found it difficult to know how to do better.

Owners have reported that getting information and changing direction can be the hardest part, especially as business impact on biodiversity can be vast.

Holidaymakers expect clean beaches and unpolluted seas.
Monkey Business Images/Shutterstock

One events venue worked hard to find information to change its waste management systems. The team knew that waste has a negative impact on nature and so started small with recycling. They have now developed a zero-waste project for the entire site. They researched packaging, talked to waste management companies and discovered that not all recyclable food packaging could be processed locally.

This led to a comprehensive review of the supply chain. They worked with local catering companies to change the food packaging used during events. It also meant changing customer behaviour so that waste was put in the right bin.

Making progress on their zero-waste goal has meant years of innovating and adapting. But the success has been achieved through bringing their suppliers, staff, external experts and technology along on the journey. It began with the value of nature and innovation, and developed into a whole-business approach.

This shows that one business’s decision to find out more can have far-reaching benefits as they collaborate with others to reduce their impact.

Many businesses’ image, brand and produce require a healthy planet. It is no longer enough to talk about a commitment to nature, it requires action or their business simply cannot expect to survive.

I have found that businesses taking action now are leading the charge when it comes to positive reputations with customers. The innovators are developing products that respond to their landscape, working with suppliers with similar mindsets and carving out loyal customer bases. Examples I’ve encountered include making big changes to premises, suppliers, livestock and ingredients.

Businesses can start by taking a moment to look at the nature around them, before examining the values demonstrated across their supply chain and in the workplace. Whether Cop16 results in future change is yet to be seen, but businesses are thriving by taking action for biodiversity now. Läs mer…

Time is running out for a treaty to end plastic pollution – here’s why it matters

On March 2 2022, delegates to the UN environment assembly adopted an ambitious resolution to develop the text of a new treaty by the end of 2024 to end plastic pollution. With 24 days of formal negotiation between almost 200 countries completed, spread over meetings in Peru, France, Kenya and Canada, the fifth and final negotiation meeting is about to take place in Busan, South Korea. This is crunch time. Agreement must be found or the opportunity to take global action to tackle plastic pollution might be lost.

I have studied international action to tackle plastic pollution for the past decade. During this time, I have witnessed remarkable growth in plastic waste – an estimated 400 million tonnes is thrown away every year. Plastic pollution is now ubiquitous.

The issue of plastic pollution has moved up the public and political agenda in a way few could have predicted. Global action has always been the missing piece of the picture, as the plastics economy transcends national boundaries, and actions in one jurisdiction, while locally beneficial, tend not to address global pollution patterns.

To tackle plastic pollution, a shift in the entire plastics economy is needed. This should focus on reuse and refill schemes, which reduce the need for new plastic products and the substitution of plastics with other materials that are less polluting or harmful.

Refill schemes need to be scaled up to phase out single-use plastic.
Daisy Daisy/Shutterstock

With my team of policy researchers, I have attended the last three plastics treaty negotiation meetings as an observer to gauge progress towards a global treaty. For the most part, progress has been slow, largely because of delaying and blocking tactics by a few countries that depend on fossil fuel industries. Lobbying from the petrochemical industry frustrates progress further. Given the tight timescale to agree the treaty, I worry that no agreement will be reached.

Three priorities

Final negotiations must include three things.

An immediate priority is to agree on the rules governing how decisions are taken in the negotiations between member states, known as the “rules of procedure”. At present, decisions are taken by consensus, meaning all delegations must agree before a decision is reached.

Given the entrenched positions of some countries, consensus-based decision-making is unlikely to yield rapid agreement because the positions of some nations are so far apart. The rules of procedure needs to include a voting mechanism so that when there is decisive agreement between most nations a decisions can be taken and progress can be made, when consensus cannot be reached.

The second critical issue is finance. Plastic pollution is a challenge most acutely faced by low- and middle-income countries. The plastics treaty is only likely to be effective if there’s adequate funding for countries most affected by plastic pollution to take action.

As witnessed in the climate debate, finance is incredibly contentious and raises critical questions. That includes who will pay for the problems plastic pollution has already caused and the new measures to tackle plastic pollution, plus how supporting countries can best provide necessary technology and training.

The role of the private sector is also significant in the plastics economy, and discussions are underway about innovative options for private finance to support treaty implementation. For the treaty to be credible, agreement on the broad terms of a finance mechanism for treaty implementation is essential.

The treaty must also focus on actions most likely to reduce plastic pollution. There is clear evidence that reducing the production of primary plastic polymers reduces plastic pollution most efficiently and effectively.

Plastic is made at such a rate that it is impossible for waste management systems to keep up. So a treaty that focuses on waste management will not reduce plastic pollution significantly enough. Only putting the brake on plastic production will stop the inundation of plastic waste.

There are, of course, many other important elements to agree on during negotiations. Criteria must be set to identify problematic, unnecessary and avoidable plastics that companies should stop making. Problematic plastics have harmful effects on human health or the environment, so any chemicals of concern must be removed from plastic materials and products. Unnecessary plastics are those with a function that is deemed non-essential, while avoidable plastics have an essential function but could be replaced by a non-plastic alternative.

Subsidies on virgin plastics that make single-use products so financially attractive need to be stripped away. Any changes in the plastics economy that this treaty create need to benefit workers in the informal waste sector too.

This week is critical for the world’s relationship with plastics. People and planet depend on it.

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Knowing superstitions aren’t real doesn’t stop us behaving superstitiously – why?

Former New Zealand prime minister John Key has three white rabbits painted on his helicopter, a nod to his “massively superstitious” habit of repeating “white rabbits” three times at the start of every month.

Tennis champion Rafael Nadal performs the same sequence of actions (shirt-tug, hair-tuck, face-wipe) before every serve. Taylor Swift paints “13” on her hand for good luck before a show, while Rihanna won’t allow anything yellow in her dressing room.

Perhaps you, too, are superstitious. Maybe you have a lucky number, avoid black cats, or shudder at the thought of opening an umbrella indoors.

Even if you don’t consider yourself superstitious, little things like saying “bless you” after a sneeze, knocking on wood or crossing your fingers are all examples of behaviours with superstitious origins.

We humans are particularly susceptible to superstitions. But why are we so quick to develop superstitious behaviours, and do we really believe they can bring good or bad luck?

In our new research, we set out to answer this question. We tested whether people could tell the difference between outcomes they caused and outcomes they didn’t cause, and this told us something about the cognitive roots of human superstition.

Learning about cause and effect

From as early as four months, infants learn their actions produce outcomes – kicking their legs shakes the crib, shaking a rattle makes an interesting noise, dropping a toy on the floor means mum or dad picks it up.

Lucky 13: Taylor Swift in concert.
Getty Images

As we grow older, we develop a more sophisticated understanding of cause-and-effect relationships, asking “why?” questions about the world around us.

This sensitivity to causes and effects sets the stage for important developmental milestones, like imaginative play, planning actions to achieve a goal, predicting others’ intentions, anticipating and regulating emotions, and cooperating with others.

The ability to learn about relationships between causes and effects is a defining feature of human cognition. But how does this square with our superstitious tendencies?

When cause and effect is an illusion

We learn about causes and effects from experience. When our behaviour is followed by an outcome, we learn about the relationship between our action and that outcome. The more often this action-outcome pairing occurs, the stronger the perceived link between them.

This is why we repeat behaviours that produce rewarding outcomes, and avoid repeating behaviours that produce punishing ones.

But what happens if an outcome follows our actions by coincidence? If I wear my lucky socks and my favourite sports team wins, this is probably just a coincidence (it’s unlikely my sock-wearing actually caused the win). But if this happens a few times, I may develop a superstition about my lucky socks.

This suggests superstitious behaviour arises because we aren’t particularly good at discerning when our actions cause an outcome, versus when our actions just coincide with (but do not cause) an outcome. This is a common explanation for superstition – but does it have any weight?

Testing our ability to detect causality

We can test what underpins superstitious behaviour by simply asking people “who caused that outcome?”. Getting it right would suggest we can discern action-outcome relationships (and therefore that there must be some other explanation for superstitious behaviour).

Our research did exactly that. We asked whether people could tell when their actions did or didn’t cause an outcome.

Cause and effect.
Getty Images

We recruited 371 undergraduate students from a large New Zealand university, who participated in one experimental session for a course credit. Participants played a game where a positive outcome (winning) or a negative outcome (losing) occurred either after their own action (clicking a button), or independently of their action.

Importantly, participants weren’t given any information beforehand about the type of outcome or whether it would depend on their behaviour. This meant they had to rely on what they actually experienced during the game, and we could test their ability to judge whether they had caused the outcome.

This also meant participants’ preexisting superstitions and other characteristics (such as age) didn’t affect our results. Their behaviour during the task was representative of human behaviour more generally.

Participants’ scores indicated they often got it right: in about 80% of trials, they knew when they’d caused the outcome, and when they hadn’t.

A built-in bias

The distinction between causing and not causing the outcomes was sometimes very subtle. This made it more difficult for participants to tell what had occurred.

When they weren’t sure, participants defaulted to saying “I caused it”, even if they actually hadn’t. They were biased to attribute outcomes to their own actions, particularly after winning outcomes.

This bias may be the key to explaining why we’re superstitious: something I did caused something to happen, even if I can’t be sure what it was. And it suggests knowing superstitions aren’t real may not actually stop us from behaving superstitiously.

On the surface, this may not make sense – why expend energy doing things we know don’t affect outcomes? But if we look deeper, this bias serves an important purpose, because it helps ensure we don’t miss any potential connections between our actions and their outcomes. In other words, it’s better to be safe than sorry.

Research shows that engaging in superstitious behaviour can also increase confidence in our abilities to achieve a goal, improve performance in different tasks, and alleviate anxiety by giving us a sense of control.

The tendency to attribute positive outcomes to our actions (as we found) can boost self-esteem and psychological wellbeing. So, perhaps we’d all benefit by indulging in a little superstitious behaviour. Touch wood. Läs mer…

What’s fuelling the media’s enduring hate campaign against Meghan Markle?

Earlier this year, the Daily Beast published a story that contained highly derogatory allegations about the Duchess of Sussex, Meghan Markle, quoting anonymous sources.

The piece was apparently aimed at refuting an earlier story in US Weekly that praised Markle and her management style, and featured people quoted by name.

The Daily Beast piece, written by a British-born journalist, was another example in a well-established pattern of relentless negative media framing of Markle, particularly by the same U.K. tabloids that have been sued by her husband, Prince Harry, and often via the use of unnamed sources.

This framing is readily identifiable by conducting a simple Google News search on her name. Markle, in fact, recently described herself as being one of the most bullied people in the world — which was met with more online bullying.

Although tabloid gossip is a feature of any celebrity’s life, the longstanding and seemingly orchestrated media campaign against Markle, a private citizen who left the United Kingdom almost five years ago and hasn’t spoken publicly about the Royal Family in years, is exceptional.

There have even been allegations of British media outlets attempting to pay people to lie about her.

Prince Harry and Meghan Markle on their wedding day outside Windsor Castle in May 2018.
(AP Photo/Matt Dunham)

These efforts reveal important information about the intersection of media power, gender and race.

As a communications scholar, I wanted to examine how Markle has been represented in the media and what other academics have determined in their own research about the coverage of her. The goal is not to assess the media’s derogatory claims about her; rather, it’s to shed light on the concealed structural issues underlying everyday news.

A disruptor in Brexit-era Britain

Since the onset of her relationship with Prince Harry, Markle’s identity as a feminist, biracial, American media celebrity has been under heavy media scrutiny. Early on in their relationship, The Daily Mail ran a highly controversial piece with the headline: “Harry’s girl is (almost) straight outta Compton: Gang-scarred home of her mother revealed — so will he be dropping by for tea?”

This piece made no attempt to conceal its racism and was replete with negative stereotypes of Black urban poverty, depicting Markle as unfit for the privileged life of the monarchy.

Nonetheless, the couple’s wedding received generally favourable media coverage from a diverse array of outlets. This disparity prompted scholars to inquire into the symbolic meanings of the royal wedding.

In an essay that garnered significant media attention, historian Hannah Yelin and sociologist Laura Clancy argued that the monarchy co-opted Markle’s feminist rhetoric.

They wrote:

“A celebrity (post)feminist such as Markle is of great value to a British monarchy keen to set themselves apart from these other forms of patriarchy and to mask, or at least deflect attention from, their own intensely problematic relationship with issues of race, gender, class and religion.”

But when The Sunday Times published a story based upon Yelin and Clancy’s essay, it chose an eye-catching yet problematically inaccurate title: “Academics accuse Meghan Markle of dropping feminism like a hot potato.”

As this story was reproduced by other publications, Yelin and Clancy found themselves targeted with sustained online hostility. Their criticism of proliferating misogyny was co-opted into increasingly negative media coverage of Markle. This twist was a telling revelation of how attacks on Markle are closely associated with mounting public tension around feminism and visible feminists.

Prince Harry and Meghan Markle at an Invictus Games training camp, in Whistler, B.C., in February 2024.
THE CANADIAN PRESS/Darryl Dyck

Racial identity

Besides the gender perspective, racial identity is also central to media discourses surrounding Markle, whose marriage to Prince Harry was depicted by some media commentators as a marked progress in British race relations.

This widely held opinion, however, is disputed by many scholars. For example, Kehinde Andrews, the first Black Studies professor in the U.K. who led the establishment of the first Black Studies program in Europe at Birmingham City University, considers Markle’s inclusion into the royal family a “cosmetic change in representation.”

He adds that framing her entry into the family as a sign of progress is “the perfect example of a post-racial delusion that demonstrates how poorly the nation understands racism and the power of the desire to live in a fantasy of progress rather than address continuing issues.”

The Duke and Duchess of Sussex’s high-profile departure from the Royal Family in 2020 occurred in the broader context of Brexit, and it was naturally labelled as #Megxit in online discussions.

This play on words allowed racist ideologies to persist under the guise of humour. As media scholar Kendra Marston noted:

“Staged fantasies of Markle’s expulsion from the Royal Family and indeed from Britain — neatly encapsulated in the Twitter hashtag #Megxit — seek to preserve a fantasy of the British monarchy as an exclusive symbol of national heritage that is conservative, patriarchal, white and, importantly, legitimate.”

Meghan Markle walks among the members of the Royal Family at Queen Elizabeth’s funeral in September 2022.
( Jacob King/Pool via AP)

Market-oriented journalism

Media narratives about Markle should also be understood against the backdrop of British regulatory environments and market mechanisms.

First, journalists in the U.K. navigate a maze of statutes and legal precedents. As such, their focus can be drawn to what is legally possible, and there is more legal leeway for reporting on celebrities and members of the Royal Family than there is for reporting on private people.

Ethical considerations appear in professional codes of conduct. McNae’s Essential Law for Journalists, a tome elaborating what may get journalists into legal trouble, is the British journalist’s “Bible.”

Second — and unlike the U.K.’s statutorily regulated broadcast sector — oversight of the print sector primarily rests with the industry-established Independent Press Standards Organisation. The extent to which this self-regulatory arrangement curbs newspaper excesses is a matter of debate.

Prince Harry leaves court after giving evidence in London in June 2023 against a tabloid publisher he accuses of phone hacking and other unlawful snooping.
(AP Photo/Kin Cheung)

Market pressures weigh on British media ethics, but there is a difference in coverage between the more sober “quality” press like The Guardian and sensationalistic tabloids like The Daily Mail and The Sun, which lean towards hyper-competitive, market-oriented journalism.

Media scholar James Curran has noted that quality news historically attracts high-end advertisers seeking high-end “niche” audiences; tabloids have sought larger, mass audiences and the advertisers targeting them. Sensationalism and outrage deliver large readerships, as does gossip, which helps audiences feel “in the know” about exclusive, high-status groups.

Gossip does appear in the quality press, though tabloids excel at providing it.

In 2012, the U.K.’s Leveson inquiry into media ethics resulted in a series of recommendations on how to regulate British newspapers in the wake of phone-hacking scandals. Those recommendations have largely been ignored.

British Prime Minister Keir Starmer said recently he would not revive the long-awaited second part of the inquiry, to the dismay of media regulation advocates and many parliamentarians.

Read more:
Brexit and migration: our new research highlights fact-free news coverage

Societal tensions

The media’s portrayal of Markle reveals the societal tensions underlying daily news, particularly concerning race and gender.

It also underscores the complexity of news ethics, especially in the U.K., which are exacerbated by the supposed self-regulation of some media outlets. Market pressures and the desire for clicks often result in sensationalist celebrity coverage that can often be factually problematic or, in Markle’s case, even incendiary at times.

Given the media’s impact on public perception and how it can incite online abuse of the type Markle is frequently subjected to, it seems the media should rethink how it reports on public figures and private citizens alike. Läs mer…

Russia needs a peace deal soon as it is running out of soldiers

For Vladimir Putin, Donald Trump’s win couldn’t come soon enough. Putin may reportedly accept a deal where Moscow gains significant territory in Ukraine (about the size of the US state of Virginia) and Ukraine remains neutral and forgets about any plans to join Nato or the EU.

Though Ukraine is experiencing war fatigue, so is Russia. Russia is making steady advances in the Donetsk region of Ukraine, but the Kremlin is still struggling to recruit soldiers for the conflict. The recent revelation that North Korean soldiers were fighting in Ukraine attests to this.

Even as Russia ramps up the war, with reports from Ukraine suggesting Moscow had fired its first intercontinental ballistic missile of the war, it’s become clear that a peace deal would be in the interests of Moscow, as much as Kyiv.

According to western assessments, around 115,000 to 160,000 Russian troops have died, 90% of the personnel it had at the beginning of the war. While another 500,000 have been injured. To offset these losses, Russia has been recruiting 20,000 new soldiers a month.

Recruiting soldiers into the army has never been that easy in Russia even during peacetime. Recruits are often subject to hazing and bullying by more experienced soldiers, and as such joining the army is viewed as something to be avoided by many young Russian men. Known as dedovshchina, Russian bullying, hazing and beating of conscripts has been a notable pastime in the Russian military since the end of the 17th century.

After the Soviet Union dissolved, the Russian media exposed the appalling conditions in the military, noting that troops suffered from poor medical care and severe malnutrition. Many Russians may also remember how poorly prepared conscripts were treated who were sent off to fight the war in Chechnya in the mid-1990s.

The Russian government does not appear to be concerned about the average Russian soldier’s safety and wellbeing. Already unpopular during times of peace, this desperation to avoid being drafted into an active war becomes even more acute.

Putin appears to be threatening to use nuclear weapons over the war in Ukraine but analysis suggests he is running out of replacement troops.

The military is also seen as a major trap to catch the poor and underprivileged. Conscripts in the Russian army are viewed as meat for the grinder; their graves are ignored and the bodies are sometimes not identified.

Most of the recruits have come from far east republics with large indigenous populations such as Bashkortostan, Chechnya, the Republic of Sakha (Yakutzia) and Dagestan — or as far from Moscow as possible.

But even young men in Moscow are now facing an increasingly aggressive Russian state. Hundreds of thousands of Russians have fled the country, forcing the government to introduce a tougher draft law to round up troops.

With the new law, implemented on November 1 this year, instead of receiving a draft notice through the post, draft notices are now delivered online. Once the notice enters a Russian man’s digital mailbox, those called up are immediately barred from leaving the country and can face stiff penalties if they do attempt to leave.

This means that any time a Russian man is in contact with the government – to pay taxes, renew a passport or driver’s license, or receive any type of government service – the Russian government can contact them and automatically give them their draft card. Having an online presence in Russia — such as having a bank account or a mortgage or car loan – also makes it harder to evade the draft.

Since the start of the war, Russian men have resorted to all kinds of tactics to avoid being drafted – faking that they had a drug dependency, falsifying medical documents and even in some cases breaking their own bones.

Moving locations within Russia or purchasing property in someone else’s name was also a common tactic, but now these strategies have become more difficult. Someone I interviewed for this article was drafted even though they had not lived in Moscow since 2006. Struggling to find recruits, the Russian government has resorted to going after Russian citizens who live abroad.

Russia has also notably drafted prisoners, which include murderers and paedophiles. This has caused Russia’s prison population to plummet.

But Putin is running out of men. To attract more recruits, the ministry of defence has increased pay, making it more lucrative than civilian jobs, doubling the bonus for people enlisting in November of last year.

Relying on the North Korean military offers another solution, but North Korean troops have no combat experience, use different military tactics and most don’t speak Russian, which makes it more difficult to coordinate for specific combat operations.

Russian soldiers have complained that they do not know what to do with them. Though this would be widely unpopular in Belarus, Putin may try to force Belarus to offer support, as Belarusian soldiers are familiar with Russian tactics and operations.

In another sign of weakness, Putin is demonstrating that conventional war tactics are no longer enough. On November 19, Putin issued a threat that nuclear weapons could be used, in response to a Ukrainian attack using US made Atacms missiles in the western Bryansk region in Russia.

Usually when conventional war strategies are working, there is no need to lower the threshold for nuclear use.

Clearly, the war is not going particularly well for Ukraine either. They are struggling with their own recruitment issues and territorial losses. But it is a mistake to think that Putin is coming to the eventual negotiation table from a position of strength. Luckily for Putin, though he may be running out of men, a favourable deal may be on the horizon that fails to take this into account. Läs mer…

Wicked review: a stunning film adaptation that avoids all the usual pitfalls of moving musicals from the stage to the screen

The journey from successful stage musical to big-screen adaptation is rarely truly successful. From director Joshua Logan’s use of coloured filters in the 1950s adaptation of South Pacific (which looks as if something is wrong) to Tom Hooper’s recent mega-mess movie of Cats, there are so many pitfalls to avoid.

The suspension of disbelief we willingly embrace in live performance is disrupted by the naturalism of cinema so that the aggressive ballet of the West Side Story gangs looks prissy and tame when filmed on the realistically gritty streets of New York. Similarly, Nathan Lane’s Max Bailystock was hilarious onstage in The Producers, but translates to the film as monstrous over-acting.

Like these musicals, Wicked has proven a remarkable success onstage and is the second highest-grossing musical in the history of New York’s Broadway (after The Lion King). Now it arrives on-screen in two parts; the first released this year and the second in 2025. Eyebrows have been raised at the 2 hour 40 minute running time for a movie that covers act one of the musical, which is 90 minutes onstage.

Inspired by figures like Saddam Hussein, Wicked began life in 1995 as a novel by Gregory Maguire who, drawing on L. Frank Baum’s 1900 novel The Wonderful Wizard of Oz, wanted to explore how certain figures became demonised in society.

Set in the years before Dorothy crash lands in Oz, the story shows the Wicked Witch to not be evil; she is, in fact, good, becoming radicalised by the broken politics of Oz.

The novel was bought almost immediately by Demi Moore and Universal Studios who struggled to develop a screenplay until composer Stephen Schwartz suggested it became a stage musical.

Working with author Winnie Holzman, they created a female-centric story that jettisoned much of Maguire’s politics to concentrate on the “frenemy” relationship between “pretty in pink” Glinda and the green-skinned outsider, Elphaba.

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Director John M Chu’s movie takes Wicked back to its political roots. In a time when populist leaders are on the rise, it arrives as a warning of the dangers of modern fascism.

In particular, it expands the storyline of Oz’s speaking animals who lose their voices. Unlike onstage, these animals are CGI characters in fully animal form and Chu captures how societies are stunned into silence by outrageous political actions. In doing so, he emphasises the unthinking unkindness of the herd mentality. He also makes the film a paean to the power of goodwill.

Set mostly during the Wicked Witch’s schooling years, Shiz University is also more fleshed out. In this section, the movie is in danger of losing its narrative thrust. However, just as we begin to feel trapped in the love child of Mean Girls and Harry Potter, we are whizzed off to the Emerald City.

Here Maguire’s backstory to the Grimmerie, the Ozian book of spells, is now musicalized in a new sequence featuring the original stage stars Idina Menzel and Kristin Chenoweth, and topped by a cameo from Stephen Schwartz. Once in the City, Jeff Goldblum’s Wizard proves a scheming huckster too aware of his own limitations

One of the classic pitfalls of the movie musical is in casting. From Lucille Ball in Mame to Russell Crowe in Les Misérables, missteps here can prove fatal. Thankfully, Wicked is expertly cast.

Ariana Grande captures the over-dramatising spoilt brat Galinda (to become Glinda the Good Witch), with precision vocals. Jonathan Bailey has a ball with the athletic, knowingly objectified heartthrob Fieryo, cementing his place as a leading man. Michelle Yeoh and Jeff Goldblum bring sinister gravitas and reasonable vocals to their respective roles.

However, the casting masterstroke is Cynthia Erivo as Elphaba who brings the quiet dignity to the role that she first revealed onstage in The Color Purple. As a queer black woman, for her, Elphaba’s story is one of pride, this is a woman who refuses to be ashamed of who she is and is determined to fulfil her potential.

She has a distinctive singing voice and the confidence to erase memories of Menzel’s stylings. Film also brings dimensions to Erivo’s talent. The use of close-ups allows an intimacy in her relationships that is impossible in a live setting. She is also able to show her ability to convey the pain she is suffering in a simple glance.

The film is a remarkable feat of 2D and 3D design and there are a dazzling array of quotes to other cinematic renderings of the Oz legends, all of which are delivered with a contemporary sensibility. This is a mechanically driven Oz, full of cogs and wheels, which reference the stage design of Wicked and includes a stylish train.

The costume designs reference both the stage show and the all-black disco musical The Wiz (1978). While the memories of the iconic Judy Garland’s 1939 movie are prompted every few minutes. In one scene, for instance, Elphaba transports a (cowardly) lion cub in a bicycle basket reminiscent of Toto’s dog-napping.

MGM changed Baum’s silver slippers to ruby (and the Wicked Witch’s skin to green) to showcase the newly developed Technicolor process. In this film they remain silver but are first presented in a ruby-encrusted box. There’s also nods to Baum’s original. Notably, the strangeness of the book’s Oz is more accurately captured than in any other cinematic version.

The best musical theatre is like experiencing a series of highwire acts in which the performers must flawlessly execute choreography, act convincingly and hit the highnotes eight times a week. Musical films, which can be re-shot and overdubbed, necessarily lack this sense of danger.

If at times Wicked struggles to capture the sheer energy of the stage, it re-imagines the work in a spectacular, but also thoughtful fashion, deepening serious themes and emotional connection. I will be back to see it and will undoubtedly see the four-plus hours in one sitting once part two is released next autumn. I only wish Judy Garland could see it. Läs mer…

Wicked’s Defying Gravity is a musical theatre anthem – and a battle cry for outsiders

As director Jon M Chu’s first instalment of the mega-musical adaptation Wicked arrives in cinemas, a new audience of fans is connecting with Stephen Schwartz’s memorable score. Featuring hits including Popular, The Wizard and I and For Good, the musical is particularly loved for its celebration of female characters in song.

Unlike many Broadway shows, Wicked’s heroes Elphaba (played in the film by Cynthia Erivo) and Glinda (by Ariana Grande), both women, dominate the song list. They frequently sing together, whereas other musicals typically feature duets that focus on a romance between a male and female lead.

At the heart of Wicked is the anthem Defying Gravity, which closes act one of the stage production and serves as the finale to Chu’s film. It begins as an argument between Elphaba and Glinda as they debate how to solve a mutual predicament. Elphaba explains her feelings to Glinda and asks her to leave Emerald City with her.

They dream about becoming a united front but, in the end, the song climaxes with Elphaba breaking free and accepting the consequences of embracing her magic.

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The journey of the song, which begins as a conversation and ends with a battle cry, epitomises a classic musical theatre finale, as it gains momentum and rises in key.

Using similar values to Schwartz’s lyrics to Go the Distance from Hercules (1997) and his song When You Believe from The Prince of Egypt (1998), Defying Gravity is particularly special because Elphaba goes on a journey with her best friend Glinda as her audience.

The original Broadway cast, Idina Menzel and Kristin Chenoweth, perform Defying Gravity.

Many musicals feature a rousing act one finale led by a female protagonist. For example, Mama Rose regathers her strength to make her daughter Louise a star during Everything’s Coming Up Roses in Gypsy, which has just returned to Broadway. However, Defying Gravity transcends its context in Wicked by focusing on the theme of trusting yourself and believing in who you are without compromise.

Wicked is an exploration of stigma (aimed at Elphaba in the show) and where it leads, and Defying Gravity is a watershed moment. Erivo described it as an important moment in which Elphaba resolves to “not allow the things that have hurt her, that have stripped her of her humanity to keep her down”.

Friends of Dorothy

As well as offering empowering representations of its female characters and of female friendship, Wicked is one of many queer-coded musicals. These are shows where LGBTQ+ identities or themes are unnamed but can be easily identified. Theatre professor Stacy Wolf has suggested that Wicked “does more than portray women as powerful and as friends; it presents the story of a queer romance between Elphaba and Glinda”.

This places Defying Gravity alongside the queer anthem Somewhere Over the Rainbow from The Wizard of Oz, another musical adaptation based on L. Frank Baum’s 1900 children’s novel. In fact, in Defying Gravity Schwartz quotes The Wizard of Oz composer Harold Arlen’s melody in a motif set to the word “unlimited”, which can be heard several times throughout Wicked.

The trailer for the new movie adaptation of Wicked.

Defying Gravity also uses a similar structure of escalation to another queer anthem, I Am What I Am from the musical La Cage Aux Folles. It also inspired Let It Go from Disney’s Frozen (also sung by Idina Menzel, the first Broadway Elphaba), which has its own queer history.

Read more:
How Frozen became the catalyst for Disney’s shift from male-centric tales

If Somewhere Over the Rainbow imagines whimsical escapism from an unfriendly world and I Am What I Am is fierce about being rejected by the people you love, Defying Gravity is about the power of choosing and forging your own path, with or without help.

The stirring accompaniment and building vocal line connect Defying Gravity to a tradition of classic musical theatre showstoppers. Meanwhile, the musical style and message of self actualisation recognises more modern values.

As Wicked arrives in cinemas, the message of Defying Gravity feels especially timely. Its core sentiment that “everyone deserves the chance to fly” speaks to so many people – the centre piece of a powerful musical about embracing our differences. Läs mer…

Sudan’s national treasures have been stolen – we spoke with the director of museums

In September, amid the ongoing war in Sudan, reports began to surface of the looting of the Sudan National Museum in the capital, Khartoum. The museum is internationally celebrated for the breadth of its collection. It illustrates powerful and unique African kingdoms from the ancient and medieval past in a world stretching from the sands of the Sahara to the grasslands of the Sahel.

Its artefacts range from the distant stone age, to one of sub-Saharan Africa’s earliest metropolises in Kerma (2500-1500 BCE), to the extraordinary objects of the Kushite empire (800 BCE-350 CE). There, powerful kings built large stone temples, cities, and fields of pyramids.

The entrance to the museum in 2013.
Albert Herring/Wikimedia Commons, CC BY-SA

The collection chronicles millennia of change under various rulers, religions and climatic regimes. It contains whole temple edifices, colossal statues of Kushite kings, and mysterious inscriptions in the undeciphered Meroitic language. The museum is also famous for its medieval Christian frescoes and inscriptions from Islamic sultanates. These unique artefacts put a spotlight on the untold stories of Christianity in Africa and the arrival of Islam. It’s a museum communicating a thousand diverse stories.

Read more:
Looting of the Sudan National Museum – more is at stake than priceless ancient treasures

The looting was reported to have taken place at the hands of the Rapid Support Forces (RSF). They are an armed militia who have became an increasingly powerful force. Since April 2023 they’ve been locked in open hostilities with the Sudanese Armed Forces after negotiations between the two groups broke down in the wake of the ousting of former dictator Omar al-Bashir. The RSF has captured large parts of the country including much of Khartoum.

A Nubian statue outside the museum.
Ashraf Shazly/AFP/Getty Images

The museum, in the midst of the warzone and in an area controlled by the RSF, has suffered from the “fog-of-war”. This means that very little clear information is escaping from behind RSF lines about what is happening inside the museum. One of the few events that is known is from a video posted to social media by RSF fighters in June 2023. It shows them breaking into the museum’s bioarchaeological lab where ancient human remains were stored and analysed. The museum was being renovated before the conflict, so many of the objects were packed away and put in storerooms. These were possibly looted but this cannot be determined.

The reported looting is in violation of international law, which considers museums protected spaces in times of war. This is a status even non-state actors like the RSF are technically supposed to respect.

Inside the museum, before the war.
Hans Birger Nilsen/Wikimedia Commons, CC BY-SA

One of the major concerns now is that looted objects will be smuggled out of the region and sold on the antiquities market. This is what happened when Isis fighters ransacked the Mosul Museum in Iraq in 2014.

While it’s difficult to say for certain, given the proximity of Sudan and South Sudan (where the thieves were reportedly headed) to the Gulf, it’s possible the stolen objects will be smuggled there to be shipped to Europe, the US and Asia. Smaller objects may even be sold online through auction sites and sent to buyers via couriers or even through the post. If these important artefacts are sold to private collectors, there is a chance they may disappear and never be returned.

Ikhlas Abdel Latief

Aware of this possibility, the United Nations has condemned the looting. It has urged all parties to respect cultural heritage, while calling on the art market to boycott the buying and selling of Sudan’s cultural heritage.

We are archaeologists who study the region and also the sale and forgery of antiquities from it.

Concerned with the limited attention that has been given to this event in wider western media, we sat down with Dr Ikhlas Abdel Latief, Sudan’s director of Museums for the National Corporation of Antiquities and Museums, in Cairo, Egypt. We asked her about the impact of this episode.

Why is the museum important to the Sudanese people?

The Sudan National Museum is considered one of the most important museums in Sudan because it is the national museum. It contains significant collections spanning all eras of Sudanese history: starting from the Stone Ages (over 100,000 years ago) and the Kushite civilisation in its three phases (Kerma, Napata, and Meroë), along with the Egyptian presence in Sudan, the Christian period, and a minor section representing Islam through the Funj Sultanate/Kingdom.

Ancient temples are housed in the museum.
Ashraf Shazly/AFP/Getty Images

It also holds the largest antiquities storage facility and serves as the primary repository for artefacts from all archaeological sites across Sudan, including those from ongoing excavations.

How does the theft make you feel as a museum expert?

The news came as a tremendous shock to me. I was overcome with profound sadness for the loss of our national identity through what the museum displays of an ancient civilisation and proud history – a story narrated through these curated exhibits and collections.

Do you have an estimate on how many objects were taken in the trucks?

(The theft involved) three large trucks which had been tracked by the Sudanese military intelligence from August 2023 and they were headed westward. Recently, a number of thieves were apprehended in the Republic of South Sudan with two of these trucks but only one statue was found with them, the rest being ordinary stolen goods. This suggests the stolen material has already entered distribution channels.

Centuries-old Christian artefacts.
Khaled Desouki/AFP/Getty Images

Do you think this material is being offered for sale already?

Although early reports on social media claimed to have found stolen objects on eBay, what is currently being offered does not appear to be from the recent thefts of the museum, but could be personal belongings.

What groups of objects would suffer the most in transport or from poor handling?

The majority of the statues, known as funerary statues, are produced from fragile materials and all of them have been stolen. These items are definitely at risk of breaking if not handled by experts.

Is this a common pattern so far in the conflict?

The looting of the Sudan National Museum is part of a wider trend of cultural destruction in the conflict. All the museums which are located in militia areas (under the Rapid Support Forces) are exposed to risk, and reports so far indicate that the Khalifa House Museum (Khartoum) and the Nyala Museum (Darfur) have also been subjected to destructive looting.

Attempts to recover the looted material are under way. Sudan’s General Authority for Antiquities and Museums is working with local and international police forces, including Interpol and Unesco, to identify and recover the objects. They ask anyone who identifies material they believe might have been looted to contact the Sudanese embassy in the country the material was seen in, as well as Interpol.

Ikhlas Abdel Latief and other officials continue to receive updates on threats to heritage at museums and archaeological sites across Sudan. With the current front just kilometres away from the Sudan National Museum it is likely that the extent of the looting will only really be known in the months to come.

The authors thank Jack Bettar for assistance with Arabic translation and interpretation Läs mer…

Illegal mining clampdown in South Africa: treating desperate people like criminals is an injustice – legal scholar

Illegal artisanal gold mining in South Africa is in the spotlight again. Under Operation Vala Umgodi (“plug the hole”), South African authorities have since December 2023 been trying to disrupt the illicit gold mining economy by cutting off water, food and other supplies to the miners working underground.

The operation is an attempt to “stamp the authority” of the state after a series of criminal incidents in 2021 forced the government to confront the illicit gold trade as a threat to national security.

In my view, the government’s approach, which sees all artisanal mining through a criminality lens, is inappropriate and won’t work. The government’s approach ignores the context in which artisanal mining occurs:

local, national and regional structural poverty (poverty as a systemic rather than an individual issue) and unemployment that will ensure a constant flow of individuals willing to pursue artisanal mining as a livelihood strategy

an entrenched network of buyers and sellers that channels artisanal gold into the illicit trade
an insatiable demand for gold.

The illicit trade of gold from artisanal and small-scale mining is now also being seen as a threat to international security. The World Gold Council estimates that as much as 20% of annual gold supply and 80% of gold mining employment comes from a supply chain controlled by criminal gangs and armed groups, abetted by corrupt governments.

The council has called on governments, international bodies and the gold sector to collaborate to stop the exploitation of artisanal miners and to prosecute criminals. Also to prevent illicit profiteering and integrate “responsible” artisanal and small-scale mining “into the legal and viable supply chain”.

Read more:
Artisanal gold mining in South Africa is out of control. Mistakes that got it here

The South African policies and government have repeatedly characterised the artisanal miners, known as zama zamas (hustlers), as criminals. So has President Cyril Ramaphosa.

I am the author of the book State Governance of Mining, Development and Sustainability. I have also supervised a completed PhD project on artisanal mining and have co-published on the topic of artisanal mining as a livelihood strategy.

In my view, the narrative of criminality – when applied to artisanal mining as a livelihood strategy – is dangerous. It amounts to a form of injustice that will do little to resolve the problem of governing the residues of gold on the Witwatersrand basin, straddling the Gauteng, North West and Free State provinces.

Unjust act

Treating all artisanal mining as an act of criminality is unjust.

Firstly, because there is currently no legal way to be an artisanal miner in South Africa. Mining legislation only allows for large-scale mining and “small-scale mining”. Small-scale mining is where the mineral in question can be mined “optimally” within two years. The area must be mined under permit, and not exceed five hectares. All other forms of mining are illegal and an “offence” under the law.

However, small-scale mining is a misnomer. The cost of cutting through the red tape to get a mining permit puts this out of reach of the vast majority of South Africans.

In 2022, the government proposed an artisanal and small-scale mining policy as a step towards formalising the sector. However, the policy fails to address several “grey areas”. These include whether artisanal mining permits could exceed five hectares, and whether large-scale mining rights could also be granted over areas designated for artisanal mining.

In addition, its proposals have not been put to work through amendments to the mining legislation. Anyway, this policy would be of little help to artisanal and small-scale gold miners. That’s because “artisanal mining”, as defined, is limited to rudimentary mining methods to access mineral ore “usually available on surface or at shallow depths”.

Read more:
Ghana’s informal mining harms health and the land – but reforms must work with people, not against them

The crime of illegal mining is therefore a statutory offence and will likely remain so until the 2022 policy is revisited. When zama zama miners commit harmful and anti-social crimes, such as murder, rape, robbery and theft, or even other statutory offences such as tax evasion and money laundering, they must be arrested and prosecuted. But it is unclear how the activity of artisanal mining, if formalised and regulated, could harm society.

The narrative of criminality is also unjust because according to section 35 of the constitution all accused persons are innocent until proven guilty in a court of law. Upholding the rights of arrested, detained and accused persons is a fundamental pillar of South Africa’s democracy.

Finally, the narrative of criminality is dangerous. It has a dehumanising effect that oils a slippery slope, whereby miners come to be seen as less than human. This must be resisted. Everyone’s humanity must be respected as a matter of principle. South Africa’s proud constitutional tradition rests on human dignity.

Problematic narrative

This narrative of criminality – directed at the actors at the bottom of the supply chain, artisanal gold miners – does little to resolve the real problem, which is how the state should control and govern mining activities targeting the remnants of gold in ownerless, derelict or abandoned mines and benefit from the tax revenues.

Read more:
Senegal’s small scale gold miners still use poisonous mercury: how to reduce the harm

There may also be arguments regarding the effectiveness, efficiency and sustainability of a criminalisation approach. The South African state will need to continue “stamping” its authority on artisanal and small-scale mining as an illegal trade for years to come. But for reasons of justice, it is time to desist from characterising artisanal and small-scale gold miners as criminals. Läs mer…