Paternalistic Care Research Articles

Back to Kindergarten? Paternalistic Care Behavior in Healthcare Contexts and Older Adults’ Mental Health

Back to Kindergarten? Paternalistic Care Behavior in Healthcare Contexts and Older Adults’ Mental Health

Parent‒Child Cogovernance and Corporate ESG Performance: Evidence from China

ABSTRACT Motivated by the research gap in parent-child intergenerational succession, this study adopts a stakeholder perspective and utilizes data from listed family firms in China spanning from 2010 to 2021 to explore the influence of parent-child cogovernance on corporate ESG performance. The findings reveal a significant positive relationship between parent-child cogovernance and corporate ESG performance, with this effect becoming more pronounced as parent-child cogovernance deepens. Furthermore, our analysis identifies “paternalistic care” and “reducing agency costs” as crucial mechanisms through which parent-child cogovernance enhances ESG performance. Importantly, the impact of parent-child cogovernance is particularly notable in firms characterized by lower first-generation control, limited political connections, and weaker external governance. The robustness of our results is confirmed through various methodological approaches including two-stage least squares estimation (2SLS), Heckman two-stage estimation, propensity score matching (PSM), and staggered difference-in-difference (DID) analysis. This study contributes significantly to the literature on intergenerational succession and corporate ESG performance.

‘Specialist before physiotherapist’: physicians’ and physiotherapists’ beliefs and management of chronic low back pain in Ghana – A qualitative study

Purpose This study provides an understanding of the chronic low back pain (CLBP) beliefs and management practices of physicians/doctors and physiotherapists in Ghana, and the mechanisms underlying their beliefs and practices. Materials/Methods Thirty-three individual semi-structured interviews, involving eighteen physio­therapists and fifteen physicians involved with CLBP management, were carried out. Interviews were audio recorded, transcribed, and analysed using Straussian grounded theory principles and critical realist philosophy. Results Five categories were derived: The predominance of bio-medical/mechanical beliefs, maladaptive beliefs, maladaptive practices, limited involvement of physiotherapists and other healthcare professionals (HCPs) and evidence-based beliefs and practices. The predominant mechanisms underlying the HCPs beliefs and practices were: the healthcare environment (professional roles/identity hinged around paternalistic and biomedical care, fragmented CLBP management, limited physiotherapy/HCPs’ knowledge) and sociocultural environment (sociocultural/patients’ expectations of passive therapy and paternalism). Conclusion The CLBP beliefs and practices of HCPs involved with CLBP in Ghana is modelled around a professional identity that is largely hinged on paternalism and bio-medical/mechanical understandings. Lack of collaboration and sociocultural expectations also play a significant role. There is the need for a reconstitution of Ghanaian HCPs’ CLBP beliefs and management approaches to align with evidenced-based approaches (e.g., imaging should not be universally prescribed, biopsychosocial and patient-centred care).

Paternalistic state care and the dynamic of COVID-19 pandemic governance in Jakarta's rented social housing

The COVID-19 pandemic has reignited debates on care, exposing the vital role of social reproduction despite its ongoing devaluation. Recent studies underscore the urban marginal's multidimensional vulnerabilities during the pandemic, coupled with inadequate state support and excessive policing amid their disproportionate engagements in low-paying care work essential to the city.This study extends the literature by exploring the discourse of care amid the pandemic in Jakarta's rented social housing (rusunawa), Indonesia. As a state-owned settlement hosting displaced residents from informal settlements, rusunawa represents a new form of urban marginality. Based on an ethnography of three rusunawa between 2019 and 2021, I argue that paternalism defines the state's vision and operation of rusunawa. By portraying the residents as vulnerable yet ignorant, the state justifies the combination of disciplines and supports in ‘caring’ for them.The continued paternalistic care during the pandemic, with an intensification of disciplines and assistance, ameliorated the residents' antagonism against the state. Yet, access to state relief programs still hinged upon the residents' invocation of vulnerabilities and personal connection with rusunawa management. Lastly, I demonstrate the residents' intractable desire for a state that embodies a powerful yet nurturing parent, shaping their assessment of the quality of state care.

Buttery Smooth: Privacy’s Bundling with Attention in Web Browser Performance

Long considered an object of the law, Americans increasingly encounter privacy via the operations and settings of networked technologies. Based on ethnographic fieldwork with privacy engineers and their corporate colleagues, this paper examines how privacy’s manifestation in web technologies opens it to pragmatic linkages with new sensuous qualities and interpretive possibilities. The paper’s primary object is Project Quantum, a company-wide effort initiated by the Mozilla Corporation in 2016 to build a new engine for its Firefox web browser, thus radically improving Firefox’s “performance.” I show that animating Project Quantum was an ideal of smooth, snappy performance that Firefox engineers understood to be keyed to the demands of user attention and attempted to establish for users as meaningful signs of Mozilla’s engineering prowess and paternalistic care. Drawing on the study of “qualia”—phenomenal experiences of abstract qualities—I identify performance engineering as a key site of privacy’s semiotic bundling with attention, through which privacy’s practically available forms are taking on idealized qualities of speed and smoothness. Attending to privacy’s qualia, I propose, provides methodological access to the institutional and global value systems reconfiguring privacy’s political capacities as it becomes an object of technological stewardship and intervention.

A qualitative exploration of the lived experience of informal caregivers of people with severe mental illness and co-existing long-term conditions

IntroductionPeople with severe mental illness (SMI), including schizophrenia and bipolar disorder, experience significant health inequalities and are more likely to develop long-term physical health conditions (LTCs), such as type 2 diabetes and cardiovascular disease. Many people with SMI rely on informal caregivers, typically friends and family, to support their health and enable them to live in the community. Informal caregivers of people with SMI experience high levels of caregiver burden, social isolation, and poor health outcomes. However, it is unclear how co-existing LTCs contribute to the caregiving experience.ObjectivesThe aim of this study was to explore the lived experience of informal caregivers of people with co-existing SMI and LTCs.MethodsWe conducted a qualitative study with informal caregivers of people with co-existing SMI and LTCs in England. We recruited 12 informal caregivers and conducted five semi-structured interviews and two focus groups between December 2018 and April 2019. The interviews and focus groups were audio recorded, transcribed verbatim and thematically analysed.ResultsSMI impacts profoundly on the health and well-being of both service users and their informal caregivers. Service users were described as too unwell with their SMI to engage in self-management of their mental and physical health, with the primary responsibility for these tasks falling to informal caregivers. There were significant barriers to adequate physical healthcare for service users, therefore informal caregivers needed to advocate extensively for their loved ones to ensure access to services. Informal caregivers felt significantly under-supported and struggled with the caregiver burden associated with SMI and LTCs. This burden included the constant monitoring of risk, anxiety around the vulnerability of their loved one, repeated hospitalisations, physical health concerns, lack of respite services, lack of recognition of their role, the guilt associated with paternalistic care, shame and stigma, and the difficulties managing the changeable nature of SMI.ConclusionsInformal caregivers of people with SMI face an additional caregiver burden resulting from co-existing LTCS. This adds substantially to their caring role, yet they do not receive the necessary support, and therefore their own health and wellbeing are negatively impacted. Improved recognition of the role of informal caregivers and additional support, including improved provision of respite services, are needed to improve the well-being of informal caregivers.Disclosure of InterestC. Carswell: None Declared, J. Brown: None Declared, D. Shiers Consultant of: DS is an expert adviser to the National Institute for Health and Care Excellence Centre for Guidelines; the views expressed are those of the authors and not those of National Institute for Health and Care Excellence., P. Coventry: None Declared, N. Siddiqi: None Declared

CARE, INC.: HOW BIG TECH RESPONDED TO THE END OF ROE

After the leak of the Dobbs decision that ultimately overturned Roe v. Wade, technology companies made a series of public statements in support of user privacy: Apple released an advertisement showcasing privacy features; Google promised to delete location data of abortion clinic visitors; Meta announced testing of default end-to-end-encryption. Corporations like Meta once worked to convince users that their platforms were morally neutral. Now, they publicly “crack down” on manipulation and speak out for racial justice, despite privately subjecting activists to state surveillance. To bolster their authority and popularity, platforms engage in “commodity activism,” in which corporations take positions on social issues. Ultimately, this enhances corporate capital rather than enacting social change. Care, in its ideal, is opposed to neoliberalism: resisting individuality in favor of community and refusing to reduce humans to capital. Yet, paternalistic care can be a weapon – used to ensnare and to oppress. Through a critical technocultural discourse analysis of platforms’ public utterances and policy changes after the Dobbs leak, we find that platforms redefine care in three main ways. For users, care is neoliberal - platforms provide good privacy options, for which users are individually responsible. For employees, care is paternalistic - employees are offered money for healthcare, at the expense of free expression. Finally, ultimate care is for the platform - that company culture is protected, alliance with the state unthreatened, and above all, profit is promoted. Platform decisions are revealed to extend care in some ways, while also maintaining control over users and their data.

Conrad, Lawrence, and the Sabotage and Salvage of Genre

Abstract This article considers Joseph Conrad's Nostromo and D. H. Lawrence's Women in Love as modernist reworkings of the industrial novels of the mid-nineteenth century, such as Elizabeth Gaskell's Mary Barton and Charles Dickens's Hard Times. Conrad and Lawrence, the article argues, rework the industrial-novel genre as a way to figure a crisis of British culture—and of the novel as a form. In the era of British imperial decline, the apparent massification and globalization of modern Western culture, and revolutionary changes in gender relations and family life, the synoptic historical narratives of Nostromo and Women in Love describe the transformation of the earlier promise of development into an apocalyptic present, and, in turn, the dissolution of the progressive assurance of the realist novel. While the nineteenth-century novels plead for reform and paternalistic care to moderate but protect the free market and liberalism, Nostromo and Women in Love narrate precisely the historical fulfillment of this wish—but, then, in turn, also narrate the end of that reformist logic and the triumph of a fully globalized and “perfected” capitalism, which they characterize as worse than the free-market capitalism that the earlier novels both criticize and celebrate. Drawing on Marxist-feminist theories of “social reproduction,” the article describes especially how the modernist novels imagine the family as a machine for maintaining and servicing capitalist production: the regeneration of the family—a trope so important to the resolution of plot in the realist novel—is now a sign of decay instead of resilience.

Disrupted identities, invisibility and precarious support: a mixed methods study of LGBTQI adolescents and young adults with cancer

BackgroundLesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) adolescents and young adults (AYAs) with cancer report higher levels of depression and anxiety and lower health related quality of life than non-LGBTQI AYAs with cancer, and LGBTQI adults with cancer. This mixed methods study examined LGBTQI AYAs' experiences of cancer and cancer care, to understand these health disparities.MethodsOnline surveys were completed by 95 LGBTQI AYAs with cancer (age 16–39 years); 19 AYAs took part in a one-to-one semi structured interview. Reflexive thematic analysis of interviews and open-ended survey responses facilitated in-depth examination of subjective experiences; descriptive statistics performed on individual closed-ended survey items identified the percentage of AYAs reporting experiences identified in the qualitative analysis.Results63% of AYAs reported high or very high distress on the K10. Three themes were identified in the qualitative analysis: 1) “Identities in flux”, included subthemes “Cancer disrupts developing identities, and involvement with LGBTQI communities”; “Internalized prejudice impacts identities”; and “Cancer facilitates identities and embodiment”. 2) “Invisibility in cancer care”, included subthemes “Navigating disclosure amongst cis-heteronormative assumptions”, “Discrimination and paternalistic cancer care” and “ Cis-heteronormativity within cancer information”. 3) “Precarious social support for LGBTQI AYAs with cancer”, included subthemes “ Social support during cancer is helpful for LGBTQI AYAs”, “LGBTQI AYAs navigate limited support”, and“ Finding cancer peer support networks is difficult for LGBTQI AYAs”.ConclusionsLGBTQI AYAs with cancer experience psychosocial vulnerabilities related to identity development, experiences of care, and social support networks. These factors likely contribute to their previously evidenced elevated risk of distress, relative to both non-LGBTQI AYAs and LGBTQI older adults. AYAs affected by cancer may require additional, tailored supportive care, including targeted information resources, LGBTQI AYA specific cancer support groups, or partnerships and referrals to LGBTQI community organisations. Additionally, it is evident that health care professionals and cancer services have much work to do in ensuring LGBTQI AYAs receive affirming and appropriate care across paediatric and adult clinical settings. They must move beyond assuming all patients are cisgender, heterosexual and do not have intersex variations unless otherwise stated; work to signal inclusivity and facilitate disclosure; and be able to respond appropriately with tailored information and care, which is inclusive of LGBTQI partners, chosen family, and support systems.

Shared decision making: a personal view from two kidney doctors and a patient.

Shared decision making (SDM) combines the clinician's expertise in the treatment of disease with the patient's expertise in their lived experience and what is important to them. All decisions made in the care of patients with kidney disease can potentially be explored through SDM. Adoption of SDM in routine kidney care faces numerous institutional and practical barriers. Patients with chronic disease who have become accustomed to paternalistic care may need support to engage in SDM-even though most patients actively want more involvement in decisions about their care. Nephrologists often underestimate the risks and overestimate the benefits of investigations and treatments and often default to recommending burdensome treatments rather than discussing prognosis openly. Guideline bodies continue to issue recommendations written for healthcare professionals without providing patient decision aids. To mitigate health inequalities, care needs to be taken to provide SDM to all patients, not just the highly health-literate patients least likely to need additional support in decision making. Kidney doctors spend much of their time in the consulting room, and it is unjustifiable that so little attention is paid to the teaching, audit and maintenance of consultation skills. Writing letters to the patient to summarise the consultation rather than sending them a copy of a letter between health professionals sets the tone for a consultation in which the patient is an active partner. Adoption of SDM will require nephrologists to relinquish long-established paternalistic models of care and restructure care around the values and preferences of patients.

Designing Systems with Care: Responding to Inequality in an Online Course in South Africa

Contemporary South Africa is a highly unequal society, emerging from a history of racial segregation, characterized by diversity along dimensions such as class, race, ethnicity, linguistic background, religion, culture and rural-urban locations (Czerniewicz et al., 2020). Informed by this diversity, higher education institutions attempt to “balance the pursuit of equity, quality and development goals” (Badat, 2020, p. 26). Over the last few years, in particular during COVID-19, care-oriented approaches that emphasise student wellbeing and belonging, such as humanizing online teaching, intentional hospitality, liberating structures,and trauma-informed design have gained traction in higher education. Drawing on three dimensions of human relations, namely affect, reciprocity and power associated with Bronfenbrenner’s ecological systems theory, we reflect on how adopting a care approach and working with trauma-informed pedagogies in a postgraduate course on blended and online course design was experienced by course participants. In this paper, we draw on voluntary participant interviews and our own reflections as course facilitators to make an argument for a caring learning design that intentionally creates caring learning experiences for a highly diverse group of students. Participants in this course come from geographically diverse locations, from secondary or corporate environments with differently positioned home institutions and diverse access to resources. Also, participants’ positionality and disciplinary backgrounds require different forms of care. We found that Tronto’s concepts of paternalistic and parochial care useful to reflect on our own care practices, as they highlight the importance of creating spaces where students can co-create the care relationship, while understanding how their different positionalities impact their voice and agency, but also remind us how important it is to understand how students’ context differ from our own and to set up caring relationships that suit their contexts.

Project20: Maternity care mechanisms that improve (or exacerbate) health inequalities. A realist evaluation

BackgroundWomen with low socioeconomic status and social risk factors are at a disproportionate risk of poor birth outcomes and experiences of maternity care. Specialist models of maternity care that offer continuity are known to improve outcomes but underlying mechanisms are not well understood. AimTo evaluate two UK specialist models of care that provide continuity to women with social risk factors and identify specific mechanisms that reduce, or exacerbate, health inequalities. MethodsRealist informed interviews were undertaken throughout pregnancy and the postnatal period with 20 women with social risk factors who experienced a specialist model of care. FindingsExperiences of stigma, discrimination and paternalistic care were reported when women were not in the presence of a known midwife during care episodes. Practical and emotional support, and evidence-based information offered by a known midwife improved disclosure of social risk factors, eased perceptions of surveillance and enabled active participation. Continuity of care offered reduced women’s anxiety, enabled the development of a supportive network and improved women’s ability to seek timely help. Women described how specialist model midwives knew their medical and social history and how this improved safety. Care set in the community by a team of six known midwives appeared to enhance these benefits. ConclusionThe identification of specific maternity care mechanisms supports current policy initiatives to scale up continuity models and will be useful in future evaluation of services for marginalised groups. However, the specialist models of care cannot overcome all inequalities without improvements in the maternity system as a whole.

Older patients' autonomy when cared for at emergency departments.

BackgroundOlder patients in emergency care often have complex needs and may have limited ability to make their voices heard. Hence, there are ethical challenges for healthcare professionals in establishing a trustful relationship to determine the patient’s preferences and then decide and act based on these preferences. With this comes further challenges regarding how the patient’s autonomy can be protected and promoted.AimTo describe nurses’ experiences of dealing with older patients’ autonomy when cared for in emergency departments (EDs).Research designThis study adopted reflective lifeworld theory and a phenomenological design.Participants and research contextA total of 13 open-ended interviews were performed with nurses working at two EDs in Sweden.Ethical considerationsThe study was reviewed by the Ethical Advisory Board in South East Sweden and conducted according to the Declaration of Helsinki. All participants gave consent.FindingsNurses’ experiences of dealing with older patients’ autonomy in EDs are characterized by moving in a conflicting uphill struggle, indicating obscure thoughts on how patient autonomy can be protected in an ethically challenging context. The phenomenon is further described with its meaning constituents: ‘Being hampered by prioritization under stress’, ‘Balancing paternalism and patient autonomy’, ‘Making decisions without consent in the patient’s best interests’ and ‘Being trapped by notions of legitimate care needs’.ConclusionStressful work conditions and lacking organizational strategies in EDs contribute to nurses maintaining unjustified paternalistic care, regardless of the patient’s ability and medical condition, and questioning who has legitimacy for participating in decisions about care. The nurses’ protection and promotion of older patients’ autonomy is dependent on the opportunity, ability and willingness to create a patient relationship where the patient’s voice and preferences are valued as important. Consequently, strategies are needed to improve patient autonomy in EDs based on the idea of ‘relational autonomy’.

Patients' Lived Experiences of the Paternalistic Care Behavior: A Qualitative study.

Introduction: The major role of nurses in caring for patients puts them in a position where they can feel a sense of independence or lack of autonomy in dealing with patients throughout their actions. The present study aimed to explain patients’ lived experiences of paternalistic care behaviors. Methods: This qualitative research was conducted with the design of hermeneutic phenomenology consistent with Heidegger’s philosophical view and using the purposeful sampling method. Data richness was achieved after 13 interviews with 7 patients who had been hospitalized and received care in the hospitals of Tehran, Iran. The data were collected during 8 months (November 2020-June 2021) using an unstructured interview and analyzed using Diekelmann et al seven step approach with MAXQDA version 10 software. Results: Data analyses revealed four themes, thirteen sub-themes, and one constitutive pattern (duality of support and suppression of independence) forming the structure of patients’ lived experience of paternalistic caring behaviors. The themes included (1) Support at helplessness, (2) Inflexibility (3) Vague awareness, and (4) Despair due to lack of autonomy. Conclusion: The meanings discovered in this research revealed that patients have dual emotions regarding paternalistic care behavior. On the one hand, they are pleased with the care provided, but on the other hand, they feel desperate and unable to make decisions due to being deprived of their independence. We can see the creation of new ethical values in care behaviors. Performing supportive care behavior with emphasis on patient participation should be considered as a key ethical principle in patient care.

Prescribing the Binary for Intersex (and Transgender) Children.

Robert Perske argued in 1972 that "there can be such a thing as human dignity in risk, and there can be a dehumanizing indignity in safety." Though Perske was referring to paternalistic care for the intellectually disabled, we can extend his counsel to the persistent attempts to impose a different kind of "safety," including efforts to enforce the gender and sex binary, as intersex surgeries were (and still are) meant to do. This article argues that when physicians surgically and hormonally alter the genitals and gonads of intersex infants, shaping their bodies to safely align with typical male and female bodies and gender roles, they unwittingly subject them to a dehumanizing indignity. Imposing the binary legislatively with anti-transgender bills is similarly harmful and can inadvertently undermine intersex care. Conservative lawmakers' tacit dismissal of young people's transgender identities parallels physicians' paternalistic, even if well-intentioned, efforts to make intersex bodies fit neatly into prescribed categories. Whether legislative or medical, these interventions promote the traditional gender and sex binary and undermine the dignity of such persons' eventual self-authorship.

'The System is Not Set up for the Benefit of Women': Women's Experiences of Decision-Making During Pregnancy and Birth in Ireland.

In this article, I draw on in-depth qualitative interviews with 23 women, conducted in 2019/2020, focusing on their involvement in decision-making during pregnancy and birth. The study is located in Ireland, where comparably progressive national policies regarding informed choice in labour and birth clash with the day-to-day reality of a heavily medicalised, paternalistic maternity care system. I represent the subjective experiences of a diverse group of women through in-depth interview excerpts. In my analysis, I move beyond describing what is happening in the Irish maternity system to discussing why this is happening – relating the findings of the research to the international literature on authoritative knowledge, technocratic hospital cultures and risk-based discourses around birth. In the last section of the article, I offer concrete, empirically grounded and innovative recommendations how to enhance women’s involvement in decision-making.

Engineering care in pandemic technogovernance: The politics of care in China and South Korea’s COVID-19 tracking apps

This article critically examines South Korea and China’s COVID-19 tracking apps by bridging surveillance studies with feminist technoscience’s understanding of the “politics of care”. Conducting critical readings of the apps and textual analysis of discursive materials, we demonstrate how the ideological, relational, and material practices of the apps strategically deployed “care” to normalize a particular form of pandemic technogovernance in these two countries. In the ideological dimension, media and state discourse utilized a combination of vilifying and nationalist rhetoric that framed one’s acquiescence to surveillance as a demonstration of national belonging. Meanwhile, the apps also performed ambivalent roles in facilitating essential care services and mobilizing self-tracking activities, which contributed to the manufacturing of pseudonormality in these societies. In the end, we argue that the Chinese and South Korean governments managed to frame their aggressive surveillance infrastructure during COVID-19 as a form of paternalistic care by finessing the blurred boundaries between care and control.

Current perceptions of cancer nurses in France about their role and the evolution of nursing practices: Findings and perspectives

BackgroundFlorence Nightingale lamented that nurses were seen as merely obedient and devoted. Our two previous oncology studies demonstrated the continuum of strictly curative care and paternalistic care practices among healthcare professionals. At a time when France has just formalized the nursing sciences, this article seeks to shed light on the specifics of the nursing role in oncology and the evolution of standard nursing practices in a rapidly changing environment. MethodsWe performed a secondary qualitative analysis, on the same dataset, focusing only on the nursing population (n = 20), to answer a question not excavated through the two previous studies. The COREQ guidelines were used to ensure the rigorous reporting of this study. FindingsThe data analysis show that the inherent role and application of medical directives characterise the profession of nursing in oncology. The former is essentially an intermediary role, whereby the nurse directs the patient to a professional specialist for a problem identified through clinical nursing expertise. The latter is expressed through the application of various medical instructions. The results highlight a minor evolution in nursing practices, despite an evolving environment. Oncology nurses do not seem to authorise themselves to become agents of change. ConclusionVarious reforms and studies of the nursing profession, as well as public funding of programmes dedicated to nursing research were designed to facilitate the integration of Evidence Based Practice to encourage the autonomy of nurses in their practices. Education in research is fundamental to awakening critical thinking and considering scientific validity as vital. Continuing education and leadership by advanced practice nurses are two strong levers to acculturate registered nurses to gaining empowerment, improving their ability to question practices, helping them adapt to increasing the quality of care and making oncology nursing care more efficient. For cancer nurses in France, research education is the challenge to be met.

The First Quarantine: How the Plague Became a Political Disease

The great plague of 1665-1666 is one of the starting points for the birth of biopolitics in its modern form. The quarantine measures introduced by the government have been considered effective from the medical point of view since the middle of the 18th century. However, many of those contemporary with the plague were convinced that the state was only worsening matters for London’s inhabitants. The author examines why the plague elicited such an ambivalent response in England and how the disease stopped being a composite object and turned into a “comfortable, domesticated” concept. The article investigates why the moral assessment of those measures has become so different over the past hundred years and shows how the quarantine in London influenced the “hygienic revolution.” Apart from its historical interest, this case is a suitable topic for the use of STS methodology because it illustrates the impossibility providing a complete description of the quarantine process and subsequent medical treatment in terms of a conflict between different actors. In order to understand why these measures have subsequently been perceived in this fashion, the author applies the concept of Lovecraftian horror, which offers a way to describe the situation of “collisions” with the plague. By describing how biopolitics released the moral tension built up by the co-existence of different interpretations of the causes of the epidemic, the author reconstructs the retrospective creation of the myth about the success of the quarantine. He contrasts the logic of “multiplicity” with the unifying descriptions and shows the kind of problems a “blurred” ontology can bring on during a crisis in everyday life. This leads to a discussion of the difficulty of holding onto unstable objects that have the potential for liberation from the logic of paternalistic care.

Национально-культурные организации в современном сибирском городе: проблема этнического представительства

The so-called ‘national-cultural’ (natsional'no-kul'turnye organizatsii, NKO, or natsional'no-kul'turnye avtonomii, NKA), or ethnicity-based organisations, that started to emerge in Russia at the turn of the Soviet and the post-Soviet epochs have become an ordinary attribute of the country’s urban space. We were interested in the question of why and how these organizations have found themselves at the intersection of ethnic and migration discourses. For nearly 30 years we have been studying the case of Tomsk and Irkutsk national-cultural organisations (based on observations, participation in the events and activities organised by NKO/NKA and in the meetings of specialised advisory boards, interviews and surveys, materials released by national-cultural organisations and municipal authorities, mass media reports, etc.). This allows us to understand what role migrants themselves had to play: whether they were subjected to paternalistic care or contributed to accumulation of social capital by leaders and activists of national-cultural organisations, or both. Local authorities have come to see such organisations as a convenient tool to manage ‘diasporic’ communities, that is, organised ethnic groups, whose membership is associated with one’s ethnic origin or ethnicity and which are entitled to act independently as agents of social relations. NKO/NKA leaders are considered to be ‘diasporic bosses’ exercising the right to control and regulate their ‘diaspora compatriots’. That these organisations serve to meet specific ethnic groups’ cultural needs is not their single and possibly not even their main function. Their legal status (resulting from a special law on organisations of this type and a law on public organisations more generally) allows them to be in close contact with the authorities, and, in fact, to have a symbiotic relationship with them. As a result, these organisations have come to be informally tasked with assisting adaptation of migrants in Russian cities. Enthusiasts developing national/ethnic culture (‘ethno-entrepreneurs’) enjoy a certain degree of power given by the state and receive limited but important material and symbolic resources to present their activities as a consolidated ethnic group (‘diaspora’) in urban space. Leaders of ethnic organisations can also benefit from their status in both symbolic and material terms, serving as intermediaries between the ‘diaspora’ they construct and the authorities, and maintaining a relationship with their historical homeland.