Hot transformations: governing rapid and deep household heating transitions in China, Denmark, Finland and the United Kingdom

The rapid decarbonisation of heat remains a challenging energy and climate policy priority. In this study, after screening 461 global case studies, we examine four national household transitions in heat, and examine their implications for governance. These transitions were both rapid, involving transformations in heat provision in a short timeframe of 18 to 35 years; and deep, involving diffusion that collectively reached more than 100 million households and more than 310 million people. From 1995 to 2015, China stimulated industrial research with strong municipal and national targets and policies to the point where they saw adoption rates for solar thermal systems surpass 95% market penetration in many urban areas. From 1976 to 2011, Denmark blended small-scale decentralized community control with national standards and policies to promote district heating so it reached 80% of household needs. From 2000 to 2018, Finland harnessed user and peer-to-peer learning, and innovation, alongside national and European policies and incentives so that heat pumps reached almost a third of all homes. From 1960 to 1977, The United Kingdom coordinated a nationalized Gas Council and Area Boards with industry groups, appliance manufacturers, installers and marketing campaigns so that gas central heating reached almost half of all homes. These four rapid case studies share commonalities in polycentric governance, rooted in (1) equity, (2) inclusivity, (3) information and innovation, (4) ownership and accountability, (5) organizational multiplicity, and (6) experimentation and flexibility. The study affirms that designing the right sort of political and governance architecture can be just as salient as technical innovation and development

The authority of next-of-kin in explicit and presumed consent systems for deceased organ donation: an analysis of 54 nations

Background. The degree of involvement by the next-of-kin in deceased organ procurement worldwide is unclear. We investigated the next-of-kin’s authority in the procure-ment process in nations with either explicit or presumed consent. Methods. We collected data from 54 nations, 25 with presumed consent and 29 with explicit consent. We char-acterized the authority of the next-of-kin in the decision to donate deceased organs. Specifically, we examined whether the next-of-kin’s consent to procure organs was always required and whether the next-of-kin were able to veto procurement when the deceased had expressed a wish to donate. Results. The next-of-kin are involved in the organ procure-ment process in most nations regardless of the consent principle and whether the wishes of the deceased to be a donor were expressed or unknown. Nineteen of the 25 nations with presumed consent provide a method for individuals to express a wish to be a donor. However, health professionals in only four of these nations responded that they do not override a deceased’s expressed wish because of a family’s objection. Similarly, health profes-sionals in only four of the 29 nations with explicit consent proceed with a deceased’s pre-existing wish to be a donor and do not require next-of-kin’s consent, but caveats still remain for when this is done. Conclusions. The next-of-kin have a considerable influ-ence on the organ procurement process in both presumed and explicit consent nations