SPP and the Way Forward for North American Integration

During the past year, relations among the NAFTA partners took on an increasingly two-tier structure. More visible were a widening array of disagreements over issues including BMD, Iraq, US demands on passports, the Senate’s vote to keep the border shut to Canadian cattle, alleged American gun trafficking and, above all, Washington’s efforts to evade the NAFTA ruling on softwood lumber. Yet, despite this mix of genuine grievances and political posturing, we saw substantial movement toward a more efficient North American economic system. Reports from the Security and Prosperity Partnership Working Groups set up after the Bush-Fox-Martin meeting in Waco, Texas, illustrated a wide array of activities under the politico-journalistic radar. Perhaps more important are the myriad of business- and community-driven initiatives underway to expand and improve cross-border links. How much of all of this will actually lead to concrete results is unclear. But several conclusions are evident. One is that this movement is driven by deepening interdependence. The second is that the current two-tier process in which national leaders kick each other in the shins while businesses and bureaucrats in federal, state, and municipal governments and community groups squirrel away to repair problems in the North American system will not work. Third is that integration-by-stealth is also unacceptable. The time has come to examine carefully what is happening in North America, to explore what our interests are in this emerging continental system, and to open a dialogue about different, even competing, visions of North America. The dialogue should involve perspectives from different regions, different economic and social sectors, and those who oppose as well as support integration. The process must get outside of the beltways—it must give voice to community and economic leaders who are most deeply involved in this new system

Staying Alive: North American Competitiveness and the Challenge of Asia

While analyses of North American integration after NAFTA continue to stress outdated notions of country-to-country trade and the exchange of finished products across national borders, our paper starts from the premise that what we have now is a single, integrated regional economic system whose expansion has followed the pace and contours of business strategies emphasizing continentally-integrated supply chains, but whose management via regulatory and policy coordination has lagged dangerously behind. Most dangerous of all has been the massive gap between our region\u27s infrastructure needs – ports, transportation, and borders – and what has been coordinated and facilitated by the public sector. In this paper we investigate this current impasse from the point of view of reframing the competition with Asia\u27s export giants – in particular China – as an impetus to enhance the competitive edge not of our national economies but rather of the regional economic system as a whole. We highlight the potential for synergy between the dynamism of cross-border regions such as the Pacific Northwest and their gateway strategies of coping with booming trade with Asia, on the one hand, and the aim of enhancing North American regional competitiveness via a more rationalized and effective continental transportation and infrastructure strategy. For example, British Columbia\u27s plans to expand the Prince Rupert port facility, or the West Coast Corridor Coalition\u27s plans for transportation links from B.C. [British Columbia] to B.C. [Baja California] would do well to explore their potential to connect with developing transportation networks and trade corridors in the center of the continent, as well as emerging export centers on the Eastern seaboard (Halifax/Atlantica), and on Mexico\u27s Pacific coast. In keeping with North America\u27s unique integration pattern – decentralized and business-driven – this focus on cross-border regions and public-private partnerships could bridge the infrastructure gap, linking local concerns with greater continental prosperity

HHV-6 Myocarditis Progressing to Ventricular Standstill Requiring Cardiac Transplant

Human herpesvirus-6 (HHV-6) is an increasingly recognized cause of myocarditis. We present the case of a 46-year-old woman who presented with fulminant HHV-6 myocarditis requiring heart transplantation. (Level of Difficulty: Advanced.

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Friday Keynote: “The Trials of Judge Garzón: Legal Remembering and Societal Forgetting in Spain”

Spanish Judge Baltasar Garzón burst onto the international scene in October 1998, issuing an audacious international arrest warrant for former Chilean dictator Augusto Pinochet, at the time recuperating from surgery in a London hospital. Transcending space and also time, Garzón’s “Warrant Heard ‘Round the World” – based on the principle of universal jurisdiction – let it be known that not only were there no places to hide for leaders who abused the rights of their citizens, but there were also no statutes of limitations for these crimes, no amount of time, or domestic amnesties, that could render their criminal responsibility extinguished. No less audacious – and, it should be added, no more immediately successful – a decade later was Judge Garzón’s short-lived attempt to launch a judicial investigation in his home country into the crimes of the Civil War and the Franco regime. In two detailed and passionately argued judicial decrees, or Autos, at the opening and the abrupt conclusion of his investigation in the fall of 2008, we see Garzón engage in a public process of “legal remembering” that at once reflects a narrow but deep societal awakening to the corroding effects of impunity, as seen in the growing “historical memory movement” within civil society and its campaign to locate, exhume and identify remains from mass graves; while it also confronts the broad persistence of “societal forgetting” legitimated by appeals to the Transition’s forward-looking “culture of consensus” and enforced by a positivistic and conservative judiciary wielding the 1977 Amnesty Law. By remembering the franquista past through the lens of international law and globalizing anti-impunity norms, Garzón’s Autos proclaim that Spain is not different: its mass graves share their horror with those of Baba Yar and Srebenica, its “stolen children” resonate with Argentina’s “Dirty War,” and its dictatorship’s eliminationist spirit and actions against civilians can be excused only insofar as we can excuse the “excesses” of the Khmer Rouge. International law, then, becomes the language of, and vehicle for, memory in a society whose own laws – including the “almost-but-not-quite” “Law of Historical Memory” of 2007 – appear designed to protect citizens from their own history, while also protecting the democratic state from its responsibility to confront the crimes of the past. That Judge Garzón currently stands accused of judicial misconduct for opening this investigation only further underscores the incomplete and ongoing nature of the legal-cultural transformation taking place in Spain today. Even as Garzon’s legal remembering confronted societal forgetting, it may just be that for change to come, it will ultimately be up to societal remembering to confront and overturn the edifice of legal forgetting that protects the Spanish state from its international obligations – and from its obligations to generations of its citizens still seeking justice

Evolution or Revolution? Transitional Justice Culture Across Borders

In recent years, both a theory and a practice of “transitional justice” have taken hold in democratizing contexts worldwide. As an organized and systematic set of beliefs and a way of ordering individual, group and state behavior according to those beliefs and practices, it can be characterized as a “culture,” one which has diffused transnationally via a variety of vectors, such as human rights NGOs, international lawyers, international criminal tribunals, and the media. This culture has been overtly didactic: it offers templates, normative guidance and a veritable database of national experiences to bolster the contention that transition to democracy requires a public accounting of the crimes of the past authoritarian regime. An interesting wrinkle in this story of one-way diffusion is provided by the experiences of countries which have defied or contradicted this master narrative, either by managing their democratic transitions and their consolidations through amnesties and pacts (Chile and Spain), or by reversing processes of transitional justice in response to untenable instability (Argentina). But the wrinkle deepens when we consider that all three of these countries have experienced, at different moments and to varying degrees, a return to transitional justice practices and debates at a later date, often years into consolidation. Was this the result of the increased projection of transnationalized “transitional justice culture,” responsible for a “revolution” in expectations underscored by the Pinochet arrest in 1998 and the Milosevic trials a few years later? Or are there more compelling “evolutionary” domestic-level explanations? This paper explores the competing hypotheses, analyzes the precepts and ideological contradictions of “transitional justice culture,” and contends that a key dyad connecting the revolutionary and evolutionary dynamics at work in the spread of anti-impunity norms across borders is formed by victims’ groups and national courts. Both have been the targeted reception sites for trasnationalized norms, and they have served as potential nodes of transformation for their respective national legal cultures. By suggesting that universalizing revolution is channeled, tempered and ultimately transformed by particularlized evolution, this paper argues for a more nuanced, multi-dimensional approach to transitional justice politics, at once highly globalized and yet not in the least homogeneous.Peer reviewe

Evolution or Revolution? Transitional Justice Culture Across Borders

In recent years, both a theory and a practice of 'transitional justice' have taken hold in democratizing contexts worldwide. As an organized and systematic set of beliefs and a way of ordering individual, group and state behavior according to those beliefs and practices, it can be characterized as a 'culture,' one which has diffused transnationally via a variety of vectors, such as human rights NGOs, international lawyers, international criminal tribunals, and the media. This culture has been overtly didactic: it offers templates, normative guidance and a veritable database of national experiences to bolster the contention that transition to democracy requires a public accounting of the crimes of the past authoritarian regime. An interesting wrinkle in this story of one-way diffusion is provided by the experiences of countries which have defied or contradicted this master narrative, either by managing their democratic transitions and their consolidations through amnesties and pacts (Chile and Spain), or by reversing processes of transitional justice in response to untenable instability (Argentina). But the wrinkle deepens when we consider that all three of these countries have experienced, at different moments and to varying degrees, a return to transitional justice practices and debates at a later date, often years into consolidation. Was this the result of the increased projection of transnationalized 'transitional justice culture,' responsible for a 'revolution' in expectations underscored by the Pinochet arrest in 1998 and the Milosevic trials a few years later? Or are there more compelling 'evolutionary' domestic-level explanations? This paper explores the competing hypotheses, analyzes the precepts and ideological contradictions of 'transitional justice culture,' and contends that a key dyad connecting the revolutionary and evolutionary dynamics at work in the spread of anti-impunity norms across borders is formed by victims’ groups and national courts. Both have been the targeted reception sites for trasnationalized norms, and they have served as potential nodes of transformation for their respective national legal cultures. By suggesting that universalizing revolution is channeled, tempered and ultimately transformed by particularlized evolution, this paper argues for a more nuanced, multi-dimensional approach to transitional justice politics, at once highly globalized and yet not in the least homogeneous.