The Paris Climate Agreement and the Three Largest Emitters: China, the United States, and the European Union

"The Paris Agreement would not have come into being had China, the United States (US), and the European Union (EU), which together contribute more than half of all global greenhouse gas emissions, not signaled their intent to take major steps to reduce their domestic emissions. The EU has been at the forefront of global climate change measures for years having issued binding domestic emission reduction targets for 2020 and 2030. For many years, China refused to announce a target date for when it might begin reducing its greenhouse gas emissions, and the US Congress blocked action on climate change. In the lead up to the Paris climate negotiations, however, there were major shifts in China's and the US's climate positions. This commentary examines the climate policies of the three largest emitters and the factors motivating the positions they took in the Paris negotiations. Given that the commitments made in Paris are most likely insufficient to keep global temperature from rising 2 °C above pre-industrial levels, the commentary also considers what the likelihood is that these three major economies will strengthen their emission reduction targets in the near future." (author's abstract

The Ethics of Nuclear Energy: Germany’s Energy Politics after Fukushima

The Fukushima nuclear accident had a large impact in Germany, a countrythat was already greatly sensitized to nuclear risks. Germany had one of thelarger nuclear power sectors in the world in the 1970s and 1980s. It began tobuild nuclear power plants in the 1960s and 1970s as a follower of the conceptof the Atoms for Peace Program. The government and industry invested heavilyin nuclear energy in the hopes of obtaining a cheap and sustainable supply ofenergy. Germany’s anti-nuclear movement questioned the safety and costs ofnuclear energy and pointed to the ethical concerns about leaving nuclear wasteto future generations. In the 1970s the United States and its allies were in a ColdWar with the Soviet Union. Germany was at the center of the Cold War as acountry divided between east and west. Concerns grew about whether Germanymight be used as a base for nuclear missiles and whether it would becomeground zero in a conflict. Anti-nuclear protesters marched against the stationingof nuclear weapons and the construction of nuclear power plants in Germany.These movements became the basis for the emergence of Germany’s verysuccessful Green Party, the first political party to openly take an anti-nuclearstance. After the Chernobyl nuclear accident, support for nuclear energy inGermany dropped sharply. The Social Democratic Party responded by callingfor a phase out of nuclear energy. With both the Green Party and the SocialDemocratic Party opposed to nuclear energy, the days of nuclear energy becamenumbered.The conservative political parties, the Christian Democratic Union, theChristian Socialist Union, and the Free Democratic Party continued to supportnuclear energy arguing that German safety standards were very high and thechances of a nuclear accident in Germany extremely small. They also tried tofind new ways to support nuclear energy linking its use to efforts to controlclimate change.The election of a Social Democraticy Party-Green Party coalition in 1998opened the door for the first nuclear phase out law in 2001. A decade later,however, a conservative government coalition tried to slow down the nuclearphase out linking the extension of the operating time of Germany’s nuclearpower plants to a new climate and energy plan with ambitious renewable energytargets. This policy may have stayed in place had it not been for the Fukushimanuclear accident. The Fukushima nuclear accident brought back memories ofChernobyl and strengthened societal opposition to nuclear energy. The Germangovernment reached a second decision to phase out nuclear energy in 2011.The main differences with the earlier phase out law are that this one led tothe immediate shut down of the 8 oldest nuclear power plants and scheduled theshut down of the remaining nine nuclear power plants by 2022. Thegovernment’s decision to phase out nuclear energy was supported by the work ofan Ethics Commission for a Safe Energy Supply. An important argument madeby the commission for the phase out of nuclear energy is that safer forms of lowcarbon energy are available. An energy transition to a renewable energydominated system would lead to the development of a system that is less conflictridden and can provide the world with a new energy model

China, the United States, and the European Union

The Paris Agreement would not have come into being had China, the United States (US), and the European Union (EU), which together contribute more than half of all global greenhouse gas emissions, not signaled their intent to take major steps to reduce their domestic emissions. The EU has been at the forefront of global climate change measures for years having issued binding domestic emission reduction targets for 2020 and 2030. For many years, China refused to announce a target date for when it might begin reducing its greenhouse gas emissions, and the US Congress blocked action on climate change. In the lead up to the Paris climate negotiations, however, there were major shifts in China’s and the US’s climate positions. This commentary examines the climate policies of the three largest emitters and the factors motivating the positions they took in the Paris negotiations. Given that the commitments made in Paris are most likely insufficient to keep global temperature from rising 2 °C above pre-industrial levels, the commentary also considers what the likelihood is that these three major economies will strengthen their emission reduction targets in the near future

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Explaining growing climate policy differences between the European Union and the United States

Strong rhetorical differences between the European Union and the United States on climate matters have been evident for almost two decades. Since the mid-2000s, such differences are becoming visible in their respective climate policies as well. We propose three explanations for differences in climate policy outcomes in the EU and the US. First, the agenda-setting privileges of their policy-makers are significantly different, influencing how agenda setters shape policies and link issues, such as energy and climate policy. Second, while issue linkage has helped overcome distributional obstacles in the EU, it has led to more complexity and greater policy obstacles in the US. Finally, legislative rules, procedures, and norms have constrained the coalition-building efforts of lawmakers in the two systems in different ways, affecting negotiation processes and outcomes. Such differences in agenda-setting privileges, potential for issue linkages, and legislative procedures in the EU and the US have left them wide apart in international climate negotiations.submittedVersio