The U.S. has as much moral authority as Saudi Arabia on the legitimacy of elections. Let there be no mistake, Sunday's regional and municipal elections in Venezuela are nothing more than a sham, reads a recent statement authored by Republican U.S. Senators Jim Rich and Michael McCall. The illegitimate Maduro regime has taken drastic measures to dismantle or control every independent institution in the country, including hijacking political parties and the National Electoral Council to ensure state-sponsored electoral fraud. Today's elections in Venezuela are as illegitimate as Maduro's tyrannical regime, reads a tweet by Republican Senator Rick Scott. The Venezuelan people deserve free and democratic elections now. The U.S. and all freedom-loving nations must stand up, condemn these sham elections, and support the people in their fight for freedom. The imperial media are lining up behind the official U.S. government line on Venezuela's gubernatorial and mayoral elections, with the New York Times assuring us that conditions are far from freely democratic. And the Washington Post reporting that opposition parties say the elections have been stacked against them by the socialist government of President Nicolas Maduro, who sees the elections as, quote, a chance to reassert strength while projecting a veneer of legitimacy, end quote. This level of intrusiveness into Venezuela's heavily internationally monitored democratic process is typical of what we've been seeing from the U.S. political media class with regard to electoral contests and empire-targeted Latin American nations like Bolivia and Nicaragua, which is really silly because the U.S. has no more authority over the legitimacy of democratic processes than a totalitarian monarchy like Saudi Arabia. U.S. elections are, of course, corrupt and fraudulent, entirely dominated at the federal level by legalized oligarchic bribery in the form of campaign contributions, manipulated primaries, gerrymandering, voter suppression, shutting out third parties, and the worst voting system in the Western world. More than this, though, the United States is also the world's single-most egregious offender when it comes to interfering in foreign elections. As Claire Burnish has observed in the Free Thought Project, the U.S. government's own data shows that it has interfered in no fewer than 81 foreign elections just between the years 1946 and 2000. You'd never know it from the shrieking of the political media class post-2016, but this would also include brazenly interfering in Russia's elections in the 90s to ensure the presidency of Washington lackey Boris Yeltsin. And that's just election interferences. It doesn't include more brazen interferences in who governs foreign nations like direct military interventions, staged coups, color revolutions, and proxy wars. As a completely undemocratic country whose government is far and away the world's single-most aggressive saboteur of democracy, it is fair to say that the U.S. institutions are the absolute least qualified to comment on the validity of any nation's elections on the entire planet. Everyone would laugh if Saudi Arabia's psychopathic crown prince Mohammed bin Salman began opining on the quality of various nations' democratic processes, especially if these criticisms were directed at the so-called liberal democracies of the West. But this same scrutiny of a power structure who has no business commenting on electoral integrity never gets directed at the United States, whose institutions issue such criticisms on a daily basis despite being no more morally qualified to do so than the House of Saud. If you think about it, Saudi Arabia is nothing other than a more honest version of the United States. Its oligarchs and its official government are the same people. It doesn't pretend that its warmongering is humanitarian. When it wants to kill a journalist, it just dismembers him with a bone saw rather than trying to squeeze him to death with lawfare in a maximum security prison. And it makes no pretense about being a democracy. The more I observe its behavior on the world stage, the more hilarious it gets to see US political and media figures criticizing the democratic processes of foreign nations. It's like McDonald's evaluating whether mom-and-pop restaurants are sufficiently eco-friendly and vegan. Very silly stuff, mate.


Hello and welcome to this session. In this session we will discuss the following question and the question says, Jane had 500 shares of face value $100 in a company paying X% dividend. Later she sold one-fifth shares when the price rose to $180 and the remaining shares when the price again rose by 30%. Then she invested the total proceeds in 15% $100 of a company at $180 and increased her income by $6,800. Finds the value of X. Let's start the solution now. We are given that Jane had 500 shares of face value $100 and the rate of dividend is X%. So annual income from 500 shares of $100 each paying X% dividend is equal to number of shares into face value into dividend since the annual income from one share is face value of one share into dividend. Therefore annual income from 500 shares is number of shares multiplied by annual income from one share that is face value into dividend. This is equal to number of shares is 500 into face value which is 100 into dividend which is X% that is X upon 100 dollars. The zeros get cancelled. So this is equal to 500 X dollars. It is given that later she sold one-fifth shares when the price rose to $180. So the selling price of one-fifth shares that is one-fifth of 500 which is equal to 100 at $180 per share is equal to the number of shares that is 100 into $180. This is equal to $18,000. It is also given that she sold the remaining shares when price again rose by 30%. So new increased price per share is equal to 130 upon 100 into price of one share which is $180. This is equal to $234. Now the total number of shares is 500 and out of those one-fifth shares that is 100 were sold at $180 per share. So the remaining shares are 400 in number and selling price of remaining 400 shares when the price rose by 30% is equal to 400 into new increased price per share which is $234. This is equal to $93,600. So the total income from sale of shares is equal to $18,000 plus $93,600. This is equal to $111,600. It is given that then she invested the total proceeds in 15% $100 of a company at $180. So this total amount is invested in $180 shares. Therefore number of shares purchased $180 per share is equal to 111600 which is the total income upon price of one share which is $180. Zero gets cancelled and $18,620 times is $11,160. So this is equal to $620. Now the annual income from dividend these shares is equal to number of shares into face value into rate of dividend. So this is equal to number of shares is $620 into face value of one share which is given to be $100 into rate of dividend which is 15% so $15,500. These zeros get cancelled. So this is equal to $9,300. Now we are given that she increased her income by $6,800. Now the difference of income is $9,300 minus $500x. So difference in income is equal to $9,300 minus $500x. But increase in income is given to be $1,800. Therefore $9,300 minus $500x is equal to $6,800. This implies $500x is equal to $9,300 minus $6,800. This implies $500x is equal to $2,500. This implies $x is equal to $2,500 upon $500. Zeros get cancelled and $5,5 times is $25. So this is equal to $5. Therefore $x is equal to 5%. So dividend is equal to 5%. This is the final answer. With this we end our session. Hope you enjoyed the session.


So, I have the privilege of introducing the one person in the room who needs no introduction, Dr. Mark Siegler. So, as you all know, Mark has been here for 50 years. We're actually celebrating his 50 years. He came here having graduated Princeton. He came here from the University of Chicago for Medical School in September 1963. And 50 years later, he's still as busy as ever and still the social entrepreneur and the hub in a sense for all of us, the center of all of our work. Today, he's going to talk to us about the McLean Center and the birth of clinical medical ethics. So a warm welcome to our friend and colleague, Mark Siegler. I am so glad to be here today and my warm welcome to everybody and my great thanks to our wonderful board and to Barry and Mary Ann McLean, the chairs of the board. I wonder if I could just ask the board members to stand up so we can recognize you. Thank you, you hear me all right in the back? Yeah, good. Here's the outline of my talk. It's in four parts. The first one is very short on the medical ethics renaissance because you've all heard me talk about that. And the final three parts will be on what is clinical medical ethics, the origins of clinical medical ethics and the McLean Center. And then what I take to be some of the signal contributions of the McLean Center to clinical medical ethics. I begin with the medical ethics renaissance post-1945. As you've heard me say often, I think there were three, probably more than three. But these three were particularly important driving forces in the emergence of the field. One was human experimentation with a special prominence of unethical research involving human subjects beginning with the Nazis during World War II. But continuing in America of course with the great article by Beecher in 1966 in the New England Journal on unethical research. The Tuskegee experiments being revealed in 1971 and so on. A very important ongoing area that has driven attention to medical ethics. The second one I would point to is a change in civil and human rights. Certainly in the United States, Canada and Europe. Probably more broadly than even than that. A new understanding of the relationship of individuals to authority figures. I think in the United States it clearly started with the civil rights movement. It probably next involved women's rights in the late 1960s. The student rights movement in Columbia, Berkeley, Paris. And I think medicine was part of that larger social and political evolution which led to the understanding and the widespread acknowledgement that patients had to be better informed and had to be involved in reaching their own decisions. And then of course there's a third one that's with us and all of these are with us as we go forward. And those are the extraordinary, the absolutely incredible technological advances in medicine that cure illness, delay death, assist in reproduction. The last 100 years has been, I use the word renaissance at the beginning, has been one of the great intellectual flourishings in history. You can talk about doubling of life expectancy in 100 years. Reduction of infant mortality. I'll give you one statistic I just heard last week. And that is that 40 years ago, 16% of the US population died before the age of one. 16%. At what age today do you think you have to go to to get 16% of the population dying? What? 16. 61. 61 is the answer. So in 40 years, there's this unbelievable change. I show some of the changes very quickly, the organ transplant revolution, starting in Boston in 1954, between these two twin brothers, identical twin brothers to overcome the immune problem. The development of effective ventilators like in the early 70s. The Bennett volume ventilators, and then of course the IVF and Louise Brown and assisted reproductive technologies. I just talk about this control over birth and death. In any event, that is my point about the medical ethics renaissance. I now want to turn to the second question, and that is what is clinical medical ethics? Let's begin by acknowledging that there are many definitions. But also let's say the following. But hey, we invented it, so we get to define it. And so here goes a try. Clinical medical ethics is a new field aimed at helping patients, families and health professionals reach good clinical decisions, taking into account the medical facts of the situation, the patient's personal preferences and values, as well as the external summarized socioeconomic considerations. And clinical medical ethics examines practical ethical issues that arise in these situations every day, in the office, in the hospital, and in all healthcare institutions. To go on with part of the definition, clinical medical ethics is derived, its foundations are found in medicine, not primarily in philosophy or theology. Further, in 2013, to be a competent practitioner of any discipline within medicine or surgery, or Peds or OB, physicians must know and apply the basic elements of clinical ethics. Gotta know something about truth telling, informed consent, end of life care, confidentiality and privacy, research ethics, and the centrality and importance of the doctor-patient relationship. Clinical medical ethics, as I said earlier, is not a theoretical or armchair exercise. It has to be practiced and applied by clinicians every day in their care of patients. Forgive me for the somewhat lengthy quote from Kierkegaard in which he tries to distinguish theory and practice. He said, let us imagine a ship captain who'd passed every examination with distinction, but he had not as yet been at sea. Imagine him in a storm. He knows everything he ought to do, but he is not known before how terror grips the sailor in the blackness of the night. He's not known the sense of impotence that comes when the captain sees the wheel in his hand become a plaything for the waves. He's not known how the blood rushes to the head when one tries to make calculations at such a moment. In short, he has had no conception of the change that takes place in the knower when he has to apply his theoretical knowledge. That dramatic change. The Spanish perhaps say it a little bit more succinctly, and this is Siegler's translation, as one moves from the stands into the bull ring the appearance of the bull changes. Thank you, Teyad and Caroline for finding the bull picture. Practical every day. And now I turn to part three of the talk, the origins of clinical medical ethics and the McLean Center. I think it's fair to say that the McLean Center is seen as the birthplace of clinical medical ethics, the first ethics program in the world to focus on this new field. About 10 years before we had a McLean Center, I ended up being the medical director of an ICU here at the university, which was our first Miku, one of the first Mikus in Chicago. It was a six-bed unit on W5 in the old hospital. I directed it, I attended for 12 months of the year for the four or five years that I directed it. And that ICU experience raised for me many of the core issues in the field of clinical ethics. I had wonderful teachers and mentors, not just in the medical side, but on the campus side. And the fact that the University of Chicago has this integrated campus in which the medical school and hospital are 50 feet across Ellis Avenue from the rest of the campus was so important. When I started, Jim Gustafson was my primary mentor on the left. Dick McCormick was on campus at the Catholic School of Theology. Leon Kass arrived three or four years later to become the loose professor of the humanities. And then a few years later, Steven Thulman came to the university. It was so important to the ethics program throughout the late 70s and 80s. But I mean, these are people who meant so much to me personally and to the evolution of the field of clinical ethics. It was out of that ICU experience that I wrote my first paper on Pascal's wager in the hanging of crepe. That came directly from the medical ICU. Some of you in the back will not be able to read the second bullet, but it was at Jimmy's, a bar near the University of Chicago campus, which still, by the way, exists, where the residents and I from the MICU would occasionally meet and the residents told me at one of these occasions that they were systematically lying to the family members of patients by telling them that their loved ones in our unit were definitely going to die. And they even had a name for this approach, which they called hanging crepe. That was the background of the paper on Pascal's wager in the hanging of crepe. Many of you have asked me about the origin of the name clinical ethics. The term came from Alvin Feinstein at the annual medical meetings, once again, in a bar. Somehow, I didn't realize that I put these two slides together, how important bars were in the history of clinical ethics. These were the old pre-Casino Atlantic City where the annual academic medical meetings would be held. And it was one of these meetings that Al said to me that I was not, I, pointing to me, and slurring his words a little bit, as I recall. I was not an ethicist like those ivory tower ethicists, but I was rather like he was. He was an epidemiologist, but he considered himself to be a clinical epidemiologist, and he considered me to be a clinical ethicist. And that was around 73 or 74. And the term pretty much stuck. The first use of the name clinical ethics that I can find anywhere is a grant that Anne Dudley and I and Jim Gustafson and Martin Cook submitted to the old department of HEW, Health Education and Welfare. We wrote the grant in 75, submitted in 76. It was called Clinical Ethics and Human Values. It was a three-year teaching and program grant allowing us, and Dudley remembers us, to teach medical students, law students, and divinity students around the same cases. And we did that for three or four years. It was clearly among the earliest, if not the earliest federal grant in the field of medical ethics. That's what Norm Faust said to me recently. In 1978, I wrote an article called A Legacy of Osler Teaching Clinical Ethics at the Bedside, which again, so far as I know, is the first time that the term clinical ethics appeared in the peer-reviewed literature. In 1979, I was asked to start a section of clinical ethics in a journal that used to be called The Archives of Internal Medicine. I think it's now called JAMA Internal Medicine. But that section went on for four or five years. And the opening article that I show you here on clinical ethics and clinical medicine describes some of the early ideas we had about clinical ethics. It was because of these articles and that I'm showing you that a few years later, Al Johnson and Bill Winslade called me to ask if I would join them in a project as the clinician to help write this book on clinical ethics. And I show you that when we talked to the publisher, I had two specifications for the book. One was that it would look like a Bible. And second, that it would fit into a lab coat pocket, which the first edition did. The subsequent editions did not, but that one did. And that was in 1982. In 1982, when I returned from my one and only sabbatical at Charlottesville, we received permission from the dean of the medical school and the president of the university to develop an ethics center. And it was in 1983 that Dorothy Jean McClain, Barry's mom and the McClain family joined in giving us a gift to launch the McClain Center. In 1984, the McClain Center received pilot funding from the Henry J. Kaiser Family Foundation. And then, I think in part because we had gotten that pilot grant from Kaiser, the Andrew W. Mellon Foundation in December 23rd of 1984 sent me the strangest letter I've ever gotten, which was one of these really thin letters which tell you that you've not been accepted to college, you know, one of those. Because Arthur Rubenstein and I had made an appearance at the Mellon Foundation a few months earlier and had been essentially chased out of the office as being inappropriate and we give to colleges and universities, we don't give to medical schools, leave. And so Arthur and I left with our tails between our legs and very disappointed. And so comes this letter on December 23rd of 1984, a very thin letter and I was sure it was the pro forma rejection. I opened it up and in fact there was no letter. It was no letter in this envelope. The only thing in the envelope was a check made out to me personally for $750,000. I, no comment, nothing, check. It took me, since it was a Christmas holidays, it took me about, I called Arthur. Arthur said, Mark, don't spend it. He said, we gotta check this one out. So, I didn't spend it. But because of the holidays it wasn't another week or two that we could sort of pin it down that indeed this was a general grant to the University of Chicago for the development of a center for medical ethics. It was a year or two after that that we received a six year grant, a large one from the Pew Charitable Trusts and again from the Henry J. Kaiser Family Foundation to develop a national faculty training program in clinical medical ethics. And I believe we have four or five of the original faculty trainees, if not more, in the audience today. I turn now to the impact of clinical medical ethics. Until Peter Singer gave his talk this morning on social entrepreneurship, I never considered myself to be one. It's sort of like the person who had been speaking prose all his life who didn't quite realize it. But one of the definitions that Peter gave for social entrepreneurs were developers of innovations that disrupt the status quo and transform the world for the better. I really had not thought of myself as doing that. But I did wanna tell you what I take to be some of the impact of the field of clinical ethics. In the 1970s when I was growing up in medicine there were few organizations, very few, that had ethics committees and codes of ethics. That is no longer the case. It's hard to find a medical organization today without one. As you know, there's a journal of clinical ethics and probably 10 or 12 other ethics journals that publish regularly in the field. But also clinical ethics papers are increasingly published in mainline medical journals, not just in the ethics literature. I think it's fair to say, and this Cornerstone Award that we accepted a few weeks ago at the ASPH meetings, becoming just the fourth institution to ever get one, highlighted it, it's fair to say that clinical ethics has become one of the major components of the American bioethics movement. I believe that it's almost every large hospital in the United States now has an ethics committee or an ethics consultation service to help resolve clinical ethics problems. You can't believe how different that is from 25 years ago, 30 years ago when we started. But I point most importantly to the highlighted bottom bullet that clinical ethics discussions have become a part of everyday clinical discourse that occurs in outpatient and inpatient clinical settings across this country. And that has been perhaps the greatest achievement of the field of clinical ethics. That these discussions are not aberrant or unusual but they're part of the discourse. They don't come up in every patient because every patient doesn't raise profound clinical ethics problems or issues. But when they do come up, they get talked about at the bedside or in the office. I turn out by final part of my talk, which is in a way the most important part and what I take to be some of the central contributions of the McLean Center to the development of this field, this new field of clinical medical ethics. And I will point to seven, as I was working on this list, three or four or five more came to mind. But at least I'll talk about the seven that I point to. And here are the seven. I'm gonna go over each one of these in turn so you don't have to get this list. But I think the greatest contribution was the one I've just been discussing and that is we created and developed and nurtured and grew the field. And that really was an extraordinary contribution to bioethics in this country. The Cornerstone Award that I referred to a few minutes ago is presented to a university, to a program, for quote, outstanding contributions from an institution that has helped shape the direction of the field of bioethics. And that's, and in a very nice presentation in Atlanta a few weeks ago, that's what the people were saying, that we were there and we did that with clinical ethics. I wanna highlight the early associate directors of the McLean Center, Steve Miles, who's I believe in Cambodia or Thailand and couldn't be here today, and John Lantos, John, I know is here, John. I also wanna highlight the four current associate directors, Peter Angelos, Marshall Chin, Laini Ross, and Dan Salmezzi. I wonder if you might just with John stand up and so we can acknowledge you. And of course we have an extraordinary faculty in addition to the associate directors, more than 40 faculty from the biological sciences, social sciences, law school, the Booth School of Business, and the Divinity School. You can't read their names on here, I apologize, but I think one of the contributions of the McLean Center was bringing together this extraordinary group of people, talented, knowledgeable in their own fields. And they're just wonderful. I think another contribution of the McLean Center is something that I call clinical ethics by the book. Current and former McLean faculty and fellows have published thousands of journal articles and when we started to count, we stopped at 155 books. That's a lot of books to have been written by people who have been affiliated with the McLean Center. My own book, which I refer to in that first edition, is now in its seventh edition, but just last week Al Johnson and Bill Winslade and I agreed, at least in principle, that we're gonna do an eighth edition. So the eighth edition has probably come out in 2014 or 15, late 14 or early 15. The second key contribution of the McLean Center, I think, has been this focus on the doctor-patient relationship and our contributions in helping to develop the model of shared decision-making, the model which is pretty much the prevailing model in the United States at this time. It goes under a lot of different names. You don't have to read them all, but the gist of it is that doctors and patients talk to each other, exchange truthful information, and then participate jointly in reaching the right decision for the patient. Some of that comes out of the doctor-patient accommodation model. Some of it comes out of the President's commission report of 1982, reporting on the informed consent in the patient practitioner relationship, in which they ended up saying the commission's view is intended to encompass a multitude of different realities, each one shaped by the particular medical encounter, and each one subject to change as the participants move toward accommodation through the process of shared decision-making. This is one of the early uses in the literature of the concept of shared decision-making. So I think that was an important contribution. Third, I point to the topic that Ellen Fox talked about this morning and that many in the audience, John Lapuma, wrote one of the early books with David Sheetamire. Is David here? Yeah, David's back there on ethics consultation. I think we started ethics consults officially in 1985 when John became our first ethics fellow. Informally, we were doing these consults probably from the mid to late 1970s. Chicago was among the first hospitals in the U.S. to offer ethics consultation service, and with a lot of our fellows contributing in faculty, we pretty much have helped develop much of the model for ethics consultations around the country. This was an old paper that John wrote. I think this paper was published in 1987 based on cases that John had seen a few years earlier. This is a paper that John and I wrote with Carol Stocking and Mark Silverstein. Again, reporting on our experience, this paper I think was 1988 in JAMA. We've now seen well over 2,000 cases in the past 25 or 30 years, and so far as we know, that bullet at the bottom, despite the complexity and conflicts that often encourage ethics consultation, as far as we know, no lawsuits have resulted from any of these 2,000 cases. That's an incredible record. There was a question of whether ethics consultations would generate lawsuits or reduce them, and it's a question that's never been studied, but this is a little anecdotal information on it. We also, as Laney has pointed out to me, introduced the concept of research ethics consultations, introduced it in a 1989 paper in which we said research ethics consultations is a process in which ethical issues raised by an innovative therapy are analyzed before the protocol is submitted to the institutional review board. This process has been an essential part of our liver transplant program in recent years. Well, this was the first mention of the concept of research ethics consultations, this collaboration between the clinical investigators and the clinical ethicists before the IRB, and together they review the design and implement a research project that raises novel questions in human subject protection. I should say that the CTSA, which Laney is a co-director at Chicago, has used that model in its early five or 10 years, and Megan Collins and I, I think Megan is in the audience, used it in more than 100 cases when we were the ethics committee for the Immune Tolerance Network, a national network supported by the NIH for the last 10 or 12 years. Another contribution has been the clinical ethics fellowship training. I think it's clear that this is our signature program, the McLean Center Fellowship Program is the oldest, the largest, the most successful clinical ethics fellowship in the world. It started in 1981, I mentioned this morning when Joel Howell became our first fellow. It's continued to the present. We have now trained more than 320 fellows, more than 250 physicians, more than 25 of our graduates have directed university ethics programs in the US, Canada, Europe, and China. Former fellows, 20 or more, it's hard to keep up, have held or hold endowed university professorships, and we believe that more than 50 of our fellows are holding appointments at, more than 50 US medical schools have our former fellows in their program. Most bold lines like this, which go downward, suggests that the size of the fellowship program is getting smaller, but in fact, each of those horizontal bars is a chronological year, and in fact, in 2012, 2013, we reached the greatest number of fellows. The current year has about 19 fellows or 20, so the line, as you see, is not diminishing but increasing. I wanted to call everybody's attention to the new, oh, I don't know what happened. That slide didn't come up. There's a new McLean Center website that went online yesterday. I don't know what happened to this slide. Oh, it is up there. Oh, it's not on my screen. The address is McLeanethics.universityofchicago.edu. I would urge everybody to look at it, refer people to the fellowship program, catch up on your fellowship cohort with BIOS, and let us know what you're doing so we can post the new information on the site. I did wanna say with regard to fellowship training that in the old days, we were the only game in town. There were no other training programs, but I'm delighted to say that these days, there are a half dozen or eight programs around the country that are training fellows, including the wonderful one that Rick Kodish started seven, eight years ago at the Cleveland Clinic, which trains three to five fellows a year, and he sent me a list of what his fellows are doing. It's a great achievement. There are other programs, Hopkins, Washington and Seattle, and many of these programs are doing things that we haven't quite done, and that is paying their fellows. Some day we'll come around to that. The fifth thing I'll be brief about this is our contribution to the empirical turn in bioethical research. This is using the techniques of clinical epidemiology, health services research, decision sciences to investigate ethical matters in clinical practice. In the 70s and 80s, bioethics was driven by this notion that legal and policy mechanisms would be sufficient analytic papers, but we started to work on papers suggesting that data was important if you wanted to change the behavior of colleagues, physician colleagues, and they would be moved by clinical data, empirical data that showed that a particular way of practice was better than the alternative, and for that matter, met ethical standards. And since the 1980s, the McLean Center has gathered data with survey methods and clinical studies to describe how ethical considerations are used by patients and doctors to reach clinical decisions. A brief word about the social context of clinical care. In the early 70s and 80s, as some of you know, I was pressing very hard that clinical medical ethics should stay focused entirely on the patient in the office or the hospital. It was Steve Miles in the mid-80s who said, Siegs, you can't isolate the bedside experience, the clinical experience from all the social and political forces that affect your ability to deliver clinical care, and having taken that blow from one hand long came John Lantos, who also insisted that we direct attention to the institutional, societal, and political issues that affect patient care, and of course, over the years we've tried to do so. While clinical ethics remains centered on the patient, the scope of the field has expanded to include these broader social, political, economic issues. Finally, the development of surgical ethics, fairly recent accomplishment. It builds on the McLean Center's successful clinical ethics fellowship program, allows a concentration for junior or mid-career surgeons interested in surgical ethics. The goal is to prepare surgeons, the academic careers that combine clinical surgery with studies in surgical ethics. Peter Angelos, who's the leader of this program, one of our associate directors, was featured recently on this nice story in Medicine on the Midway, and he's been writing ethical guidelines in surgical patient care, an ethics curriculum for surgical residents. I should tell you that the University of Chicago Department of Surgery has gotten the reputation around the country that if you want to train in surgery and you want to also get knowledgeable about surgical ethics, this is the program to choose. And any number of trainees in the department will say that they selected Chicago over alternative places because this was available to them. I like Karen Devon's quote in that Medicine on the Midway article, the idea of having a bunch of surgeons discussing medical complications and including cases where an ethical issue is a focus is more progressive than you might imagine. It has become part of the surgical culture at the University of Chicago. Well, having talked about the past, let me just look ahead. Where are we going and where should we be going? I think to a large degree, our past is our future. I think we've got to promote clinical ethics. We've got to defend and study the doctor-paste relationship. We've got to maintain our focus on the ethics fellowship training program and we've got to keep these key issues that have been sort of our mainstay over the years in mind, transplant, end-of-life, health policy, surgical ethics. I think we're going to continue to be the place that flies the banner of clinical medical ethics. There'll be others that are like us, but we will be the in the forefront. With regard to the doctor-paste relationship, that's been an area of ongoing interest and study since we started and it's gonna be a harder concept to work with and defend as we move into an era of health reform as we surely will. But we'll be there to try to do it. I think fellowship training, we're gonna promote the work of our former fellows and continue to train new fellows in clinical medical ethics as I say while encouraging other programs to do the same. Not seeing programs like Rick's as competition, but rather as colleagues who we have worked with already and will continue to work with. Similarly, I told you our past is our future. Lainey Ross has been one of the leaders in our focus on transplantation ethics. May I say that you work, Lainey, about the book? Yeah, Lainey is working with Robert Veach on a book, a second edition of a book on living organ donors. That's gonna be probably for the next 10 years of the Bible in the field. Dan Solmezzi, who's here, continues to write extraordinary work on end of life issues. Marshall Chen, who made Marshall, Marshall may not be here, continues to work on health policy issues. For example, this year's seminar series that Marshall and I put together 27 lectures on ethical issues in health care reform. We've already heard from David Axelrod and Mark McClellan and our dean and the first six or seven talks have been extremely good, attended by an average of 220 to 250 people. It's been a very successful series. And then, as I mentioned, surgical ethics with Peter. Is there anything new? Well, I think global ethics is an area that Peter Singer and Shola and Fumiola Patti have demanded that we get involved in and we are committed to doing so. And Peter described some of his work this morning at Grand Challenges Canada and the Rockman Center. And Shola and Fumiola aren't here today, but Fumiola is being inducted this evening into the American Philosophical Association in Philadelphia, the old Ben Franklin group, a very, very prominent program. I think we simply must get more involved in ethical issues in genetics and genomics. It is not just the wave of the future, but it's one of the superb strengths of the University of Chicago. And we have to get more deeply involved and committed to that area. As I work towards my conclusion, I want to acknowledge the McLean Advisory Board, Barry and Mary Ann McLean as the co-chairs, a wonderful board, K. Bucksbaum is here, Craig Dushiswa was here earlier, Nancy and Bud Foster couldn't make it, Dean Guestel is here, Stan Goldblatt is here, Dennis Keller couldn't make it, Jeff Keller is here, John Kinsella is not able to come, Rachel Kohler is here, Bob Murley is not, but Carol Siegel is, Brian Traubert is in Washington, George Ranney couldn't make it and Serita Walshowski couldn't. But this is one of those sterling small boards that Chicago is noted for that just has extraordinary depth of intellect and they've been very important in the evolution of the McLean Center. Barry and Mary Ann McLean have served as co-chairs of the board pretty much since the beginning. We're coming on to the 30th year into 2014 and I want to take this occasion at the end of my talk to introduce our next chair of the board who's with us today and that is Rachel Kohler. Rachel congratulations, Rachel received her bachelor's from Princeton which meant that Lainey agreed with this idea, an MBA from the University of Chicago worked for Booz Allen Hamilton and First Boston Corporation, joined the Kohler Company in 1992 as the director of corporate planning and development, has been a member of the Kohler Board of Directors since 1999 and since 2000 has been the group president of Interiors for Kohler Company. Rachel has been on the McLean advisory board for the last six, eight, 10 years and yes, time flies. We are so delighted to welcome her to the new role. We'll transition through 2014. That's the end of my remarks and I thank you so much for listening. Thank you.


T.L.O. what's poppin? We are on twitch. We are live. Well by the time you see this we won't be so leave a like comment subscribe turn on your post Notification bells. Let's continue to grow the family from Chicago to the UK I just heard a song with West of Valley. It was shocking to my soul.  But anyway Right above me You could check out that song if you go back to the stream on twitch And you know what never mind Patreon post five days a week. Don't forget. We do got merch. Let's get into this though, man. This is by mr. Who's the boss? Never heard of him, but he got 17 million salute Let me hit that like button sir might even sub up why not? Because that's the type of energy that I give all it don't take no effort to like and sub Y'all should try it on this current video inside the world's highest tech prison This behind me is HMP fosway, and it's maybe the most technologically advanced prison in the world So we're actually going to go through the full prisoners journey Understand what the potential benefit of tech in a prison actually is and then talk to a real prisoner to see The end what the potential benefit of tech in a prison What's this for? They plan video games in there like this. This is crazy. What's this?  You got some curl for us to watch this Trust me when I say it is very hard to get access to do something like this So you're about to see a lot of stuff you've never seen before and that's courtesy of Dave Who's helped to design this prison from the ground up and knows why basically every single decision has been made What we're doing is we're controlling the area by having an airlock here This is the first point of security when you're entering and the last point of security in the airlock. Why? I Mean, I guess I've done enough prison Like documentaries, I guess an airlock could stop like any potential like Breakouts if you were leaving you stay within these striped lines They make sure that you are who you say you are and only one of these two doors is ever open at the same time Every element that we put in prevents escape now as you can look like an airport Probably start to see when you're dealing with a prison you have to think about security on a whole other level So while we've already been through both an ID and biometrics check at the front desk and an airlock chamber There's more have a look in here and you see how the cameras are actually observing you There's one two three four five and you know what the crazy part is in this prison as a whole There are not 50 cameras or a hundred cameras, but 1700 active cameras. Alright, so then we go through the third stage biometric verification fourth stage metal detectors fifth stage A full body search feels more thorough than an airport for sure And you would think after all that that you must be through you would be wrong What I actually found quite interesting here is that the same biometric tech that lets the prison know who's going in and out Is also what's underlying a whole load of other systems. For example, they're issuing of equipment as well radios Cuffs battens parva is done via biometric as well for the staff. That's communicating with the server Yeah, so the server always knows when a piece of equipment is in use. Yeah, there's no high That's good, you know cricket cricket cricket cops and things of that nature And from technologies. This is HMP Fosse. This is in the UK. This is the world's high most high-tech prisoners in the UK And then just before getting out into the main prison compound itself This is the room where every key in the entire facility is stored This room is so high security that you can't see anything We have to blur everything out here because the key design cannot leak and if it does or even if a Single key is so much as misplaced then the entire prison will be considered compromised It would have to be entirely re-locked and that would cost about two million pounds Come on through. What's the beeping? Tell me this door's open Why is it a train? That sounds like a train is coming and I'm not allowed to open that door until I've locked this door So when you open the store that alarm starts beeping that alarm won't stop beeping till that door is locked because there's a sensor on the inside You can't that's annoying Open that door till that stopped beeping and that's shut So this is basically the seventh barrier when you're trying to get from the outside world to the inside world And it's a video call with the front desk You'll start to notice one interesting thing with all of these security measures That it's very much not what you see in the movies like seven separate lines of bodyguards But instead seven very varied security step So security desk airlock chamber Which is wild Almost pointless biometrics. No, it's not pointless.  This is like a real operational prison with real prisoners staying here Okay, keep talking to me. I'm interested here Experiences are to be expected with the plet see I have no issue with it with the with the prison being technologically sound because what the guards may lack in In brain power or or strength the prison could possibly make up for Because I know y'all still understaffed And under qualified some of these prison people for prison cards y'all still get your employees from GameStop and ASDA So it's not I mean all the help y'all can get Oh This is a very low tech part of a otherwise very high prison, but you know cameras cameras That's a very very high steel fence that okay. So have any of y'all ever been to a prison? Hold on. Let's go back. Hold on. Hold on. Time out time out time out time out time out. Wait, where is it? Okay, here it is Dead seven. Okay, so very varied security steps some time. So normally is If there is it I'm trying to sink it. Yes, there's a security desk There is no airlock chamber. This isn't when my stepdad when my mom's ex-husband was in jail. We used to go visit There was security desk no airlock chamber. No biometric scanner There was metal detector There was body search There was door lock no video call And then we went outside right here Technological some using a lot of a otherwise very high-tech prison, but you know cameras cameras That's a very very high steel fence They're built to a technical standard the standards that restipulates through the different categories of prison for levels of security Unmaterials that we use in the build we have to adhere to those so just Hold on. I'm gonna edit this out a brb. I put the screen My bad. My bad. My daughter is She got a cold So she every time she sneezes she called my name I got a little wiper Mother's to clarify there are four security and materials that we're using the build we have to adhere to those So just to clarify there are four different categories of prison in the uk category a is maximum security category b is for prisoners who don't need maximum security But for whom escape is still a risk category c for those who are unlikely to try and escape and then category d Which is basically an open prison any fence that we consider as a risk somebody getting over You'll see a 5.2 meter fences once we get into the prison It's more the general use area the 3.6 meter fences. Is that a mesh? You know, it's look at how crazy once we get into this looks like apartments like in the projects. It's like This looked like caprini green before it got torn down. Let's look like Any project in chicago is what it looked like And jails are modeled after them Says a lot to the prison. It's more the general use area the 3.6 meter fences Is that a national rule? That's our technical standard. Yeah, presumably no one's going to be able to jump something even half the height That height gives you enough time to respond to get stuff here We respond and that height will prevent them from doing anything before we can get here to a certain height on the fence as well You've got this sheeting and you'll see the sheeting is on this side of the fence here Placing this way so it prevents that initial attempted climb as well See and also these are not designed with fingers getting through no the anti-climb fences anti-climb fences And also on all the bolts we have to reduce them to a certain distance so they can't be used as ladders to get up as well That's the type of thing we have to look at when we're doing the build we cut the bolts off So you can't use them as a climb in it. Yeah, your fingers really struggle to get through. Yeah Really difficult. This has been tried tested and it's proven to be a good standard for the service This is a 5.2 meter anti-climb fence Hey, why are you killing them there for? Creasing the hell out of them for the good of a video But you got 17 million subs you can do that and you can go get in the crib And I'm not in the best shape I've been But yeah, there's no way there's no way so after all of those security stages We are in the prison and while the technology here is so advanced There's one common principle that will keep coming up with the way this prison thinks about security your back lines Your kind of final port of call is all manual. Yeah, is there a reason realistically? There's not a lot of risk to it because it's a physical action So we're going to start at the brand new visitor center We'll get to test what happens if you take drugs into the prison experience being locked in an actual prison cell Where the inmates live try out the high tech workshops explore the secret beating heart of the jail the control center And then finally talk one-on-one with the prisoner about their experience here So what you'll see as we walk around we design the prison with fence lines that break up the estate So that we can control access and egress from those So first up the visitor center. So the prisoners come into here. They book in at this desk They're all computerized. It's all on the system who's expected. So you can't just turn up. See I'm having a visit It has to be booked the prisoners book the visit. Yeah, is that on their tablets? That's cool No, sir, I'll be damned if I get copyrighted by there Oh, it's a lot nicer than I was expecting it to be if you have a look over the cameras that are in this place I think even you'll be quite amazed one two every five meters. There's I'm not mad at this This is for the visitors. Okay. This is the visitors hall I almost overreacted because I was looking like bro. What is their color coordinated? It's like better than my living room. My living room got a blow-up mattress in it And a table for my daughter like that's this cap Camera what's going on in there? I knew you're gonna go straight from that purple visits It's called and these are visit booths that people can do at visits online, right? Okay, so this is a well, it's like properly soundproofed So you've got a HP computer here and I'm assuming it's highly regulated what people can actually access on this Absolutely, well, it's well lit and it feels very soundproof So at least you can have the reassurance that the conversation you're having is private At least it is from other inmates. Of course the prison staff they are monitoring every call If for example, you were clear to have a visit with two people So your mother and father if then a child walked in the background it would shut down Wow And it's using AI to make sure that only the people who are meant to be on the call are on the call One of the key tenets of this prison seems to be giving the prisoners the opportunity to still keep in touch with family and friends Because what they found is that offenders who maintain family ties are 39% less likely to re-offend Presumably because their family is a trying to help set them straight And then b because assuming you do manage to keep those connections while you are in prison You're not going to then feel when you come out of prison like the entire rest of your life has disappeared You've still got it together. So this is a virtual courtroom In what situation would you use this when they're not required to attend court in person? It prevents risk. So if a prisoner's not leaving establishment, there's no risk of anything happening while they're out It's also cost effective. It's time efficient as well on staff. It's just a really efficient way to do it Technology is absolutely brilliant. But also There is a place for old ways of working to be honest some things you can't replace It's a great thing to say on a technology channel. Oh, well, well, yeah, and I'm going to show you that with the dogs Yes, he said dogs and we're about to see why even in such a high facility That they're still deciding to use dogs as part of their security arsenal So there's four types of dog There's the passive drug dog the active drug dog the explosives dog and then the attack dog more of a cat guy myself This is a passive drug dog. He's named Harvey when the dog's working. Do not try and stroke him or talk to him High stretch This is uh, not what I thought I'd be doing today Got a hit So obviously a lot of this is very manual right now Is it something that you feel like tech could ever replace not really? No, they have tried in the past child machines that it's kind of been down on you But it's been proved not to be as effective dogs. No, he's 25,000 times stronger now is 25,000 times stronger. Okay. Now the active drug dog. So what is it looking for? Oh illegal substances that prison are not allowed. Oh, he's found something. Good loud Beth Beth So hypothetically that dog could be trained to find my iPhone. Yes Um, I used to have a phone dog phone dogs are trained to find phones batteries and sim cards and that would do a much better job than the app Yes, yeah. All right. Next up is the explosives dog That's probably one of the worst jokes I've ever seen a youtuber make Like in person, you know what I'm saying like not a one tick tock and replay like I'm actually watching the video and that joke was terrible Because find my iPhone works pretty good in my opinion Straight to the corner she found her already Yeah Good girl Her core instinct is certain. So even if she's out walking she's still searching away Crazy the extent to which dogs can train the dogs. I know and not like this and then the fourth and final This dog no one's allowed to interact with them. You're not allowed to get within eight foot of them No one asked for half anyone minimum of eight foot gap is for what exactly safety reasons. Okay, and to the lead This is the most dangerous dog. This is the most force that can be inflicted Right, so just to be clear this dog can inflict the most force that can be inflicted and I should be eight feet away That's nice. So eight foot gap at all times At a minimum, I feel like I don't quite have that now. Is there any tech involved in this this process? Or is it very much like manual human and dog? Yeah, very much human.  I would not trust this You're too close and you can't get away because I seen I seen the bend you put on them air force ones It'll be too tough on them I don't know no sir No way I asked that question It's quite hard to think straight when there's an attack dog directly locking eyes with you I'm gonna you're gonna spark this one up. Sorry. When you say spark it up, what do you mean? Are they quick trainers? How quickly can you get over that fence Aaron? I've tried already it didn't work very well So the eight sleep is a pod cover that It's on a map. That was awkward.  Yeah, as I did So your plan is usually to take the dog out let it bark a few times dissolve the situation We don't go out with the intention of setting the dog on someone. Absolutely But there's one more part to this whole incident response It's if something breaks out what you don't want to do is to just rush a staff member in there to try and fix it Because they could put themselves in harm's way. So there's also a drone The drone is going to be thrown up into the air Scope the area from above to make sure the situation is what we think it is. So you're using a dji Mavic Mavic 3t. I guess that's smart. That's smart. They're using their birthday. How much are you paying the people who work here? This gotta like everybody has to get a good paycheck here Because they're trained and stuff that other people officers are not trained in that regular prison And what's the reason you've gone for this one? We change over to dji because they're a lot more flexible A lot easier to put up a lot quicker for response. This is an enterprise edition of the drone What is different about the enterprise edition? We've got thermal cameras on this for obviously the night incidents with this system now Because dji is very Piable with the system we use we can data transmit live imagery now to our gold command So during an incident they get live updated imagery of what's going on The drone can obviously follow the prison around it'll also put out any points that are vulnerable to it Allow it to put containment lines in to keep the prisoner in one area rather than have the full flexibility We're up and going in in about 30 seconds while the drone's up the second colleague of them be Data transmitting the imagery through to headquarters assume the entire prison complex is designed in a way that from this bird's eye view point You can see everything. Yes We can use this collaboration with our dog teams for searching for a prisoner if they've escaped So we'd be the air support looking ahead of the staff and then we could guide them in and locate them into anything we find In a ways, so they don't even need the chopper no more They didn't took the police chopper out of policing with drones Especially kind of reassuring for the consumer That even in an industry where it's so so important to have the absolute best that they're still using consumer grade year In a sense the tracking features of that dji drone. That's good enough to track and escape prisoner All right, so this is my response vehicle here So we're going to the house block dude is not funny. Like what is this the joker of the like I mean, I guess it's cool to be like Jokey-jokey-hee-hee-ha-ha-ha, but if you're not funny, just hang it up So we're going to the house blocks now So this is actually where the prisoners themselves are staying and after that we're going to talk to one everybody's Inception of a prisoner's bars, isn't it and you can see the barless windows and when you say barless windows You mean I guess No metal bars. Yeah, it's glass. I'm assuming there's a lot that's gone into the actual material as well to make sure No one can oh, yes. Yeah. Oh, yes We build two technical standards and the technical standard for this is they have to be attack resistance for 90 minutes We did testing on these and we used their national resources to do it So they attack the window with anything we can find in the area what we'd expect to find We get one person to attack it for 30 seconds and stop stop watch and then we put someone else in as well We do it for 90 minute period which takes six hours to do that's That's a good testing They switch out somebody every 30 seconds. So they got the maximum strength that they could have Because you know some of these prisoners just all they do is program all day program is lift weights, you know what I'm saying get fit shadow bombs like they big and Okay Nominal the barless window is not about preventing the air coming in It's about not preventing that view which then refocuses the brain really Okay, now on to the inside where you're greeted with the hallways Which is where the routine medication is stored for all the inmates now that we're coming into the new world and getting with technology We've got this great piece of equipment. So that is biomedic. So they scan their finger and their specific medication will become available So they'll be in one of these lockers So where we have put bars and where we believe there's a need for bars We've put the bars horizontally and that's because they look like blinds rather than bars That's a specific decision you made for the psychological well-being of people Absolutely. Notice you've got another big green button here. Yeah, don't touch it Wait, they're all all over the place. Those are all emergency buttons. Yeah, and you need one there as well as there They're put in areas of risk. Is there a reason this is held open right now? Yep Because you're not allowed to see the workings of a lock a door is either locked Or it's in what we call a lock back why we're not using biometrics for this You'd have to look at the expense of the what happens if they fail And then just before the cells there is a recreational area as you can see This is a nice pool table. It's nicer than some of the pool halls I'll be Going to sometimes not a lot anymore. See, I mean it's pleasant, but it is what it is Are they free to use this at all times? No, absolutely not They're expected to go to work or education during the day So just notice the entire building is an x is very specific to the shape of an x Something to do with being able to see from all angles what's happening You're absolutely spot on if you were to sit there you've got a field of vision where you can see down all landlid Loads of sound dampening. Yeah, acoustic tiles. It creates a calmer environment, doesn't it? So we need people to be able to speak to people at a certain level which keeps that calmness We're the default talking. Okay, so I thought this was just going to be like, okay We're super technological for the staff, but they even got it implemented for like the prisoners as well The prisoners is benefiting on this too. What type of prisoner do you have to be to make it here? Like you just can't go commit a crime and be sent here. You got to be you got to be Like an outstanding prisoner, you know, the volume is talking volume. Yeah, it was very calm space Let's go see a cell. I wasn't really sure what to expect here. All right, so you've got There's a bed There's a bed frame. There's a phone here. Who can they call with this? So it could be family members any individual they can put in a real risk assessment and we bet who they allow to call They then go to work to education and the finance phone in the room Just to pay for the focus It seems like one of the big questions this prison is trying to answer is How do you keep someone away from normal society for many years? But not let them forget how that society works And so a common theme here is there are plenty of opportunities to learn to grow to improve to keep in touch with your family So long as the prisoner also puts the effort in from their end And the idea of that is to get them ready for normal life again when they're out on the other end So you've got a monitor keyboard mouse. There's actually a mini pc strapped to the back They can book metal appointments. They can do open university as well. Wow.  If the hub is not available, I'd be in university all day You know what I'm saying? What else is there to do? But do push-ups do apply what is it plyometrics and In learning right? Part of the equipment is obviously very inexpensive very simple keyboard and mouse But I guess the idea is function without wasting Look at the mouse though. Why do they have this? I think it's an elite type mouse like don't gamers use this mouse Cash you've got the television that runs through this as well They've got like access to watch hammers. It's the bare minimum that we would expect to see You've got the glass with just the strength and glass and you've got a polycarbonate Outer on there so to kind of create a lock and that's the way they get the 90 minute attack resistance And I guess what that means is if a prisoner went rogue and used every bit of equipment available to them in their cell And attacked that for 90 minutes straight. It's been tested to resist that So we even test with a toilet and a sink as well But we know we threw that as well We threw that as well. Who would they call with this? Some staff not to deliver toilet roads because I run out of toilet and that was almost funny But it's just like when he said it it became instantly not funny. The rule is for um medical emergencies or somebody in crisis When the other guy the cameraman said it was okay. I got a little smirk but as soon as he said it it was like Okay, so I am the cell alone This is what it would be like I mean it's still it's a prison. It feels like a prison But there are some you know, really thoughtful quality of life features. I guess like the fact that we actually have a window here Instead of bars, obviously there isn't much to do here But the main focus will most likely be the computer So using it for education and then using it for entertainment because it's it's got a tv box attached to it too That's the shower Got the drain you got the toilet sink and a little ledge here So that's the cells now for the workshops where the prisoners would go to skill up And the idea is the prison has contacted a whole load of partner companies who work in the local area And they've said come in teach prisoners who are on their final stretch the skills they need So that they can actually have employment ready for them when they get out the prison So this is the industries building. We're about to see a digger Nobody's like be realistic. It's hard to get a job as an ex-con This is basically a full recreation of the inside of a cat digger So it's made by the actual company. You've got a seat. You've got all the controls You've got a meta quest headset and then three 40 inch or so screens So let's take this for a spin. It feels like the real deal There's even like resistance on these joysticks So this is basically like they've taken the entire internals and electronics of a real cat digger Gutted them and stuck them in this room and with the screen in front. Oh, yeah, there we go. That's me Oh my goodness. Oh, yeah. Yeah. Yeah. Yeah Oh, it really feels like I'm in Like the seats vibrating. I'm feeling the engine and that actually changes the vibrate Because construction is one of the jobs that they can get in You know, I'm saying because a lot of constructions be construction firms or whatever be privately owned and It's a possibility missions in the sea. That's phenomenal. I got it. I got it It's got all the physics that you would experience in a real machine So, yeah, this is not a toy This is an actually licensed simulator meaning that prisoners aren't using it to fool around They'll be using it to get real qualifications to be able to leave these four walls with Prospects and walking through the rest of this building. I couldn't believe how many of these workshops there were We saw music workshops barber work That's where my L20 that's where everybody be recording workshops even classes that teach prisoners how to make the optics that go into glasses Okay, time to head to the very heart of the operation How is it that we have an electronic lock when we're already inside a six-step secured facility? It's a brilliant question. And the reason we've got this is this area is critical So what we've got is the commander suite and we've got the control room So this is a restricted area where you have limited access even for the staff that work here And it's also again what we call a bit of a citadel. You can't afford to lose this area This is where the cameras are operated where the biometrics are processed where the harbor the security is So you can see why it's heavily guarded. This is the nerve center Yeah, absolutely. So this is a very real operational control room of the entire prison. It's where the 1700 cameras are controlled from But how it's an intelligent system that's used by the operator And they program it to remove the cameras and the cameras come up on screen Where they need them at whatever time of day they're required So when someone comes into this facility, you'll tell them like look the 1700 cameras here And it's recording all the time. Yeah, absolutely And now that's done. Let's find out how all this stuff has played into the experiences of someone actually serving their sentence here Where are you roughly in your sentence? I've got four years left and I've done best parts of years And how are you feeling about this place as a whole? It's not what I imagined. It's far better than what I imagined I've done English in education. The education department was great And when you say you've done English, so is someone here like teaching it? Yeah, someone's teaching English. Yes, and that's an actual qualification that you can do Yeah, it's an actual qualification. Yeah, right, right. What about contact with the outside world? Do you feel like you're able to keep in touch? Yeah, yeah, yeah, yeah You've got email a prisoner family friends can email me. They can send me photos. I can't send photos back for obvious reasons Yeah, and you can eat. What do you like? What's your email address? First last name at HMP What is the HMP floss? Loss? Loss? Email a long essay if you like. If someone subscribes to Unify Messenger, which is a secure messenger service On your Intel computer and your CMS, you can send back and forth text messages, instant messages, just like you could on WhatsApp One of the things I imagined would be quite difficult to be completely without a phone, without the internet If you think of something, you can't just, ah, I'll just Google it. It's completely taken away from you So that is hard. So it's been years since you've actually been able to Google something It's been almost two years, yeah If I want a phone, I have to ring my door so I can ring my sister or someone and I do it for me Do you wish you had more to do? I feel like there's plenty to do. I don't feel bored at all I like to learn Spanish. I've gone on to just translating on the computer.  Yeah, yeah, I'm learning Spanish, yeah Do you really take this as an opportunity to just scale up? 100%, yeah, yeah. There's actually not enough time to do everything that I want to do You've seen a lot of things here that I didn't expect to and I've learned a lot more than I expected to So I hope you felt the same and uh I did not feel the same. Actually, I did, man. This is, this What, how much did they say this prison would cost? I know they said if one key gets lost, they gotta redo all the keys and that alone is two million That's tough Don't y'all gonna get them locked up to be in here, man, because I know how y'all be, man With the mallaws out there in the UK. Anyway, tell or leave a like, comment, subscribe, turn on the post. I'm gone


It is great to be here. I'm really, really honored. It's the very first time that I get to present at LinuxCon. And I got to tell you a little bit of a personal story about that. When I was 15 years old, from all the money I saved, I bought my first computer. And I don't think many of you will know it, but it was a ZX80 from Sinclair. And now you know about how old I am. The nice thing about it was that it had one kilobyte of memory. And you can imagine what you can do with one kilobyte of memory. Right now, you can do nothing with a kilobyte of memory, but at the time, I managed to squeeze out as a youngster with not much money to buy anything more than one kilobyte of memory. I managed to squeeze out a lot of this little machine. I did it through coding, not through basic, even though that was the language which was supplied on the ZX80, I coded in assembly. And I taught myself assembly. And from assembly, I taught myself C, and then I taught myself C++. And many years later, I found myself heading a technology department in an IT company, writing device drivers for Unix. And then for Linux. And I couldn't be happier to, even though I'm no longer a developer, I'm no longer the guy who works with the code, but I'm still in technology. I'm still working with source code, and I'm working for what I believe the most awesome company in the world, which is Red Hat. What I'm going to do today is I'm going to talk to you about Red Hat. I'm going to talk to you about why Red Hat has been successful on making money with free software. And why am I saying it so explicitly? Because I've heard this question being asked many, many, many times in the last few days. Most of the people here in the audience who I spoke to so far have asked me, OK, how do you make money with open source? So I'll tell you how we do it, and I tell you why we are very committed to the principle of open source and why we would want you to be too if you think you can monetize open source. But first of all, let me brag a little bit, even though that's not something we normally do amongst developers, right? But bragging is OK if you're telling something which is actually true. So one thing we are very proud of as Red Hat is that we have had 60, 60 quarters of consecutive growth. And isn't it surprising to know that there is no other company in the world that has shown 60 consecutive quarters of consecutive growth? Not one quarter was less than the one before. It's an amazing result, but it's in my mind not just about the dollars that we made, it's a reflection of open source adoption. If you look at how these results stagger from 2003 to 2017, I joined Red Hat at the end of 2003, and when I talked to a customer about open source, when I talked to my customers about open source, this was about the level of excitement we got. If I now go to my customers and I talk about open source, this is the level of excitement I get. And this level of excitement about open source has been growing and growing and growing. We're simply a reflection of it. But this is why open source is such a great way of developing software. So the numbers speak for themselves, and the fact that we've made a solution and monetized a business model around open source is something that really works. It really works for us, it can work for you too. But it's all about being very, very committed to open source. And we've been extremely committed to open source. We believe that everything we do needs to be contributing to the upstream community. And the upstream community is extremely, extremely important when it comes to making open source successful. You can't do stuff in isolation. You've got to have meritocracy. You've got to have agreement about how software is being created, written, and deployed. So it's therefore not about being the first. It's about doing the right thing, and that's what we very much believe in. And by the way, we also make mistakes. We were probably not the first company to adopt OpenStack. But when we realized how important it was going to be for the community, we very quickly changed our minds and invested in it. And now we're a leading player in OpenStack. Other things we did, as you can see, we did many acquisitions. For example, we acquired a company that was very strong in cloud management platforms, which was ManageIQ, a proprietary solution only supporting VMware. And what we always do and what we're very, very committed to is when we acquire software that is not open source, we will open source it. As a matter of fact, most of the due diligence we do about acquisitions of the companies we acquire is around how easy it is to open source the software that we do acquire. So in the case of ManageIQ, there is now a product called Reddit CloudForms. And that has a community which is called the ManageIQ community. So the best proof of all these things is actually also that we work not upstream alone, but also look at downstream. For example, CentOS. When the CentOS people joined RedHead, it gave us the ability to better understand the needs of our customers and it gave the CentOS community to better connect with RedHead. So we connect both upstream and downstream. So upstream first is what it's really all about. Making sure that whatever you do has the full commitment and acceptance of the open source community. So we've been collaborating and committing to hundreds and hundreds of projects upstream in the community. The kernel, Docker, OpenStack, Kubernetes, et cetera, et cetera. Collaboration drives innovation. The nice thing about this, and that's what I firmly believe in, is that with the business model we've created, we've really become the first disruptor in the industry. Because think about it, RedHead, we have no intellectual property. We don't own intellectual property, yet we have a profitable business model. This disruption is because of collaboration and collaboration that drives innovation and that we very strongly feel about. We don't believe, however, in committing half. You can't be half pregnant, right? You have to be 100% committed to open source. So things like open core models are not 100% committing to open source and we want to be pure and clean about that, 100% open source. We also guide our customers and partners in this direction. I'll give you some examples of that later, but customers and partners of RedHead often have questions around that. How do you do it? How do we contribute? How can you help us? And in the spirit of collaboration, we're always happy to do so. So here's our recipe. This is how we do it. This is how we make a product that we can commercially benefit from, from an open source community. If you look at this, the open source community has many, many open source projects. From the projects, you see many different distributions being created, like Fedora, Manage IQ and all the others. And from the distributions, we create products like Enterprise Linux. And those products we sell as a subscription to our customers. And the way we summarize a subscription, a subscription really, is a subscription to a stream of innovation. And it really covers all the risks that an enterprise customer would potentially have with using open source. And we covered it. The way I tell my mother sometimes is, when she asked me, what are you actually selling? Because she thought I was selling drugs. I said, no, it's actually a subscription we're selling. And it is about like an insurance. We ensure our customers, they can use open source by adding the right value to it. So building upstream distributions for commercial offerings is where you bring products together. It's like making a raw offering. Like Fedora upstream is real and over upstream is virtualization, et cetera, et cetera. Productizing things is a very viable subset of making solutions. And of course, making sure that the long life cycles that our customers need and the documentation and all the other value is there is important. Bringing this then to market is something that we don't do in isolation either. We like to collaborate on all fronts. So we do this through partnerships. We got very many important, valuable partnerships. First of all in the cloud, like with Microsoft Azure, AWS, as well as Google Cloud. But also technology partners are very important because ultimately there's so much technology out there that needs software solutions that it needs to connect well. We have very important technology partners like Intel who is our oldest partner in that sense. But to keep it local here for China, Lenovo, Inspire, Huawei, ZTE, they're very important partners for us. And then on the other end, we need partners that use implementation services, system integrators. System integrators that actually really understand very well what customers need and that have the challenge to bring that to life with the use of open source solutions. So our system integrator partners are many, many as well. But just to name a few from China, there is YouSys technologies. They are for the last six years ranked as the number one banking and IT solutions company and they're present in almost every bank in China. Then there is UEC, which is a leading SI in China's Finance and Commercial and Government Center for over 10 years. So these are important partners and there's many, many more partners that we work with. But working in an open source community is all about giving back, is about sharing information. So the information we're sharing and what we're doing is investing in buying and sponsoring research that will help us as well as our partners to understand the opportunity you have with open source. These are some great examples of phenomenal business opportunities that open source has to offer. Moving on, if you then see what kind of customers are willing to pay for open source. Again, one of these questions that many of you have been asking, who is paying for open source? It's mainly enterprise customers. 100% of the Fortune 500 companies in these industries that you see here are using Redhead. 100% of airlines, 100% of telcos, 100% of healthcare providers, and 100% of commercial banks are Redhead customers. ZTE is a great example. The NEP Telecom Industry Solutions, ZTE 5G microservices platform is based on Redhead solutions. It enables ZTE to deliver microservices platforms with extreme fast service delivery. And it helps ZTE to establish a leading position in the global telecommunications market. Another great example that's one of my favorites here in China is the Shenzhen Stock Exchange. Shenzhen Stock Exchange is using Redhead, both Enterprise Linux as well as J-Bos Middleware, to run a highly competitive solution with extremely low latency that they need to stay competitive in the market. And there's many other examples. So Linux is the foundation of the modern infrastructure. Let's talk a little bit why Redhead Enterprise Linux, both hardware and software ecosystems are safe and important for customers. We started with Linux when it was just a physical solution. And then came virtualization in the form of KVM, VMware, Hyper-V, but also things like PowerVM or even ZOS from EBM, who are currently platforms on which you can run Enterprise Linux. In the recent years, through higher degrees of self-service and automation, new subscription offering and support both for public and private cloud have then been requested. We call it the open hybrid cloud solution. Of all of these solutions, Linux is the foundation. If we then look at containers, you can very easily come to the conclusion that Linux and containers are almost the same. Developers get a great experience by containerizing their applications. The ease of use combined of testing and reliable foundation for developers, creating an environment in which you can very easily and very quickly develop and deploy solutions is what containers offer. And it's based on Linux technology. I would like to say containers are Linux. We obviously work upstream very closely with the community in projects like Origins, and we have a commercialized solution which we called OpenShift. And OpenShift is our container platform that combines Docker and Kubernetes distributions and really allows our customers to very efficiently deploy containers. So our interest in Kubernetes was one of these projects that we were very early on participating in. We saw the opportunity that Kubernetes offered to our customers and we actively became a participant in that community. We are now the second largest code contributor after Google, of course, and combining it with OpenShift, this really offers a great solution. Now bringing this all together in a vision that we already had in 2007 is a vision called any app anytime, anywhere. And this is a really powerful message. Just think about it. Running any app at any time you wanted, anywhere, whether it's on physical or in the cloud is such a powerful message. And 10 years ago we saw this as a vision and now we see it as a reality. Through our OpenShift container platform we enable our customers to containerize solutions and run them anytime, anywhere at any app. So this is the best enterprise platform for getting your code into production and that's really awesome. I promised you a use case. One use case that I personally really like is Macquarie Bank. It's an Australian bank and they had the challenge to become a commercial bank. They were actually a large, and they are a very large multinational bank operating in over 28 countries, but they saw that there was an opportunity for them to leverage themselves as a commercial bank and to compete because currently to compete you don't necessarily need all these branches. With their solution and with their technology they actually won the 2017 Red Hat Innovation Award for enterprise transformation. So what did they do? Their mission was to build a digital retail bank to access a complete new customer segment. Their first priority was to choose their platform for execution. And they chose Red Hat OpenShift container platform in combination with Red Hat Enterprise Linux. They integrated a natural language processing facility that basically allows you to talk to your app on your iPhone and ask the bank, hey, Bank, how much money did I spend on WeChat this year? And you get an answer. So great technology. For them it is so important because they need to stay ahead of their competition. So therefore they need to be able to deploy new code very quickly, at least faster than their competitors. But also they had some other challenges they wanted to collaborate with Red Hat because they had developed some solutions that they really needed to be supported upstream in the community. And in good collaboration we helped them to get this code accepted in the upstream Jenkins community. Just an example of how we help our customers to also get things upstream. So basically with all of this I am very happy to share with you today how proud Red Hat is to be part of this open source community. How great it is to have been accepted as a commercial company that has created a model that is commercially viable and that helps innovation grow faster and faster in a world that really needs it. So we're very proud to be here today. And the one thing I wanted to tell you, if you want to be successful with a commercial solution and open source, then I would ask you to commit or everything you do upstream so that we can commit to collaborate with you. Thank you very much.


We must hold love in our hearts, there is no need to export it to heaven. We do not know whether it's meaningful there or not, but here, you being in love, being a heartful of love will make you into a beautiful human being. The best in you will come out when you're loving, your intelligence, the unfolding of your genius, your competence and the goodness of being human will naturally flow out of you effortlessly when you have become love. So love is not something that you do, love is something that you become.