Commons and Matters of the Heart

When most people think of commons, they think of open fields, verdant woods or the vast oceans.  They point to the sky or the space beyond and see things that we cannot or will not lay claim to as either individuals or states.  All of these examples are open access resources and they are also sites of trouble when it comes to acting responsibly.  It has proven difficult for human communities to come to grips with these large, obvious open-access resources, to determine the rules of responsible use and to think about the ability of future generations to access these resources.  The atmosphere and space beyond it, the oceans and the earth’s unclaimed spaces are powerful evocations of the commons but they are also problematic examples.  Focusing solely on open-access and essentially unmanaged resources reinforces the idea that all commons are subject to abuse, or are tragedies waiting to happen.  The irony is that making commons synonymous with these ‘big things’ may have the effect of promoting the idea that privatization and enclosure are not only inevitable but desirable.  But what if our understanding of commons was slightly different, slightly more subtle?

In Take Back the Economy we argue that it is better to think of commoning as a set of ethical negotiations.  In our view commons do not exist without communities of people (at various scales) who determine the rules—who has access to a commons, who can use it, who benefits, who cares for it, and who exercises responsibility for it.

What makes a commons is a community that ensures access is widely shared, where the rules of use are negotiated by a community, where the benefits are widely distributed and the care and responsibility are also assumed by a broader community.  In this definition something could be private property—for example, the woods of Maine privately held by paper companies—and yet might function  as a commons for the people who access these woods to hike, hunt, snow mobile but also care for the paths through these land and the woods beyond them.  This, of course, has changed dramatically in the past twenty years as the paper companies have sold off their forest holdings in Maine, but there is a chance that communities in Maine will continue to find ways to care for the forests as commons.

If commons can be private-property, we can also see how commons are distinct from open access resources, and why the latter are such a problem. In general, open access resources like the oceans do not have communities large enough to truly care for them as commons. Though we see glimpses of where this has happened. For example, in the last decade the global community has banned the use of CFCs and as a result the ozone hole is slowly repairing itself.

Seeing commons as something communities make and share, as something that is  a product of collective action also allows us to extend our consideration of the commons beyond the big, obvious commons, and attend to other kinds of commons—cultural commons, knowledge commons, social commons.  Here too, the story that looms the largest is the future of the internet in an era where the rules that determine access are being re-written.  Likewise, the ongoing dispute over whether or not intellectual property law can be extended to the genetic realm is hugely important. However, if we focus attention exclusively on them we miss the opportunity to see other extraordinary but perhaps more subtle instances where knowledge becomes common and this brings us to matters of the heart.

Arterial fibrillation has been determined to be a major risk factor for stroke, particularly with individuals who have already suffered a stroke.  The diagnostic and monitoring options available to physicians historically have been the use of expensive electrocardiogram or Holter monitors, cumbersome devices worn by patients for days or weeks at a time that can detect heart irregularities.  These approaches work to detect afib but they are difficult to use.

There is another possibility whose detection efficacy was recently confirmed in a study published in Neurology in July 2014.  A group of 256 older patients who had already suffered a stroke were taught to take their own pulse in a way that allowed them to detect irregularities in their heart beat. These irregularities put them at increased risk of a second stroke.  Friends and families members were taught to distinguish regular from irregular heartbeats with an even greater accuracy than patients themselves.  The findings in the journal were shared by National Public Radio in the US, making this important knowledge commons available to many more people. The American and British Heart Foundations have also contributed by sharing knowledge about how to feel for a pulse and to tell when something is not right.

In our view the results of this study not only underscore the importance of approaching health care as a field where patients, their family and friends can make a significant contribution to the prevention and treatment of diseases.  We can also see a practice of knowledge-commoning—an attempt at making sure the results of this study and its benefits are widely distributed.  Such a practice of commoning is a bit harder to see than the vast commons we often think about or the dramatic legal struggles over intellectual property, but they are no less significant.

pulse ii



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