Category: Academic Reportage

Source: The Conversation – USA – By Christopher Justin Einolf, Professor of Sociology, Northern Illinois University

The New York Times reports that a senior Department of Justice official recently “instructed more than a half dozen U.S. attorneys’ offices to draft plans to investigate” the Open Society Foundations – philanthropies funded by the billionaire George Soros.

Citing a document that the news outlet said its reporters had seen, the report listed possible charges the foundations could face “ranging from arson to material support of terrorism.”

The philanthropic institution denied any wrongdoing.

“These accusations are politically motivated attacks on civil society, meant to silence speech the administration disagrees with and undermine the First Amendment right to free speech,” Open Society Foundations stated in response to the reported investigations. “When power is abused to take away the rights of some people, it puts the rights of all people at risk.”

The term “civil society” isn’t familiar to all Americans. But it’s part of what helped this country grow and thrive because it encompasses many of the institutions that uphold the American way of life. As a sociologist who studies nonprofits and civil society in the U.S and around the world, I have always been interested in the relationship between the health of a nation’s civil society and the strength of rights and freedom within its borders.

I’ve also noticed that often the term is used without a definition. But I think that it’s important for Americans to become more familiar with what civil society is and how it helps sustain democracy in the United States.

Civil society

The Encyclopedia Britannica defines civil society as “the dense network of groups, communities, networks and ties that stand between the individual and the modern state.”

This constellation of institutions consists of not-for-profit organizations and special interest groups, either formal or informal, working to improve the lives of their constituents. It includes charitable groups, clubs and voluntary associations, churches and other houses of worship, labor unions, grassroots associations, community organizations, foundations, museums and other kinds of nonprofits – including nonprofit media outlets.

Civil society does not include government agencies or for-profit businesses.

Political scientists and sociologists have long claimed that a healthy civil society, which in the U.S. includes a strong and independent nonprofit sector, helps sustain democracy. This is true even though most nonprofits don’t engage in partisan political activities.

My own analysis of survey data from 64 countries has shown that authoritarians have begun to use civil society groups to support their own purposes. But in the United States, at least, most civil society organizations still support democratic values.

Sometimes, scholars call civil society “the third sector” to distinguish it from the public and private spheres.

Most scholars agree that civil society strengthens and protects democracy, and that true democracy is impossible without it. These scholars distinguish between liberal democracies and illiberal democracies.

Liberal democracies have a separation of powers – meaning the executive, legislative and judicial branches of government. They protect individual rights, allow a free press, maintain an independent judiciary and safeguard the rights of minorities.

In illiberal democracies, there are periodic elections, but they are not necessarily fair or free. Civil society tends to be more restricted in illiberal democracies than in liberal ones.

An American strength from the start

The strength of America’s civil society helps explain the long success of democracy in the United States.

In 1835, when the French scholar and diplomat Alexis de Tocqueville visited the country, he marveled at the tendency of Americans to “constantly unite.” They created associations, he wrote, “to give fêtes, to found seminaries, to build inns, to raise churches, to distribute books, to send missionaries to the antipodes; in this manner they create hospitals, prisons, schools.”

Whereas the government initiated grand projects in France and the nobility did so in England, in the United States voluntary associations of ordinary individuals were behind most great endeavors.

What happens in nondemocratic countries

One way to see how important a robust civil society can be is to look at what happens in countries that do not have one.

The totalitarian countries of the 20th century, particularly communist China and the Soviet Union, outlawed civil society under the pretense that the party and the state represented the people’s true interests.

When the Berlin Wall fell in 1989, the United States and Western Europe devoted much diplomacy and foreign aid to helping the former USSR and the countries of Eastern Europe develop civil society institutions, believing this to be a precondition of those countries’ transition to democracy.

Today, civil society flourishes in formerly communist nations that have successfully made the transition to democracy, such as the Czech Republic, Estonia, Latvia and Lithuania. Civil society is restricted in that region’s countries that don’t embrace democracy, such as Belarus and Russia.

Not your grandma’s authoritarians

Today’s authoritarian rulers realize that civil society has the potential to support democracy and pry loose their grip on power. But few of those leaders outlaw civil society organizations entirely.

Instead, authoritarian leaders subordinate civil society organizations to achieve their own ends. In China, which had no civil society before the 1990s, the Communist Party now creates government-organized nongovernmental organizations, or GONGOs, which look like nonprofits and are technically separate from the state, but remain under state control.

Some authoritarians who take power in countries that already have a civil society sector tame these organizations and harness their power through a range of oppressive tactics. They leave alone service-providing organizations, like food banks, free clinics and homeless shelters, and use them to show citizens how they are bringing them benefits.

However, they crack down on advocacy organizations, such as human rights groups, labor unions and feminist groups, as these are a source of potential opposition to the regime. They then cultivate pro-regime civil society institutions, providing them with formal and informal support.

When authoritarians crack down on civil society groups, they sometimes destroy offices and imprison the organization’s leaders and members of their staff. But they generally use more subtle means.

For example, they may pass laws restricting the amount of funding, particularly foreign funding, available to nonprofits. They add layers of red tape that make it hard for nonprofits to operate, such as audits, registration requirements and information requests.

Authoritarians may use those hurdles selectively. Nonprofits that are neutral or friendly to the regime may find they can operate freely. Nonprofits the regime perceives as opponents undergo extensive audits, are forced to wait a long time when they seek to incorporate, and face constant demands for personal information about their funders, members and clients.

Attacks in the United States

Even before news broke of the Trump administration’s reported demand that the Open Societies Foundations be investigated, there were mounting signs that the U.S. was becoming more like authoritarian countries than it used to be in terms of how it treats civil society.

In March 2025, for example, President Donald Trump signed an executive order restricting a federal program that forgives student loans for people who work in public service organizations or the government. The order said that employees of institutions that the Trump administration deems to “have a substantial illegal purpose,” such as providing services to undocumented immigrants or serving the needs of transgender clients, would become ineligible for loan forgiveness.

Over the summer, Congress held three investigative hearings on nonprofits. The Republican Party’s leadership signaled its disdain and distrust of those groups with hearing titles like “Public Funds, Private Agendas: NGOs Gone Wild, ”How Leftist Nonprofit Networks Exploit Federal Tax Dollars to Advance a Radical Agenda,“ and “An Inside Job: How NGOs Facilitated the Biden Border Crisis.”

After the murder of conservative activist Charlie Kirk, Vice President JD Vance threatened “to go after the NGO network that foments, facilitates and engages in violence,” including the Ford Foundation and the Open Society Foundations, despite the fact that there is no evidence that these organizations support violence.

Some nonprofits have published open letters, issued public statements and provided congressional testimony in opposition to the administration’s claims.

What happens next is unclear. The threat to strip organizations of their nonprofit status may be an empty one, given that the Supreme Court has already ruled that doing so is regulated by law and the president cannot do it on a whim.

Many scholars of nonprofits are watching to see if the United States takes more steps down this road to authoritarianism, stays where it is or reverses course.

We are studying how America’s flourishing civil society resists any restrictions that limit the freedoms that have largely been taken for granted – until now.

Christopher Justin Einolf does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Civil society helps uphold democracy and provides built-in resistance to authoritarianism – https://theconversation.com/civil-society-helps-uphold-democracy-and-provides-built-in-resistance-to-authoritarianism-265705

Source: The Conversation – USA (3) – By Mark Louie Ramos, Assistant Research Professor of Health Policy and Administration, Penn State

Claims from the Trump White House about links between use of the painkiller acetaminophen – often sold under the brand name Tylenol in the U.S. – during pregnancy and development of autism have set off a deluge of responses across the medical, scientific and public health communities.

As a father of a child with level 2 autism – meaning autism that requires substantial support – and a statistician who works with such tools as those used in the association studies cited by the White House, I find it useful to think about the nuances of association versus causation in observational studies. I hope that this explanation is helpful to parents and expecting parents who, like me, are deeply invested in the well-being of their children.

Association is not causation, but …

Most people have heard this before, but it bears repeating: Association does not imply causation.

An often-cited example is that there is a very strong association between ice cream sales and incidents of shark attacks. Of course, it goes without saying that shark attacks aren’t caused by ice cream sales. Rather, in the summertime, hot weather drives more appetite for ice cream and beach time. The increased number of people at the beach does, in turn, cause the likelihood of shark attacks to increase.

Yet pointing this out on its own is neither intellectually satisfying nor emotionally appeasing when it comes to real-life medical concerns, since an association does suggest potential for a causal relationship.

In other words, some associations do end up being convincingly causal. In fact, some of the most consequential discoveries of the past century in public health, like the links between smoking and lung cancer or the human papillomavirus (HPV) and cervical cancer, started out as findings of very strong association.

So when it comes to the issue of prenatal acetaminophen use and autism development, it is important to consider how strong the association found is, as well as the extent to which such an association could be considered causal.

Establishing causal association

So how do scientists determine if an observed association is actually causal?

The gold standard for doing so is conducting what are called randomized, controlled experiments. In these studies, participants are randomly assigned to receive treatment or not, and the environment where they are observed is controlled so that the only external element that differs among participants is whether they received treatment or not.

In doing this, researchers reasonably ensure that any difference in the outcomes of the participants can be directly attributed as being caused by whether they received the treatment. That is, any association between treatment and outcome can be considered causal.

Yet oftentimes, conducting such an experiment is impossible, unethical or both. For instance, it would be highly difficult to gather a cohort of pregnant women for an experiment and extremely unethical to randomly assign half of them to take acetaminophen, or any other medication for no particular reason, and the other half not to.

So when experiments are simply infeasible, an alternative is to make some reasonable assumptions on how observational data would behave if the association was causal and then see if the data aligns with these causal assumptions. This can very broadly be referred to as observational causal inference.

Parsing what the studies mean

So how does this apply to the current controversy over the potential for acetaminophen use during pregnancy to affect the fetus in a way that could result in a condition like autism?

Researchers who try to understand causal roles and links between one variable and potential health outcomes do so by considering: 1) the size and consistency of the association across multiple attempts to estimate it, and 2) the extent to which such association has been established under observational causal inference frameworks.

As early as 1987, researchers have been working to measure possible associations between acetaminophen use during pregnancy and autism. A number of these studies, including multiple large systematic reviews, have found evidence of such associations.

For instance, a 2025 review of 46 studies that examined association between acetaminophen use and an array of neurodevelopmental disorders, including autism, identified papers with five positive associations between acetaminophen and autism.

In one of those studies, which examined 73,881 births, the researchers found that children who were exposed to acetaminophen prenatally were 20% more likely to develop borderline or clinical autism spectrum conditions. Another examined 2.48 million births and reported an estimated association of only 5%.

Both of those are weak associations. For context, estimations of increased lung cancer risk from smoking in the 1950s were between 900% to 1,900%. That is, a smoker is 10 to 20 times more likely than a nonsmoker to develop lung cancer. By comparison, in the two autism studies above, a pregnant woman who takes acetaminophen is 1.05 to 1.20 times more likely than one who does not take the drug to have a child who would be later diagnosed with autism.

It’s also important to keep in mind that many factors can affect how well a study is able to estimate an association. In general, larger sample sizes provide both greater power to detect an association if one does exist, as well as improved precision over estimating the value of the association. This does not mean that studies with smaller sample sizes are not valid, only that from a statistical perspective, researchers like me place greater confidence in an association drawn from a larger sample size.

Once an association – even a small one – is established, researchers then must consider the extent to which causation can be claimed. One way to do this is through what’s called dose-response. This means looking at whether the association is higher among women who took higher doses of acetaminophen during pregnancy.

The study mentioned above that looked at 2.48 million births shows an example of dose-response. It found that pregnant women who reported taking higher doses have higher autism risk.

Another way to examine possible causality in this context is to analyze sibling outcomes, which that same paper did. Researchers looked at whether associations between acetaminophen and autism persisted within families with more than one child.

For example, in a family with two children, if the mother used acetaminophen during one pregnancy and that child was later diagnosed with autism, but she did not use it during the other pregnancy and that child was not diagnosed, then this strengthens the causal claim. Conversely, if acetaminophen was used during the pregnancy of the child who was not diagnosed with autism and not used during the pregnancy of the child who was, then that weakens the causal claim. When this was included in the analysis, the dose-response disappeared, and in fact the overall 5% increased risk mentioned before likewise disappeared. This weakens the claim of a causal relationship.

Consult your doctor

At present, there is clearly not enough evidence to establish a causal association between prenatal acetaminophen use and autism.

Yet as a parent who wonders if my daughter will ever be able to write her name, or hold a job or raise kids of her own, I understand that such explanations may not appease the fears or concerns of an expecting mother who is suffering from a fever.

Naturally, all of us want absolute certainty.

But that’s not possible when it comes to acetaminophen use, at least not at this time.

Your doctor will be able to provide you with much sounder advice than any existing study on this topic. Your OB-GYNs are very likely aware of these studies and have much better judgment as to how these results should be considered in the context of your personal medical history and needs.

Researchers, meanwhile, will continue to dig deeper into the science of this critically important issue and, hopefully, provide greater clarity in the years to come.

Mark Louie Ramos does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. What parents need to know about Tylenol, autism and the difference between finding a link and finding a cause in scientific research – https://theconversation.com/what-parents-need-to-know-about-tylenol-autism-and-the-difference-between-finding-a-link-and-finding-a-cause-in-scientific-research-265946