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Global elites were blindsided by the rise of populism across Europe, the UK's vote to leave the EU and the election of Donald Trump in the US. What is the next big development they are missing?

In her column this week, Rana Foroohar argues that corporate leaders are ignoring “deglobalisation” at their peril. What they are missing, she says, is the emergence in the US of a far-right/far-left consensus around an economic nationalist agenda. It is not just the trade hawks in the Trump White House — notably Peter Navarro and Robert Lighthizer — who believe that the US should disentangle itself from China and pursue a domestic industrial policy. Many supporters of the socialist Bernie Sanders agree.

Chief executives may be in denial, Rana writes, but the markets have sensed that something is afoot. How else to explain last week's rout on the stock market and the divergence over the past few months between US and emerging market equities? 

Wolfgang Munchau suggests that the worst thing partisans of the liberal multilateral order can do is merely defend the status quo and fulminate against populism.

Philipp Hildebrand writes that while French president Emmanuel Macron is suffering political difficulties and is losing popular support, we should not overlook the success of the far-reaching supply-side reforms his government has already implemented.

Chris Giles argues that the end to austerity promised by the UK government will be just hot air without some honesty about the need to raise taxes to fund improved public services.

What you've been saying

AI cannot replace diligent bedside assessment— letter from F D Skidmore, London, UK
I gained my Fellowship of the Royal College of Surgeons (FRCS) 50 years ago. I have an extensive and expanding medicolegal practice. Time and again, the errors being made by a younger generation of medical specialists in many disciplines are due to excessive reliance on scans and other images when these reports are at variance with the history given by the patient, and to increasingly cursory clinical examinations.

Sir William Osler (1849-1919), founder of the Johns Hopkins Hospital in Baltimore, US, was called “the greatest diagnostician ever to wield a stethoscope”. There remains no substitute whatsoever for a doctor who has been trained by good teachers carrying out a meticulous bedside assessment of a patient and thereby constructing a provisional diagnostic matrix.

Can AI assess abdominal rigidity in a patient with peritonitis? AI cannot smell odours that accompany disease. AI cannot assimilate or validate pain on an analogue scale. Osler (there is an excellent entry on Wikipedia) was the father of modern medicine. His aphorisms were numerous. The most telling one is: “As is your pathology so is your medicine.” The clinical giants that taught my generation of doctors were diagnosticians. Surgeons should be physicians who can operate, not narrow-vision technicians.

Disease processes do not change. Meticulous assessment of a patient’s symptoms and signs remain just as relevant today. AI can be used to confirm the clinical diagnosis but should never be allowed to refute it. Unfortunately, with errors in communication and failure of continuity of care responsibility, excessive and unquestioning reliance on AI can lead to clinical delay in patient management, with disastrous consequences.

In response to “ Britain should focus on its future trade with Ireland”, Stephen T says
The debate so far has understandably focused on “peace and good relations with Ireland”. Rightly so. But it has been at the expense of proper scrutiny of the alleged benefits of the future trade agreements with 3rd countries. A trade agreement is an exchange of better market access for our exporters for better access to our market for their exporters. I have not seen a shred of evidence of what better market access a specific British industry sector could achieve that they are not already getting under the umbrella of the EU trade deals. Not a shred of evidence! We are told about our consumers getting cheaper stuff. That is the easy bit in any trade deal to give away easy access. But that alone is a route to a catastrophic collapse of our already adverse trade balance. Where is the evidence we could get a better deal for our exporters? What value (in £'s) does it unlock?

Drag racing has mixed the genders for half a century— letter from Eric J Redemann, Walnut Creek, CA, USA
In your report “ Racing prize aims to put women in F1” (October 11) you quote Catherine Bond Muir, the chief executive of W Series, as saying: “There are lots of different sports where men and women can compete equally and all of those sports have segregated series.” Ms Bond Muir is mistaken.

The rather American motorsport of drag racing has had mixed genders for more than half a century. And the women are often driving machines generating close to 7,000 horsepower, hurtling 400m in about four seconds to terminal speeds in excess of 300mph. Search for Shirley Muldowney, Erica Enders-Stevens, Alexis DeJoria, Angelle Sampey, and sisters Ashley, Courtney, and Brittany Force on the internet. Women running motorcycles have enjoyed sponsorship of such nominally male brands as the United States Army and Marlboro.

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