Worldwide, the United States has the highest incarceration rate per capita. Thousands of people are released from US correctional facilities each year, including many who are impacted by HIV infection and substance use disorder (SUD), two frequently comorbid conditions that present multiple challenges upon reentry. Reentry and care engagement research involving justice-involved people with HIV (PWH) with comorbid SUD has been largely limited to the perspective of those released. To formulate effective interventions for this population aimed at maintaining health and reducing recidivism, it is crucial to collect data from formerly incarcerated individuals with firsthand experience of the reentry process as well as other actors within the reentry framework. Insights from medical and legal service providers working in reentry systems have the potential to address key implementation concerns. To inform an intervention aimed at helping recently-released individuals PWH and SUD, we conducted a qualitative study to assess barriers and facilitators to community reentry from the perspectives of diverse consumers and providers of medical, legal, and reentry services.Fifteen stakeholders within XXX County participated in in-person interviews. Results indicated that 1) Patients/clients emphasized psychosocial support and individual attitude more than medical and legal participants, who chiefly focused on logistical factors such as finances, housing, and transportation; 2) Patients/clients expressed both medical and legal needs during the reentry period, though medical providers and participants from legal entities mainly expressed concerns limited to their respective scopes of work; 3) All three participant groups underscored the need for a low-barrier, collaborative, patient-centered approach to reentry with the goal of achieving self-sufficiency.Findings support and extend existing literature detailing the barriers and facilitators to successful reentry. Our findings underscore the notion that an effective reentry intervention addresses both medical and legal needs, includes an individualized approach that incorporates psychosocial needs, and focuses on establishing self-sufficiency. The United States has the highest incarceration rate per capita globally, with 830 out of every 100,000 adults in prison or jail , XXX (state) to examine perspectives on reentry and care reengagement after incarceration as well as the utility of community health workers during the reentry period. To ensure collection of a variety of viewpoints, three different categories of stakeholders were interviewed: patients/clients, medical providers, and representatives from legal entities. Specific job titles and roles within the medical provider and legal entities groups have been withheld to prevent participant identifiability. The University of XXX Institutional Review Board approved all study procedures.A purposive sample of participants was approached and recruited based on their personal experience, medical and security knowledge from these organizations: (1) XXX a XXX-based, attorney-led diversion and reentry brokerage network that collaborates with specialty courts, offers post-release legal advocacy services, and provides reentry plans and referrals to social service organizations for individuals leaving prison and jail (2) the XXX clinic, a safety net community-based clinic that provides HIV services, (3) the XXX County jail and (4) the local Sheriff’s department. Patients/clients comprised individuals who had a history of incarceration, some living with HIV and/or SUD, and previously-incarcerated individuals receiving reentry services at XXX [re-entry agency]. Medical providers included both HIV and non-HIV clinicians and nurse case managers working in jail- and community-based settings. The legal entities group was comprised of jail security staff and reentry specialists and advocates from XXX [re-entry agency].Interview guides included the same domains for all participants, with the first half of the interview consisting of tailored questions about experiences with reentry services or the participant’s specific job function in the reentry arena. Questions about perspectives on reentry were slightly different based on the participant group; interviews with people who were formerly incarcerated included questions about firsthand experience with reentry, while the medical and legal participants discussed reentry through the lens of their jobs. The patient/client-directed questions addressed: experiences at the HIV clinic, barriers/facilitators to medication and appointment adherence, possible experiences with substance use, possible experiences during incarceration and challenges faced upon reentry, and experiences with HIV case management. The medical provider-directed questions addressed: preparing patients for release from jail and subsequent follow-up, protocol and process measures at the jail and community HIV clinic, challenges commonly faced by patients in keeping appointments and filling medications, and experiences working with patients recently released from jail/prison. The legal entity-directed questions addressed: explanation of jail culture, barriers to reliable discharge planning from jail, and challenges with post-release service provision and uptake.The second half of the interview guide focused on a proposed community health worker intervention and research study aimed at increasing engagement in HIV and substance use care following release from incarceration and reducing recidivism. Interviewers inquired about the value of community health workers in the reentry period to assess feasibility of integrating them into post-release care and explored patient/client feelings about working with them one-on-one. Participants provided feedback on the purpose and plan, execution of the study, and brainstormed potential challenges to implementation. Interviews were administered using an open-ended method with probing as necessary. Sample interview guide questions are provided in Table Individual face-to-face interviews were conducted by research personnel trained in qualitative methods, in English, in a setting that ensures the privacy of the participants. Each interview lasted between 0.5–1.5 h. The interviews took place over 3 months in one of three locations: in a conference room at XXX [re-entry agency], in a patient room at the XXX HIV clinic, or in a conference room in the XXX County jail. All participants were provided with a study information sheet and participants provided verbal consent. Each interview was audio-recorded with a handheld voice recorder and transcribed by a professional transcription service. At the completion of the interview, eligible respondents received a gift card.Each of the 15 interviews were assigned a participant ID and independently coded by two separate research team members trained in qualitative methods. The codes emerged from the interviews directly and thematic analysis was used. Coders met after analyzing the first interview to reconcile coding technique and resolve discrepancies. The interviews were coded sequentially in order of interview date until half of the interviews were completed. At this point, a preliminary codebook was developed between the two coding team members based on frequency and relevance of codes from these first 8 interviews. The subsequent 7 interviews were then coded in order of interview date, with the coding team members meeting weekly to update and edit the codebook with new and emerging themes and assess inter-coder agreement. After 15 interviews, all transcripts were reviewed by the coding team and assessed for recurring ideas. Codes were quantified and compared both within and between the three interview groups to determine that thematic saturation was reached. All interviews were eventually dual-coded, with all differences reconciled by consensus. All codes with corresponding interview passages were compiled and organized using NVivo software 12.0  Patients/clients highlighted the significance of psychosocial support and individual outlook more than medical and legal participants, who primarily focused on logistical factors such as finances, housing, and transportation; 2) Patients/clients expressed both medical and legal needs post-incarceration, though medical providers and participants from legal entities expressed concerns specific to their respective scopes of work; 3) A commonly shared perspective across participant groups emphasized the need for a low-barrier, collaborative, patient-centered approach to reentry with the goal of achieving self-sufficiency. Additional thematic quotations are provided in Table “That's one of the biggest things that people need to realize is when they come out of either incarceration or rehab facility, they need to have somewhere to go. They need to have family support, not just a, a shelter, but they need to have somebody where, that really cares about them, that watches over them, and wants them to do better, encourages them to do better.” -Patient/clientPatients/clients spoke about barriers and facilitators related to psychosocial factors that affect their self-esteem and impact their experiences upon reentry. Multiple patient/clients stressed the need for support from family and community members to sustain positive reentry efforts:“I had somebody who cared and so, it made me care.” -Patient/client“I was scared of navigating someplace that I have never been, you know, in 14 years and 8 months, I was scared of failure, you know? I didn’t wanna let a lotta people down, you know?” -Patient/clientSome patients/clients touched on social support as external motivation to do well. Knowing that someone else cared about them facilitated their own efforts for success upon returning to the community following incarceration:“You know, you believe that lie that, you know, hey, you know, your life is never going to be the same. But this helped me get back on track with like that positive attitude. Hey, we're willing to help you, you know. We're going – we have relationships with people that will give you a shot, give you a chance.” -Patient/client“When I got out in 2010, everybody saw that I was serious so, you know, and it feel good to where I could go to my sister house and she wouldn't watch me and I could tell the difference, you know, and I could get a car, you know, and I could borrow money and wouldn't have to ask for it twice. You know, it got the confidence back and it feel good. It's a difference, you know, when you're doing right and you're doing wrong.” - Patient/clientPatients/clients also emphasized the importance of a positive outlook, trust from others, and self-confidence as facilitators to reentry:‘Cause there’s a lot of people down there that feel like they just don't have anybody. You know, they're just down there, wasting away, and nobody cares about me, my life is over, and I don't know what to do, and you know, they kinda give up.” -Patient/client““Yeah, just give someone, you know, some hope … Once you lose that, you're done. So, have that through a community or somebody who has been through it, I think it helps a little bit.” - Patient/client“But the baseline of all this conversation basically is getting the best help support that you can, and that's people that really love you and care about you. You know, and if you don't have anybody, those are the people that rebound and go back to what their old habits were.” -Patient/clientIn addition to the benefits of social support, patient/clients mentioned the negative consequences of attempting reentry without it:“If the client gets their basic needs met – food, housing, clothes – then they're more … they usually will follow through, have a better follow-through if they get their basic needs met.” -Medical“They're homeless, there is no job, … there are literacy issues, and there is paperwork that you have to fill out to... get into care. Then, if you're in special programs, there are probation fees. There is a certain time you have to be back, so I can't go to [the HIV clinic] and sit hours and hours and hours. I don't have the money to catch the bus. So, I just think they just don't have the support and the means to be successful, most of them.” -MedicalParticipants from the medical and legal entities, conversely, noted mostly structural factors and logistical needs relating to employment, education, housing, and transportation as key determinants of successful reentry:Participants representing legal entities mirrored the perspectives of the medical providers:“ … if they don't have anywhere to lay their head or a shelter, nothing else matters.” -Legal“And, uh, employment because, again, if they don't have a job to feed themselves or get housing, they're gonna do whatever it takes to survive which is possibly to reoffend. And we don't want that.” -Legal“We know that when they have a good paying job with good benefits, um, and good transportation and good housing, their chances of going back are slim.” - Legal“So, that's the biggest challenge, is to get them well here and then for them to be dumped back into a system and not be linked to care, and still go through the issues that they go through with trying to be accountable and stay up on their medication.” - MedicalGetting their medication...I think that's a big challenge. And, uh, getting the necessary documents to get back into care.” -Medical“Medical providers perceived issues related to their field as main barriers to successful reentry and medication adherence:“The patient can understand the HIV, but, if the people around them don't understand HIV and continue to treat them like a disease or, you know, as contagious...I've heard a mom break down because, ‘Oh, I can't kiss my babies anymore.’ Yes, you can. ‘Oh, my babies can't eat after me.’ So, she's feeling like she's going to lose her closeness or her bonding or her cuddling with her child because of lack of education...I can teach my patient all day, but if the people that they need the most – ... That's a scary place to be. Even though the medications have gotten better, that's still scary.” - MedicalOne provider pointed to issues surrounding an HIV diagnosis and health literacy as foundational barriers affecting reentry:“Well, you got to get a XXX [state] license because it's so hard to navigate the system without a current ID with a current address...And to me it seems really simple, picture ID, proof of address, proof of income, but for some people that's just – they can't seem to get that together.” -Medical“I say, ‘When you get down to ten pills in your bottle you – your next thought is gonna be where am I gonna get my next month's supply? Do I have a refill? Do I know the pharmacy? Am I updated with my program?’...it's like a full-time job for the patient” - MedicalSome providers pointed to patient documentation issues and the time-consuming nature of staying current with medications:“Sometimes they just, ‘I'm doing fine, I'm feeling fine. I just don't want to deal with that now.’” -MedicalOne alternative medical perspective touched on the phenomenon of patients not addressing medical concerns and medication refills because they do not necessarily feel sick and have other things they choose to prioritize:“That's the problem with our society to begin with...that's why it's so hard for people coming out of prison to get jobs, because nobody forgives them for a mistake that they made. You know, you steal something, well, no, um, salesperson, or sales, wants you to work there, ‘Sorry. You steal.’” - LegalPeople don't realize that some nursing homes and assisted living facilities, you can't have a criminal history living there.” - Legal“But the ones who are on parole, I already have to go to my parole officer. I have to go see him. I gotta go report to these meetings I really don't wanna attend for a year or so. They're tired of going up there. So if you wanna say, let's go see our reentry coordinator – let's go see my reentry case manager, it's like, uh, no, I'd rather be out here hitting my head against the wall.” - Legal“Participants from legal entities focused on barriers to reentry that relate to their own field, including navigating life with a history of incarceration or conviction(s), in addition to probation and parole requirements:When asked which clients face the most challenges upon reentry, one legal participant stated:“All of ‘em...It depends on the charge, honestly. Um, if they're aggravated charges, they have a – just as much difficulty as a sexual offense charge because aggravated charges are still charges. They're a liability to anyone who hires them or even going to school … so they... have the same level of difficulty finding work, housing … education … There still will be doors shut.” - Legal“Depends on … how long they were locked up. It would be education on the public transit system. Um, of course, employment. Um, and just simple, everyday skills. How to dress for an interview. Um, how to communicate between your employer and even your co-worker.” - LegalWhen asked what clients need the most assistance with, the same legal participant pointed to length of incarceration as a key determinant:“If they've got a lot of criminal stuff going on, they're not going to give you truthful information.” - LegalOne legal participant cited averting legal authority as a potential barrier to fully engaging in services upon reentry:“I do think, ultimately, it is the responsibility of the person who has the illness, um, however, um, in healthcare, if we're gonna be successful in helping people, we have to recognize that we're a big part of helping to enable that person to be able to take responsibility … So we have a responsibility to help create a sense of responsibility, I think, in the person that we're treating. And I think the best healthcare professionals are good at that.” - MedicalPatients/clients, medical providers, and participants from legal entities shared an emphasis on the need for an accessible, collaborative, patient-centered approach that helped patients/clients achieve autonomy. In discussion about who bears responsibility for successful connections to care in the community, one medical provider pointed to a collaboration between patients/clients and their providers:Another medical provider discussed the team nature of the patient-provider relationship:“ … and my thing is I tell them we're on the same team. So, it's a partnership between the client and me, you know, being an advocate for them.” -Medical“I've got … a lot of belief in the idea of community health workers. People who the patient believes that they can relate to because they've, sort of, walked the same, kind of, walk. … It seems like it would be a very effective way. As opposed to the doctor saying, you've gotta go do this, and moving on to the next patient, I think it's a warm connection.”-MedicalOne medical provider praised the inclusion of community health workers as part of the care team, sharing they can connect well with patients and personalize care:“If [a community health worker] actually coming down to visit me and talk to me about trying to help me along, and get me the medication, and get me the resources that I need, I think that would be huge. I think that would change somebody's mentality, change their outlook, change, change the way they feel.” -Patient/client“I mean, I don't feel like I'm just some number. I feel like, you know, she really is truly trying to figure out a way to help me. So, that's always a good thing.” - Patient/clientIn agreement with medical providers, patient/clients underscored the importance of working together with community health workers and other service providers and the impact that such collaboration and partnership can have on their attitude and reentry experiences:“‘Cause you can’t take advice from somebody that can’t relate to you.” -Patient/client“Yeah, that's good because they know. They know the dos and don'ts, you know, the whats and whatnot. They can really reach out and help somebody because they know where they come from.”-Patient/client“That person’s … trying to stop you from going through what he went through, trying to help you not go have the problem that he had. I think that's excellent … And a person will work with them, too, ‘cause they'll know that this guy done been through this. I'm listening, you know what I'm saying? I'm gonna pay attention to what he's telling me and do what he's telling me to do. Yeah. ‘Cause he's been through it.”-Patient/clientThough most patients/clients did not have prior experience with a community health worker, they praised the concept of a community health worker that has experiences in common with the people whom they serve – an added credibility that allows for effective collaboration and encouragement upon reentry:“A lot of ‘em didn't have the social skills or the know, know-all to – or how to communicate with someone if they're needing help or assistance. Some of them may be intimidated by authority figures. So I think that advocate would be great.” – Legal“Some people may be too timid or afraid to go out there by themselves. And to have someone say, “Hey, it's all right. Let me show you the way,” one or two times – it would give them that self-esteem and that determination. And that will to say, “I can do this.” And go do it.” -LegalParticipants from legal entities, like those from medical and patient/client groups, condoned the use of community health workers as a means of reentry support:“I think hearing from someone who has been in their shoes makes a big difference … And it's, I need somebody who looks like me and has been where I've been and sounds like me, to tell me. And then I'm gonna do it. And I think that's gonna make the difference. I really do. I think it's gonna help a ton.” - LegalOne legal participant echoed the sentiments of the patient/client group, explaining that a community health worker with shared lived experience to those they serve is key:“Success is measured based on that person's goal, not mine.”- LegalOne participant from the legal entity succinctly summed up their patient-centered approach, stressing the need to meet patient/clients where they are:“I'm gonna keep nudging you to try to … get you off the meth or crack cocaine, but if you're not ready yet, I'm not gonna push you ‘cause … that's not gonna help you.” -MedicalSimilarly, a medical participant stressed the importance of individualized, patient-centered health care, particularly related to substance use:“It's not on us to make it work. We'll be there to do whatever for them, but at the end of the day, it's on them to make it work. And so we impress upon them from the get-go that this is a, you know, a hand up, not a hand out. They have to work the program, and if they're not ready, we'll be there when they are” - Legal“The mission is to get the clients to self-sufficiency so they do not go back. To reduce recidivism rate in our community.” -Legal“It's, uh, it's almost like looking at your children. You know, we've got to let go at some point, and I know we care about these and we know what's going to happen, and it's just going to be a vicious cycle, but we have to learn to let go.” - LegalParticipants from the legal entities, also emphasized the need for eventual patient/client independence:In line with the legal participants, patients/clients also stressed the value of self-sufficiency:“You can’t take the freedom for granted, you know, to have your own checking account, have your own credit cards, to be able to take your own key and open your door, get in your car and go eat what you wanna eat, you know? -Patient/client“You know me working, me paying my own bills. Me being able to feed myself, me being able to pick up the phone, ‘Hey, ma, you need anything?’ You know now I’m feeling more confident about myself and, hey, I’m all right.” - Patient/clientMuch of the literature outlining the challenges of reentry following incarceration is limited to the perspective of those released, often excluding the viewpoints of community medical, legal, and social service providers who interact with this population. In the current study, we obtained data from a unique group of stakeholders - medical providers and administrative staff from jail-based clinics, representatives from the Sheriff’s office, staff from a community HIV clinic that serves justice-involved individuals, leadership and staff from acommunity reentry program focused on legal advocacy, and formerly incarcerated patients/clients of these entities - and found key similarities in their perspectives on reentry. Among the three groups, participants acknowledged the significance of logistical barriers to community reentry and obtaining basic needs, benefits of team-based and patient-centered approaches to reentry, and an end goal of self-sufficiency. However, there were key differences between groups in additional themes viewed as relevant. Patients/clients focused heavily on psychosocial barriers and facilitators to reentry, while the other groups chiefly emphasized logistical needs. Additionally, specialty-specific focus seen in the medical and legal groups highlighted the siloed services and challenges of competing priorities that patients/clients returning from incarceration experience. Data gleaned from the qualitative interviews were intended to assess feasibility and inform implementation of a community health worker reentry intervention for these patients/clients aimed at enhancing HIV and substance use disorder health outcomes and reducing recidivism.Participants from medical and legal entities primarily noted logistical barriers  whereas the patient/client group emphasized that social support and encouragement from people close to them were just as important as other practical facets of reentry. The latter group discussed wanting to succeed because they knew people close to them were invested in and hoping for positive outcomes. Further, they noted how it built their self-confidence when family members who previously did not trust them started to do so and how that made them want to continue to do even better. These sentiments mirror those presented in Rozanova et al. , who fouNarratives from all three participant groups in this study support the utilization of community health workers, often seen in interventions like the Transitions Clinic model (Shavit et al., Medical providers and representatives from legal entities that serve formerly incarcerated individuals concur that people reentering the community following incarceration face myriad logistical barriers to health and stability. However, participants from each group primarily discussed issues with which they are most familiar and perceived barriers related to their own respective fields of work as paramount, reflecting the competing priorities with which the reentering population contends. Medical providers spoke about medication adherence and HIV stigma, seldom mentioning the obstacles of parole or probation requirements and other legal burdens that patients carry, results that are consistent with Sidibe et al. . ParticiOur results point to the need for integrated, low-barrier reentry interventions that serve as a “one-stop shop” for reentering patients/clients living with HIV and a history of substance use to address health, employment, housing, and other legal and logistical needs. Such interventions, often referred to as medical-legal partnerships, exist across the United States and serve varying populations such as cancer patients, families with children, and veterans. In New York and Connecticut, for instance, medical-legal partnerships that had legal professionals embedded in hospitals showed positive physical and mental health and legal outcomes for veterans (Tsai et al., Lastly, study findings indicate the need for a patient-centered collaboration between all three stakeholder groups that encourages patient/client and medical and legal service provider input and communication. Like participants in Rozanova et al.’s  qualitatThe current study is not without limitations. First, patients/clients interviewed in the community were already linked with HIV and/or reentry services. Additional inquiry is required to examine the viewpoints of those not yet received into such supportive environments. Additionally, the purposive sample was diverse with respect to the roles that people had rather than their race, gender, and ethnicity. Though roughly half of interviewees were female, all patients/clients identified as male, reflecting the male majority seen in the local jail population and justice-involved settings at large. Capturing data from a more racially and ethnically diverse group that includes justice-involved women may help create a more complete picture of the reentry experience for people living with HIV and substance use disorder and inform a richer intervention. Despite these limitations, our findings suggest a clear necessity for collaborative, multi-sectoral, co-located service provision that addresses psychosocial and logistical needs.This study aimed to highlight perspectives of a variety of stakeholders - individuals recently released from incarceration living with HIV and SUD and the medical and legal providers who serve them - in hopes of informing a community health worker reentry intervention. The results of this qualitative study support and extend existing literature documenting the barriers and facilitators to successful reentry. Our findings underscore the notion that a successful reentry intervention includes an individualized, longitudinal approach which incorporates psychosocial needs, involves a medical-legal partnership, and focuses on establishing self-sufficiency.


Rural, remote, northern, and Indigenous communities on Turtle Island are routinely—as Cree Elder Willie Ermine says—pathologized. Social science and health scholarship, including scholarship by geographers, often constructs Indigenous human and physical geographies as unhealthy, diseased, vulnerable, and undergoing extraction. These constructions are not inaccurate: peoples and places beyond urban metropoles on Turtle Island live with higher burdens of poor health; Indigenous peoples face systemic violence and racism in colonial landscapes; rural, remote, northern, and Indigenous geographies are sites of industrial incursions; and many rural and remote geographies remain challenging for diverse Indigenous peoples. What, however, are the consequences of imagining and constructing people and places as “sick”? Constructions of “sick” geographies fulfill and extend settler (often European white) colonial narratives about othered geographies. Rural, remote, northern, and Indigenous geographies are discursively “mined” for narratives of sickness. This mining upholds a sense of health and wellness in southern, urban, Euro‐white‐settler imaginations. Drawing from multi‐year, relationship‐based, cross‐disciplinary qualitative community‐informed experiences, and anchored in feminist, anti‐colonial, and anti‐racist methodologies that guided creative and humanities‐informed stories, this paper concludes with different stories. It unsettles settler‐colonial powers reliant on constructing narratives about sickness in others and consequently reframes conversations about Indigenous well‐being and the environment. Myriad discourses converge to produce rural, remote, northern, and Indigenous geographies as pathologized spaces.Pathologizing rural, remote, northern, and Indigenous geographies leads to people and places being susceptible to discursive mining.New and different stories must be created and told about rural, remote, northern, and Indigenous geographies. We  live, learn, work, love, mourn, and play across the messy complex geographies of so‐called northern British Columbia (BC). Northern BC is an area governed and stewarded for many thousands of years by 17 overlapping First Nations and, today, it is the home of close to 47,200 First Nation people representing 35.6% of the province's First Nations population . Thousands of Métis and non‐status Indigenous peoples share these same geographies. We all live, learn, work, love, mourn, and play across watersheds and mountain ranges that, if mapped in ways more consistent with settler‐imaginaries , is equal in size to France, that nation with such a long colonial relationship to the country now known to so many as Canada. We also all live, learn, work, love, mourn, and play together, every day, with an ever‐present “background noise” of news accounts about fracking, clear‐cut logging, open‐pit mining, oil and gas pipelines, forest fires, and salmon stock depletion. We live to the sounds of 18‐wheel trucks hauling logs from pine‐beetle‐killed trees mingling with broadcasts about missing and murdered Indigenous women and girls. We awake to social media pings about high crime rates and poor health outcomes, and we go to work amongst announcements about brand new research initiatives discovering new disparities in the communities we know as home.While some of us are Indigenous to the lands of so‐called northern BC, with kinship lines that extend back into time immemorial, others of us are Indigenous from other parts of Turtle Island. Some of us are non‐Indigenous settler folx. Not all of us who are non‐Indigenous are white, which is important because we observe that, often, a moniker of “non‐Indigenous” or “settler” is automatically taken to mean white and of European descent. Which, to be clear, a number of us are. We are not all academics or researchers. We are varied in age as well as in sexual and gender orientation. We do not always agree on all things, but together we work on many things. In other words, we are a diverse group of people—a diversity reflective in many ways of the socio‐cultural and physical geographies that comprise the present‐day states of coloniality that are northern BC (and beyond).together—as opposed, for instance, to the story being authored only by people Indigenous to northern BC—we are taking a geographically specific anti‐colonial stance against colonial modalities that insist on dualities and opposition and do not recognize complexity and slippery intersectionality  a kind of wellness narrative—a sense of being healthy. This wellness narrative and sense of well‐being is based on being at a conceptual and territorial distance from what is imagined to be, and storied as, the inherently lesser, if not downright diseased and toxic, geographies of rural, remote, northern, and Indigenous geographies. This contention is at the heart of our paper, a paper that is also engaging a larger theme of Indigenous peoples and the environment. We are fundamentally asking why, when we speak to  people about where we live in rural remote northern geographies, are we so often met with confused looks of semi‐disapproval? Why, when we look around the disciplines of (for instance) geography, medicine, or health sciences, are we inevitably met with research that seems to suggest the environments where we live are sick and toxic (deficit‐based) places? Why are our homescape environments so often rendered as ugly, exploited, unhealthy, damaged, emptied, or under threat? What, we wonder in this paper, are the implications of some environments being consistently This paper, in efforts to re‐story the geographies of northern BC, is itself and like so much scholarship, in many ways a story. While Indigenous peoples have an immeasurably long history of storywork and storytelling, the discipline of geography is also historied by story and, increasingly, is turning to stories as geographic method and methodology  and ontologies  are co‐constitutive. In other words, what is thought about and written about “stuff” (like rivers and rocks and bodies and diseases) is actually, in great part, what that “stuff” is. King  cautionsge” Tuck , which wge” Tuck , 415 empTuck , 417 conWhere does this theory come from? What is the context? How was it generated? Who generated it? How is it useful in the context of my own [Indigenous] people? Can [we] use it in an ethical and appropriate way (my ethics and theirs) given the colonial context within which scholarship and publishing take place?Simpson , 63The inherently critical, anti‐colonial, and feminist methodological framing of research and knowledge production of the three premises that underlay this paper are also deeply informed by Nishnaabeg scholar Leanne Betasamosake Simpson. Simpson  has receunderpinnings of research but, instead, are entire structures of thoughts and beliefs that define all aspects of the world. To again echo Million  about stories, environment, ecology, and health for Indigenous peoples means taking to heart the idea that theories systematize and structure understandings about each of these concepts. Health, Indigenous peoples (and settlers), and the ecologies in which life unfolds are impacted by the stories that circulate about them. The very separation of health from ecology is partly anchored in actions of theories and theoretical frameworks, in this case, colonial (mostly Euro‐white) ways of defining the world that conceptualize lands and waters—remember these are Richmond , 128 poiRichmond  eloquentWith reference to the theme of Indigenous people's health and the environment (or ecologies and geographies), we now turn to various ways that knowledge is made about rural, remote, and Indigenous geographies in northern BC. To be clear, we are not seeking to tell Indigenous stories. We are, however, seeking to reveal how stories about the health of lands, waters, and peoples on unceded Indigenous territories in what is now referred to as northern BC create a narrative about peoples and places—what Ermine  has termTreaty 8), are un‐treaty‐ed, unceded lands, not all Indigenous geographies in northern BC are rural or remote. While it is impossible to fully parse apart the northern from the rural from the Indigenous when considering geographies of BC beyond the 50th parallel, it remains important to understand there are a series of intersectional and interconnecting considerations at play across northern BC and thus also at play as contexts to our conversations. These complex relationalities also mean we are acutely aware of gradations of power forming and informing the geographies about which we write and within which we live, learn, work, love, mourn, and play. While recognizing it is impossible to generalize our discussion across genders, abilities, class, sexual orientations, racializations, locations, stages of life, etcetera, we survey the influential literatures and research about Indigenous peoples, after which we move into scholarship and narratives about northern, rural, and remote geographies. We will chart broad patterns and ask: Who do these patterns serve and what structures of power do they uphold?We must be clear about a few details. While all of northern BC, with some small exceptions where treaties have been negotiated  point to similar concerns, asserting that:Davis and Todd  align wiWastelanding by Traci Voyles  narrative to be written. This narrative is one that we argue allows for pathologized narratives to be re‐inscribed—re‐storied onto northern places. Those writing about and busily creating this distance do so both literally and morally. Indeed, re‐inscribing distance through not seeing themselves/ourselves as culprits of the colonial present is deeply characteristic of settler colonialism, and of the extractive relations that are perceived as the sole economic drivers of northern BC. Speaking to the settler colonial contexts in the United States, Whyte  elaboratThe “gifts” provided by settler ancestors—ancestors to many of the authors of this paper—make way for lands, lives, and territories to be re‐inscribed. These gifts also include a sense of what constitutes “good” health, including how humans should relate to lands and what decisions must be made that concern health. The gifts about which Whyte writes ultimately narrow and restrict expressions of well‐being, rendering both giver and receiver of said gifts as ultimately both unrecognizable and unaccountable. As long as (mostly white) settler‐geographers write about rural, remote, northern, and Indigenous geographies  as toxic unhealthy places—both ecologically and socio‐culturally—they never need to see themselves/ourselves as part of the issue, as tied to a “gift” that constantly allows for the gift of distance and neutrality to be made invisible. As inheritors of the gift, we're/they're always more likely to be healthy, to be not(as)toxic.Such distancing is necessary for colonial logics; it also buttresses racial capitalism at work in our communities. Writing from settler‐colonial, capitalist United States, Laura Pulido shows how the targeted geographical practices of waste are located in the very logic of racial capitalism. Pulido  asserts,is Indigenous theory, and how the power of Indigenous narratives creates meaning by and for peoples in self‐determined ways:Narratives seek inclusion; they seek the nooks and crannies of experiences filling cracks and restoring order. Narratives lay boundaries. Narratives give orphans homes. Narratives both make links and are the links that have been made. Narratives are our desire to link one paradigmatic will to knowledge to discursive and material projects that have consequences. Narratives serve the same function as any theory, in that they are practical vision….The felt experience of Indigenous experience in these Americas is in our narratives and that has made them almost unrecognizable to a Western scholarship that imagines itself objective.Million , 35Million  exploresTo what end—and for what purposes—do often white‐geographical narratives that bring the “gift” of good health inscribe distancing and re‐inscribe sickness? Can Western scholarship unpack its conception and distancing of “healthy” when health in faraway places is steeped in colonial narratives? We are inspired by Million's words here to critically look at how our research props up narratives of “healthy.” Indeed, following Million, we now shift to explore how communities and health care practitioners from Indigenous communities in northern BC are re‐narrating health and healing to re‐story northern geographies.Close your eyes. Imagine gatherings around kitchen tables. There are cans of salmon and slabs of fresh halibut. There is laughter and at least four generations of family. People are telling stories and laughing. There is a lot of laughter.Luu amhl goodi'y win gya'an allows a nurse, social worker, or doctor to say, “I am happy to see you” to a patient while Hindahl wila win? asks, “How are you?” The booklets also contain words for places and feelings, for spiritual prayers and offerings—as resources, the booklets inherently link health to place, language, and culture. They are also testaments of strength. Of living health. The booklets were the dreams and work of the Northwest Aboriginal/Indigenous Health Improvement Committee, itself an outcome of a health authority  that was the first in Canada to appoint an Indigenous woman as Vice President of Indigenous Health. When the booklets were launched in 2017 and 2018, a gathering of more than 150 people from across northern BC laughed in unison as we learned the Gitxsan word for “butt.” Say it loudly and together, a Gitxsan Elder encouraged us: Ts'im bok’! Ts'im bok’! Humour and laughter abounded, both felt to be medicines unto themselves.Close your eyes again and try to imagine something else. Imagine two booklets, each one only slightly larger than the palm of your hand. The cover of one is a cacophony of red and black, soft, tanned, leather‐clad feet carefully stepping forward toward you from a frame of swishing white tassels and the telltale ovoids of northwest coast Indigenous iconography (a language unto itself). The cover of the other booklet is a silvered, cedar totem face, a wise but somehow utterly inviting gaze, calling out to any reader. The booklets are offered as gifts to future and current health care providers in northern BC, with the caveat of “don't get discouraged, we are here to help you [learn our language]”  from northern BC joined by a Lheidli T'enneh Nation singer/songwriter, a Filipino hip hop artist and mental health advocate, and a kendama performer extraordinaire. Conjure an evening of performances about healthy environments and communities, with youth taking part in a friendship dance, trying their hands at the kendama, and collectively keeping the beat for performers during two hours of events all speaking about relationships to land and water during times of resource extraction. Youth wrote poems and identified what they saw as the strengths, challenges, and priorities for their community through hands‐on exercises and sharing circles  who are working with local Divisions of Family Practice to undertake everything from reconciliation training in hospital and emergency wards to running arts‐based health groups in remote First Nations who do not have a dedicated physician. Or what about the more than 50 undergraduate medical students training in northern BC, who, as part of the Truth and Reconciliation Committee's Calls to Action and commitments to the United Nations Declaration on the Rights of Indigenous Peoples, are annually placed in very remote northern First Nations for extended experiential community‐based learning programing? What about stories as counter‐narratives, stories that are the sharing of Indigenous and settler engagements with watersheds in northern BC, in ways that highlight ongoing relationships and collective efforts focused on connections of land, water, health, and well‐being  geographer settlers write about rural, remote, northern, and Indigenous geographies (in for instance northern BC) as toxic unhealthy places—both ecologically and socio‐culturally—we (mostly white settler geographers) never need to really see themselves/ourselves as actively and right now part of the issue. As we've pointed out earlier in this paper, we're/they're always healthy and not (as) toxic. We're able to distance ourselves from a colonial present that, of course, we are deeply and intimately implicated within and complicit in perpetuating.We suspect it is a certain kind of colonial corporate conceit to suggest clear answers and tidy conclusions. Let it be known and clearly stated, then, that we remain firmly rooted in a sense of uncertainty and humble confusion. We do not want stories about the challenges and difficulties and illnesses of rural, remote, northern, and Indigenous geographies to simply cease. Rather, what we are calling for is a surfacing, an awareness of, and a realization that distancing one's self, through critique and counter‐narrative constructions of people and places (geographies), might ultimately be re‐inscribing of  coloniality. This distancing, this constant attention to sickness and pathology and toxicity and extraction, never demands that those (of us) who are busily producing distance and finding problems actively see and understand them/ourselves as culprits in the colonial present. Instead, we get to be objective, neutral, What might be needed, ultimately, is an intensely reflective effort at balance, at an always unsettling of how and what we write. Different stories need to be told. Stories need to be told different ways. Different people need to tell stories. New narratives need to be imagined and given space. Perhaps the best place to start is with the land and the water: they are never static, never unchanging. If health and well‐being are linked to the strength of ecology and environment, if medicine is story and story always rests in place, perhaps it is time to speak and learn stories of and in place. Perhaps it is the time (and place) to stop mining lands and waters and ecologies and environments of rural, remote, northern, and Indigenous geographies for stories of pathology. Perhaps, instead, new stories can be centred, stories focused on geographies of health and well‐being.


We particularly highlight the roles of: historical precedent; the management of risk, workload, and cost; institutional and professional identities; and research design in constituting A(SP)A's edges. In doing so, we demonstrate the importance of paying attention to how, in practice, animal law requires a careful balance between adhering to legal paragraphs and allowing for discretion. This in turn has real-world implications for what and how science is done, who does it, and how animals are used in its service.This paper explores how the boundaries of the UK's Animals (Scientific Procedures) Act (A(SP)A) are constituted, as illustrative of the rising importance of legal procedures around animal research and how these are continuously being challenged and questioned. Drawing on empirical work in animal research communities, we consider how it is decided whether activities are undertaken for an “experimental or other scientific purpose”. We do this by focusing on “edge cases”, where debates occur about whether to include an activity within A(SP)A's remit. We demonstrate that the boundaries of animal research regulation in the UK are products of past and present decisions, dependencies, and social relationships. Boundaries are therefore not clear-cut and fixed, but rather flexible and changing  •UK animal research law covers activities done for “an experimental or other scientific purpose”.•Whether this criterion is met is debated at “edge cases”.•Examples: medicine production, wildlife tracking, fisheries and veterinary clinical research.•Legal boundaries flexible, shaped by past/present decisions and social relationships.•Key factors: precedent, risk/workload/cost management, identity, study design. We are To do this, we focus on the UK's A(SP)A, which is regulated by a specialised unit within the UK's Home Office: the Animals in Science Regulation Unit (ASRU). To require an A(SP)A licence, an activity must be: (i) performed on a “protected animal”, i.e. living vertebrates and cephalopods beyond a certain stage of development; (ii) be judged to meet the “lower threshold”, defined as causing the animal “a level of pain, suffering, distress or lasting harm equivalent to, or higher than, that caused by inserting a hypodermic needle according to good veterinary practice” , p. 10; It is important to note that the question of whether an animal research project falls within A(SP)A's remit and therefore requires licensing under the Act does not normally arise. Biomedical research using mice, for example, generally requires an A(SP)A licence even if certain parts of the research process (e.g. posthumous tissue collection) are not directly regulated under the Act. However, in some cases researchers do need to ask whether their work requires an A(SP)A licence at all. This question arises in what we term “edge cases”, which most commonly emerge when scientific research closely resembles, relates to, and/or is intermingled with activities that challenge particular, canonical views of “science”. Examples include activities that straddle the border between research and manufacture of medicines, such as the production and testing of medicinal antibodies. Edge cases also arise in settings where there is a fine line between research and activities that are excluded from A(SP)A's remit, such as animal husbandry , veterinary treatment , and identification (in the case of tagging wildlife). We draw on all of these examples to our make our case.borderlands. Drawing on Exploring how A(SP)A's boundaries are drawn is an important task because it illustrates how the interpretation and application of legal procedures has real-world implications for animal research and welfare, in terms of what and how science is done, who does it, and how animals are used in its service within the UK. In this way, the UK A(SP)A case speaks to issues around animal research law in other contexts, for example in Sweden where the legal boundary between research and animal husbandry is similarly complex . We demoAfter describing our methodology, we explore five key factors that emerged from our empirical research as important in constituting A(SP)A's boundaries. First, in section 2The Animal Research Nexus . Central goals of AnNex, and of this paper, are to explore how past and present factors have shaped the social contract around animal research in the UK, and to better understand emerging challenges and issues in the regulation and practice of animal research. This paper draws primarily on data and insights derived from one sub-strand of AnNex, which focuses on social, ethical, and regulatory issues arising when A(SP)A steps out of the laboratory and into various kinds of “field”, such as wildlife field sites, veterinary clinics, farms, fisheries, and zoos.This paper is based on qualitative research within animal research communities in the UK, undertaken as part of an interdisciplinary, collaborative research project titled This study adopted a mixed-methods approach, involving in-depth interviews, participant-observation, and documentary analysis, including analysis of historical sources. We undertook semi-structured interviews with 30 individuals, including researchers, vets, animal welfare advocates, and regulators, and an additional 24 lengthy informal conversations with others. The majority  of conversations were with researchers, while 10 (19%) were with regulators,Due to the sensitive nature of the topic, we have adopted a policy of pseudonymisation and de-contextualisation to ensure privacy of participants. All interviews were conducted with written consent from participants. This research was granted ethical approval by the Central University Research Ethics Committee of the University of Oxford (Reference Number: SOGE 18A-7).3The first feature that we propose shapes A(SP)A's boundaries is historical precedent, by which we mean past decisions about difficult and “edge” cases. Yet, as we demonstrate, decisions made in the past are not immutable. Judgements always need to be made about how precedents relate to new cases, and precedents may be challenged according to changing contexts and views about animal research and its regulation. We discuss the importance of precedent using the example of the production and testing of medicinal antibodies, which provoked discussion about the legal definition of an “experiment” in the 19th century.Because it is their job to oversee the implementation of A(SP)A, Home Office inspectors (HOIs) are central to deciding which activities involving animals fall within the remit of the legislation. Indeed, it is a common refrain amongst researchers that “it depends on your inspector” whether marginal projects are deemed to require an A(SP)A licence, implying that decisions can feel arbitrary and subjective. Like many laws, A(SP)A is designed to allow inspectors to apply a degree of judgement based on their “administrative knowledge” derived from passed-down knowledge from other inspectors, job-based customary norms, and intuition , p. 53. raising antitoxins, by injecting diphtheria toxin into horses or donkeys to make them immune and then extracting their blood to create antitoxin medicine, and testing antitoxins by injecting small rodents with the antitoxin medicine to test efficacy and safety. The CAA specified that any “experiment must be performed with a view to the advancement by new discovery of physiological knowledge or of knowledge which will be useful for saving or prolonging life or alleviating suffering” (3(1)). The production and testing of medicines were borderline in this respect, since they “cross the conventional boundaries between science, regulation, and industrial innovation”, much like “regulatory” or “mandated” science A's boundaries. For example, raising of antitoxins – i.e. extracting the blood of horses and donkeys that had been made immune to diptheria – did not fall under the CAA because it was “not for ascertaining of a scientific truth” (p.6). In 1895 they also concluded that testing antitoxins by injecting small rodents also fell outside of the CAA. However, this opinion was reversed a few months later, at which point the Officers concluded that while raising antitoxins was not an experiment “because it was done to produce a particular, specified substance and not for scientific enlightenment”, testing did count as an experiment under the CAA “as the Act did not specify that it applied only to work for the advancement of knowledge” (p.7).Initially in 1879, and again in 1894, the Law Officers for the Crown of Opinion concluded that the No new knowledge is gained from the preparation of vaccines by the infecting of an animal with a micro-organism; so this is not regarded as an experiment. But the testing of vaccines on animals, for potency and safety, is an experiment. , p. 19.It would seem that this verdict stuck, and similar decisions were made regarding more modern forms of similar work, such as the production and testing of vaccines using animals. Thus, in 1979–1980 when the Laboratory Animals Protection Bill (a precursor Bill to A(SP)A) was reviewed by a select committee within the House of Lords, the Committee observed that under the CAA.However, this established precedent was contested by four groups that presented evidence to the Committee. The Royal Society, Research Defence Society, British Veterinary Association, and the Home Office itself all objected to the narrow interpretation of “experiment” within the CAA and argued for its expansion under the new law. All four groups explicitly mentioned the use of animals for culturing viruses and parasites, or producing immune sera for medicine production, as examples of unregulated practices that they believed should be regulated under the new law because these practices can lead to animal suffering. The Home Office's argument for this proposal was that such unregulated activities “may nevertheless involve discomfort to the animal and it is arguable that such activities should be covered by legislation so that the animals are protected by it” (experiments may have directly shaped A(SP)A's wording and scope. This meant that while for a time the precedent established in the late 19th century – that producing medicinal antibodies is not regulated, but testing antibodies is regulated – held, this was later challenged and reversed on the grounds that producing antibodies can significantly harm animals. In other words, growing concerns about animal welfare, in the late 1970s and early ‘80s particularly, prompted subtle changes in the scope of animal research law, leading to a broadening out of what could be understood as “science” for legal purposes.Today, “the development, manufacture or testing of the quality, effectiveness and safety of drugs” and other substances – undertaken for several specified purposes such as disease prevention and treatment – is identified as a “permissible purpose” under A(SP)A , p. 43. 4all work that we might describe as “regulatory compliance testing” is regulated under A(SP)A. For example, routine batch testing of vaccines for both veterinary and human drugs is covered by A(SP)A A , but they A(SP)A . In conty A(SP)A . Furthery A(SP)A  attractey A(SP)A . This exIt depends what people are doing as to how high risk it's deemed to be. […] Badgers are a public concern, there's been a lot of controversy about those projects, so they are likely to be inspected more frequently than the general project that goes on in an establishment. [… On] the other end of the scale, there are people who are doing conservation work on species that perhaps are not so high in the public consciousness and so the relative risk for the minister then is lower than it would otherwise be. They're trying to preserve the species, [and] the likelihood of them doing anything wrong, because of that main concept, is lower. [For example] they may only be, […] capturing them to measure them.Two main kinds of risk would appear to be relevant to decisions about whether routine compliance testing and other borderline activities are counted under A(SP)A. First, there is risk to the animals themselves, as raised for example by the Home Office in its submission to the House of Lords Select Committee  and internationally. While there has clearly been a push towards risk-based regulation within UK civil service generally, uptake of such policies across departments is variable, and how they are implemented depends on specific institutional contexts and histories . As DemeIn this context, some of our research participants identified a lack of appetite within the Home Office to extend A(SP)A into perceived low-risk areas, such as the capture and marking of wildlife by citizen scientists. Capture of wildlife is not counted as a procedure under A(SP)A, even when it is undertaken for science, although A(SP)A guidance does allow for some oversight of trapping A in secret, you can't have a secret Home Office licence. It would be known – there would be ways of getting that from an organisation, and from a PR point of view most zoos wouldn't risk doing that. Risk management, particularly risks of bad publicity directed at institutions, also plays a role in how researchers interact with the borders of A(SP)A, and in particular whether they are incentivised to avoid or embrace undertaking work that would require regulation under the Act. For example, Emma – a professional who was involved in overseeing UK zoo research for about 20 years – when asked how many A(SP)A licences she thinks are held by UK zoos – responded:Emma noted that a key issue is that “[i]f you say ‘animal research’ people think bad stuff”, meaning that “if some anti-zoo lobby – of which there are many, and we have to be very wary all the time – published a list of zoos that have an animal research licence, it'd be very difficult to counter that negative PR”. Similarly, However, avoiding A(SP)A-licenced research can create problems for zoos too, since one of the ways zoos have sought to establish legitimacy as conservation institutions has been to emphasise their role in research . Indeed,Meanwhile, we heard from others that they have secured A(SP)A licences for somewhat borderline activities that arguably don't require licensing, as part of their institutions' efforts to appear – in the words of one wildlife researcher – “whiter than white” . In a sense, such institutions are, like zoos, managing their relationship with A(SP)A based on public image and risk management. While zoos view securing A(SP)A licences as a risk to their public image, well-regarded universities and government institutions may be more concerned about appearing to be, in the words of wildlife researcher Hugh, “exemplars of good practice, and that means not only are you doing it as well as you can but you need to be seen to be doing it perfectly well” . In part this is about managing reputational risk, considered increasingly important in managing not only government bodies but also research universities , and in 5they [the Home Office] don't want to do that [including trapping and collaring wildlife under A(SP)A] because then that has such a huge – which I can understand – that then has such a huge implication across the board on local mammal groups and all this kind of thing. .As we have seen, regulators may be incentivised to avoid drawing perceived low-risk activities (such as the capture and tagging of wildlife) into the remit of A(SP)A, given efforts to focus on activities most likely to attract criticism. An additional reason to avoid bringing such activities under A(SP)A is workload and cost management, for both regulators and researchers. Wildlife researcher Genevieve reflected that although, in her view, trapping an animal and putting a collar on it involves sufficient harms to animal welfare to be regulated under A(SP)A,Awareness of this concern is longstanding. In a supplementary memorandum submitted during the House of Lords Select Committee hearings leading up to A(SP)A, the Department of Education and Science stated: “if bird-ringing were to be included as a licensable procedure, there are at present 2200 ringers, each operating on average at four sites” , p. 239.it's just become too expensive, too time consuming […] I just thought it's not worth it. So I've compromised. But I genuinely think there are some important questions that I'm not addressing because of that. .Researchers themselves actually often described a desire to steer clear of A(SP)A licensing if at all possible, due to the large investment of time and resources that this requires. Wildlife researchers regularly complained about the large number of permits, from a wide array of different institutions, required to undertake their research A-licenced research is an extreme case, other researchers spoke of avoiding AS(P)A by modifying their project design to make it clearly sub-threshold, or abandoning projects altogether. Participants also occasionally expressed concern that some researchers may avoid A(SP)A via more devious means, such as by exploiting loopholes, though no participants described doing this themselves.There is therefore an incentive for wildlife researchers to avoid undertaking work that requires an A(SP)A licence if possible. Thus, contrary to 6it's just amazingly complicated and bureaucratic, and they [zoos] just don't have the resources to manage it. I've been on ethics committee for [a company], which was a big lab […] and their ethics committee is entirely about reviewing the Home Office licences. The paperwork is … Most zoos do not have the resources to manage that.The incentive to avoid A(SP)A licensing may be even stronger for non-university researchers – such as citizen scientists and those based in zoos and teaching-focused agricultural colleges – since their institution  would be unable or unwilling to secure a licence due to cost and a lack of institutional expertise. For example, Calum, who is involved in the capture and tracking of birds, argued that requiring A(SP)A licences for such work “would scupper most of it” due to the difficulty of securing licences for citizen scientists . Similarly, in explaining why zoos avoid doing research that would require an A(SP)A licence, Emma noted thatThus, researchers linked their sense of being able to secure A(SP)A licences to their institution's resources and familiarity with the “knowledge format” of the A(SP)A licence application .management, the latter being excluded from A(SP)A. Heather described a “rule of thumb” for distinguishing research and management as “it's not about what you do, it's about the fact that you have a plan”: “so if you have a plan about what you're doing depending on the results, it's probably fisheries [management] because you've got an action plan and you know what you're going to do.” For example, if you are validating a model about how to manage river systems, a pertinent question is: “are you managing similar river systems from your information?” If the answer is genuinely yes then “that is still management”, whereas “[i]f you haven”t built that model yet, if you are validating that model, it's science”. This distinction means that if a model becomes sufficiently validated that it is used as a foundation for management plans it can move from being A(SP)A-regulated research to fisheries management. However, Heather acknowledged that fisheries managers might not be aware of this distinction and therefore might not realise that they are doing science, noting that “I would have guessed that two thirds of fisheries trusts didn't even know the Home Office [ASRU] existed”. However, she pointed out that this is “not a problem with A(SP)A” per se, but rather of ignorance among fisheries managers, potentially at an institutional level. While arguably fisheries managers  have a “duty to know” about A(SP)A and its definition of research  may also have another important effect, namely whether researchers are even aware of A(SP)A's existence and scope. Many participants reflected that potentially only certain groups are aware of the law and therefore think to “ask the question” about whether they need an A(SP)A licence. As summarised by wildlife researcher Genevieve, “I think if you worked in a group which didn't have licences you probably wouldn't ask the question”. The Home Office is clearly aware of this risk. For example, former HOI Heather explained that there is a fine line between fisheries research and research , in pracThe importance of institutional knowledge is demonstrated by the key regulatory role played by local Animal Welfare Ethical Review Bodies (AWERBs): legally mandated committees with a number of specified tasks and membership requirements. AWERBs are widely acknowledged to be crucial in deciding what research is licensed, because they are tasked with advising establishment licence holders whether to support or reject project proposals before they are sent on to the Home Office . AWERBs emphasis added):you're doing it for a different purpose now, you're not benefiting the animals by taking this sample therefore you need to apply all these other rules,” and they just kind of roll their eyes at you and say, “Hmm.” vets get confused at the interface between veterinary clinical practice and veterinary research, and they say, “Well we're just taking a blood sample, I do that every day of the week.” I'm saying, “Ah In addition to institutional knowledge, the related matter of professional identity was often highlighted as leading to inadvertent self-exclusions from A(SP)A. For example, former inspector Colin – himself a vet by training – proposed that vets may struggle to distinguish recognised veterinary practice (RVP), which is excluded from A(SP)A, and research A, “so that when they come out, if nothing else they ask the question”. Colin here speaks of the risk that professional identity might shape how people think about whether their work counts as “science”. Similarly, zoo researcher Emma suggested that “my general impression of vets is that they feel they're allowed to do stuff because they're vets”. In other words, there is a worry that vets assume they are doing RVP, or otherwise working under the Veterinary Surgeons Act (1966), simply because of their profession. Meanwhile, former HOI Heather suggested that you might have “interested marine biologists who have gone to work for a fisheries trust” who also don't think to ask about regulation, because they have come to think of themselves as involved in fisheries management.purpose and profession, while A(SP)A is intended to consider only the former. This slippage was conveyed by university-based fish researcher Evan, who referenced his identity as a scientist and the activities he was undertaking to some extent interchangeably:So my interpretation, which might be wrong, is that if the procedure's happening anyway, so if a fisheries manager or shepherd or whatever, is dealing with animals and doing something to them and you're simply standing there collecting the data, then that wouldn't be A(SP)A. But if the only reason it's happening is because you're doing some experiment or you as a scientist … Especially, I've been told that, you know, well you're from a university therefore it must be science. You're not doing it for husbandry reasons. In other words, participants sometimes suggested that there is a tendency to conflate purpose, profession also indirectly comes into assessments about licensing: given that he works for a university, how could anything he does not be science? Thus, the shared identity of scientists – marked by things like formalised training, shared publication in specialised journals, and location in specific institutions – and similar identities developed in other professions such as among vets, could potentially result in people involved in edge cases including or excluding themselves from A(SP)A.Evan indicates that while he is well aware of A(SP)A's focus on scientific 7While earlier sections identified reasons why researchers might want to avoid their work being under A(SP)A, in other cases an A(SP)A licence was seen to confer advantage. We saw this, for example, in cases where highly-regarded research universities and government institutions secured A(SP)A licences for projects that arguably didn't require this as a way of managing reputational risk. In addition, some researchers spoke of A(SP)A licences as a mark of credibility and reliability. For example, veterinary clinical researcher Charles observed that not only does going through A(SP)A licensing help ensure that he feels “confident that we're […] doing the right thing by people and the patients”, but it also provides a mark of credibility for drug companies seeking to undertake clinical trials. Comparing the regulatory ease of conducting veterinary clinical trials in the US and the UK, Charles reflected that “it is easier to do these things in the States but do you know, I think pound for pound you get more bang for your buck in the UK” .good science, which is considered sufficiently likely to reveal important information that harms to animals are considered justified. Thus, insufficiently rigorous studies should (in principle) fail the harm-benefit analysis, and on these grounds be declined A(SP)A licences. Consequently, despite the focus on “scientific purpose” embedded in A(SP)A, ideas about methodological rigour are also a part of how the borders of A(SP)A are established.Thus, working under A(SP)A can confer an impression of work as methodologically rigorous. This impression may derive from the fact that A(SP)A is in many ways concerned with scientific method and research design. The harm-benefit analysis, which is central to A(SP)A's process, requires assessing benefits of research. This assessment in turn involves screening for research integrity and good experimental design . In otheSo for instance, if you have a single case – so a dog that is sick – and you want to perform a procedure on it that has never been done in a dog before, that has been done in a human before, and you may have good reason to believe that it would be successful in that dog, that's an experimental procedure. It is not recognised veterinary practice, because it's never been done in a dog before. So it can't be done under RVP, but it can't be done under A(SP)A [either] because it's not for a scientific purpose. HOIs might even decide that methods are so poor that the work cannot count as “science”. This idea very often came up with reference to experimental or highly novel veterinary treatments, which sit in a grey area between science and RVP because they are ideally intended to simultaneously advance the science of veterinary medicine (and perhaps human medicine), and have therapeutic benefit for the animal patient/research subject . The proSo some of these things are not able to be regulated under A(SP)A because they're not actually science, because actually if you put them forward as an inspector I would have bumped it and said, “Your science is too poor, I'm not going to let you do it.”Indeed, former HOI Heather confirmed that from the Home Office's perspective such work does not count as scientific research, due to the lack of rigour and scientific outputs:Thus, according to Heather such research might potentially be allowed to proceed under the Veterinary Surgeons Act, but it “couldn't go in the research bucket because this is not proper research”. Thus, experimental design (or the lack thereof) is considered in deciding which projects fall within A(SP)A's remit.Home Office countered by arguing that there was sufficient support to believe this would benefit individual animals, meaning the project should fall under RVP. Eventually, the researcher was permitted to proceed with his work under RVP. He reflected that while he is certainly happy that the situation was resolved and he was able to proceed, he would have liked to make the project more “scientific” by increasing the sample size through more active recruitment and soliciting peer review, but has been to some extent prevented from doing so by the project's classification as veterinary treatment rather than science. Thus, research design can play a role in shaping A(SP)A's borders with RVP, in that rigorous methods are required for securing an A(SP)A licence, and in turn work classified as RVP assumes – and perhaps demands – less rigorous methods.The relationship can potentially also go in the opposite direction. An example of this came up during an extended informal conversation with a veterinary clinical researcher who was performing a novel treatment on companion animals . As he articulated, his work falls into a grey area because it is intended for the animal's benefit, but it is also novel, and he is hoping to build material for publication based on a series of cases. While his institution's ethics board proposed that it should be okay to conduct the project under RVP, the Royal College of Veterinary Surgeons (RCVS), which is responsible for defining RVP, indicated that he should approach the Home Office as it would probably fall under A(SP)A. After requesting to view the researcher's evidence for thinking the treatment would work, the 8As we have argued, the boundaries of UK animal research law are shaped by historical precedent; risk, workload, and cost management; institutional and professional identity; and research design and perceptions of methodological rigour. Historical precedent, as we demonstrated in section not securing A(SP)A licences for “edge cases”, as with highly regarded universities and government research institutions. They may also be concerned about workload and cost, with the process of securing A(SP)A licences regularly described as expensive, challenging, and time-consuming. Researchers may also believe that their institution lacks the experience and knowledge required to successfully apply for A(SP)A licences. In some cases, researchers and their institutions may even be unaware of the existence and remit of A(SP)A, potentially leading to unintentional self-exclusions. Despite these disincentives to conduct work under A(SP)A, researchers in other cases saw an A(SP)A licence as a sign of methodological rigour and high standards. On the other hand, the potential to undertake experimental work might suffer if researchers' work is classified by regulators as non-scientific, illustrating that research design and perceptions of methodological rigour play a role in shaping A(SP)A's borders.Meanwhile, researchers may be concerned about negative public attention from either securing A(SP)A licences (as in the case of zoos) or from Thus, the borders of A(SP)A – and particularly the meaning of “experimental or other scientific purpose”, which has been our focus in this paper – are constituted flexibly by past and present actors, who are incentivised to include and exclude certain practices from the scope of animal research law. We do not point out this flexibility simply to identify a contradiction in the application of A(SP)A; that A(SP)A can be flexibly applied to meet on-the-ground challenges is one of its great strengths. It is therefore more useful to think of the boundary between regulated and non-regulated work under A(SP)A as less of a firm line that can be easily (or even uneasily) drawn, but more as a regulatory borderland. Within this borderland, researchers, regulators, and others involved in animal work can adapt – or “tailor”  – their We suggest that the constitution of A(SP)A's edges, and in particular how “science” is understood and used to define the Act's remit, demonstrates the importance of paying attention to the ways in which legal procedures shape what and how science is done, who does it, and how animals are used in its service. As we have seen, researchers say they often avoid doing certain kinds of studies that they believe would be important or interesting because of a perceived difficulty in getting A(SP)A licencing. Wildlife researcher Graham, for example, explicitly stated that “there are some important questions that I'm not addressing” due to his reluctance to work under A(SP)A. It could be debated whether this is a positive or a negative situation. Some might lament that important research ends up being done offshore due to the difficulty of conducting it in the UK  not only encouraged for projects falling under A(SP)A, but potentially also discouraged if it is desired that a project classified as non-science remains so. We therefore propose that understanding how the boundaries of animal research law are constituted is not merely of academic interest, but also has important real-world implications for animal welfare and animal research.Pragmatic decisions about what not to regulate are important, shaping not only what research gets done, but also who does it. Certain institutions and individuals may face greater barriers to entry than others. For example, students and researchers based in institutions such as zoos and teaching-focused agricultural colleges and citizen scientists are among those who would likely struggle to secure A(SP)A licences, due to limitations in both resources and expertise see . Further10.13039/100010269Wellcome Trust for funding this research (Collaborative Award WT205393/A/16/Z).We gratefully acknowledge the None.