This chapter contains sections titled: References.

Stuart White and others claim that providing welfare benefits to citizens who do not, and are not willing to, work breaches the principle of reciprocity. This, they argue, justifies placing a minimum work requirement on welfare recipients. This article seeks to rebut their claim. It begins by rejecting the attempt to ground the work requirement on a civic obligation to work. The article then explores the principle of reciprocity, and argues that the practice of reciprocity depends on (...) the particular conception of distributive justice adopted. An examination of different interpretations of egalitarian justice and their corresponding patterns of reciprocity demonstrates that unconditional welfare benefits are compatible with, and sometimes even warranted by, the principle of reciprocity. Thus, imposing a work requirement on welfare recipients is by no means a mandate of reciprocity. Key Words: contractualism • unconditional basic income • reciprocity • welfare state • work. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Women on the Global Market: Irigaray and the Democratic StateNicole Fermon (bio)Best known for her subtle interrogation of philosophy and psychoanalysis, Luce Irigaray clearly also conducts a dialogue with the political, proposing that women’s erasure from culture and society invalidates all economies, sexual or political. Because woman has disappeared both figuratively and literally from society [see Sen, “More Than 100 Million Women Are Missing”], Irigaray conceives the contemporary ethical (...) project as a recall to difference rather than equality, to difference between women and men—that is, sexual difference. She characterizes relations between men and women as market relations in which women are commodities, objects, but never subjects of exchange, objects to men but not to themselves: women do not belong to themselves but exist “to keep relationships among men running smoothly” [TS 192]. Women under these conditions require imaginative ways to reconfigure the self, to subvert the melancholy and regression of masculinist economies and envisage a future in which women would not be ashamed of the feminine, would experience it as a positivity worth emulating.Irigaray contends that after the gains of egalitarian politics are carefully examined, the inclusion of women in the political arena has failed to take into account women’s distinct and different position from men, and from each other, as well as perpetuating the fiction of the “neutral” citizen, the ahistorical individual citizen of the nation-state. It is that fiction Irigaray dispels in her critique of liberal democratic politics and its creation, “citizens who are neuter in regard to familial singularity, its laws, and necessary sexual difference” [SG 112] in order to benefit the State and its laws. The subject is male; the citizen is neuter. Who is the female citizen in contemporary society? What is the ethical elaboration of the contractual relations between women and men, and between sexed individuals and the community? How do women imagine a distinct set of rights and responsibilities based on self-definition and autonomy, given the particular strictures of contemporary politics—that is, the market-driven, antidemocratic nature of the current economic national and global forces? Irigaray suggests that “the return of women to collective work, to public places, to social relations, demands linguistic mutations” and profound transformations, an embodied imagination with force and agency in civil life [TD 65].Irigaray warns that if civil and political participation is construed in overly narrow terms, if focus is on economic or judicial “circuits” alone, we overlook the symbolic organization of power—women risk losing “everything without even being acknowledged” [TD 56]. Instead an interval of recognition can expand the political to include the concerns and activities of real women, lest silence imply consent to sexual neutrality, or more likely, to women’s obliteration under men’s interests and concerns. Women’s insistence on self-definition and wage labor, on love and justly remunerated work, [End Page 120] testifies to the obduracy of women’s difference, one that is not likely to disappear. The patriarchal family is still the legal norm, even when certain exceptions are made, while enduring questions regarding women’s health and children’s physical welfare as priorities beyond market considerations are consigned to legislative obfuscation, still a political afterthought. Instead, in the US the liberal state removes the slender welfare net specific to women and children, Aid to Families with Dependent Children, and fails to provide medical coverage to those who are among the most vulnerable of its citizens. Women without access to the legal protection of sex-neutral citizenship, poor working women without language (the money for an effective “mouthpiece” to represent their distress in a court of law), are further disempowered by liberal politics’ insistence on sexual neutrality—that is, on repression or amnesia regarding the lived experiences of women.Sexual difference is key to any project of self-definition by women. Irigaray insists on the sexual nature of this self-definition, not solely for its obvious procreative necessity, but because the natural world is a source of renewal and fecundity which requires attentive interrogation and respect [SG 15]. This rebirth seems alien to the structure of male politics, which instead seem to provoke disasters (Bhopal, Chernobyl, or the current runaway... (shrink)

Until 1996, poor single mothers in the United States could claim welfare benefits for themselves and their children under the Aid to Families with Dependent Children (AFDC) program if they had no other source of income. With the 1996 passage of the Personal Responsibility Work Opportunity Reconciliation Act (PRWORA), paid work and work-related activities became a mandatory condition for receiving aid. At the same time, the law promotes marriage as a route out of poverty. Using a feminist reinterpretation (...) of Althusser’s concept of interpellation, I turn to Job Clubs, mandatory week-long workshops that teach job search skills, to analyze the citizen-subject generated by front-line representatives of the state in the context of this new legislation. Based on participant-observation, I conclude that while PRWORA ostensibly promotes both marriage and paid employment, Job Club trainers enforced a masculine worker-citizen subject through the deployment of three discursive strategies. These discursive strategies 1) promoted paid work over welfare-receipt as both a pragmatic and moral choice, 2) posited an individual-psychological account of women’s welfare receipt, and 3) portrayed parenting skills as marketable skills. In the conclusion, I speculate that current welfare reform efforts require the generation of a self-reproducing worker-citizen and that workshops like Job Club become a site in which the existence of this autonomous citizen is affirmed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Comment on Hospice of Washington's PolicyJohn A. Robertson (bio)The recent history of medical ethics may accurately be described as a history of coming to terms with personal autonomy and informed consent across the range of medical practice. Nowhere has this recognition been more important than in decisions to withhold or withdraw life-sustaining medical procedures from terminal and chronically ill patients.Despite the widespread acceptance of autonomy in these decisions, many (...) people—physicians, families, and policymakers—have balked at extending it to the withdrawal of artificially supplied fluids and nutrition. The symbolic connotations of food and water have led some persons to perceive cessation of medically-supplied fluids and nutrition to be a cruel, barbarous act, rather than the merciful respect for the dying patient that such withdrawal usually represents.Two recent events might help resolve the controversy, and ensure that decisions about artificial fluid and nutrition are handled like any other medical intervention—according to patient and family choice and patient welfare. One event is the Supreme Court decision in Cruzan (Cruzan v. Director of Missouri Department of Health, 110 S.Ct. 2841, 1990). Although the Supreme Court upheld Missouri's constitutional power to require artificial nutrition for a patient in a persistent vegetative state, its decision was not based on the symbolic importance of artificial fluids and nutrition. No Supreme Court justice saw a significant difference between medically-supplied nutrition and hydration and other medical interventions, thus allowing them to be discontinued either directly or by advance directive on the same basis as other medical interventions.The second event is the publication of the statement of "Philosophy Regarding Medical Intervention to Supply Fluids and Nutrition" by Hospice of Washington (or similar statements by other organizations). This statement is useful and important because it removes the issue of food and water from its symbolic overlay [End Page 139] and places it in the real context of dying hospice patients. It makes clear that the overriding consideration should be benefit to the patient "in accord with the patient's wishes or those of the appropriate surrogate(s) for the patient." Depending on those wishes and their impact on the patient, this position may or may not involve medically-supplied fluids and nutrition.This statement is also helpful in showing the medical complexity of such decisions in terms of their actual effect on dying patients. Rather than an either/or position, it recognizes that fluids may harm a dying patient by increasing discomfort, and that "persons near death do not ordinarily tolerate substantial volumes of enteral feedings." Thus rather than adhere to a symbolically-based position about the meaning of food and water to a dying patient, the important thing is to look to that patient's needs and give fluids or not, as the patient's wishes and situation demand.Fortunately, the law in most jurisdictions will recognize such a position. In those few jurisdictions that have made a fetish of artificial fluids and nutrition, the law should be changed, for the HOW statement makes clear that such a position may actually end up harming dying patients. Patient welfare should be privileged above all else, and patient welfare may often entail that fluids and nutrition not be medically supplied. Even then, however, caregivers will look to patient comfort and remedy dry mouths and lips with lubricants and ice chips.The HOW statement is, in my view, a very useful guideline not only for hospices but for hospitals, too—for any situation in which a patient is terminally ill and soon to die. A somewhat different set of issues arises, however, when the patient is chronically ill and incompetent, and will survive for long periods with medically-supplied fluids and nutrition. Recognition of patient rights in those situation should also permit cessation of fluids and nutrition on the same basis that respirators, antibiotics, and other life-sustaining measures may be withheld. But the withholding of medically-supplied fluids and nutrition from a patient who no longer has interests in surviving in an extremely debilitated condition raises different issues from withholding fluids that could cause such discomfort and nutrition when the patient is imminently dying. In either case, patient... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Just Share: Justice and Fairness in Resource Allocation*Pat Milmoe Mccarrick (bio) and Martina Darragh (bio)Each of us has some basic sense of what the words “fair” or “just” or “fairness” or “justice” mean. Each of us probably also has an idea of what is “fair” in health care. The attempt by the state of Oregon in the mid-1980s to quantify this notion made a previously private exercise (...) a public one. This transition has been chronicled in the bioethics literature that focuses on resource allocation. These works examine both theories of justice and concepts of “health”; the fair distribution of health resources has been of continuing interest since the beginning of bioethics in the 1960s. Early writing on justice includes authors Tom L. Beauchamp, Robert H. Blank, James F. Childress, H. Tristram Engelhardt, Paul T. Menzel, Paul Ramsey, and Robert M. Veatch (VII).During the 1980s, bioethicists such as Daniel Callahan and Norman Daniels proposed thinking of health care decisions not as moments of personal crisis but as choices that span a lifetime, possibly involving tradeoffs in other areas of one’s life, e.g., education. The Oregon experience added another dimension to the discussion. The initial rank-ordering of health services by cost produced a skewed list—for example, surgery for life-threatening conditions ranked below minor, elective procedures. For the project to make sense, the ranking algorithm could not be based on cost alone, but rather on a combination of costs and benefits both to individuals and to the community—“concatenations of individual and group goods” (I, Jecker and Jonsen 1995). Various metaphors have been used in the literature to facilitate discussion of this shift from individual to individual/community trade-offs: medical services as a “commons” (I, Asch 1995, Jecker and Jonsen 1995, Michels 1994); resource allocation as a “lifeboat” (I, Campbell 1995; III, Kaveny 1994); medical care as “shares” in a community health (III, Nelson 1992, Ford and Kissick 1995; II, Anderson 1993); and rationing as traveling through the desert with one jug of water for two people (a story from the Halachah literature) (I, Zoloth-Dorfman 1995). [End Page 81]Such metaphors do not promote any one “theory of justice” but rather draw from the work of a number of bioethicists as well as from theological, sociological, economic, and business literature. The five major conceptions of justice that are referenced most frequently are: “(1) a libertarian conception, which takes liberty to be the ultimate political ideal; (2) a socialist conception, which takes equality to be the ultimate political ideal; (3) a welfare liberal conception, which takes contractual fairness or maximal utility to be the ultimate political ideal; (4) a communitarian conception, which takes the common good to be the ultimate political ideal; and (5) a feminist conception, which takes a gender-free society to be the ultimate political ideal” (I, Sterba 1995).The use of new metaphors also draws on expanded concepts of “health.” “As health care is currently practiced, the most powerful symbols for public and professional alike are those that promise the defeat of time” (I, Campbell 1995). When medical care is perceived as an unrelated series of individual cures, the fact that health care resources are finite cannot be addressed.Reflections concerning the difficulties in limiting the use of health care resources have an ancient lineage and reveal a tight bond with the obsession to postpone death at all costs. Plato in Book 3 of the Republic recognizes the quandary of infinite expectations and finite resources that characterizes the challenge of health care choices. (I, Engelhardt 1996)The proliferation of expensive medical technologies and the loss of autonomy by health care professionals further complicates perceptions of the crucial issues at hand. Some have said that Americans place too much emphasis on individualism to address these issues. Daniels et al. believe that this is too pessimistic a view and that the American commitment to protecting equal opportunity for all provides a firm basis for developing a public consensus on what is fair in health care (III, Daniels, Light, and Caplan 1996). Finally, several authors suggest that the nature of all four principles of medical ethics, not justice alone, must be... (shrink)

United States federal regulations for pediatric research with no prospect of direct benefit restrict institutional review board (IRB) approval to procedures presenting: 1) no more than "minimal risk" (§ 45CFR46.404); or 2) no more than a "minor increase over minimal risk" if the research is commensurate with the subjects' previous or expected experiences and intended to gain vitally important information about the child's disorder or condition (§ 45CFR46.406) (DHHS 2001). During the 25 years since their adoption, these regulations have helped (...) IRBs balance subject protections with the pursuit of scientific knowledge to advance children's welfare. At the same time, inconsistency in IRB application of these regulations to pediatric protocols has been widespread, in part because of the ambiguity of the regulatory language. During the past decade, three federally-charged committees have addressed these ambiguities: 1) the National Human Research Protections Advisory Committee (NHRPAC) (Washington, DC), 2) the Institute of Medicine (IOM) Committee on the Ethical Conduct of Clinical Research Involving Children (Washington, DC); and 3) the United States Department of Health and Human Services Secretary's Advisory Committee for Human Research Protections (SACHRP) (Washington, DC). The committees have reached similar conclusions on interpretation of language within regulations § § 45CFR46.404 and 406; these conclusions are remarkably consistent with recent international recommendations and those of the original National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1977) report from which current regulations are based. Drawing on the committees' public reports, this article identifies the ethical issues posed by ambiguities in regulatory language, summarizes the committees' deliberations, and calls for a national consensus on recommended criteria. (shrink)

This article focuses on the issues related to obtaining the status of a military invalid and the changes in the policies and rules of this process in Russia in the post-revolutionary period. Particular attention is paid to the process of medical examination, its bureaucratic practices and forms of documentation. The key role of the examination for the material well-being and stability of the status of a military invalid led to several demands, dissatisfactions and calls for changes in the system that (...) had been in place since the beginning of World War I. This became possible with the emergence of new state aid institutions in 1917 (from the Ministry of State Patronage to the later People’s Commissariat of Social Welfare) and forms of self-organisation (the Union of Maimed Warriors). The problem of military invalids during the organisational changes of 1917-1918 is analysed from the perspective of the actors involved, their institutional positions and their motivations. These discussions are seen as a space to produce knowledge about the disabled body, as well as to control over it, and raise a number of questions about existing and proposed taxonomies of disease and injury, methods of diagnosis, and communities of experts involved in determining disability. Special attention is paid to the position and role of the military invalids themselves, who, in the conditions of the postrevolutionary period, expanded their sphere of action by referring to the “conquered” right to vote. On the basis of archival material from state relief institutions and departments of the Union of Maimed Warriors, legislative acts and periodicals, the article shows how the increasing concretization of the affected body was justified as a benefit to the state and to the disabled warrior, what community of experts was gathered around the disabled body, and what role the Act on the Results of Medical Examination played in the communication between a military invalid and state relief institutions. (shrink)

The theme of this issue of Ethical Perspectives is the French tradition in liberal thought, and the unique contribution that this tradition can make to debates in contemporary liberalism. It is inspired by a colloquium held at the Katholieke Universiteit Leuven in December of 2008 entitled “In Search of a Lost Liberalism: Constant, Tocqueville, and the singularity of French Liberalism.” This colloquium was held in conjunction with the retirement of Leuven professor and former Dean of the Institute of Philosophy, André (...) Van de Putte, who found much inspiration in this tradition. A revised version of his valedictory lecture from the conference serves as the final contribution to this issue. Much contemporary liberal political philosophy is currently done in conversation with a line of liberal thinkers starting with John Locke, running through Immanuel Kant and John Stuart Mill, and culminating in the work of John Rawls and his followers. The reasons for the enormous appeal of this philosophical tradition are, among other things, the combination of the central role of the intuitively appealing value of individual liberty with a strong rationalistic, universalistic, and normative character. The thread running through most of these liberal theories is a commitment to what the French liberal Benjamin Constant referred to as “the liberty of the moderns,” that is, liberty in a negative sense, as a lack of interference in one’s activity from others and from government. This focus has expanded over time to include a richer body of civil, political, social, economic and cultural rights, for instance, in the work of liberal thinkers who have tried to integrate the insights of communitarian thought and discourse ethics in their work. However, the emphasis on individual liberty in the negative sense continues to be the normative and theoretical touchstone and default position for many contemporary liberal theories. The limitation of the canon of liberal thought to the aforementioned authors and themes deprives the contemporary debate of a rich source of ideas: the French liberal tradition. Montesquieu, considered to be the father of this tradition, provides a good example of how it can enrich current debates in liberal theory. Montesquieu’s work evinces a keen eye for the dynamics of power relations and the limitations of the power of the better rational argument. His insight that power can sometimes only be checked by an equal and opposing power, so that a system of separation and balance of powers is necessary in order to preserve liberty, is reflected in the foundations of most modern democracies. Montesquieu also argues that contingent environmental, historical, social and economic conditions play a dramatic role in determining what kind of government is appropriate for a particular society. On his view, ignoring these facts when framing a government can inadvertently end in despotism. Montesquieu’s observations challenge us to reexamine some of contemporary liberalism’s universalist and rationalist claims. Benjamin Constant is most famous for his distinction between two kinds of liberty: the liberty of the ancients and the liberty of the moderns. The ancient form of liberty manifested itself in the active political participation of citizens in the ancient republic. While this form of government and decision-making was suitable for small, homogeneous city-states, Constant argues that it is impracticable for large modern nation-states. Hence, the concept of modern liberty shifts to an emphasis on the rule of law and the non-interference of the state in private matters. This form of liberty is familiar to us from contemporary liberalism – and Constant cherishes this form of freedom as much as any liberal does today. However, his position is complex: he also argues that the liberty of the ancients should not be neglected. Active political participation is needed to ensure that the government is executing its duty of preserving the modern form of liberty by publicly pointing out violations. The contemporary relevance of Constant’s work is clear when we consider the alleged “democratic deficit” that plagues the EU and international institutions such as the UN, the IMF, and the World Bank. Not only does this democratic deficit threaten the modern form of liberty by placing decision-making processes out of sight of the people, it also threatens citizens’ sense of self-respect derived from self-governance. Constant’s argument for the necessity of combining the liberty of the ancients with that of the moderns provides a fruitful resource for confronting these contemporary issues. Tocqueville’s work on liberalism benefits from his opportunity to observe a society founded on liberal democratic principles – the United States of America – in action. In his Democracy in America, he examines the social consequences, both intended and unintended, of building a society on ‘the equality of conditions’, as he defines ‘democracy’. Tocqueville sees a tension between the democratic value of equality and the aristocratic value of the rule of the best. He observes that democratic societies do not necessarily choose the best leaders and instead promote mediocrity instead of virtue, talent, and excellence. Democracy also confronts citizens with the threat of ‘soft despotism’, where a government that preserves the outer signs of the liberty of the moderns nevertheless controls the behavior of its citizens in minute detail through a system of detailed rules ostensibly aimed at their welfare. This paternalism is an even more insidious threat to liberal values than the hard variety of despotism, since it is so difficult to detect and done in the name of liberal values themselves. Taking Tocqueville’s observations seriously would add complexity to attempts to theorize about the modern social-democratic welfare state. The contributions to this issue supplement and critique mainstream liberal thought and its relation to contemporary issues through a serious engagement with the French liberal tradition. Annelien De Dijn’s contribution discusses Bertrand de Jouvenel, a lesser-known 20th Century representative of the French political tradition she terms ‘aristocratic liberalism’. This tradition has its roots in the work of Montesquieu, and emphasizes the importance of intermediary bodies, most importantly the aristocracy, in providing a check to the top-down power of despotic state authorities and the bottom-up power of revolutionary leveling tendencies, both of which threaten liberty. De Dijn situates Jouvenel in this tradition, but then indicates an important difference between his thought and that of his predecessors: his most significant work, On Power, is not only on French history, but on European history. Pointing to the enthusiastic reception of this work in the Anglophone world, she suggests that the rise of totalitarianism in Europe gave the anti-totalitarian features of aristocratic liberalism a broader appeal. Valentino Lumowa’s paper concerns Constant’s classic text, The Liberty of the Ancients Compared with that of the Moderns. Lumowa argues that in order to understand Constant’s piece, we must be aware that its two parts were written under different historical circumstances and decipher the argumentative thrust inherent in the text. Following Stephen Holmes, he argues that to understand the shift Constant made in the second part of the text, we should read it within the context of the increasing influence of the ultra-Royalists in the legislature during the Bourbon Restoration. However, in contrast to Holmes, he contends that the spirit of both civic and individual freedom, which enlivens representative system, is the backbone of the text in its unity. Demin Duan’s essay investigates an apparent ambivalence between liberal and imperialist tendencies in the work of Alexis de Tocqueville, which has already drawn some attention from Tocquevillian scholars. These interpretations of Tocqueville and his writings on empire generally agree that Tocqueville stands in a recognized tradition of liberalism, which is characterized by respect for human rights, individual freedom and a sense of universal humanism. On this standard view, Tocqueville’s support of imperialism represents nothing but an unfortunate breach of his own otherwise consistent liberal thinking. Duan’s article questions this standard position. By questioning the assumption of Tocqueville’s liberalism in the first place, he tries to gauge the influence of both the old republican tradition and the new liberal perspective on his thinking. In conclusion, he argues that Tocqueville’s overall thought, especially his notion of freedom, is very much informed by an old republican tradition. His support of French imperialism could be better understood from this perspective rather than be rendered simply as a deviation from liberal norms. Pawel Marczewski’s contribution is an attempt to show that Tocqueville’s conception of liberty transcends the divisions between negative and positive aspects of freedom. He begins by juxtaposing this conception with the opposition drawn by Constant between liberty of the ancients and liberty of the moderns. While Tocqueville and Constant shared a concern for the preservation of individual rights, Tocqueville was much more reluctant to accept the modern loss of the communal dimension of liberty. He did not accept the view that jouissances privées, private pleasures, are the main compensation that the modern world has to offer for the lost ancient treasure of political participation. The essay then looks into the relevance of Tocqueville’s standpoint for current debates between liberal defenders of negative freedom and republican advocates of freedom as non-domination. Participants on both sides of the debate seem to be so devoted to showing that their particular approach provides the best guarantees against actual and possible threats to liberty that they overlook the fact that their definitions of freedom remain significantly similar. By arguing that ‘to be free is to be guided by one’s own will’, contemporary republicans, as well as their liberal counterparts, move along the lines drawn by Constant towards private pleasures. By questioning the inevitability of this turn, Tocqueville provides us with a valuable contribution to these discussions in contemporary political philosophy. Finally, André Van de Putte’s contribution, an adaptation of his emeritus speech that closed the conference on French Liberalism, appeals to Tocqueville in order to draw attention to the importance of intermediary, dialogical bodies in mitigating the implicit despotic tendencies of the democratic drive to equality. In Tocqueville’s view, the transition from the feudal corporate inequality to democratic individual equality was not a clean break. Rather, this transition is a continual process of democratization that is driven by a desire for equality, or egalité des conditions. This dissolution of distinctions of estate, class and status has the unintended consequence of concentrating the diffuse power of these entities into a centralized state, which is responsible for ensuring the equality of all under the law. This process leaves increasingly isolated and atomized individuals to face the power of a monolithic state in defense of their freedom, and moves toward a soft, paternalistic despotism. Constant’s freedom of the moderns is not sufficient to protect individuals from this centralized power. Democracy also requires the political freedom of the ancients. Van de Putte argues for a system in which atomized individuals organize themselves into intermediary bodies that, in a Montesquieuian balance of powers, can enter into dialogue with each other and the state on more equitable terms. Van de Putte’s contribution closes with a plea for a conception of democracy as a regime of dialogue. (shrink)

The State You See uncovers a racial gap in the way the American government appears in people's lives. It makes it clear that public policy changes over the last fifty years have driven all Americans to distrust the government that they see in their lives, even though Americans of different races are not seeing the same kind of government. For white people, these policy changes have involved a rising number of generous benefits submerged within America's tax code, which (...) taken together cost the government more than Social Security and Medicare combined. Political attention focused on this has helped make welfare and taxes more visible representations of government for white Americans. As a result, white people are left with the misperception that government does nothing for them, apart from take their tax money to spend on welfare. Distrust of government is the result. For people of color, distrust is also rampant but for different reasons. Over the last fifty years, America has witnessed increasingly overbearing policing and swelling incarceration numbers. These changes have disproportionately impacted communities of color, helping to make the criminal legal system a unique visible manifestation of government in these communities. While distrust of government emerges in both cases, these different roots lead to different consequences. White people are mobilized into politics by their distrust, feeling that they must speak up in order to reclaim their misspent tax dollars. In contrast, people of color are pushed away from government due to a belief that engaging in American elections will yield the same kind of unresponsiveness and violence that comes from interactions with the police. The result is a perpetuation of the same kind of racial inequality that has always been present in American democracy. The State You See is essential reading for anyone interested in understanding how the American government engages in subtle forms of discrimination and how it continues to uphold racial inequality in the present day. (shrink)

Energy services have a particularly significant impact on the daily life and welfare of consumers. The importance of such services is high, and their regulation is also changing both at the EU and Member States level, especially after the adoption of the Third Energy Package1, which is focused on improving the operation of retail markets to yield real benefits for both electricity and gas consumers. In order to implement the main or the most relevant goal of the EU, (...) such as high level of consumer rights protection, resulting in consumer trust in business sector, proper and effective functioning of the EU internal market etc., it is essential to ensure clear and sufficient legal regulation, establish responsibility of the services providers, consumer rights and duties as well as promote more effective, faster and cheaper ways of solving consumer and business disputes. The authors of this article feel the lack of scientific analysis on this issue. Despite its importance, discussions take place at political or practical level, but no recent analyses exist as to why energy services sector is so fragmented and how it affects different conditions or rights of consumers in various Member States. This article also clearly supports the idea that the above-mentioned goals can be achieved by close and more fruitful cooperation between the EU and national competent authorities, participation in various ad hoc expert working groups and committees, such as the Vulnerable Consumers Working Group. This article reflects general ideas about the problems arising in the energy consumer services sector, the activity of the EU and national institutions, seeking to ensure fair and transparent provision of such services to consumers, it also contains an analysis of alternative dispute resolution (hereinafter – the ADR) methods and good practice of their application in the EU Member States. This article highly supports the application of alternative procedures in the field of energy services and sees them as a possibility to minimise increasing consumer problems, e.g. a new phenomenon – consumer energy poverty in the EU, which is defined as the situation where a household is unable to access a socially and materially necessitated level of energy services at home and pay for the provided services. (shrink)

Failings of a categorical systemFor decades, standardized classification systems have attempted to define psychiatric disorders in our mental health care system, with the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association (APA), 2013) and International Statistical Classification of Diseases and Related Health Problems 10th revision (ICD-10; World Health Organization, 2010) being internationally best-known. One of the major advantages of the DSM must be that it has seriously diminished the international linguistic confusion regarding psychiatric disorders. Since (...) its introduction, it contributed extensively towards one common international language for defining and conceptualizing psychiatric disorders. Strikingly, within the field of psychological testing a similar step forward seems to have not yet been taken. At present, there exists no international standard for the use of psychological tests that takes the definition of a specific symptom as listed in DSM-5 as its starting point, and reliably and validly measures this symptom. Rather, the majority of tests are measuring constructs consisting of a multitude of symptoms. For example, the Beck’s Depression Inventory (Beck et al., 1996) measures core symptoms of depression summing up to a depression score. Accordingly, we believe it is time for a change. The diagnostics of psychiatric disorders, where disorders are defined as nosological units with a single cause, a single organic substrate, and a single time course, has been problematic for centuries. The field of psychiatry has always been ambivalent about its desire to follow a medical model (Blaney, 2015), but afflicted due to its definitions of pathology. The definition of a psychiatric disorder in DSM-5 offers little room for a clear cut pathogenesis and harsh demarcation of syndromes. This is reflected in the DSM-5, where it states: “A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning” (APA, 2013, p.20). An unfortunate and recognized consequence of this definition within the current system is that many symptoms overlap within categories of psychiatric disorders and patients end up diagnosed with many co-morbid disorders.Two fundamental problemsRegardless of new attempts to improve the diagnostics of psychiatric disorders, the DSM-5 represents the status quo. Consequently, the distinction between diagnosis and classification remains substantial and more than a discussion on semantics. We identify two fundamental problems within the current framework. Generally, a psychiatric diagnosis is considered to be descriptive (Hengeveld and Schudel, 2003). The clinician will describe a syndrome (its nature, timespan, and severity) within the framework of a disorder, and often include a differential diagnosis, predisposing protective or vulnerability factors, and provoking or maintaining factors. Within the DSM-5 framework, a similar ‘approach to clinical case formulation’ is taken (APA, 2013, p. 19). Evidently, a descriptive diagnosis has a hypothetical character. It consists of the clinician’s hypothesis and is based on his or hers professional considerations according to the abovementioned factors. Once the clinician has formulated a descriptive diagnosis, it is then complementary ‘translated’ into a DSM-5 classification. Herein lies the problem. For the layman, the existence of this distinction between diagnosis and classification is usually unknown. Preceding treatment, the clinician will give the client a classification of the existing psychiatric problems and the client may attribute more meaning to it than appropriate, thereby fostering the risk of reification. Second, the DSM-5 is a categorical system. Thus, individual disorders are regarded as discrete units – ‘you either have it, or you don’t’. DSM-5 states about this: “(…) scientific evidence places many, if not most, disorders on a spectrum with closely related disorders that have shared symptoms, shared genetic and environmental risk factors (…)”. And “(…) we have come to recognize that the boundaries between disorders are more porous than originally perceived.” (APA, 2013, p. 6). This leads to a fundamental problem. Because the overwhelming majority of psychiatric disorders examined thus far using taxometric methods appear to be dimensional in nature (Haslam, 2003; Widiger and Samuel, 2005), consequently all of their categorizations become artificial and debatable. Even though DSM-5 took a modest step towards a more dimensional approach, its core remains categorical. To illustrate, consider the Borderline Personality Disorder (BPD). This classification consists of nine diagnostic criteria of which a minimum of five need to be present for the diagnosis of BPD. A simple numerical combination algorithm leads to a staggering number of 256 distinct presentations of BPD (Albion et al., 2013). Due to this chameleon-like nature, the disorder’s diagnostic validity becomes questionable. Strikingly, this number is relatively small when compared to other conditions, e.g., there are 636,120 ways to have posttraumatic stress disorder (Galatzer-Levy and Bryant, 2013).DSM-5 does propose an alternative model for personality disorders based on personality functioning and traits (APA, 2013, p. 761), as a possible answer to the problem that most patients fit with multiple co-morbid personality disorders or to the category of personality disorder not otherwise specified. In November 2012, the chair committee of APA decided to move this alternative model to section III of DSM-5 and to sustain the categorical system in section II. A potential solutionDSM-5 and its predecessors have brought about an invaluable improvement regarding the formulation of a common international language for psychiatric disorders. However, the individual disorders fit poorly with its starting point of discrete units and strict boundaries. Van Os (2014) has argued for a better balance between the categorical and personalized aspects of psychiatric disorders. We argue for a two-step approach.Particularly due to the ‘weak boundaries’ between disorders, it might be beneficial to limit ourselves by merely categorizing clients into the main categories of the DSM-5 according to their most prominent symptoms (Van Os, 2014), i.e. their main complaint. In other words, clinicians could first ask themselves whether the symptomatology is concerning a neurodevelopmental disorder, or a bipolar and related disorder, or a depressive disorder, and so on. It will drastically reduce the over 400 classifications in DSM-5 down to 20 categories. Van Os (2014) even argues to combine some of the main categories, reducing this number even further to 15 categories. The advantages of reducing the over 400 classifications are fivefold: 1) a syndrome, being an aggregation of symptoms, creates a false relation between symptoms that are that are already heterogeneous themselves; 2) 15 broad categories are functional: it results into a very heterogeneous group of clients within a category and thus prevents stereotypes and invites further personalizing of complaints; and 3) a dimensional measure of a symptom rather than a syndrome will correspond better with the client regardless of it not providing the complete picture. Focusing on the main complaint will indicate where there is an immediate need for care (Van Os, 2014); 4) it will allow clinicians to recognise subthreshold conditions more easily (Magruder and Calderone, 2000); and 5) it might facilitate the development of clear demarcations between normal and abnormal functioning (Kessler, 2002; Widiger and Samuel, 2005). Please, see also Table 1.This also fits well within scientific advances, as thus far strongest evidence has been found for a distinction between internalizing and externalizing disorders, even superseding these 15 main categories (DSM-5; APA, 2013, p.13, but see Weiss et al., 1998). The second step would concern the personalized aspect, which we argue to define on a level of core symptoms of the specific main category, to be agreed upon later. To assess these core symptoms, the field of psychological testing could develop an internationally applicable instrument to reliably and validly measure each (core) symptom on a dimensional scale. Many of these instruments are readily available and have proven its psychometric properties within scientific research. Elements from these instruments could be easily transformed to work within the new system. Within the field of psychology, this approach could aid development of a common international language to define symptoms, analogous to the field of psychiatry. Importantly, current psychological testing mainly implies the use of self-report measures. This leads to an abundance of auto-amnestic information. To increase the reliability and validity of psychological tests to assess DSM-5 symptoms, it may be important to add two additional information resources. This would entail psychological tests where a next of kin answers questions about the symptom of the client, and psychological tests that include the clinicians’ judgment, such as structured clinician-based interviews. Conversely, we also need to acknowledge the well-known limitations of clinical judgment (e.g., Faust, 1986; Garb, 1998). Advantages of a new frameworkThe changes we suggest have big implications and are not easily implemented in the current framework. Clients may prefer the comfort of a single clear label, similar to what they are used to in other areas of medicine. Health insurance providers and policy makers may argue for single labels as well. Therefore, it would require a lot of explanation from our clinicians to promote a change. Our suggestions for broader categories may not disambiguate the current situation better than the existing approach, but it will promote personalisation of health care. Difficulties in diagnostic reliability will remain in disorders that fall on the boundaries of the taxons, e.g., schizoaffective disorder versus bipolar disorder with psychotic characteristics, which may benefit from further study. There are also some politically tinged questions to keep in mind: How will we finance our health care, and how will we ensure a gradual transition from the current financing system, including clients who already have their labels? What about visitations from insurers and health inspection? How can they control for a good standard of quality in health care when considering the increasing heterogeneity? Nevertheless, we argue that the benefits outweigh the disadvantages. We will see a shift from a categorical to a personalized approach, which will lead to less (self) stigmatizing, less estrangement, and it will challenge reification thinking. DSM-V states that “a reformulation of research goals should also keep DSM-5 central to the development of dimensional approaches to diagnosis that will likely supplement or supersede current categorical approaches to diagnosis in coming years” (APA, 2013, p. 13). Our proposition for psychological testing on symptom level could contribute to this development. Furthermore, this new approach will do more justice to the heterogeneity of symptoms within and outside of classification categories, see also Table 1. Moreover, in this new approach we join forces of expert knowledge from the fields of psychiatry and psychological science. Finally, it offers new and potentially better opportunities to map health care needs. This in turn will lead to a better interface for allocation of appropriate treatment. It will present a clearer picture of when preventative care is preferred over treatment and vice versa. Importantly, health care needs will be more closely attuned to the ‘own story’ of the client.We argue for the national and international psychological associations in Europe and the United States of America to support the idea of a collective approach to develop an internationally standardized psychological testing battery to reliably assess all the core symptoms of the main categories in DSM-5. (shrink)

This review analyzes the book Rental Society: In the Shadow of Labor, Capital, and Democracy. The book’s authors consider factors and conditions for the transition from a social state and a society of mass labor to a rental type of society. The main reasons for this transformation are the depletion of resources on a global scale and the replacement of humans by machines, which entails the growth of social groups living off various forms of rent (benefits, unconditional basic (...) income, additional payments, etc.). Meanwhile, fewer and fewer people are involved in the production of wealth. Under these conditions, the only active political subject becomes a non-democratic and non-egalitarian state, which distributes rents to various social groups. Simultaneously with the transformation of economic, political, and social structures, the content of moral consciousness also changes during the transition from a labor society to a rent society. There is a transition from labor morality to rent-parasitic morality, which, in view of the objective conditions for the existence of the rent majority, is internalized and gradually becomes a new moral norm. Two possible scenarios for the further development of the rental society are discussed. The positive scenario is a formation of a new type of economy due to the development of science, personality, new socialization forms. Negative scenario is associated with the deepening and globalization of rent processes, leading to “neoliberal feudalism,” to a society without mass labor and economic growth but with a hierarchy of class-rent groups, between which the state distributes rents and privileges using non-economic methods. In addition, the article shows significant shortcomings of the reviewed research: inconsistent understanding of the concept of rent, overly broad understanding of the subjects of rental processes, unjustified extrapolation of rent relations to the whole history of mankind (so called rent presentism). (shrink)

This paper explores the implications of libertarianism for welfare policy. There are two central arguments. First, the paper argues that if one adopts a libertarian framework, it makes most sense to be a Lockean right-libertarian. Second, the paper argues that this form of libertarianism leads to the endorsement of a fairly extensive set of redistributive welfare programs. Specifically, the paper argues that Lockean right-libertarians are committed to endorsing welfare programs under which the receipt of benefits (...) is conditional on meeting a work requirement, and also endorsing some form of publicly funded jobs of last resort for potential welfare recipients. (shrink)

Photo by Karl Raymund Catabas on Unsplash “After Buddha was dead, they still showed his shadow in a cave for centuries – a tremendous, gruesome shadow. God is dead; but given the way people are, there may still for millennia be caves in which they show his shadow. – And we – we must still defeat his shadow as well!” – Friedrich Nietzsche[1] INTRODUCTION Friedrich Nietzsche famously declared that “God is dead!”[2] but lamented that his contemporaries remained living in the (...) shadow of God. For Nietzsche, the morality of his time was still based in the Christian tradition, even though faith in God was waning. Bioethics lives under a similar shadow: the shadow of Enlightenment Era-rationalism. Bioethics curricula focus on principles derived from Kantian deontology and utilitarianism. The allure of maintaining a moral framework that provides a rational method that can be handily applied to any situation remains strong. The principlist approach advanced by Tom Beauchamp and James Childress is taught to nearly all medical students in the United States,[3] and is essentially the canonical ethical framework of bioethics. In this model, the principle of autonomy is Kantian in nature, and the principles of beneficence and non-maleficence are utilitarian in nature.[4] Moreover, the presented framework is an approach that, when applied rationally to any healthcare scenario, will yield an outcome “considered moral.”[5] This reflects a faulty conception of philosophy that plagues much of bioethics, wherein the only contribution of philosophy pertinent to bioethics is moral philosophy elucidated by European thinkers in the Enlightenment Era. The landscape of moral philosophy has evolved significantly from the 18th century. However, the bioethical world has not kept up with the philosophical world, remaining instead in the shadow of antiquated moral thinking. Also lacking in bioethics are other disciplines of philosophy, such as philosophy of language, existentialism, and aesthetics, which are often given no consideration at all. The inclusion of both modern moral philosophy and other philosophical fields is necessary if bioethics is to survive its transition into modernity. l. The Shadow of Enlightenment Enlightenment Era philosophers such as Immanuel Kant argued that one need only employ reason to obtain knowledge; emotion bore no relevance when determining ethical behavior. Kant’s moral theories thus privileged a duty to act according to moral imperatives over feelings. Other Enlightenment Era philosophers such as John Locke developed systems that attempted to quantify human goods and human ills. This quantification potentially reduces human welfare and suffering to utility. Today, in the world of philosophy, such a “neutral analysis,” as Cora Diamond noted, is “dead or moribund.”[6] Bernard Williams remarked that such moral philosophy is “empty and boring,”[7] and G. E. M. Anscombe stated that it “no longer generally survives.”[8] And yet, just as the atheists in Nietzsche’s world dwelt in the moral code of a dead God, bioethicists still pursue a unified moral system that takes an input, applies some moral rules, and generates a moral outcome, like the four principles approach that Beauchamp and Childress laid out.[9] Some detractors of principlism take issue with their approach for not being unified enough and want to replace it with a procedural framework that is even more systematic and complicated. They argue that the resulting moral framework would be a “comprehensive decision procedure for arriving at answers”[10] that retains the “impartiality that is an essential part of morality.”[11] The shadow of rationalist morality has caused bioethical decision making to become detached and rigid when bioethics should concern itself with the humans whose lives it affects. A rational, divorced-from-emotion way of thinking ultimately fails to yield satisfactory results when decisions are made by and for emotional beings. Dr. Paul Farmer, among others, championed the idea that bioethics should be de-philosophized, as philosophy, cold and calculated, fails to adequately respond to the realities of those worst off.[12] Instead, Dr. Farmer emphasized the inclusion of the social sciences, like sociology and anthropology, in bioethics. Undoubtedly, Dr. Farmer was on the right track; bioethics should certainly engage directly with the people whom its decisions involve. If the narrow band of moral philosophy currently found in bioethics – that of stringent rationalism – were all that philosophy had to offer, I, too, would advocate for a de-philosophization. Ludwig Wittgenstein notes that to attempt to capture the complexity of moral thinking in a manner that employs reason alone and casts aside emotion is a “hopeless task,” like reconstructing a sharp image “from a blurred one.”[13] Unfortunately, bioethics is mired in the remnants of this hopeless task. To Dr. Farmer, the dominant moral framework was too restrictive and was unresponsive to the social and humanitarian needs of those whom bioethics is meant to help. As such, he wished to free bioethics from the shadow of a morality derived from rationalist thinkers. ll. Beyond Rationalism Like Nietzsche, who tried to resolve Europe’s post-religion vacuum by providing his society with a new way to live, Dr. Farmer wanted to replace the rationalist philosophy upon which bioethics was built with a “resocialization” of the field.[14] I agree with Dr. Farmer’s call for resocialization, as well as his denouncement of philosophy as it exists in bioethics. Evaluating risks and benefits along a predetermined array of moral principles is far too rigid and impersonal to guide what are often the most important decisions one will make. For Dr. Farmer, the most needed change was restoring the social element of bioethics. However, in advocating for this resocialization, Dr. Farmer casts philosophy as the antithesis of social science, noting that “few would regard philosophy … as a socializing discipline.”[15] I disagree. Rationalist moral philosophy may be lacking in socializing force, but there are other fields of philosophy that are responsive to our social reality. Rather than de-philosophizing bioethics, it makes more sense to replace the antisocial philosophies predominant in bioethics with prosocial philosophies better suited to it. Of course, the contribution of philosophy to bioethics is more than moral theories from the Enlightenment Era. There are more recent philosophical contributions from outside the field of moral philosophy that have roused bioethical interest. Jennifer Blumenthal-Barby, et al., argue for philosophy’s continued place in bioethics, citing Derek Parfit’s “non-identity problem,” which altered the landscape of reproductive ethics, and David Chalmers’ contributions to philosophy of consciousness, which have implications for the moral status of brain organoids.[16] Still, these are narrow applications of philosophy to highly specialized areas of bioethics, which not all bioethicists are inclined to delve into. Philosophy in bioethics should not be confined to niche applications in specialist fields but should influence all bioethical thought. Fortunately, there remains untapped a wealth of philosophical disciplines that pertains to exactly this. Philosophy of language investigates the nature of meaning and understanding in communication, which is a necessary social action. Successfully deciphering and conveying moral values in discourse is a bioethicist’s bread and butter, as is resolving disagreements and reaching agreements. Indeed, it is often the case that miscommunication lies at the root of an impasse between a doctor and a patient. An understanding of the nature of the disagreement would help resolve the conflict, as different types of disagreements require different interventions for resolution. For instance, a “substantive disagreement,”[17] in which two parties use the same terms in the same ways and have a fundamental disagreement on which outcome is more desirable, can be resolved only if one party yields to the other. On the other hand, a “merely verbal dispute,”[18] in which two parties use the same terms to represent entirely different concepts and values, requires standardization of terminological usage for its resolution. As such, no one can overstate the moral importance of successful communication in bioethics, and an exploration of language itself would prove invaluable to a bioethicist’s training. Existentialism is another subset of philosophy that acknowledges the social nature of human existence, noting that one’s being in the universe is concomitant with the existence of others sharing the same universe.[19] Thus, there is the recognition that whatever existence is, it is not complete without the existence of others. With this as a starting point, existentialists examined how to live meaningfully with others in this world. Since ethics crucially involves others, it is no surprise that existentialists pondered how to live moral lives. Existentialist conceptions of morality did not revolve around acting in accordance with a set of rules, but rather, recognized individual freedom in choosing how to act and emphasized acting authentically. In this vein, bioethicists should commit to doing what is right rather than committing to applying a set of principles. Existentialism, while part of the broader bioethics literature, is less common throughout bioethics curricula and deserves more prominence. Martin Heidegger, for instance, emphasized the difference between two types of thinking: “calculative thinking” and “meditative thinking.” Heidegger characterizes calculative thinking as a computation, wherein from some given starting conditions “definite results”[20] are determined, and contrasts this with meditative thinking, which he describes as “thinking which contemplates the meaning which reigns in everything that is.”[21] Heidegger was critical of the pervasiveness of calculative thinking, seeing it as the “ground of thoughtlessness,”[22] in which we only relate to the world in a meaningless, mechanical way. This is the emphasized type of thinking in rationalist conceptions of morality popular in bioethics; from a set of starting conditions, a series of rules are applied, and a moral outcome is calculated. Such a technique, however, discounts the personal meaning individuals place on the aspects of their lives relevant to their decision making, as well as the meaning in committing to doing what is right. Under calculative thinking, such a commitment is reduced to rote rule-following. A turn to meditative thinking would ensure that bioethical decisions comport with living meaningful lives. Even aesthetics, a discipline devoted to examining beauty and taste,[23] has a place in bioethics. Just as the viewing of a painting, the listening of a song, or the reading of a book elicits an effective response, hearing a patient’s story leaves an emotional imprint. The recounting of a traumatic moment imparts sadness, and a joyous occasion begets joy in the listener as well. As acknowledged in the field of everyday aesthetics, these aesthetic experiences often spur us to act:[24] The unsightly appearance of a polluted riverbank drives us to remove the trash; the presence of sorrow in one’s life drives us to ameliorate it. To be mindful of aesthetic experiences and allow them to affect us emotionally is paramount to the motivation of a bioethicist to serve the patient, not out of an obligation to a job description, but out of a desire to truly avail the patient of their anguish. For example, the new field of narrative medicine utilizes critical reading and literary techniques to train clinicians and bioethicists in emotional understanding and listening skills that stress the social aspects of medicine beyond rational analysis and decision making. CONCLUSION Dr. Farmer is absolutely correct; bioethics is in dire need of resocialization. It should not be the case that the justification for a moral action is essentially that “the rules say so,” or that simply by teaching such rules to medical students, the very act of making bioethical decisions that diverge from those determined by principles can be seen as an act of “bad faith … hubris or, worse, malpractice.”[25] As bioethicists are coming to realize, the rationalist philosophical traditions that bioethics was founded upon are past their expiry, and the time for change is now. Indeed, as Dr. Farmer urges, “socializing disciplines” like anthropology, history, political economy, and sociology are necessary to humanize the field of bioethics.[26] So too, however, can philosophy be a socializing discipline, if we know where to look. Bioethics should evolve. Its new goal should be to focus on meaningful human relationships, and to phase out rigid, impersonal modes of moral thinking. The limited sampling of unsatisfying moral theories from hundreds of years ago leaves many bioethics students cold, and it is easy to see why bioethicists are ready to part ways with philosophy. I believe this is a move in the wrong direction; there is a place for philosophy in the future of bioethics. Just as bioethics needs a resocialization, it is also needs of a re-philosophization. These enrichments complement one another. There is more to bioethics than mechanically determining the right course of action in a healthcare setting. Bioethics engages with the most ancient of philosophical questions: questions of what makes human existence meaningful, what makes us who we are, how we want to relate to others, how and why we feel, what our place in the world is, how we can communicate what we think, and why our moral intuitions are so compelling. We would be remiss if we did not begin to investigate additional contributions to morality from a wider range of philosophies that try to provide answers to such questions, as they offer a richness to moral thinking that cannot be gleaned from traditional bioethical approaches alone. - [1] Friedrich Wilhelm Nietzsche, The Gay Science: With a Prelude in German Rhymes and an Appendix of Songs, ed. Bernard Williams, Josefine Nauckhoff, and Adrian Del Caro, Cambridge Texts in the History of Philosophy, 109. [2] Nietzsche, 120. [3] Daniel C O’Brien, “Medical Ethics as Taught and as Practiced: Principlism, Narrative Ethics, and the Case of Living Donor Liver Transplantation,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 47, no. 1 : 97, https://doi.org/10.1093/jmp/jhab039. [4] K. D. Clouser and B. Gert, “A Critique of Principlism,” Journal of Medicine and Philosophy 15, no. 2 : 219–36, https://doi.org/10.1093/jmp/15.2.219. [5] O’Brien, “Medical Ethics as Taught and as Practiced,” 97. [6] Cora Diamond, “Having a Rough Story about What Moral Philosophy Is,” New Literary History 15, no. 1 : 168, https://doi.org/10.2307/468998. [7] Bernard Williams, Morality: An Introduction to Ethics, Canto ed, xvii. [8] G. E. M. Anscombe, “Modern Moral Philosophy,” Philosophy 33, no. 124 : 1, https://doi.org/10.1017/S0031819100037943. [9] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 7th ed, 13. [10] Clouser and Gert, 233. [11] Clouser and Gert, “A Critique of Principlism,” 235. [12] Paul Farmer and Nicole Gastineau Campos, “Rethinking Medical Ethics: A View from Below,” Developing World Bioethics 4, no. 1 : 17–41, https://doi.org/10.1111/j.1471-8731.2004.00065.x. [13] Ludwig Wittgenstein, Philosophical Investigations, ed. Joachim Schulte, trans. P. M. S. Hacker, 4th edition, 40. [14] Farmer and Campos, “Rethinking Medical Ethics,” 20. [15] Farmer and Campos, 20. [16] Jennifer Blumenthal-Barby et al., “The Place of Philosophy in Bioethics Today,” The American Journal of Bioethics: AJOB, June 30, 2021, 3–5, https://doi.org/10.1080/15265161.2021.1940355. [17] Brendan Balcerak Jackson, “Verbal Disputes and Substantiveness,” Erkenntnis 79, no. S1 : 31–54, https://doi.org/10.1007/s10670-013-9444-5. [18] C. S. I. Jenkins, “Merely Verbal Disputes,” Erkenntnis 79, no. 1 : 11–30, https://doi.org/10.1007/s10670-013-9443-6. [19] Steven Crowell, “Existentialism,” in The Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta, Summer 2020, https://plato.stanford.edu/archives/sum2020/entries/existentialism/; Anita Avramides, “Other Minds,” in The Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta, Winter 2020, https://plato.stanford.edu/archives/win2020/entries/other-minds/. [20] Martin Heidegger, Discourse on Thinking, Harper Torchbooks, 46. [21] Heidegger, 46. [22] Heidegger, 45. [23] Nick Zangwill, “Aesthetic Judgment,” in The Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta, Winter 2021, https://plato.stanford.edu/archives/win2021/entries/aesthetic-judgment/. [24] Yuriko Saito, “Aesthetics of the Everyday,” in The Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta, Spring 2021, https://plato.stanford.edu/archives/spr2021/entries/aesthetics-of-everyday/. [25] O’Brien, “Medical Ethics as Taught and as Practiced,” 112. [26] Farmer and Campos, “Rethinking Medical Ethics,” 20. (shrink)

This article examines the relationship between income concentration and policy outputs that determine the generosity of two major state-level safety net programs: unemployment insurance and cash social assistance. Using a difference in differences framework, it tests the degree to which the top 1 percent share is associated with benefit replacement rates for these programs during the period 1978–2010. The results suggest that higher state income inequality lowers those states’ welfare benefits significantly in ways consistent with a (...) “plutocracy” hypothesis that has been suggested in work by scholars such as Bartels, Bonica, Gilens, and Page. The results are robust to controls for several alternative explanations for benefit generosity, including citizen ideology, party control of government, fiscal pressure on programs, state racial heterogeneity, and public opinion liberalism. The results thus support the notion that growing income concentration at the very top undermines social protection policies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Insightlessness, the Deflationary TurnJennifer Radden (bio)Keywordsinsightlessness, deflationary turn, Harry Stack Sullivan, open placebos, space of reasonsMarga Reimer argues that treatment compliance in patients who are without any, or complete, insight into psychotic symptoms may be neither particularly abnormal nor entirely unreasonable. In broad sympathy with these conclusions, I wish only to add a couple of ancillary observations and some historical context.Reimer's discussion can be placed alongside other research (...) on aspects of psychosis putting forward what have been called "deflationary" accounts, accounts that depict psychotic symptoms as differing from normal states, traits, and responses in degree rather than kind. Such accounts have been offered about auditory hallucinations or "hearing voices" (Leudar and Thomas 2000; Romme and Escher 1989; Smith 2007), about delusional thinking (Bentall 2003; Bentall et al. 1989; Bracken and Thomas 2005; Hamilton 2007; Kinderman and Bentall 2007), and spiritual experiences (Jackson 1997; Jackson and Fulford 1997); in the introduction of the notion of "benign psychosis" (Jackson 2007), and even in recognition that insight is a complex, dimensional attribute (Amador and David 1998). Harkening back to the middle years of the twentieth century, and associated with Adolph Meyer's influence in the United States, as well as the influence of psychodynamic (and psychoanalytic) ideas, this deflationary turn challenges the neo-Kraepelinian presuppositions of our contemporary biomedical psychiatry. Rather than sharply separating psychotic states and symptoms from normal experience, the deflationary approach emphasizes the continuities and similarities linking them.Reimer proceeds in two separate steps. To the extent that treatment compliance among patients suffering psychotic states occurs in the absence of any or full insight, it is shown, this seems not dissimilar from other more ordinary cases where treatment compliant behavior occurs either without—or without regard for—a recognition that one is ill. (The term insightlessness is here used to indicate the absence of full and complete insight. This recognizes the dimensional and complex nature of insight, which has been shown to involve a range of beliefs over one's disorder, those about its presence, about the need for treatment, and about the social consequences of suffering it.)Had her discussion stopped here, Reimer would have completed the first "deflationary" step. By showing that this sort of insightless treatment compliance also occurs in the absence of mental disorder, she encourages us to see psychotic patients' lack of insight into their disorder as at least akin to more benign and commonplace responses. In doing so, she would have shifted something of the burden of proof within discussions of insight. Those insisting insightlessness is an irresoluble obstacle to positive treatment outcomes would [End Page 81] now be required to explain why this should be so. And those denying the analogy between the insightless compliance of the psychotic patient and more everyday cases such as those Reimer describes, might be called upon to show why these cases were disanalogous.Reimer does not leave matters there. She goes on to establish that none of the instances of insightless treatment compliance that she discusses can be judged to be entirely unreasonable. Treatment compliance without full insight is not only quite normal, it may not even be particularly irrational. As she explains, the patients in each case anticipate benefits from the treatment, even though such benefits are not understood in terms suggestive of pathology. Unfailingly, they conform to a general human tendency: [T]o act in accordance with what we perceive, rightly or wrongly, to be in our best interests.Reimer locates the error in more traditional thinking about lack of insight at the immodest assumption that there is but a single way to accurately characterize the patient's condition—medically. This view, which she attributes to contemporary psychiatry, she finds mistaken—and mistaken, I agree it is. Rather than one, there seem likely to be several accurate ways to frame things. And although the medical framing will best fit the interests and purposes of clinicians, other framings may better suit the interests of their patients.When the possibility of alternative, non-medical perspectives is granted, and our goal is to assess insightless compliance vis à vis rationality norms, a number of considerations gain salience. The insightless patient, Reimer shows, may... (shrink)

Children accrue experiences with buoyancy on a daily basis, yet research paints a mixed picture of children’s buoyancy knowledge. Whereas children’s predictions and explanations of the floating and the sinking of common objects are often based on a single feature (e.g., mass or facts), children’s predictions of novel cubes reveal solution strategies based on mass and volume integrations. Correspondingly, category learning theory suggests that categories (e.g., floaters vs. sinkers) are easier to identify when items mainly vary from one another in (...) the relevant defining features. For example, a set of cubes only varies in mass and volume and hence density, thereby being able to highlight the deterministic role of density when placed in water. Here we asked how item variation during hands-on exploration affects children’s subsequent predictions and explanations of buoyancy. Kindergarteners and first-, second-, and third-grade children individually explored either a set of 10 systematically varied cubes (i.e., systematic condition; n = 95) or a set of 10 common objects (i.e., non-systematic condition; n = 96) in a water basin. Next, the children predicted the buoyancy of five new cubes and five new common objects one at a time. Subsequently, the children explained their predictions one subset at a time. The children in the systematic condition were more accurate in their predictions of the test cubes than the children in the non-systematic condition. Latent class regression analyses identified three cube prediction solution strategies. The children in the systematic condition were more likely to use a strategy in which buoyancy decisions were made based on an accurate integration of mass and volume, while the children in the non-systematic condition were more likely to use a strategy in which mass was given more predictive load than volume. A third strategy was characterized by guessing. Latent class analyses of the children’s explanations revealed different explanation strategies, each appealing to several features, but as hypothesized, no clear condition differences were found. The findings indicate that even 5 min of exploration with systematically varied cubes can already help children use an advanced buoyancy prediction strategy. This provides evidence in favor of using category learning theory to inform early science education design. (shrink)

Local development enhances the economic capacity and quality of life of the residents and, in particular, attracts tourism to the area. The co-creative value of the residents and the tourists can improve the consensus of the residents on the sustainable development of the place. This study focuses on the factors influencing the co-creation of value between residents and visitors in the Tamsui area near Taipei. The research hypothesis is based on the components of local attachment, economic benefits brought by (...) tourists, environmental costs, social and cultural welfare of the place, life satisfaction of the residents, and the value of co-creation between residents and tourists. A total of 430 questionnaires were collected through a questionnaire survey and statistical data were analyzed using a structural equation model, including descriptive statistical analysis, measurement reliability and validity verification, model fit, and structural model analysis to validate the research hypotheses. The study found that place attachment positively and significantly affects the economic benefits, environmental costs, and socio-cultural welfare of residents about tourists. Resident satisfaction is positively and significantly affected by the environmental costs from visitors and by socio-cultural welfare, but there is no significant impact from economic benefits. Finally, based on the findings of the study, practical recommendations were made for enhancing co-creation value between Tamsui residents and visitors, including enhancing residents’ feelings of place attachment and construction of local social culture and welfare. For the residents of Tamsui, unlike the local government and enterprises, need to be able to create value with tourists in order to have a friendly relationship with them and develop regional tourism in a sustainable manner. (shrink)

The possibility of cooperation and the stability of political order are long-standing problems. Polybius, well known for his Histories analysing the expansion of Rome and his description of the Roman constitution, also offers an intriguing social and political theory that covers ground from psycho-anthropological micro-foundations to institution-based political order, providing a genealogy of morals and political order that is best understood in game-theoretical terms. In this paper I try to give such an interpretation. Polybius’ naturalistic, proto-game theoretical views show similarities (...) with Hume, Smith and especially Hobbes’ doctrine of sovereignty by acquisition. However, Polybius is original in crucial regards, giving a motivationally plausible account of institutional and especially constitutional solutions to moral and political problems. Constitutional order, for Polybius, embodies and makes possible in the first place a kind of political reason that cannot be had individually. Polybian political theory thus offers interesting solutions to problems concerning moral motivation, collective action, and the conditions for political order, as well as the explanation and character of institutions. (shrink)

Recent scholarship has focused on the tensions, contradictions, and limits of place-based branding through labels of origin, place-named agricultural products, and geographical indications. Existing literature demonstrates that even well-intentioned efforts to use place-based branding to protect the livelihoods and cultural and ecological practices of small producers are often undermined by transnational firms, states, and local elites who attempt to capture the benefits of these marketing strategies. Yet, little attention has been given to the implications of place-based branding for competition (...) among geographically dispersed agricultural producers. While place-based branding can be used for emancipatory ends, it can also be used strategically by agricultural producers to expand their market share at the expense of others. To explore these dynamics, I trace an alternative history of place-based branding that begins not in the potentially emancipatory politics of protecting terroir but rather in the tensions and contradictions characterizing the rise and decline of the US food regime. Drawing on a cross-time comparison of branding strategies within the global cotton trade, I make two key arguments. First, I argue that US producers and the US state forged the use of different types of branding strategies in response to the distinct tensions and contradictions characterized by the rise and decline of the US food regime. Second, these distinct branding strategies organized competition among geographically dispersed cotton producers in different ways. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:_Russell_ journal (home office): E:CPBRRUSSJOURTYPE2402\INDEXISS.242 : 2005-05-19 13:34
ibliographies, rchival nventories, ndexes INDEX TO RUSSELL’S THE IMPACT OF SCIENCE ON SOCIETY R H Summerfields, The Glade Escrick, York  , .. @.. he edition of the richly allusioned The Impact of Science on Society Tindexed here is that of George Allen and Unwin, published in London in . The pagination of Simon and Schuster’s edition (New York, ) is (...) different and spans pages – instead of the first British edition’s –. The very first edition of the book (New York: Columbia U. P., ) contained two paragraphs comparing Catholicism and Communism that were overlooked for the British and all subsequent editions. Russell regarded them as important, and Sir Stanley Unwin wrote him that they would be incorporated in the next printing. The next printing was not until , and the paragraphs were again overlooked. They belong just before the paragraph on page  beginning “Every fanatical creed” in Chapter , “Science and Values”. These paragraphs are not indexed.—Ed. I meet many people who think that the evils of Communism can be combated by Catholicism. This seems to me a dangerous error. What are the evils of Communism as it has developed? First, adherence to a rigid and static system of doctrine, of which part is doubtful and part demonstrably false. Second, persecution as a means of enforcing orthodoxy. Third, a belief that salvation is only to be found within the Church and that the True Faith must be spread throughout the world, by force if necessary. (These are the beliefs of Communists.) Fourth, that the priesthood, which alone has the right to interpret the Scriptures, has enormous power, physical east of the Iron Curtain and spiritual over the faithful in partibus. Fifth, that this power is used to secure an undue share of wealth for the priesthood at the expense of the rest of the population. Sixth, that bigotry, and the hostility that it engenders, is a potent source of war. Every one of these evils was exhibited by the Catholic Church when it had power and would probably be exhibited again if it recovered the position it had in the Middle Ages. It is therefore irrational to suppose that much would be gained if, in the defeat of Communism, Catholicism were enthroned in its place. (Pp. –) russell: the Journal of Bertrand Russell Studies n.s.  (winter –): – The Bertrand Russell Research Centre, McMaster U.  - _Russell_ journal (home office): E:CPBRRUSSJOURTYPE2402\INDEXISS.242 : 2005-05-19 13:34    Abraham  absolute monarchy  Adler, Alfred  adventure, impulse to ,  vs. rashness  aeroplanes  Africa cotton market  North, and Romans  age, average, in West – agriculture effects of  in history of man  integration into larger economy – wasteful of natural resources – see also soil conservation air power and governments  Alexander the Great and superstition  ambassadors, independence of  America see United States anaesthetics  anarchy  Anaxagoras ,  animals, and man  anthropology  apathy  Arab-Israeli conflict – Arabian Nights slaves of lamp in  Arabs and scientific technique  Archimedes , ,  Argentina agriculture  Arians  Aristotle  and causation – movement of heavenly bodies  armed forces and civil authorities  international, as concentration of power ,  perceptions of own/other nations’  in Russia –,  artillery  arts: authors and artists independence of –, –,  ascetic mentality  Asia: population and prosperity  astrology – astronomers Greek  prospects for life on earth  astronomical events indicating disaster  Atlantic Pact  atom bomb , , ,  atomic energy –, ,  Attica, history  Attlee, Clement  Augustine, Saint scientific argument against astrology – Auschwitz  Australia aborigines ,  agriculture  federal government  Austria: war with Prussia  Authority and the Individual (BR)  authority vs. observation –,  autonomy of physical world , – Aztecs and cannibalism  and infanticide  Babylonians and eclipses  Bacon, Francis and witchcraft  bacteriological war  Baltic–White Sea canal  barbarians, and late Roman Empire ,  Barbarossa (Frederick I)  , independence of  Bede, the Venerable on comets  belief(s) on basis of authority, as unscientific – science as determinant  in superstition  uncivilized peoples  benefits of scientific technique – _Russell_ journal (home office): E:CPBRRUSSJOURTYPE2402\INDEXISS.242 : 2005-05-19 13:34 Index to Impact of Science on Society  Bentham , ,  Bergson, Henri  Bible, false statements in  see also individual books of biological conditions of stability (of society) –, – biology technique(s) from – birth control and population , , – birth rate, low ,  Black Death , – Blimps, Col., Romans as  breeding, scientific – Bright, John  Britain, happiness in  British Empire... 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Photo ID 222412412 © US Navy Medicine | Dreamstime.com ABSTRACT In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. INTRODUCTION Medical resources in an austere environment without quick recourse for resupply or casualty evacuation are often (...) limited. The shortage extends not only to supplies like blood products and drugs, but physicians and other medical personnel. In the midst of a mass casualty scenario, such as a battle that includes intense ground fighting, the medical staff will stretch scarce resources and triage casualties according to specific criteria. Typically, they proceed by providing care for the most severely wounded first, referred to here as conventional triage. At times, though, the staff may reverse the triage so that soldiers with minor wounds can return to the fight. In a mass casualty situation, when medical personnel apply conventional triage and treat casualties from opposing forces, a dilemma may arise. We argue that it can be permissible for military physicians to prioritize their own soldiers over enemy combatants in a mass casualty triage, where reverse triage does not apply. The case we will focus on is as follows: Battlefield Triage: During combat operations on a remote island in the Pacific Ocean, a compatriot soldier and an enemy combatant arrive at the compatriot soldier country’s medical treatment facility. Both have similar gunshot wounds to the abdomen, and they arrive with similar conditions. Both have low oxygen saturation and excessive blood loss. The sole physician only has enough time to stabilize one person. The scenario is brief, and we are aware that medical rules of eligibility will most often dictate how the physician proceeds,[1] but this scenario is useful in setting up the question we focus on in this paper: would it be wrong to favor the stabilization of a soldier just because the soldier is the physician’s compatriot? In other words, can nationality serve as an ethically justified tiebreaker in a situation such as Battlefield Triage?[2] In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. The AMA’s Code of Medical Ethics asserts that physicians have “ethical obligations to place patients’ welfare above their self-interest and above obligations to other groups.”[3] The World Medical Association’s Declaration of Tokyo affirms that “no motive, whether personal, collective or political, shall prevail against this higher purpose” of alleviating distress.[4] Physicians are taught early on that triage decisions must be medically indicated and made without consideration of factors such as race, ethnicity, religion, social status, and nationality. They are taught that public trust and obligations of justice grounded in equality demand that only medical indications be considered. But military physicians in a military setting are beholden to obligations, duties, and responsibilities as members of the military, and when these obligations, duties, and responsibilities conflict, as they do in Battlefield Triage, which loyalties win out and why?[5] Critics of partiality on national grounds argue that partiality undermines public trust in medicine and justice because everyone should be treated equally regardless of nationality.[6] Proponents of partiality argue that military obligations supersede equality and that justice requires partiality in such cases.[7] Despite the critics’ disagreement, both agree that there is a morally right, perhaps even blameless, course of action. Drawing on insights from virtue ethics, we argue that Battlefield Triage is a moral tragedy in which justice is unattainable and there is no action without moral cost. The assumption that there is a morally right choice is flawed. We argue that while no decision in this scenario is free from moral blame, there are reasons to favor treating one’s soldiers over enemy combatants. I. The Case Against Partiality There is a common assumption that there is a morally right or just decision in Battlefield Triage. A number of organizations and scholars claim that it is wrong for military physicians to favor their own soldiers on the grounds of nationality or some form of ‘group membership.’ (In a conflict involving service members from multiple nations working as a coalition, a soldier from an allied country may receive the same priority as the US service member due to ‘group membership.’) The World Medical Association’s WMA Declaration of Lisbon on the Rights of the Patient, which was reaffirmed in 2015, posits that, “[i]n circumstances where a choice must be made between potential patients for a particular treatment that is in limited supply, all such patients are entitled to a fair selection procedure for that treatment. That choice must be based on medical criteria and made without discrimination.”[8] This echoes what was set forth in Article 12 of the Geneva Conventions, which states that “[o]nly urgent medical reasons will authorize priority in the order of treatment to be administered.”[9] The argument for impartiality in Battlefield Triage is that every person is morally equal, and equality entails that medical distribution is, “based on a combination of medical need and urgency.”[10] This is in keeping with the bioethical principles that are generally applied.[11] II. The Case for Partiality On the other side, there are arguments that favoritism is the ethically right decision in Battlefield Triage.[12] The argument asserts that members of the military form a morally significant community of friends and participation in these relationships demands partiality. Just as parents have strong ethical duties to their children and not just any children, military personnel have ethical duties to their group, a group that involves an affirmation of mutual aid and support. Some have termed these ‘associative duties. According to Michael Gross, obligations of friendship, care, and solidarity “leave very little room for generally applicable principles of justice that would obligate a medic to treat enemy or non-compatriot wounded ahead of their compatriots.”[13] This is true in Battlefield Triage, but it may also be true even if the enemy’s soldier were more seriously wounded: “the ethics of small group cohesion, largely an ethics of care, mostly replaces the demands of impartial justice.”[14] In a more recent article, Gross explains that preferential treatment is ethically justified based on fighting capability and “the special obligations people owe friends, family, and, no less, comrades-in-arms.”[15] To not show partiality to the US soldier would be morally wrong on the grounds of friendship and mutual care.[16] III. The Moral Tragedy of Battlefield Triage Defenders and critics of Battlefield Triage favoritism based on nationality both frame their position as just or fair. For example, Justin List argues that physicians are “bound to practice medical neutrality,”[17] Marcus Adams denies that physicians “possess special ethical obligations” to enemy combatants because of their profession.[18] These perspectives assume that there is a morally right decision and that justice is attainable. The assumption that there is or can be a morally right Battlefield Triage decision, and we need to put our heads together to figure it out, remains strongly entrenched. However, the facts of the situation should give us pause; there are too many people and too few resources, and this demands a decision-making process that determines who will receive scarce resources. By its very nature, a battlefield triage decision has to be made based on some characteristic or value, a characteristic or value that will inevitably favor some at the expense of others. This is precisely why competing analyses “in the military context struggle to resolve these conflicts satisfactorily.”[19] Drawing on the insights of virtue ethics, we suggest that Battlefield Triage is a moral tragedy. Virtue ethics suggests that morality is about acting virtuously, which is to say that we should do what a virtuous person would do in the situation. Ethics is about figuring out how a just, wise, compassionate, loving, and fair person would act, and then doing that, as one grows in virtue. But life is not always clear cut, and it is possible that virtuous people may find themselves in a moral tragedy, a situation in which, through no fault of one’s own, a person must make a morally objectionable decision. After the action the virtuous person “emerges having done a terrible thing, the very sort of thing that the callous, dishonest, unjust, or in general vicious agent would characteristically do.”[20] Stated differently, a moral tragedy presents a virtuous person with two or more courses of action, all of which have a moral cost.[21] In Battlefield Triage, no matter how the physician goes about deciding, there is going to be defensible concern from those not saved. The fact that there are more people than can be helped fosters competing values in battlefield triage: maximize lives saved, treat people equally, treat the worse off, and support the war effort. Treating people equally may create tension between treating the worse off, maximizing lives saved, and supporting the war effort. Reverse triage is a case in point, as supporting the war effort conflicts with treating the worse off first, as is a fair lottery system since deploying a lottery may not maximize lives saved or support the war effort. There can be reasons why one person is selected over another, to be sure. Yet, there are reasons for making a decision, and that the decision is subject to legitimate moral concern is another. To recognize the moral tragedy of Battlefield Triage is to recognize the impossibility of acting blamelessly in the situation. In this situation, the virtuous military physician is going to have to sacrifice important values such as justice, compassion, and respect for others, even with a defensible criterion in hand. The physician will grieve this sacrifice accordingly. The physician may find her decision difficult or stressful, and rightly so, because of what her circumstances require of her. This kind of moral tragedy results “in actions which betray and violate the rights of persons to whom there may be a strong duty of care. When this happens, it properly triggers an appropriate moral emotion since our moral integrity has been violated and this affects how we think of ourselves and what we have become.”[22] Rather than view her triage decision as the morally superior choice, the virtuous military physician will view her decisions in these circumstances in a different light: it is the least bad option in a terrible situation, and she did something ethically problematic, something that is contrary to her moral character. She deeply regrets the circumstances in which she had to act. IV. Virtue Ethics A virtue ethicist has insight into how one should go about deciding what to do in a moral tragedy, although virtue ethics may not be as helpful as one may hope. The goal of the virtuous military physician in Battlefield Triage is to adopt the best course of action or the action that she feels she ought to do, all things considered. This does not make her choice devoid of serious wrongdoing—a decision must be made, but that does not make it just. The virtuous military physician will approach the situation with courage, responsibility, and insight. She will think about the decision carefully, wisely, and conscientiously; she will weigh the goods and harms of the choices before her, in conjunction with a proper conception of the good life, human worth, and understanding of her obligations to others—including chain of command, fellow soldiers, and the medical community. She is attuned to the value of human life and has a reasonable idea of the various ways her decisions will affect others. She recognizes that she is in this non-ideal situation through no fault of her own: she is not the one fighting in battles; she is serving her country as a physician, whose job it is to save lives, treat everyone justly, and promote military objectives. She regrets the decision she is forced to make in battlefield triage, acting “with immense regret and pain,” Hursthouse explains, “instead of indifferently or gladly.”[23] This is because, no matter what decision is made, the virtuous military physician “does something terrible or horrible,” something she otherwise would not do and is contrary to her values.[24] V. A Resolvable Moral Tragedy Instead of asking whether there is a morally right decision, in which a decision is morally blameless and above reproach, the virtue ethicist asks whether there is a decision with a convincing rationale, knowing that a decision can have a clear rationale but still be morally tragic. It is perfectly reasonable to think that different virtuous persons will arrive at different courses of action: “two virtuous agents, in the same situation,” Hursthouse writes, “may act differently” in irresolvable moral tragedies, in cases in which there is no clear course of action.[25] Because a person must act in a moral tragedy, one goal is to identify reasons for choosing the chosen action. Some decisions are clearly indefensible—treating neither the compatriot soldier nor the enemy combatant in Battlefield Triage would be wrong—and some decisions are more problematic than others. If the military physician selects to treat the soldier because she does not like the enemy combatant’s skin color, such a reason would be deeply problematic. But much of the debate over how to act in a moral tragedy is not over clearly indefensible or problematic criteria. Instead, the literature is largely about different standards or implementations of justice. Some scholars defend nation-impartial triage as right, while others defend nation-aware triage as right, and each argues that the other side is promoting an unjust or otherwise wrong solution to Battlefield Triage. We suggest that Battlefield Triage is a resolvable moral tragedy and that virtue ethics offers convincing reasons to prefer the treatment of the compatriot soldier rather than the enemy combatant on the grounds of national identity. Virtues are integral to living a good life, a flourishing life, but as Aristotle observed long ago, human beings are inherently social, interdependent and interconnected in profound ways.[26] This goes beyond the obvious fact that we need each other to survive day to day (one person makes clothes, another farms, and another makes tools); the claim is that a good or flourishing life depends in large part on one’s social network or community. This is why many of Aristotle’s moral virtues are other facing: justice, friendship, generosity, and magnanimity, to name a few. Courage, a typically self-facing virtue, is understood by Aristotle to be the virtue that regards one’s fear of death in battle, a battle fought on behalf of one’s city.[27] All of this remains true today. Namely, there is an important sense in which our community matters to our lives: it is easier to live a good, flourishing life if one is part of a good, flourishing community. Our community is made up of smaller groups, and it is more accurate to say that we are simultaneous members of different groups within a broader community. A person may be part of a family, friend group, research team, large state university, city, state, and nation. Groups can function well or not, as we all have experienced, and this suggests that there are virtues or excellences that groups can instantiate. Good groups are unified in purpose, with each member doing their duty alongside others for the attainment of that purpose. Good groups manifest solidarity among their members. Although Aristotle does not list solidarity as a virtue, a number of modern-day virtue ethicists have begun examining how group solidarity can be a virtue that contributes to a good or flourishing life.[28] Solidarity is not conceptualized as an individual virtue, a virtue possessed by a person in isolation of others; instead, it is a collective virtue, a virtue that is shared among members of a defined group with particular ends.[29] “A group has solidarity to the extent that its members are disposed to: (1) share values, aims, or goals; (2) care about those values, aims, or goals; (3) act in accordance with those values, aims, or goals; (4) trust the testimony of other group members with respect to those values, aims, and goals; and (5) feel a sense of belonging to the group.”[30] The virtue of collective or group solidarity involves individuals having special concern for each other, shared aims and values, trust, loyalty, and a sense of belonging with these specific others. There is a oneness to the group in the pursuit of a definite goal or purpose, involving mutual support and affirmation of each member. As such, the group has ends and goods above and beyond the good of each individual person. Sometimes solidarity requires personal sacrifice for the collective (for example, a father sacrificing food so his child can eat). The virtue of collective or group solidarity is important to the military and medical community at every level, and for clear reasons. In the military, there is a clear hierarchy of command, unity of purpose and end, mutual trust and support in complex settings, and so on. Soldiers need to know they can count on one another, and solidarity grounds a soldier’s ability to trust others and be assured of mutual aid. In medicine, solidarity maintains self-regulation of the profession, shared values and goals, as well as public support, not to mention that day-to-day operations require physician trust, engagement, and effort toward the ends of clinical care. Physicians need to work together, along with others, in pursuit of health, and disunity is sowed when there is mistrust, selfishness, or disengagement among the healthcare team and organization. Importantly, just as we are all members of various groups and hence may manifest group solidarity in different settings, the virtuous military physician instantiates collective solidarity with both the medical profession and the military. Her dual loyalty contributes to the moral difficulty of acting in Battlefield Triage. The military physician has competing obligations to distinct groups and cannot satisfy all obligations in Battlefield Triage. Solidarity with the military supports the consideration of favoring the soldier for reasons of national identity, whereas solidarity with the medical community does not. Something has to give, which is why it is a moral tragedy. The virtuous military physician, therefore, must weigh the costs of each course of action. To fulfill her obligations to the medical community would require that she does not use nationality and other non-medical considerations in Battlefield Triage. Since the soldier and enemy combatant are equally injured, justice would demand a random process, perhaps a flip of the coin. Although this may satisfy obligations the military physician has to the medical community, this would be costly to the physician’s military group. If word gets out that the physician decides who to treat based on a coin toss, soldiers, families, and citizens may become frustrated and angry. Soldier morale may go down if it becomes known that a coin flip led to the preventable death of a soldier and the saving of an enemy combatant who had killed (or attempted to kill) other soldiers. As Gross highlights, military solidarity involves a mutual aid promise that military personnel promise to help one another.[31] A military physician is part of the military and, as such, is part of the mutual aid promise, which would appear to be violated if the physician flips a coin. Treating a member of one’s own team may be psychologically more beneficial than treating an enemy combatant and may lead to less moral distress.[32] Finally, treating soldiers rather than enemy combatants promotes broader military and social aims, including returning soldiers to health, maintaining unity of purpose, and minimizing community suffering from a soldier’s death. Favoring members of one’s group, that is, triage based on nationality in Battlefield Triage, would fulfill obligations of military group loyalty, which is contrary to the values and duties of medicine. It does not seem as though showing favoritism in this particular situation is very costly to the medical community or general public, but this is because there is recognition that the physician is in the military. Medicine is impartial to non-medical indications partly because of fairness and to promote public trust in medicine. However, Battlefield Triage is unique, as medicine is being practiced in a non-public, wartime setting. In ordinary circumstances, a patient’s identity is irrelevant, and physicians ought not play favorites. Since Battlefield Triage is not an ordinary circumstance, decisions based on patient identity may not undermine public trust in medicine. In addition, it is contestable that fairness in Battlefield Triage requires that no consideration be paid to one’s nationality. Fairness is about giving each person their due, what is owed to them, and the case can be made that soldiers who place themselves in danger for the sake of the common good or a just cause are owed special attention when they suffer harm in the line of duty. In other words, soldiers voluntarily undergo risk to themselves for the greater good, and society owes them for this sacrifice. This plausibly includes preferential treatment in a situation such as Battlefield Triage. So, while the medical community affirms justice demands non-preferential treatment, the military community can affirm the opposite. The demands of fairness are unclear at best or in conflict in this situation: demands of physician justice decry favoritism, while demands of military justice support favoritism. Triage not based on nationality is arguably unfair and triage based on nationality may not undermine public trust, after all. All things considered, there is a clear rationale for favoring nationality-based preferential treatment in Battlefield Triage. Adopting a nationality-based preference in this situation is more defensible than not. This does not make such a decision ethically right or just. Preference based on nationality is the least bad decision, but it is not morally blameless. It involves one in a serious moral wrong, a wrong otherwise avoided and contrary to one’s character. The virtuous military physician is in a situation in which obligations conflict, and we disagree with Gross, who posits that care of fellow soldiers “is important to the near exclusion of all else.”[33] Gross fails to appreciate the collective virtue of solidarity as applied to those in medicine. The military physician has duties to fellow soldiers but also to fellow physicians, to the medical community, and humanity. To favor a soldier on grounds of nationality violates her duties and responsibilities to this latter group. She is involved in a moral tragedy and can only seek the most just action given the circumstances, yet, at least in virtue ethics, the action remains far from blameless. CONCLUSION We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. As such, the virtuous military physician incurs a moral cost to acting as she does—there is a moral residue. However, despite being a moral tragedy, there are clear reasons to act in favor of treating one’s own, considering group solidarity. As such, these kinds of tragedies are resolvable: virtuous military physicians should favor treatment of their own, although they would do so with sorrow. - [1] Militaries set forth medical rules of eligibility or guidelines used to determine whether a person qualifies for specific medical interventions or treatments in certain circumstances, and these guidelines are binding for a military physician. For example, despite opposition from medical organizations, militaries have adopted reverse triage guidelines for military physicians to follow. For ethical discussion, see Falzone, Elisabeth, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, and S. Mérat. "Triage in military settings." Anaesthesia Critical Care & Pain Medicine 36, no. 1 (2017): 43-51. https://doi.org/10.1016/j.accpm.2016.05.004 [2] There are issues that are related to this, including the triage of civilians and allied soldiers. We set related issues aside for purposes of this paper [3] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [4] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [5] This is termed the “dual loyalty” dilemma in military medicine and has been described at length elsewhere: Institute of Medicine (US) Board on Health Sciences Policy. Military Medical Ethics: Issues regarding Dual Loyalties: Workshop Summary. Washington (DC): National Academies Press (US); 2008. Toward a Framework for Resolving Dual Loyalties. Available from: https://www.ncbi.nlm.nih.gov/books/NBK214853/ [6] See Kenneth G. Swan and K.G. Swan, Jr., “Triage: The Past Revisited,” Military Medicine 161:8 (1996): 448–452. https://doi.org/10.1093/milmed/161.8.448; Jerome A. Singh, “American Physicians and dual loyalty obligations in the ‘war on terror,’” BMC Medical Ethics 4.4 (2003): 1–10. https://doi.org/10.1186/1472-6939-4-4; Beam, Thomas E. "Medical Ethics on the Battlefield." Military Medical Ethics: Sect. IV. Medical ethics in the military. Medical ethics on the battlefield: the crucible of military medical ethics 2 (2003): 369-402; Hereth, Blake. "Health justice for unjust combatants." Journal of Military Ethics 20, no. 1 (2021): 67-81. https://doi.org/10.1080/15027570.2021.1949782. [7] See Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. Gross, Michael L. "Comradery, community, and care in military medical ethics." Theoretical medicine and bioethics 32 (2011): 337-350. https://doi.org/10.1007/s11017-011-9189-6. Gross, Michael L. "The limits of impartial medical treatment during armed conflict." In Military medical ethics for the 21st century, pp. 71-84. Routledge, 2016. [8] World Medical Association, WMA Declaration of Lisbon on the Rights of the Patient. 5 December 2022, https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ [9] Geneva Convention for the Amelioration of the Condition of Wounded, Sick in Armed Forces in the Field. 12 August 1949. https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.30_GC-I-EN.pdf. [10] List, Justin M. "Medical neutrality and political activism: physicians' roles in conflict situations." In Physicians at war: The dual-loyalties challenge, pp. 237-253. Dordrecht: Springer Netherlands, 2008. 240 [11] Beauchamp, T., and J. Childress. 2013. Principles of Biomedical Ethics, 7th ed. Oxford, United Kingdom: Oxford University Press. [12] Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. [13] Gross, "Comradery, community, and care in military medical ethics," 347. [14] Gross, “Comradery, community, and care in military medical ethics,” 349. [15] Gross, Michael L. "When medical ethics and military ethics collide." Narrative inquiry in bioethics 13, no. 3 (2023): 199-204. 202 https://dx.doi.org/10.1353/nib.2023.a924191 [16] Our argument draws on virtue ethics, from which care ethics derives, and it is worth clarifying how our argument relates to Gross’s. We do not think that the virtue of friendship grounds triage decisions, for we think it is unlikely that the physician and wounded soldier are friends. Instead, as explained below, we think the collective virtue of group solidarity better captures the moral significance of group loyalty and that Gross would agree with us. But since military physicians are part of distinct groups, with competing obligations, the military physician will be forced to sacrifice a value in battlefield triage cases. In other words, we think Gross downplays the dual group membership of a military physician. [17] List,”Medical neutrality and political activism,” 250. [18] Adams,”Triage priorities and military physicians,” 235. [19] London, Leslie, Leonard S. Rubenstein, Laurel Baldwin-Ragaven, and Adriaan Van Es. "Dual loyalty among military health professionals: human rights and ethics in times of armed conflict." Cambridge Quarterly of Healthcare Ethics 15, no. 4 (2006): 381-391. 383. [20] Hursthouse, R. On Virtue Ethics. OUP 1999. 74 [21] Nussbaum, Martha C. "The costs of tragedy: Some moral limits of cost-benefit analysis." The Journal of Legal Studies 29, no. S2 (2000): 1005-1036, 1007. [22] De Wijze, S. (2005). Tragic-remorse–the anguish of dirty hands. Ethical theory and moral practice, 7(5), 453-471, 457. https://doi.org/10.1007/s10677-005-6836-x [23] Hursthouse, 73 [24] Hursthouse, 81 [25] Hursthouse, 72 [26] Aristotle, Politics 1253a8. Reeve, C. D. C., Indianapolis: Hackett Publishing Co., 2017 [27] Aristotle, Nicomachean Ethics. III.6.114a, 34-35. 2002, Nicomachean Ethics, Christopher Rowe (trans.), Oxford: Oxford University Press [28] Byerly, T. Ryan, and Meghan Byerly. "Collective virtue." The Journal of Value Inquiry 50, no. 1 (2016): 33-50. https://doi.org/10.1007/s10790-015-9484-y; Federico, Veronica. "Conclusion: solidarity as a public virtue." Solidarity as a Public Virtue (2018): 495-542. https://doi.org/10.5771/9783845290058. Rehg, William. "Solidarity and the common good: An analytic framework." Journal of Social Philosophy 38, no. 1 (2007): 7-21. https://doi.org/10.1111/j.1467-9833.2007.00363.x [29] Byerly and Byerly. "Collective virtue." 43 [30] Battaly, Heather. "Solidarity: Virtue or vice?." In Social virtue epistemology, pp. 303-324. Routledge, 2022. 304 [31] Ibid., 2011: 341 [32] It might be thought that displaying altruism by helping an enemy combatant at the expense of one’s fellow soldier may be psychologically satisfiying. For evidence that military physicians find it difficult to treat enemy combatants, see Lundberg, Kristina, Sofia Kjellström, Anders Jonsson, and Lars Sandman. "Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties." Military medicine 179, no. 8 (2014): 821-826. https://doi.org/10.7205/MILMED-D-14-00038. Lamblin, Antoine, Clément Derkenne, Marion Trousselard, and Marie-Ange Einaudi. "Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study." BMC Medical Ethics 22 (2021): 1-13. https://doi.org/10.1186/s12910-021-00723-2 [33] Ibid., 2011: 344. (shrink)

In this paper it is argued that the corresponding rise of postmodernism and the triumph of neo-liberalism are not only not accidental, the triumph of neo-liberalism has been facilitated by postmodernism. Postmodernism has been primarily directed not against mainstream modernism, the modernism of Hobbes, Smith, Darwin and social Darwinism, but against the radical modernist quest for justice and emancipation with its roots in German thought. The Social Democratic State, the principles of which were articulated by Hegel, is construed as (...) a partial triumph of this radical modernism, realizing a higher level of reciprocal recognition and overcoming much of the brutality of the Liberal State. Postmodernism is shown to be a manifestation of the decadence of the Social Democratic State, characterized by the disintegration of cognitive and ethical developments which have been the condition for people to form communities based on reciprocal recognition. In this regard it parallels the decadence which took place in ancient Rome, for similar reasons: both the Roman Empire and the Social Democratic State reduced people to passive recipients of the benefits of their societies. The implications of this are twofold. If Social Democracy is to be revived, it will require a struggle for ‘strong’ democracy; that is, for a major role for participatory democracy. On the other hand if people opt for the creation of confederations of genuinely democratic communities to replace the State, this will not be achieved by postmodern decadence but through the developments of cognitive forms and communities through which the recognition of people as free agents is instititionalized. (shrink)

In this article we explore how Swedish welfare politics within health‐care and rehabilitation has opened up a space for nurses’ and occupational therapists’ professional projects. Using historical data, an analysis of the policy‐making process behind welfare programs central to the professionalization of nursing and occupational therapy is presented. The time period covered is, in the case of nurses, the larger part of the twentieth century, while the modern history of occupational therapists first began in the 1940s. Special emphasis (...) is placed on the corporative nature of the Swedish welfare state and the professional strategies utilized by nurses and occupational therapists in their struggle for jurisdiction. In the article, politicization is identified as a core strategy by which female‐dominated welfare state occupations in Sweden have tried to gain influence over the welfare policy‐making process and their occupations’ jurisdiction. (shrink)

In this collection of essays on the core values of liberalism, Stephen Holmes—noted for his scathing reviews of books by liberalism's opponents—challenges commonly held assumptions about liberal theory. By placing it into its original historical context, _Passions and Constraints_ presents an interconnected argument meant to fundamentally change the way we conceive of liberalism. According to Holmes, three elements of classical liberal theory are commonly used to attack contemporary liberalism as antagonistic to genuine democracy and the welfare state: constitutional (...) constraints on majority rule, the identification of individual freedom with an absence of government involvement, and a strong emphasis on the principle of self-interest. Through insightful essays on Hobbes's analysis of the English Civil War in _Behemoth_, Bodin's writings on the benefits of limited government, and Mill's views on science and politics, Holmes shows that these basic principles provide, to the contrary, a necessary foundation for the development of democratic, regulatory, and redistributionist politics in the modern era. Holmes argues that the aspirations of liberal democracy—including individual liberty, the equal dignity of citizens, and a tolerance for diversity—are best understood in relation to two central themes of classical liberal theory: the psychological motivations of individuals and the necessary constraint on individual passions provided by institutions. Paradoxically, Holmes argues that such institutional restraints serve to enable, rather than limit, effective democracy. In explorations of subjects ranging from self-interest to majoritarianism to "gag rules," Holmes shows that limited government can be more powerful than unlimited government—indeed, that liberalism is one of the most effective philosophies of state building ever contrived. By restricting the arbitrary powers of government officials, Holmes states, a liberal constitution can increase the state's capacity to focus on specific problems and mobilize collective resources for common purposes. _Passions and Constraint_ is an assessment of what that tradition has meant and what it can mean today. (shrink)

continent. 2.1 (2012): 6–21. The French philosopher and novelist Tristan Garcia was born in Toulouse in 1981. This makes him rather young to have written such an imaginative work of systematic philosophy as Forme et objet , 1 the latest entry in the MétaphysiqueS series at Presses universitaires de France. But this reference to Garcia’s youthfulness is not a form of condescension: by publishing a complete system of philosophy in the grand style, he has already done what none of us (...) in the older generation of speculative realists has done so far. His book is sophisticated, erudite, rigorous, imaginatively rich, and abundant in worldly wisdom– despite the author’s conclusion that wisdom does not exist. The quality and scope of Forme et objet took few observers by surprise, since Garcia has been treated as an emerging philosopher to watch across half a decade of Parisian oral tradition. But Garcia was not just the subject of rumor, being already well known to the French public as a writer of fiction. His debut novel, La meilleure part des hommes , 2 was awarded the 2008 Prix de Flore 3 and has already appeared in English as Hate: A Romance . 4 His follow-up novel, Mémoires de la jungle , 5 made clever use of a chimpanzee narrator. Nor was Garcia only published as a novelist before last November: his philosophical study L’Image 6 had already appeared when the author was just twenty-six, a year before he was crowned by the muses at the historic Café de Flore. And then in 2011, just months before the appearance of Forme et objet , Garcia published a widely distributed work entitled Nous, animaux et humains , 7 with its focus on Jeremy Bentham’s ideas about animals. Given this prolific and versatile track record, an optimistic scenario might envisage the young Garcia as one of those combined literary/philosophical talents who appear intermittently in France across the centuries: Jean-Paul Sartre is merely the most famous recent case. While more time is needed to see how Garcia will channel his impressive mental energies, Forme et objet displays such breadth of insight that its author has a good chance to emerge as one of the leading philosophers of his generation. If we accept Aristotle’s dictum that the peak mental age is fifty-one, then to read Garcia’s massive book is to gain some idea of what European philosophy might look like in the futuristic-sounding 2030’s. The present article is confined to Forme et objet . At 486 pages, the work is obviously daunting in size. Indeed, it is even longer than it sounds, given that many of its early sections are printed in a smaller typeface to designate them as supplemental commentary to the main flow of the argument. But while the length of the book reportedly led to delays in French publication, and will probably slow the inevitable appearance of an English translation, the length of the book should not deter interested readers– much of it results from Garcia’s teacherly writing style. Whereas Quentin Meillassoux’s prose displays an arctic economy of means, Garcia’s style is reminiscent of the repeated lessons of oral classroom proceedings. Rarely is the reader given fewer than three or four chances to master an idea before the author moves on to the next. In practice, the style feels welcoming rather than long-winded. Otherwise, the structure of Forme et objet is surprisingly simple. There is a useful Introduction of less than twenty pages. Then comes Book I: Formally , running to approximately 135 pages. Here Garcia outlines the most basic features of a thing “no matter what it is,” or n’importe quoi , an everyday phrase that Garcia shapes into a technical term. This part of the book feels at times like a more amiable version of Hegel’s Science of Logic , a parallel emphasized further by the threefold articulation of its theme: 1. Thing; 2. Thing and World; 3. Being and Understanding. This is followed by the much longer Book II: Objectively , totaling more than 300 pages. It contains sixteen essay-like meditations on specific kinds of objects—including time, animals, humans, history, gender, and death. Here each chapter rolls smoothly into the next, making this second part of the book feel more like a different work of Hegel: The Phenomenology of Spirit . But these are merely analogies. Garcia is no Hegelian, even if the book contains a few dialectical flourishes that seem to reflect his early enthusiasm for the Frankfurt School. Forme et objet ends with a six-page Coda, followed by the usual page of acknowledgments. In what follows, I will briefly summarize each of these four parts of the book before ending with some more general remarks. Before doing so, it will be useful to situate Garcia biographically (as much as I am able) and philosophically. Though Toulouse is his native city, his formative years were spent largely in Algeria, where his family has deep roots. During our sole private conversation, Garcia mentioned that his parents are professors of literature. 8 As a student of philosopher Garcia flourished so early that many of his current ideas date to his teenaged years: “There are sentences in Forme et objet that I wrote when I was seventeen,” he said in response to a question on that cold night on the Canal St.-Martin. I recalled that remark when reading his brilliant account, late in the book, of the central role of adolescence in contemporary culture. While many prodigies blow through their formal academic training without serious obstruction, Garcia’s student memories are rich in tales of isolation and struggle, though equally rich in gratitude for a half-dozen or so exceptional teachers who provided the intellectual space he needed: Meillassoux and Alain Badiou are simply two of the most prominent figures on that list. Though there are many points of agreement between Garcia’s philosophical position and my own, he not only reached his position years before reading my work, 9 he arrived along a rather different path: not through phenomenology, but via the Frankfurt School, which may be one of the reasons for his profound fascination with aesthetics. Garcia’s cultural background is as broad as one could wish: he is no less informed about punk rock and European football leagues than about the spiritualist roots of Bergson’s philosophy. Curious about everything and contemptuous towards nothing, Garcia can be expected to write insightfully on dozens of topics in the years to come. Given that his philosophy is so personally tantalizing in its agreements and disagreements with my own, and given the great internal richness of Forme et objet itself, the present review is no better than a first effort at coming to terms with the challenges posed by this minstrel from the rising generation. This is especially intriguing for older Generation X’ers like me, since confrontation with the younger generation is one of the many themes treated insightfully in Garcia’s book. 1. Introduction Garcia begins in defense of a so-called “flat ontology,” in which all things are equally things. While Roy Bhaskar 10 used this term pejoratively to refer to anti-realist philosophies that flatten everything onto an epistemic plane of human access, Manuel DeLanda 11 (an admirer of Bhaskar) reversed it into the positive principle that all realities are equally realities. Similar notions can be found in the “absistence” of Alexius Meinong, 12 the “irreduction” of Bruno Latour, 13 and my own critique 14 of the undermining/overmining pair. Also noteworthy is Levi Bryant’s use of the term “flat ontology” throughout The Democracy of Objects 15 and his earlier essay “The Ontic Principle.” 16 But for Garcia, flatness is only one face of the cosmos, and one that he ultimately declares to be rather impoverished. Even so, he always remains an advocate of a flat ontology. Insofar as everything is equally something, no matter what it is ( n’importe qui ), everything is equally a thing, equally solitary in its relation with world. This is why his book abounds in those long lists of random, ontologically equivalent entities that Ian Bogost has playfully termed “Latour Litanies.” 17 The first litany in Garcia’s book runs as follows: “We live in this world of things, where a cutting of acacia, a gene, a computer-generated image, a transplantable hand, a musical sample, a trademarked name, or a sexual service are comparable things.” (7) Yet Garcia is frankly dualistic; his flat ontology only lasts until page 159 and the end of Book I (entitled “Formally”), which deals entirely with things that are equally things. Thereafter Garcia turns his attention from things to objects, which are not flat in the least, but engage in hierarchical relations with one another. In agreement with both DeLanda and the speculative realists, Garcia proclaims that his book “proposes to put to the test a thought about things rather than a thought about our thought about things .” (8) Just as ducklings are “imprinted” (9) after hatching and treat the first creature they see as their mother, philosophers are imprinted by the idea with which they begin. Hence, philosophies that begin with human access will never truly find their way back to things. This makes Garcia rather suspicious of twentieth century philosophy, since “the twentieth century—to which in some way this work proposes to bid adieu—has been a period of theorizing modes of access to things rather than things...” (9) Among other possible benefits of the philosophy of things that Garcia proposes, it is fully able to account for thought as a special variant of things, while the reverse is not possible.(10) In Book I of Forme et objet , Garcia’s “things” are so flat, so de-determined, that he is forced to renounce some of the most basic features ascribed to things by most realists. As he tells us in his foreboding third footnote: “We will maintain that the solitude [of things] is less than unity, less than identity, and that it does not imply acceptance (any more than refusal) of the principle of non-contradiction.” (11) In a contemporary world cluttered with too many things, Garcia’s flat and formal plane provides us with some breathing room: “The formal plan of thought enables or re-enables us to cut short all accumulation—whether of knowing, experience, or action—by a simplicity, an impoverished surface...” (13) As Garcia says elsewhere in responding to a Deleuzian critic of the book, his starting point in flat ontology is designed to obstruct the claims of both analytic philosophy and Hegelianism: “Hence, this work seeks to protect each thing—real, imaginary, inconsistent, contradictory—both against Ockham’s Razor and against the Aufhebung or dialectical process.” 18 Yet contrary to the equalizing spirit of many flat ontologies, “we will add to our formal ontology of the equal, an objective ontology of the unequal.” (13) But initially, Garcia joins all flat ontologists in holding that everything is irreducible: “this irreducibility, which we will term the ‘chance’ of each thing... also marks the refusal of a positive thought that reduces things exclusively to natural things, or social things, or historical things, etc.” (15) This irreducible “chance” of a thing emerges as an important technical term in the book, always paired with its inverted brother, the “price to pay” ( prix à payer ). On pages 17-19, we find the only diagrams in the book. What they illustrate is that Garcia wishes to avoid two equally dangerous extremes. The first is the philosophy of substance, featuring the thing-in-itself as a mighty river fed by attributes as if by subordinate tributary streams. This model can be found in many of the classic thinkers of West and East alike. In it, “there is obviously a hierarchization between that which is dragged towards something other than itself, and this other which serves it as an ontological support while supporting its proper being.” (16) For Garcia, the second extreme worth avoiding is the philosophy of events: “One thus conceives trajectories of being, identified as events, facts, powers, intensities, or intentionality. These vectors of being come first, bearing and supporting being, displacing it, but without ever finding a stopping point, a buffer, an objective consistency.” (17) The first model gives us a thing too wrapped up in itself, too compact . This word “compact” (the French and the English are the same) is another technical term for Garcia. But if the “compact” model of things leads us to something more than things, the philosophy of events gives us less than things, by dissolving them into a play of vectors. Garcia’s alternative lies midway between these two extremes: Being enters the thing, being comes out of it. And a thing is nothing other than the difference between the enters and the being that comes out. Thus, the circuit of being is never halted. In the thing, there is never the thing-in-itself. And the thing is never in-itself, but outside of itself. Nonetheless, being is not eventally “pollinated” by vectors: it possesses an objecting halting-point... (19) This single idea is the key to Garcia’s book: the thing is neither a self-contained durable lump nor some sort of evental flux. Instead, the thing is the difference between its various components and its relations with its environment. Or stated differently: “the price to pay for this disposition is a circulation of being that systematically distinguishes two senses of things: that which is in the thing , and that in which the thing is , or that which encompasses it and that which it encompasses,” (19) translating comprendre here as “encompass.” 19 In a beautiful description of a piece of black slate, Garcia sums up the various minerals, qualities, and shapes that compose [ comprend ] it, and calls them “that which is in the thing,” (20) noting that this tells us nothing about “that in which [the slate] is”—namely, all the various situations in which the black slate can be found. Instead, the slate is the difference between these two: the most characteristic principle of Garcia’s philosophy. 2. Formally Book One of Forme et objet , “Formally,” is concerned with the formal equality of all things in a flat world. “Two questions mark the boundaries of reflection: of what is everything composed [ composé ], and: what do all things compose?” (27) Looking downward, we wish to know what everything is made of; looking upward, we want to know the ultimate result of the combination of all things. Here we must turn our attention to the thing n’importe quoi— no matter what it is. (30) Anything with finite qualities is obviously too specific to be relevant to global ontological questions. To an equal degree, something possessing all qualities (think of Whitehead’s God) 20 would not be n’importe quoi either, since it would still be too definite, even if incredibly vast. The same holds for contradictions, since these all differ from each other. The square circle, the non-white black white, and the non-city city are all too distinct to count as the thing no matter what it is. The n’importe quoi must be devoid of all specific qualities, including contradictory ones. In one of the more intriguing points in his book, so reminiscent of Meinong, Garcia proclaims that “the ‘no matter what it is’ is neither a reality nor an abstract construction, nor both of these at once; the ‘no matter what it is’ is simply the plane of equality of that which is real, that which is possible, that which is inexistent, that which is past, that which is impossible, that which is true, that which is false, that which is bad.”(39-40) Since everything has two faces, it would be a grievous mistake to focus on just one of them at the expense of the other, as physicalism or materialism do when reducing the world to minuscule physical underpinnings. For scientistic materialism, “it is either atoms, particles, or fields of force... which are the things.” (47-48) Moreover, “these more-than-things are accompanied by less-than-things: for example, ideas or facts of consciousness are determined by the state of matter and are not autonomous things, but manifestations reduced to secondary effects of material processes...” (48) On this point, Garcia’s position is in complete accord with my own critique of undermining and overmining. 21 Where we disagree is that Garcia is more deeply suspicious of the notion of substance, which I view as salvageable with a few needed changes, while Garcia sees this operation as hopeless: “A substance, in the history of philosophy, is the more-than-thing par excellence.” (51) Another agreement between our positions is visible when Garcia claims (correctly, in my opinion) “that it is vain to distinguish between things which are material and those which are not.” (52) Yet we also find an even more important disagreement, since for Garcia withdrawal cannot be the quality of a thing. Instead, the absence of a thing is simultaneous with it, embodied in all that is not it– the absence of the sculpture of a woman is to be found in the mold that appears at the same time as it, and thus withdrawal must be viewed as an “event” rather than as something pertaining to an object. For Garcia, nothing withdraws beyond access. Since we must distinguish between “that which is something” and “that which something is,” and since the former is identified with “no matter what it is is” and the latter with “ not no matter what it is,” we can say that “everything is thus a milieu, a fragile link between ‘no matter what it is’ and ‘ not no matter what it is.’” (62) And here we find Garcia’s critique of the thing-in-itself: “A thing is never defined en bloc . We can affirm that a thing is this or that, but that does not suffice. It is still necessary to state precisely that which is this thing .” (62) Stated differently, “something is not in itself : for that which is in the thing is not the thing, and that in which the thing is is not the thing.” (62) And here Garcia and I, facing the same evidence, draw opposite conclusions. For me, the fact that nothing can be identified with either its components or its concrete location means that the thing must be something in-itself distinct from both of these. Yet for Garcia, to be in-itself would mean to be identified with just one of these two extreme terms, and hence the thing can only be the difference between them. Garcia is equally suspicious of the classical tendency to view “unity” as a property of the thing, since in his eyes unity is too relational a property to belong to things. (65) While specific things are situated determinately with respect to other things, we are still speaking here about the thing no matter what it is, and this can be viewed only in terms of solitude, which all things share: a human being, a hand, or a chair or all equally things insofar as they are on their own , not insofar as they are one . (64) A thing is alone, and relates only to the one thing that is not another thing: world. In a striking parallel to my own argument for a partial revival of occasionalism, Garcia tells us that “the things communicate only by their solitude: it is because everything is equally on its own in the world that things can be together, enmeshed in one another.” (67) Alone in their solitude, things all relate to world, which serves as a mediator allowing them to become mixed up in one another. As we have seen, one reason that nothing can be in itself is because everything is in something else. For Garcia, “to be in something and to be something are equivalent.” (69) Stated more broadly, “being is thus the difference between the two aspects of each thing: that which is it, and that which it is.” (70) And even more vividly: “a thing is almost like a sack: there is that which one puts in the sack and that which remains outside the sack.” (70) But not quite like a sack, “since a thing is not a thin skin or film. Instead, a thing is comparable to a sack that is immaterial and without thickness: it is nothing other than the difference between that which is this thing and that which thing is, between content and container.” (71) Nothing can be in-itself because everything is two selves at once. For example, we cannot say that our self is defined by our consciousness: “Everything has a self because nothing is in itself. The self is not the quality of that which is related to itself (which is conscious, for example) or which thinks itself related to itself. Nonetheless, for an entity called ‘conscious’ to be related to itself, it is necessary that this very relation should be another thing than the self to which it is related.” (71) Consciousness cannot be the self, precisely because it is other than that of which it is conscious. Nothing is able to grasp itself. The self is “the function by which being and composition [ compréhension ] are mutually excluded...” (72) The self is “the point of shadow of everything that projects some light...” (72) The in-itself faces two opposite dangers: “For something to be in-itself is to be a self. Something which is a self flies out through one of its two sides... Stated differently, being in-itself is simply the possibility of a double failure.” (73) The in-itself can be termed compact : “There remains to us a means of thinking that which does not fully enter into the world, though without exiting from it. This means is what we call the compact.” (76) In a sense, the compact is the opposite of the world. For in the case of the world, everything enters it and it enters nothing; as for the compact, it enters the world (since it is something, after all) while nothing enters it. (77) The compact marks the presence of the impossible in the world. (78) It is not impossible, but possible only on the condition that it fails. (78) The time has come to speak of where a thing is located. “The sole condition of a thing is that of being in another thing than itself, and thus in another thing than something.” (78) A condition is “that which determines something, that which forms something, that in which something is.” (78) As for humans, “the condition of someone is his situation; my social condition is that which socially determines me, my place and my function...” (79) More generally, “to be conditioned is to find oneself reduced to that in which one is.” (79) Everything is conditioned, but nothing is reducible to this condition. To determine the condition of something is to determine in what it is. A thing is located in that which contradicts it, just as a statue exists in its mold, which is precisely that which it is not. Since the thing is finite and definite, its condition or form must be infinite and indefinite. That in which all things are is the world, which Garcia also terms “the whole.” (81) “To try to be in-itself is to attempt to remain outside the world. And indeed, to try to be in-itself is only a path of entry into the world.” (83) For Garcia, “the world is not the pre-existent container of the things it contains, a priori , nor the construction by the mind of a fictional ensemble of all things, a posteriori .” (85) Instead, the world is simultaneous with all things; the two always go together. The world cannot be a determinate world, such as the physical universe or mathematical space, since these are already too specific and limited. “Every determinate world, which is in fact a universe , is a ‘big thing’ [ grosse chose ]: it is a set, however vast, of composite things which itself embodies a thing.” (85) Every determinate world is really just a “big thing.” Stated differently, “it is nothing other than a balanced milieu between the things that compose it and the thing that it composes.” (85) We generally picture the world as a physical univer. (shrink)

In the work of Karl Polanyi, the negative effects of a self-regulating market economy are described as being limited by societal forces such as the policies of the welfare state. With the decline of the modern welfare state since the late 1970s, social activities of business firms are increasingly regarded as an important complement to or even as a substitute for welfare state policies by a part of the literature. However, and controversially, another stream (...) of argumentation regards these activities as being aimed at advancing the reach of market forces. To fully grasp the ambiguous nature of the social activities of business, in this paper I provide an account of affirmative as well as of critical interpretations of these activities throughout the history of modern capitalism. On this basis, the power of critique to disentangle the diverse motivations that underlie the social engagement of business is highlighted as a condition for facilitating a role of business in society that balances economic and social considerations. (shrink)

A common view of politics is that it is reducible to applied ethics. If politics, in a classic phrase, is about “who gets what, when, and how,” then the task of normative political theory would simply be to tell us who is morally entitled to get whatever the “what” is in that statement.This view, however, can easily reduce politics to a dizzying vortex of actions to assess from an ethical perspective. And while the task of moral philosophy may be precisely (...) to articulate principles by which to pass such judgment, the focus of political theory lies elsewhere.To study and assess politics means attending to the institutional frameworks and structural conditions that enable or constrain human action to begin with. The question for normative political theory, in other words, is whether the organizational structure of a given society—embodied in its decision-making procedures, its distribution of power, and its defining patterns of production, reproduction, and distribution—is defensible or not.This question of justice in the institutional makeup of society has not been entirely ignored in animal rights literature. Animal advocates have always been clear about the massive societal ramifications of dismantling the speciesist order. Likewise, rights theorists and activists have often proposed concrete legal measures for improving the protection of animals, be it by piecemeal welfare reform in animal agriculture, by the abolition of specific practices in biomedical research, or by seeking the equivalent of human rights for select species like great apes or dolphins. The field has also seen fierce debate among animal advocates about the appropriate strategies for engaging with the state and the legal system.Nonetheless, most discussions have been about what it means to treat individual animals with respect, and not about what is required of a political order aspiring to just treatment of all species. In fact, it is only in the last decade that the issue of political justice has taken up a place at the center of animal ethics.Though the field is still developing, we may take it as a sign of maturity that it can now sport its first “short introduction” book: Alasdair Cochrane's Should Animals Have Political Rights? (2020). Its appearing as part of the Polity Press series Political Theory Today further attests to the book's timeliness.The starting point of Cochrane's book—and of political animal studies in general—is that political relations between humans and other animals are not optional but inevitable. Other animals live among us, and the way we organize our societies has a massive impact on the lives of other sentient animals both inside and outside the borders of our human communities. Assuming that these creatures possess intrinsic value as experiencing individuals with morally relevant interests, the question seems inescapable: What kind of polity can accommodate for the multispecies character of our communities and embody justice for all sentients? Cochrane's answer is largely the same as the one he offered in his previous book, Sentientist Politics: A Theory of Global Inter-Species Justice (Oxford University Press, 2018), where he laid out his full vision of a postnational and species-neutral “cosmozoopolis.”The present book is much more concentrated and written as an accessible introduction for readers new to the field. Over seven short chapters, Cochrane reconstructs his argument for an interspecies democracy by assessing a series of arguments and propositions drawn from previous literature on the topic.The first notion to be scrutinized is the popular idea that animal welfare legislation is enough to secure respect for animals. Here, Cochrane acknowledges that welfarism goes some way toward safeguarding animal interests, but he also stresses that its historical record has been disheartening. Welfarism protects animals only insofar as their protection coincides with human interests, and this is far from enough to ensure respect for the animals’ intrinsic value.The second line of argument tries to push beyond welfarism by claiming constitutional protection for animals. By this move, reformers hope to place animal interests on an equal footing with human interests and prevent the overriding of the former in the name of human entitlements (to property, artistic expression, freedom of science, and so forth). Looking at real-world cases, however, Cochrane finds that these constitutional provisions tend to be sidelined when they come into conflict with the interests of big agribusiness.Noting that more than constitutional protection is needed, Cochrane turns to a third set of arguments about legal personhood for animals. Winning personhood for animals would certainly constitute a radical step toward equalizing the interests of different species. Nonetheless, Cochrane argues that personhood alone would be insufficient. Intrinsic value, to him, cannot be fully respected unless animals win the political right to have their interests factor into society's articulation of the public good. As sentient beings, we can all make a claim on the political communities we are part of to not only recognize us as members but furnish us with the means to live well.The fourth and final step for Cochrane is to argue that democratic representation for animals is necessary for realizing these political membership rights. Without representation, he contends, political rights risk being watered down, leaving animals with much less than they are entitled to as sentient beings. Cochrane critically discusses several different models for how this representation could be organized. While he is partial to a system where specially trained human representatives are tasked with voicing the animals’ interests in the legislative process, he leaves many of the practicalities open for future experimentation.Readers familiar with the field of political animal studies will find little new in Should Animals Have Political Rights? For students new to the field, however, Cochrane's book does an excellent job introducing the main issues in a very accessible format. Students of “regular” political science will also benefit from the book's fresh challenge to the discipline's understanding of “the political” as well as its important insights into the relationship between individual and political rights. (shrink)

Classical liberals have a long and convoluted history with the welfare state. Welfare policy has engaged liberals ever since the debates round poor relief, land ownership, and distributive justice in authors like John Locke, Thomas Paine, Herbert Spencer, and Henry George. However, the majority of the welfare state debate, from David Hume and Adam Smith to Milton Friedman and Richard Epstein, has been conducted primarily on the basis of rule-consequentialist reasoning, weighing the expected (long-term) costs (...) and benefits of different institutional rules. Classical liberals tend to be primarily concerned with welfare in the “happiness of individuals” sense and only secondarily with welfare in the “government handout” sense. This necessitates an investigation into the expected benefits and costs of various institutional rules and social policies. As a result, any disagreements about the best institutional pathway forward must be settled through comparative institutional analysis. Today, it seems to me that the classical liberal perspective must choose between two alternative pathways, each of which has its pros and cons, and each of which seems compatible with the abstract and general rules of the market society: 1) The Minimally Redistributive State based on a classical liberal constitution supported by robust market institutions and a civil society mosaic of polycentric mutual aid networks; or 2) The Welfare State of Law which, in addition to all of the above, adds a few carefully rule-bound and market-conforming redistributive mechanisms, the most important of which is the robust guarantee of something like a conditional minimum income scheme or an unconditional UBI/NIT scheme. In addition, the 3) “Third Way” models of the Social Market Economy and the Free Market Welfare State are also sometimes included as a third option. (shrink)

When may a physician enroll a patient in clinical research? An adequate answer to this question requires clarification of trust-based obligations of the state and the physician-researcher respectively to the patient-subject. The state relies on the voluntarism of patient-subjects to advance the public interest in science. Accordingly, it is obligated to protect the agent-neutral interests of patient-subjects through promulgating standards that secure these interests. Component analysis is the only comprehensive and systematic specification of regulatory standards for benefit-harm evaluation (...) by research ethics committees (RECs). Clinical equipoise, a standard in component analysis, ensures the treatment arms of a randomised control trial are consistent with competent medical care. It thus serves to protect agent-neutral welfare interests of the patient-subject. But REC review occurs prior to enrolment, highlighting the independent responsibility of the physician-researcher to protect the agent-relative welfare interests of the patient-subject. In a novel interpretation of the duty of care, we argue for a “clinical judgment principle” which requires the physician-researcher to exercise judgment in the interests of the patient-subject taking into account evidence on treatments and the patient-subject‘s circumstances. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Christianity and Contemporary Politics: The Conditions and Possibilities of Faithful Witness, and: Migrations of the Holy: God, State, and the Political Meaning of the ChurchAbbylynn HelgevoldChristianity and Contemporary Politics: The Conditions and Possibilities of Faithful Witness Luke Bretherton Oxford, UK: Wiley-Blackwell, 2010. 272 pp. $41.95.Migrations of the Holy: God, State, and the Political Meaning of the Church William T. Cavanaugh Grand Rapids, Mich.: Eerdmans, 2011. 206 (...) pp. $18.00.In their recent books, William Cavanaugh and Luke Bretherton explore the nature of a distinctively Christian political presence in a diverse, modern, liberal democratic society and in an increasingly global world. Both Cavanaugh and Bretherton claim that a Christian life is political in ways that many Christians fail to see. They encourage their readers to think differently about what “politics” is by thinking beyond the parameters for political activity set by the dominant voices and practices of the nation-state or the market.In Migrations of the Holy, Cavanaugh pulls together a number of thematically linked essays in an effort to “give Christians and others some critical tools with which to turn the despair of modern politics toward real hope” (6). That hope is to be found in the church’s promotion and creation of complex social spaces “in which alternative economies and authorities flourish” (42). According to Cavanaugh, Christians ought to acknowledge that the modern nation-state is not oriented toward the pursuit of the common good. Instead, it is fueled by a desire to secure greater power and to perpetuate itself. The nation-state thrives by instilling in its citizens a religious kind of devotion to its ideals and to its continued existence. This religious devotion, animated by the state’s distinctive liturgies and methods of indoctrination, is the vehicle through which the state secures the loyalty of its citizens. Under these idolatrous conditions, Christian citizens become willing to justify and endorse the nation-state’s use of extreme violence; tempted to identify the will of God with the will of the nation-state; and stunted in their ability to imagine alternative political possibilities because they have accepted the limits on religiously informed political activity set by the nation-state. In contrast to the state, the church ought to embody and [End Page 215] enact an alternative social space that is characterized by neighborliness and a love of diversity born out of charity, a penitential and humble disposition born out of an awareness of the reality of sin, and a willingness to pass judgment on prevailing political and economic conditions that fail to reflect God’s will for humanity.These essays are thoughtfully developed. Engaging with them leaves one with the sense that a truly Christian political presence will be vigilant in seeking always to identify and expose the libido dominandi at work in the world and in itself and will inspire the formation and development of societies oriented toward the proper love of God. Cavanaugh challenges the idolization of the nation-state and urges his readers to make use of Christian teachings, stories, and practices to help make possible alternative ways of relating to others and working toward the common good.Bretherton shares many of Cavanaugh’s concerns. In Christianity and Contemporary Politics, Bretherton characterizes the contemporary political life of Christians as being heavily influenced by the “dynamics of co-option, competition, and commodification” (2). Rather than take a theoretical approach to challenging these dynamics, as Cavanaugh does, Bretherton adopts a practical approach. He analyzes concrete examples of Christian political activity that offer alternatives to the earlier-mentioned dynamics in an effort to develop a vision of faithful political witness. His analysis is coupled with an interest in identifying the genuine goods that are present in contemporary liberal societies. In contrast to Cavanaugh, who is more inclined to liken the governance of the nation-state to the services provided by a utility company, Bretherton urges his readers to remember that the peace of Babylon, though not the ultimate peace, is a genuine peace, and that their welfare is tied to its welfare (Jeremiah 29:7). Christians are called not only to be critical of the prevailing status quo but also to... (shrink)

The article aims to contribute to the sociological theory of the welfare state by addressing a fundamental puzzle of social policy, namely, the weakness of its claim to be a rational effort of society dealing with problems of social integration. Drawing on the work of Franz-Xaver Kaufmann, I distinguish between the cultural or ideational side of the welfare state and the social engineering or outcome side, arguing to take the rhetoric and symbolism of social policy more (...) seriously. The integration of society is more due to the communicative action of social policy than to its organizational quality. As early as the axial age civilizations, symbolism and ideology emerged as an autonomous field of social conflict and societal union. Taking ancient Israel as an example, I argue that societal integration may take place even in the absence of strong institutional correlates of social politics. This can help to explain why the welfare state in modern society is compatible with ever-increasing economic and social inequality. (shrink)

From the state to the family: reconfiguring the responsibility for long‐term nursing care at homeThis paper discusses the implications of the shift in the location of the provision of healthcare services from healthcare institutions to the home, which has occurred or is projected to occur in coming years. It is argued that the responsibility for the provision of care and assistance needed by the elderly living at home and people with long‐term conditions living at home has shifted from public (...) services to the family. Studies of care‐givers have shown that in many situations they experience tremendous burdens, financial difficulties and health problems. Their social lives have been confined to the home, and contacts with friends and neighbors have been significantly reduced. This situation needs to be addressed by nurses, who in many cases serve as the bridge between the home and the official healthcare system. Using Foucault’s exploration of power, particularly his idea of governmentality, a genealogy of care‐giving in the home in Iceland’s health‐care has been constructed. The main findings were that, although this is occurring somewhat later than in many other countries, the state is withdrawing from its previously defined responsibility for the health and well‐being of the nation. At the same time the citizen’s responsibility for maintaining health is emphasized. Based on these findings, the argument is made that nurses in Iceland can have a profound influence on policy‐making in relation to the organization of services provided in those homes. Suggestions are made as to how this can be done, which may be of interest to nurses in other countries. (shrink)

This article provides a map of the UBI debate, structured into the main themes that guide and group the arguments on both sides. It finds that UBI’s supporters and opponents both draw on core principles of justice and freedom, focusing on need and poverty, discrimination and inequality, growth, social opportunity, individuality, and self-development. From an economic perspective, they both appeal to business concerns about efficiency, risk, flexibility, and consumption, as well as labour interests on work fulfilment, working conditions, remuneration, and (...) bargaining. Likewise, they focus on political questions around welfare state reforms, redistribution, taxation and funding sources, democratic citizenship, and the prospects for cross-party policy coalitions. By providing an overview of the thematic pillars of the UBI debate, this article helps researchers and activists locate and orient themselves within the wider spectrum of opinion on UBI. (shrink)

In this article, it is claimed that the protective provisions for adults with impaired decision-making capacity are misguided, insofar as they do not conclusively state whether research on this group should be permitted only as an exception, and as they arbitrarily allow for some groups to benefit from such research while others will not. Moreover, the presumed or former will of the subject is given insufficient weight, and the minimal risk standard does not make sense in this context. Because (...) of these problems, the present guidelines allow for the possibility of vulnerable people being exploited, something that is hidden behind a guise of solidarity. Instead we need to address the real issues at stake by rewriting the present statutes. It is suggested that new guidelines should be in some continuity with earlier efforts. However, in order to protect these subjects there is additional need for appointed representatives who monitor research and for legal obligations to compensate for any injuries suffered. Without these or similar measures we won't have an adequate system in place for the protection of non-benefiting persons who are unable to consent to research. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 46, no. 2. © 2020 by Feminist Studies, Inc. 403 Gyanendra Pandey Men in the Home: Everyday Practices of Gender in Twentieth-Century India This article responds to a call by feminist historians of South Asia to attend to the “complex experience of family” as conditioned by age, gender, and class, and the ordinary “daily practices of gender” in the domestic arena.1 My essay focuses on the comparatively (...) neglected aspect of men’s domesticity—their performance of life in the home—as revealed in the writings and practices of prominent nationalist thinkers and activists who lived and worked in an era of militant anticolonial agitation in India. The domestic sphere, with its assigned gender roles and routines, was at the heart of major debates between the colonizers and the colonized about the meaning of culture and enlightenment. “Among rude people, the women are generally degraded; among civilized people they are exalted,” James Mill declared, in his classic statement on domestic manners.2 From Mill, writing in the second decade of the nineteenth century, to Katherine Mayo in the third decade of the twentieth, colonialist 1. Indrani Chatterjee, introduction to Unfamiliar Relations: Family and History in South Asia, ed. Indrani Chatterjee (Delhi: Permanent Black, 2004), 4; Mrinalini Sinha, “A Global Perspective on Gender: What’s South Asia Got to Do with It?” in South Asian Feminisms, ed. Ania Loomba and Ritty A. Lukose (Durham: Duke University Press, 2012), 359. 2. James Mill, The History of British India, 4th ed. (1817), edited by H. H. Wilson, vol. 1 (London: James Madden, 1848), 309. 404 Gyanendra Pandey writers dredged up the condition of women, familial relations, and domestic life in India to demonstrate the necessity of colonialist-initiated improvement and reform.3 Colonial rule thus provided the impetus for “a thoroughgoing re-evaluation of Indian ‘tradition’ along lines more consonant with [a] ‘modern’ economy and society.”4 Faced with insistent colonial critique, nationalist reformers and thinkers set out to controvert suppositions about the fallen state of Indian women and the oppressiveness of Indian homes. They also further sought to ameliorate conditions where these had deviated from their version of a glorious past. The Hindi/Urdu writer Premchand sums up the nationalist rebuttal in a 1931 essay entitled “Nari-jati ke adhikar” (“The Rights of Women”): “In fact, the Indian woman has always been considered the goddess of the home, and she has a higher status than men in the society.” For a variety of reasons, Premchand suggests, women fell from this preeminent position over time and men began to appropriate the established rights of women. “But,” he concludes, “the [new] wave of nationalism and enlightenment that has arrived now will obliterate all these [gender] distinctions, and our mothers [sic] will be re-installed in the exalted place that is their right.”5 It was in this way that early nationalist thinkers and spokespersons produced an argument about the existence of a sacred and relatively uncolonized “inner” space of Indian society, as contrasted with a more quickly changing, compromised, and negotiated “outer” space. In what is now a familiar precept in South Asian gender history, women were cast as the (predominant) custodians of “tradition” in private and in public life; men were (predominantly) the instruments of national, social, and cultural transformation in the wider, public domain. With this framing came propositions about the need for rapid progress in the “outer” realms of science, industry, and voluntary association as well as the later goals of welfare and development, secularism, and socialism. The push 3. Ibid.; Katherine Mayo, Mother India (London: Jonathan Cape, 1927). 4. Lata Mani, “Contentious Traditions: The Debate on Sati in Colonial India,” in Recasting Women: Essays in Indian Colonial History, ed. Kumkum Sangari and Sudesh Vaid (Delhi: Kali for Women, 1989), 88. Mani makes a powerful critique of the so-called “Indian tradition” and of claimed colonial efforts to improve Indian society. 5. Premchand, “Nari-jati ke adhikar,” in Vividh Prasang, vol. 3, ed. Amrit Rai (Allahabad, India: Hans Prakashan, 1980) 249. Gyanendra Pandey 405 for such advancements developed alongside a more guarded approach to change in the “inner” world and its inherited store of spiritual resources— symbolized above all... (shrink)

This article contributes to an emerging literature on the “neo” or “entrepreneurial” developmental state that emphasizes the role of innovation policy in promoting the structural transformation of industry. It finds further evidence that supports this approach and advances it by making two unique contributions. First, it highlights an essential yet underappreciated feature of contemporary innovation policy: the state’s capacity to condition public assistance and discipline private firms that do not adhere to government guidelines. These capacities are necessary to (...) guarantee that the benefits of public investment in innovation—the social and economic spillovers—are not appropriated by private actors but shared more broadly within society. Second, it highlights that politics—reflected in the relations between innovation agencies and key social actors—represents an important causal factor in both the formation and subsequent transformation of these institutional capacities. These points are illustrated through a historical analysis of a crucial case: the state-led development of Israel’s thriving high-tech sector. (shrink)

The review of activity of local governments of Leningrad on the solution of social problems is presented in article in the period of the Great Patriotic War and restoration of municipal economy during the post-war period. The considerable attention is paid to questions of ensuring activity of the population and the main directions of social policy. Consequences of the public regress caused by war, which detained for many decades development of the social sphere in the country, are not studied yet. (...) In this regard, the judgment of process of overcoming of these consequences, research of the principles of work, methods and forms of administrative activities for the organization of full-fledged life of citizens during the recovery post-war period and in the next decades is of special interest. Completion of World War II entailed changes in a control system of the country - as it is known, extraordinary bodies of authority and management of a wartime in the capital and on places were abolished. Management of restoration and maintenance of full functioning life support system of the cities and areas transferred to local governments of the Soviet power - to city and regional councils of deputies and their constantly operating executive committees. The role of the social sphere in modern conditions more and more increases in improvement of economy, development of democratic processes. The scientific analysis of activity of the central and local authorities for protection and providing the population in years of war and the post-war period gives more deep understanding of role and importance of social questions in life of society. It reveals historical experience of creation, development and implementation of effective mechanism of such activity, that experience is useful for modern management practice of state and local authorities. The considerable case of sources, among which analytical and research works of applied and theoretical character is analyzed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Plotinus and the Augustine on the Mid-Rank of the Soul: Navigating Two Worlds by Joseph TorchiaThomas ClemmonsTORCHIA, Joseph. Plotinus and the Augustine on the Mid-Rank of the Soul: Navigating Two Worlds. Lanham, Md.: Lexington Books, 2023. vii + 237 pp. Cloth, $105.00For nearly four decades, Joseph Torchia, O.P., has written extensively on Augustine and Plotinus. He has produced numerous scholarly articles on both Augustine and Plotinus, as well (...) as monographs on Augustine’s understanding of creatio ex nihilo and tolma in Plotinus. This volume on the mid-rank of the soul in Plotinus and Augustine is the fruit of this life-long study.The major premise of Torchia’s study is the profound relation, even continuity, between Hellenistic philosophy, especially Neoplatonism, and early Christian thought. The Hellenistic view of an ordered universe, which extends from the material and physical to the spiritual and noetic, [End Page 730] places the human in a middle place. This view is exposited most clearly by Plotinus and shared, though with qualifications, by early Christians, especially St. Augustine. Torchia asserts that we are able to see this shared legacy and continuity between philosophers such as Plotinus and Augustine in “their respective anthropological and psychological theories.”The book is divided into halves; the first on Plotinus and the second on Augustine. Torchia’s discussion of Plotinus’s philosophy narrows and deepens through five chapters, from a general outline of the Alexandrian’s system to a heightened focus on the journey of the soul, as imaged through the figure of Odysseus. Torchia rightly notes the inconsistent depiction of the descent of soul(s), especially of individual souls as both in a sense “fallen” and “sent.” This tension is in part resolved through Plotinus’s emphasis on the middle place of the soul and the harmony of all the parts within the unity of the whole.The chapters on Plotinus are excellent. Torchia shows how Plotinus integrates concepts from Aristotle, especially his De anima, and qualifies the spiritualized philosophy of Plato. What we get, then, is Plotinus as a highly original philosopher, whose insights deserve closer examination. For example, Torchia glosses the Plotinian dictum, “we are soul,” to examine what is meant by “we” and “soul.” Far from leading to a dismissive view of the body and individuality (as is often stated about Plotinus), Torchia emphasizes that the middle state of the soul is the condition of soul. The lower soul, or the composite (per Torchia), cannot be simply lopped off. To do so, the unity of soul would be destroyed. Torchia thus presents a Plotinus profoundly concerned with humanity in its entirety—our affections, body, thoughts, and individuality. This is why Plotinus and Torchia land on the image of Odysseus as the journeyman to depict human existence.In the final five chapters, the book turns exclusively to Augustine. Torchia outlines the profound difference between Augustine and Plotinus as regards the ontological distinction between God as creator and the human. Because of this distinction, Torchia observes that the mid-rank of the soul takes on a more profound “existential significance.” This existential significance is witnessed in Augustine’s emphasis on free will and the “weight of love,” which, according to Torchia, shows affinities with Plotinus but also departs from the determinism and necessity of the descent of soul(s) in the Alexandrian’s system.The final chapter of the book examines Augustine’s understanding of the two cities, of God and of man. Torchia asserts that the middle-rank of the soul provides the philosophical undercurrent to Augustine’s conception of the City of God. The City of God is not exclusively a spiritual reality. Rather, much as with the middle-rank of the soul, the City of God is both “here” and “there.” The permixta of the Church as an intermediate state is “analogous to the mid-rank status of the rational soul.” For Augustine, both the individual and the Church journey, like Plotinus’s Odysseus, on the stormy seas. [End Page 731]In this book, Torchia has provided a thorough and insightful reading of Plotinus. He highlights the inherent rational optimism of Plotinus as well as the goodness... (shrink)

The debtor-creditor relation, which is at the heart of this book, sharpens mechanisms of exploitation and domination indiscriminately, since, in it, there is no distinction between workers and the unemployed, consumers and producers, working and non-working populations, between retirees and welfare recipients. They are all "debtors," guilty and responsible in the eyes of capital, which has become the Great, the Universal, Creditor.--from The Making of the Indebted Man Debt -- both public debt and private debt -- has become a (...) major concern of economic and political leaders. In The Making of the Indebted Man, Maurizio Lazzarato shows that, far from being a threat to the capitalist economy, debt lies at the very core of the neoliberal project. Through a reading of Karl Marx's lesser-known youthful writings on John Mill, and a rereading of writings by Friedrich Nietzsche, Gilles Deleuze, Félix Guattari, and Michel Foucault, Lazzarato demonstrates that debt is above all a political construction, and that the creditor/debtor relation is the fundamental social relation of Western societies.Debt cannot be reduced to a simple economic mechanism, for it is also a technique of "public safety" through which individual and collective subjectivities are governed and controlled. Its aim is to minimize the uncertainty of the time and behavior of the governed. We are forever sinking further into debt to the State, to private insurance, and, on a more general level, to corporations. To insure that we honor our debts, we are at once encouraged and compelled to become the "entrepreneurs" of our lives, of our "human capital." In this way, our entire material, psychological, and affective horizon is upended and reconfigured. How do we extricate ourselves from this impossible situation? How do we escape the neoliberal condition of the indebted man? Lazzarato argues that we will have to recognize that there is no simple technical, economic, or financial solution. We must instead radically challenge the fundamental social relation structuring capitalism: the system of debt. (shrink)

When the Mamluk Sultan Qalawun (1279-1290) moves to Syria with her army to fight the Mongols, martial law is declared in Egypt. Kalavun's son as heir Salih Ali in Egypt, published to Zaynaddin Ketboğa a tazkire that dated April-1281 containing the martial law decisions. Tezkire talks about the duties and responsibilities of administrators in the context of state-security-service. These decisions are important state affairs in the flow of daily life such as the judiciary, law, justice, security, transportation, service, (...) trade, land, fair tax system, control of civil servants and state affairs. In addition, the healthy living conditions of the detainees, It also includes issues such as meeting the needs of the detainees such as churches and baths. Tazkire decisions aiming to ensure the flow of daily life in Egypt during wartime without causing a possible instability are always valid state policies aiming at state order and social welfare. In our article, we will talk about this tezkire, which was narrated as a full text by İbnü'l-Furât (d. 1405) and Kalkaşendî (d. 1418). (shrink)

Many studies of primate vocalization have been undertaken to improve our understanding of the evolution of language. Perhaps, for this reason, investigators have focused on calls that were thought to carry symbolic information about the environment. Here I suggest that even if these calls were in fact symbolic, there were independent reasons to question this approach in the first place. I begin by asking what kind of communication system would satisfy a species’ biological needs. For example, where animals benefit from (...) living in large groups, I ask how members would need to communicate to keep their groups from fragmenting. In this context, I discuss the role of social grooming and “close calls,” including lip-smacking and grunting. Parallels exist in human societies, where information is exchanged about all kinds of things, often less about the nominal topic than the communicants themselves. This sort of indexical information is vital to group living, which presupposes the ability to tolerate, relate to, and interact constructively with other individuals. Making indexical communication the focus of comparative research encourages consideration of somatic and behavioral cues that facilitate relationships and social benefits, including cooperation and collaboration. There is ample room here for a different and potentially more fruitful approach to communication in humans and other primates, one that focuses on personal appraisals, based on cues originating with individuals, rather than signals excited by environmental events. (shrink)

The article analyzes the features of three main models of the welfare state: German, Northern European, and Anglo-Saxon. The author turns to the analysis of these models, first, because the problem of the welfare state in the world is again coming to the fore, and secondly, because social development in the most developed countries, in the author’s opinion, in the future will be largely determined by the values and behavioral models that are embedded in the three (...) main versions of the social state in Europe. From the author’s point of view, the key features of the European social model, which combines these three versions, are respect for rights and human dignity, the ideas of equality and solidarity, the ideas of social and political compromise, and the choice of an evolutionary path of development. According to the author, these features are the main difference between the European model and what characterizes the political culture of Russia with its maximalism and tendency to extremes. The author believes that the social experience of Europe is something that needs to be addressed today in Russian conditions and that can be extremely valuable for us. At the same time, as shown in the article, the welfare state in Europe has important country features. The German model is characterized by an emphasis on maintaining the socio-economic status of the individual – this is a conservative model. The Northern European model is based on the principles of universal equality and universalism – it is a social-democratic model. And the Anglo-Saxon model, based on the low role of the state, on the great importance of civil society, is a liberal model. Nevertheless, despite significant differences, as shown in the article, all these models are characterized by the desire to implement compromise principles, to find a “Golden mean,” which makes them highly effective. (shrink)

Ukraine has a special geopolitical location in Europe - between East and West, South and North. The specificity of this provision is due to multi-year contacts between peoples who lived or passed through its territory, the interactions of different cultures, traditions and worldviews. As a result, there is a rather varied ethno-national and religious palette of Ukrainian population. In today's conditions of building an independent state and civil society, this can be both a positive and a negative factor. Recent (...) events and practices show that the problem of religious and ethnic renaissance has acquired a special political and spiritual significance. Different directions of Christianity, other religions, existing for centuries on the Ukrainian ethnic basis, have been influenced by a wide range of social and national life. In addition, ethno-national and religious processes took place differently in the western and eastern regions of Ukraine, in the village and in the city. (shrink)

The dominant political ideology of recent decades, neoliberalism, have resulted in diminished sense of mattering for several groups in the society, not at least people outside the labor market. This has left its mark on vocational rehabilitation programs in welfare states like Norway. Higher requirements shall be set for benefit recipients, and compulsory work are more often applied. The problem with this policy is that it suggests that benefit recipients have a guilt to make up for and are themselves (...) to blame for the unemployment. However, the majority of people in need for vocational rehabilitation, have had poor living conditions since childhood, and have failed in education and employment for or reasons they have no control over. They often do not feel valued and have a lot of experience with not being able to add value. The problem with blaming the victims, is that it reinforces their sense of worthlessness, and thus reduces their ability to believe that they can contribute with something of value. In this way, the policy becomes counterproductive. Some even respond to these humiliating pressures by becoming more depressive or aggressive. To make vocational rehabilitation programs effective, we must make sure that everyone in need for it feel valued, we must align the political, scientific, and professional basis for welfare service politics thereafter. We must balance adding value to self with the opportunity to adding value to others, work and community. Mattering is suggested as a political, scientific, and professional basis for welfare services. (shrink)

Feminist scholarship on the relative importance of working-class institutional strength in the economy and in the state has led to two divergent conclusions. Radical feminists argue that working-class institutions dominated by men produce male-biased outcomes; socialist feminists hold that working-class institutions promote classwide interests that benefit women as well as men. This article addresses this debate by applying generic and gendered working-class strength models of the welfare state in an examination of women's public pension quality. Quality is (...) measured as women's average pension compared with that of men, relative to women's average earnings, and compared with the average wage in the society. The authors find support for the socialist feminist view. Working-class institutions, having historically organized and represented the interests of working men, benefit women by improving the security and adequacy of their retirement incomes, but it is women's access to working-class economic and political institutions that brings greater economic equality with men in old age. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Occupy Religion:Theology of the Multitude and Interreligious DialogueJoerg RiegerOne of the big questions for the present is how to bring the different liberation movements together. The different liberation theologies, as is well known, have addressed various forms of oppression along the lines of gender, sexuality, race, ethnicity, class, and other factors. What is it that brings us together without erasing our differences? This question has important implications for interreligious (...) dialogue, as we shall see.In our book Occupy Religion Kwok Pui-lan and I use the term “multitude” to reflect on unity and difference.1 This term, made prominent by political scientists and philosophers Michael Hardt and Antonio Negri,2 has deep roots in our theological traditions. Several decades ago, Korean Minjung theology noted the prominence of the notion of the multitude (this is how the term minjung can be translated into English) in the Bible. In the Gospels, the so-called ochlos (the Greek term for the masses or the common people) does not describe only the ones who are the recipients of Jesus’ transformative ministry; the ochlos also describes the participants in it and the agents of change. In addition, our Latin American colleagues have highlighted the importance of Greek term laos in the biblical traditions, which is also used to designate the common people rather than the elites.There is a distinct difference between the Greek notions of democracy and laocracy or ochlocracy. Democracy describes the rule of the demos, which is constituted by the elite citizens of a city-state. Lower-class citizens, women, and slaves are not part of this rule. Laocracy and ochlocracy, on the other hand, describe the rule of the common people, including the proverbial “least of these” of which Jesus speaks frequently. These common people include all those who have been and are being marginalized on the basis of their gender, sexuality, race, ethnicity, and class. In the ministry of Jesus, which is informed by the ministry of Moses, Miriam, Hannah, and the prophets, the common people are organized and become agents. God values their diverse contributions to life. In the world of laocracy and ochlocracy, there are different ways of being productive in the community, and all of them are acknowledged and needed. As Hardt and Negri remind us, the multitude is not the uniform entity of what has often [End Page 167] been called “the people” in various nationalisms or fascisms. Neither is the multitude the undifferentiated mass or the mob.3What brings the various liberation movements together, therefore, is not uniformity or a request to surrender difference. What brings us together is “deep solidarity,” the recognition that we are all in the same boat under the conditions of global capitalism.4 This insight is related to the topic of class, which has consistently been pushed underground in the United States but which has recently reemerged in the context of the Occupy Wall Street movement. The now-familiar notion of the 99 percent versus the 1 percent is a reminder that the majority of people are benefitting less and less from the neoliberal market economy. This includes even members of the middle class, as they have seen their retirement accounts dwindle, their job security take ever-more severe hits, their benefits erode, and their political power fade. Furthermore, the aspects of gender, sexuality, race, and ethnicity are closely linked to class, as they all increase the disadvantages of people in the neoliberal market economy, thus boosting the reality of deep solidarity. Deep solidarity ties together members of the 99 percent across the lines of gender, sexuality, race, and ethnicity, and it thrives on difference, as they can now work together and make use of their various opportunities and gifts.Deep solidarity differs from conventional ideas of solidarity, which were often based on the idea that those who are privileged place themselves on the side of those without privilege. While it is still possible for members of the 1 percent to place themselves on the side of the 99 percent, the majority of us are now part of the 99 percent, and thus belong to classes that have something to gain from liberation. Class struggle, as... (shrink)

continent. 2.3 (2012): 218–223 Vijay Prashad. Arab Spring, Libyan Winter . Oakland: AK Press. 2012. 271pp, pbk. $14.95 ISBN-13: 978-1849351126. Nearly a decade ago, I sat in a class entitled, quite simply, “Corporations,” taught by Vijay Prashad at Trinity College. Over the course of the semester, I was amazed at the extent of Prashad’s knowledge, and the complexity and erudition of his style. He has since authored a number of classic books that have gained recognition throughout the world. The Darker (...) Nations , a peoples’ history of the Third World, sent defibrillating shockwaves through an academic world that had almost forgotten the epic scope and historic dignity of the non-aligned movement and post-colonial struggles. In his recent, award-winning work, Arab Spring, Libyan Winter , Prashad delves into his capacious knowledge of the Third World to excavate the discourses and narratives surrounding the upheavals of 2011. “Revolutions have no specific timetable,” states Prashad in the opening line of this exciting and provocative look at contemporary events. Instantly, an atmosphere of suspense emerges. The reader is alerted to the problem of history. Does the making of history then involve a suspension of historical time, or is it a continuous narrative structure into which events must eventually be integrated? Arab Spring, Libyan Winter shows that the answer to the question, “How is history made?” lies just as easily in the asking. The first half of the book works through the events that transpired to bring about the explosive popular uprisings of Arab Spring: Tunisia and Egypt, Yemen and Bahrain. But the events are not put together in a cohesive, chronological fashion. Using an uncommonly gripping style more akin to the folk-story motif of the djeli than to traditionally Orientalist academia, Prashad suspends a given situation, points out its components, and traces back the characters and genealogies that define each link before resuming a narrative. Every moment is an end to itself, and an origin of something different. Thus, the making of history becomes the suspension of its own progress, it’s catastrophic 'stability,' in a process of differentiation through inclusion. Empirically, one might suggest that history is a condition of time, and by extension, of the subject, but history is also an eminent producer of the Subject and her concept of time through memory and narrative. Hence, history is often overdetermined by a dominant narrative of the sovereign. The apparently chaotic composition of Prashad’s historicity is, then, an interstitial morphology of resistance. It illustrates that the time to act for the revolutionary lies in the gaps within the dominant historical realities. It points out the sorties of signifiers constituting nothing in the obliterated ruins of history. Through such illuminations, Arab Spring, Libyan Winter breaks through “the surface of history” to elaborate revolution’s snapping synapses, exploding interruptions and breaches, connecting flows. Messianic Politics It is tempting to think, 'History is either singular, or it is diffuse. It is either one coherent factual narrative, or it is comprised of the aletheia of the multitude.' Yet the reader finds Prashad examining the structure of history on multiple levels. For Prashad, world history is shaped by geographically defined political movements, such as communism or national liberation, with historical agents like the working class for the former and the nationalist militant for the latter. Religion, however, is another matter: “Religion has an unshakable eschatology which a post-utopian secular politics lacks.” Within the telos of religion, there appears on the horizon the image of Benjamin’s thoughts on messianic time—time as “a small fissure in the continuous catastrophe,” a break with history, may contain an ultimate redemption of the human beyond the political power struggle. Succoring the split between geo-political and utopian-religious (messianic) time in the context of Arab Spring, Prashad indicates that the base of “the deep desire and commitment to some form of democracy” is forged by the affinity between eschatological Islamist politics with the People. To think about the Subject of messianic time in the context of the lack of a “coherent timetable” for emancipatory politics, it is perhaps best to return to the modern tradition of Martin Luther King, Jr., whose prefigurative blending of liberation theology and emancipatory politics became most important during his works of 1963, the climactic year of “The Letter from a Birmingham Jail,” the March on Washington, and the bombing of the 16th Street Baptist Church. In “The Letter,” King states the point bluntly: Frankly, I have yet to engage in a direct-action campaign that was “well timed” in view of those who have not suffered unduly from the disease of segregation. For years now I have heard the word “wait!” It rings in the ear of every Negro with piercing familiarity. This “Wait” has almost always meant ‘Never.” We must come to see, with one of our distinguished jurists, that “justice too long delayed is justice denied.” The timing of rebellious action must not be a part of history. It must change history. The kairos appears spontaneous and untimely in its convulsive, shocking presence, yet it is, deeper still, a path, a longue durée , forged through diligent and rigorous praxis. King put a finer point on the path of historic liberation in his declaration in his 1963 speech at Western Michigan University: “[T]ime is neutral.... Somewhere along the way we must see that time will never solve the problem alone but that we must help time. Somewhere we must see that human progress never rolls in on the wheels on inevitability. It comes through the tireless efforts and the persistent work of dedicated individuals who are willing to be co-workers with God. Without this hard work, time itself becomes an ally of the insurgent and primitive forces of irrational emotionalism and social stagnation. We must always help time and realize that the time is always right to do right.” Time, then, exists in “the neutral,” while action must turn to the kairos , not only of taking time, but taking the right time. By turning our relation to time into kairos , we move time from its context within history to a duration between histories—the longue dure?e of Messianic time. The implementation of neutrality in this context suggests a broad space of time to extend through the valley of positive and negative. In Roland Barthes’s lectures from 1978, the neutral takes place in this minimal distance of non-conflict that exists outside of two extremes. It is, in the words of Maurice Blanchot, “the non-general, the non-generic, as well as the non-specific.” For Blanchot, the neutrality of time permeates life as death, impassive and beyond control; such is the neutrality of messianic time, which permeates the charge of history, changing the "I" into the "one." The neutrality of time therefore implicates history in a case against extremism, showing that the work of the radical is not to tend to any particular side, but to have the time to navigate through the terrible terrain of history by altering its course, its patterns and rhythms of movement, connection, sociality. Hence, one does not simply “make history,” one alters the course of history in accordance to “the right time.” The historical path toward emerging power is transmitted as a gesture to the outside of history, against history; a gesture as simple as reaching out. Thus a counterhistory, to use Foucault’s term, is brought forward as the guide of time past a point of no return, a Rubicon, the point where the normal path of history falls to the past. The subject, who must be the only true agent of history, facilitates time through helpfulness, and both the Subject and her history become decentered in relation to one another. Yet history negates the neutrality of time. As Barthes discloses, although the neutral is the “thought and practice of the nonconflictual, it is nevertheless bound to assertion, to conflict, in order to make itself heard.” Engaged with history, time is charged with a destiny, and becomes an opposition. As Prashad insists, “For Arab lands, the events of early 2011 were not the inauguration of a new history, but the continuation of an unfinished struggle that is a hundred years old.” The emergence of the Subject during Arab Spring did not conceive of a new history, but changed the path of history toward a different destiny. “Historical grievances combined with inflationary pressures now met with the subjective sense that victory might be at hand—this was not simply a protest to scream into the wind, but a protest to actually remove autocrats from their positions of authority. The facts of resistance had given way to the expectation of revolutionary change.” The negativity of this charge toward “revolutionary destiny” rendered control, as a positive force, seriously lacking. The lack of control lies in the problem that the Subject is not totally detemporalized or timeless, but untimely in her presence. The Subject is untimely, because her work is visionary, and it is only through such visionary work that the Rubicon can be crossed. Still, the crossing of this border is haunted by anxiety over an impending disaster that lays in wait. It is only through the form of what Benjamin calls divine violence, captivated not with the justice of the means, but the ends—the transformation of history—that a revelation of history’s traumatic foundations can be liberated, and patterns and rhythms of time developed throughout obscured traditions awakened. In this situation, the Subject appears to be outside of right, but setting the state to rights. Because her position is correct, in-so-far as the rebelling subject rebels due to a lack of recognition, her representation appears outside of the norm, which is mistaken as right. Therefore, such visionary work must be carried out through obscured traditions, underground, away from the surveillance of empire. Explaining his method from the start along the lines of Marx’s metaphor of the mole, Prashad insists, “It is the burrowing that is essential, not simply the emergence onto the surface of history.” Arab Spring, Libyan Winter is a book on uncharted networks of time, spread out over the 252 pages like an elaborate spider’s web of passages intertwining with and overwhelming the machinery of the state. Although untimely, Arab Spring was not a flash in the pan, or a Facebook or Twitter revolution. Prashad notes that the government’s suspension of these tools led to further radicalism by furthering communications through face-to-face encounters. In existential terms, Arab Spring might be thought of as a revolution of Being over techne , an uprising of the unchartable, infinite potential of the Other. The name of this Other is found in Chance. The faith of the revolution lies in the proper decentering of the subject, its giving to the Other of time, for only with respect to time does history actually appear on the horizon of the subject, rather than as an imposition. This time of historical agency appears as a moment when anything can happen—a revolutionary truth event where everything comes into question while being realized in its Otherness as a community of the people begins anew in the streets amidst discourse, friendship, reconfigurations of hegemony, and a becoming of a constituent power. Throwing a wrench into the gears of the “cobwebbed tradition” of Orientalism, the decentering of history in Arab Spring, Libyan Winter is a defining quality of its impassioned revolutionary cry. But perhaps the most paradigmatic points of the book emerge from the unexpected voices. To make the connection between the particular manifestations of revolutionary demands to the general historic terms of revolution, Prashad quotes an anonymous young Egyptian in Tahrir Square, who reminds us, “[T]he French Revolution took a very long time so the people could eventually get their rights.” Far from timelessness, the historicization of Arab Spring must exist precisely within the most uncanny appearance of time, as something that does not appear to come from the natural state of time as we know it, but in arriving has completely transformed the way that we understand time. Strange Monsters Revolution is never as simple as a revolt from below against a rusting structure of elites trying to remain in power. As with the French Revolution, Arab Spring consisted of complex familial ties, outside interests, and religious factions fighting alongside, often in awkward juxtaposition to, liberals, working class parties, farmers, and students. It is perhaps because of this historically difficult and incongruous composition that the Arabic word for revolution is thawra , referring to the image of the bull, or thawr , which has religious significance as a pagan deity for the Ancient Semitic tribes and Cartheginians. If Daniel Guérin was correct in saying, “Anarchism and Marxism drink from the same spring,” then it is quite a different oasis that drove the thirsty beast of revolution through what Prashad calls, “the Libyan labyrinth.” Recalling Bataille’s Acéphale, the intestinal labyrinth gains significance as the mode of metabolism and rumination in which, “(the Acephale) has lost himself, loses me with him, and in which I discover myself as him, in other words, as a monster.” Unraveling the discourse of the revolution, the flows of power and hegemony—from Qaddafi’s nationalist coup in 1969 to the wars with Chad from 1978 to 1987, the neoliberal reforms of the 1990s to, finally, the War on Terror—we find that the metabolic process of Libyan Winter ends in the production of oil. In a process of what Prashad calls “involution,” Qaddafi’s bellicose policies, along with his attempts to nationalize Islam together with oil, mutated the source of his power, turning his house against itself. Already a divided nation, with its two major cities on opposite geographic sides of the country, Libya became split between two opposed political powers—liberal reformists and staunch nationalists—as Qaddafi’s political disengagement manifested through what can only be described in psychoanalytic terms as a recursive passage a l’act (mysteriously calling Wikipedia “Kleenex,” declaring that opponents drank hallucinogens with their instant coffee, and so on). Prashad declares, “The mercurial style that Qaddafi adopted was not about his personality alone, but also a leader’s natural response to a system that relied upon power brokers whose own loyalty… did not have any ideological commitment to the system.” As in the case of other nations during Arab Spring, the true expression of revolt was an outward exposition of what had inwardly been happening in microcosmic societies throughout the realm—from indigenous tribes to political parties, for a century, the people, partly motivated by (and in resistance to) economic impositions of development, had been changing the traditional social compositions and participating in what Ruth Wilson Gilmore calls, “the relative autonomy of the movement from the leaders.” It was this empowerment of political reconfigurations taking place under the context of new democratic assemblages that shocked the elites and evoked such a powerful response. Unlike Qaddafi’s awkward policy choices and rants, real acts of power from the West were clear and decisive. Prashad sets the stages of war and diplomacy, far removed from the deserts, mountains, and cities that forged the backdrop of popular politics. Taking place under the now-classic architecture of the “four pillars” of US interests—oil, the War on Terror, Israel, and the circumvention of Iranian hegemony—we find elites rubbing elbows in “Heliopolist cocktail parties and hushed conferences in Kasr al-Ittihadiya” as well as the Concorde-Lafayette hotel in Paris, which provides the setting for a meeting of anti-Qaddafi figures consolidating their power. These scenes are buttressed with the careful portraiture of key historical actors. As Prashad brings the stage of history to life, we find the diplomats and liberals like Frank Wisner, whose career has brought him from Enron in the late 1990s to the Obama Administration, under the aegis of which he was meeting with Mubarak about military support during Arab Spring. We spy the provocateurs, for instance, gauche cavalier , Bernard Henri-Levy, who telephones Sarkozy from Benghazi about the need for more NATO air strikes. We follow the rebel military establishment as it suffers mysterious deaths and even more mysterious assents (like that of apparent CIA cohort, Khalifa Hifter). In each of these intriguing characters, we find different representations of the security state biopolitique: an oil-injected reification that drives Arab Spring from the resentment of rising food prices to the brink of implosion in Libyan Winter. Reminiscent of the scenes of Cold War soirées represented in old Bond films, the aristocratic fight for oil against democracy that was Libyan Winter presents a harsh truth that the new global crisis is simply the continuation of the old history: the global exploitation of capitalism waged against the imagination of the people. As Benjamin laments, “The labyrinth is the right path for the person who always arrives early enough at his destination. This destination is the marketplace.” Yet, “(t)he labyrinth is the habitat of… a humanity (a class) which does not want to know where its destiny is taking it.” Thus, the labyrinth leads, like the desert, only further into itself. As Blanchot explains, “The desert is even less certain than the world; it is never anything but the approach to the desert.” Only the visionary can take time out of the involution toward oblivion. It is here, in this approach to and escape from history, that we find ourselves within Benjamin’s Golgotha, Blanchot’s desert: A space of indeterminate uncertainty where we become familiar only with our own exile. Blanchot writes, “For the moderated and moderate man, the room, the desert, and the world are strictly determined places. For the man of the desert and the labyrinth, devoted to the error of a journey necessarily a little longer than his life, the same space will be truly infinite, even if he knows that it is not, all the more so since he knows it.” The desert, as allegory, provides an eschatology, a mortality in the destiny of Arab Spring. But any allegory of nature might lead to a labyrinthine eschatology (for example, in Bachelard, the forest presents "a limitless world"); the prescience of the untimely is always an uncanny acceptance of the infinite within the finite—the outside of what is understood. Transgenerational and occupied with the image of the future, the untimely makes otherness its home as it proceeds toward liberation. In the work of helping time navigate this dangerous passage of history, Prashad illustrates that the more violent break with history may have occurred in the peaceable struggles of Tahrir Square, and not in the military clashes of Qaddafi with his former Generals who defected to the CIA and NATO countries. It might be possible to suggest, then, that in the case of Tunisia and Egypt, the historical subject of the people was drawn together in a Dionysian dance of different rhythms in the marvelous realm of the ancients, while we fear that the case of Libya suggests an Apollonian future where time, itself, may lay dying under the machinic hand of history. The properly Nietzschean inversion would follow: time is dead, for history has killed it. Yet, if time is dead, struck down in Golgotha, exposed in the desert, mauled by the thawra , it is only in the present sense that it is rendered impossible outside of the context into which the untimely has thrown us. Thus, if history becomes an art of revolution, life as being-towards-death (death as the provocation of the neutrality of time) becomes what Benjamin calls “the allegory of resurrection” through the glorious ruins of history. Prashad ends his work with a rousing finale: “The time of the impossible has presented itself. In Egypt, where the appetite for the possibilities of the future are greatest, the people continue to assert themselves into Tahrir Square and other places, pushing to reinvigorate a Revolution that must not die… For them the slogan is simple: Down with the Present. Long live the Future. May it be so.&rdquo. (shrink)