Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

L S Penrose’s Limit Theorem – which is implicit in Penrose [7, p. 72] and for which he gave no rigorous proof – says that, in simple weighted voting games, if the number of voters increases indefinitely and the relative quota is pegged, then – under certain conditions – the ratio between the voting powers of any two voters converges to the ratio between their weights. Lindner and Machover [4] prove some special cases of Penrose’s Limit Theorem. They give a (...) simple counter-example showing that the theorem does not hold in general even under the conditions assumed by Penrose; but they conjecture, in effect, that under rather general conditions it holds ‘almost always’ – that is with probability 1 – for large classes of weighted voting games, for various values of the quota, and with respect to several measures of voting power. We use simulation to test this conjecture. It is corroborated with respect to the Penrose–Banzhaf index for a quota of 50% but not for other values; with respect to the Shapley–Shubik index the conjecture is corroborated for all values of the quota. (shrink)

Recent scholarship, focusing on the rapid decline of microscopy after the late 1680's, has shown that the limitations of microscopy and the ambivalent meaning of its findings led to a wide-spread sense of frustration with the new instrument. The present article tries to connect this fall from favor with the microscope's equally surprising but hitherto little noticed late rise to prominence. The crucial point is that when the microscope, more than a decade after the telescope, finally managed to arouse the (...) interest of natural philosophers, it did so as a corpuscularian tool, and as such it came to share the difficult fate of seventeenth-century corpuscularianism. The essay ends with the claim that the fall of microscopy was not only due to the failure of microscopy to corroborate corpuscularianism, but also to the changing definition of natural philosophy in the late seventeenth and early eighteenth centuries and to the separation of the domains of living matter from a physica whose recent mathematical framework excluded the organic world. (shrink)

Health promotion efforts are commonly directed towards encouraging people to discard ‘unhealthy’ and adopt ‘healthy’ behaviours in order to tackle chronic disease. Typical targets for behaviour change interventions include diet, physical activity, smoking and alcohol consumption, sometimes described as ‘lifestyle behaviours.’ In this paper, I discuss how efforts to raise awareness of the impact of lifestyles on health, in seeking to communicate the need for people to change their behaviour, can contribute to a climate of ‘healthism’ and promote the moralisation (...) of people’s lifestyles. I begin by summarising recent trends in health promotion and introducing the notion of healthism, as described by Robert Crawford in the 1980s. One aspect of healthism is moralisation, which I outline and suggest is facilitated by efforts to promote health via information provision and educational strategies. I propose that perceived responsibility plays a role in mediating the tendency to moralise about health and behaviour. Since I argue that states ought to avoid direct and indirect moralisation of people’s health-related behaviour, this suggests states must be cautious with regard to the use of responsibility-indicating interventions to promote health. (shrink)

This paper identifies and critiques a tendency for public health risk communication to be ‘sneakily’ persuasive. First, I describe how trends in the social and health sciences have facilitated an approach to public health risk communication which focuses on achieving behaviour change directly, rather than informing people's decisions about their health behaviour. I then consider existing discussions of the merits of informing versus persuading in public health communication, which largely endorse persuasive approaches. I suggest such accounts are unsatisfying insofar as (...) their definitions of persuasion often fail to recognise its directional nature and the distorting effect this has on the total picture of the evidence. I re-characterise persuasion as directional influence aimed at achieving a particular outcome in the recipient and acknowledge that persuasive influence may also be manipulative. I then contrast this with (non-directional) information provision. I suggest that much persuasive public health risk communication is ‘sneaky’: it appears to be informative, but in fact presents a distorted picture of the evidence (in accordance with my characterisation of persuasion). I argue that such sneakily persuasive public health risk communication is unethical on the basis that it fails to adhere to the norms of cooperative communication. (shrink)

Although emerging scholarship in the social sciences suggests that religion can be a potential catalyst of cosmopolitanism and global citizenship, few attempts have been made to bring to the fore new theoretical positions and empirical analyses of how cosmopolitanism -- as a philosophical notion, a practice and identity outlook -- can also shape and inform concrete religious affiliations. Key questions concerning the significance of cosmopolitan ideas and practices - in relation to particular religious experiences and discourses -- remain to be (...) explored, both theoretically and empirically. This book takes as its starting point the emergence of cosmopolitanism -- as a major interdisciplinary field -- as a springboard for generating a productive dialogue among scholars working within a variety of intellectual disciplines and methodological traditions. The chapter contributions offer a serious attempt to critically engage both the limitations and possibilities of cosmopolitanism as an analytical and critical tool to understand a changing religious landscape in a globalizing world, namely, the so-called 'new religious diversity', religious conflict, and issues of migration, multiculturalism and transnationalism vis-à-vis the public exercise of religion. The contributors' work is situated in a range of world sites in Africa, India, North America, Latin America, and Europe. This work will be of great interest to students and scholars of globalization, religion and politics, and the sociology of religion. (shrink)

This article challenges François Jullien’s reading of Chinese thought based on his disjunction between ontology and shi, or propensity. According to Jullien, the Chinese history of ideas has been a never-changing entity in a homogeneous society for thousands of years. Jullien’s juxtaposing and contrasting ‘European thought’ and ‘Chinese thought’ falls into the trap of cultural essentialism he wanted to avoid. Jullien’s interpretation of shi also led him to believe that Chinese people never challenge reality, never confront or resist, tend to (...) stay in conformity, and lack interest in critical thinking. This paper argues that, despite the combination of Confucianism, Daoism and Legalism that constituted a powerful paradigm of normative governmentality of the hierarchical system in different dynasties in Chinese history, the spirit of political resistance has never ceased. Zhang Taiyan, at the end of the Qing Dynasty and the beginning of Republican China, demonstrated the tradition of such critical political thinkers. The re-reading of Zhang Taiyan’s Buddhist-inspired reading of Zhuangzi could offer us an additional possibility for the emancipatory and political thinking that can be inspirational even today. (shrink)

Since the start of the new millennium, many contemporary jurisdictions have been revisiting the fundamental principles of their civil procedures. Even the core areas of the civil process are not left untouched, including the way in which evidence is introduced, collected and presented in court. One generator of the reforms in the field of evidence-taking in recent decades has been slow and inefficient litigation. Both in Europe and globally, reaching a balance between the demands of factual accuracy and the need (...) to adjudicate disputes in a swift, cost-effective and efficient way is still one of the key challenges. The second reason that many countries are reforming their law of evidence is related to cultural and technological changes in modern societies. As the balance between, on the one side, traditional human rights such as the right to privacy and due process is shifting towards, on the other side, the modern need for security, efficiency and quick access to justice, the perception of what is admissible or not in the context of evidence-taking is changing as well."--Back cover. (shrink)

At the heart of China's remarkable economic growth is a new economic system, which has emerged out of radical reforms in virtually all areas of economic activity. Understanding this system is the key to understanding the Chinese economy. This book, the culmination of many years of research in Hong Kong and China, is a comprehensive account of these systemic reforms, as well as of their transferability to other economies in transition. The starting-point of Dr Chai's analysis is a careful examination (...) of the structural elements of China's new economic system, focusing particularly on the decentralization of property rights in both the agricultural and industrial sectors. There follows a detailed analysis of changes in the functional elements of the system: its price and financial mechanisms. An assessment of the open-door policy also considers the twin impact of the liberalization of China's foreign trade and foreign investment regimes. Finally, China: Transition to a Market Economy highlights the increasingly important role of the non-state sector in facilitating economic growth and structural transformation. It will be essential reading for any student or researcher concerned with the Chinese economy, or with transition economies in general. (shrink)

As the rising costs of lifestyle-related diseases place increasing strain on public healthcare systems, the individual’s role in disease may be proposed as a healthcare rationing criterion. Literature thus far has largely focused on retrospective responsibility in healthcare. The concept of prospective responsibility, in the form of a lifestyle contract, warrants further investigation. The responsibilisation in healthcare debate also needs to take into account innovative developments in mobile health technology, such as wearable biometric devices and mobile apps, which may change (...) how we hold others accountable for their lifestyles. Little is known about public attitudes towards lifestyle contracts and the use of mobile health technology to hold people responsible in the context of healthcare. This paper has two components. Firstly, it details empirical findings from a survey of 81 members of the United Kingdom general public on public attitudes towards individual responsibility and rationing healthcare, prospective and retrospective responsibility, and the acceptability of lifestyle contracts in the context of mobile health technology. Secondly, we draw on the empirical findings and propose a model of prospective intention-based lifestyle contracts, which is both more aligned with public intuitions and less ethically objectionable than more traditional, retrospective models of responsibility in healthcare. (shrink)

ABSTRACTPeople often continue to rely on misinformation in their reasoning after they have acknowledged a retraction; this phenomenon is known as the continued-influence effect. Retractions can be particularly ineffective when the retracted misinformation is consistent with a pre-existing worldview. We investigated this effect in the context of depressive rumination. Given the prevalence of depressotypic worldviews in depressive rumination, we hypothesised that depressive rumination may affect the processing of retractions of valenced misinformation; specifically, we predicted that the retraction of negative misinformation (...) might be less effective in depressive ruminators. In two experiments, we found evidence against this hypothesis: in depressive ruminators, retractions of negative misinformation were at least as effective as they were in control participants, and more effective than retractions of positive misinformation. Findings are interpreted in terms of an attentional bias that may enhance the sali... (shrink)

The counseling process involves attention, emotional perception, cognitive appraisal, and decision-making. This study aimed to investigate cognitive appraisal and the associated emotional processes when reading short therapists' statements of motivational interviewing (MI). Thirty participants with work injuries were classified into the pre-contemplation (PC,n= 15) or readiness stage of the change group (RD,n= 15). The participants viewed MI congruent (MI-C), MI incongruent (MI-INC), or control phrases during which their electroencephalograms were captured. The results indicated significant Group × Condition effects in the (...) frontally oriented late positive complex (P600/LPC). The P600/LPC's amplitudes were more positive-going in the PC than in the RD group for the MI congruent statements. Within the PC group, the amplitudes of the N400 were significantly correlated (r= 0.607–0.649) with the participants' level of negative affect. Our findings suggest that the brief contents of MI statements alone can elicit late cognitive and emotional appraisal processes beyond semantic processing. (shrink)

Theories of consciousness have a long and controversial history. One well-known proposal — integrated information theory — has recently been labeled as ‘pseudoscience’, which has caused a heated open debate. Here we discuss the case and argue that the theory is indeed unscientific because its core claims are untestable even in principle.

We examined if cancer patients' health-related quality of life (HRQoL) scores on the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 are affected by the specific time point, before or during treatment, at which the questionnaire is completed, and whether this could bias the overall treatment comparison analyses. A 'completion-time window' variable was created on three closed EORTC randomised control trials in lung (non-small cell lung cancer, NSCLC) and colorectal cancer (CRC) to indicate when the QLQ-30 was completed (...) relative to chemotherapy cycle dates, defined as 'before', 'on' and 'after'. HRQoL mean scores were calculated using a linear mixed model. Statistically significant differences (P < 0.05) were observed on 6 and 5 scales for 'on' and 'after' comparisons in the NSCLC and two-group CRC trial, respectively. As for the three-group CRC trial, several statistical differences were observed in the 'before' to 'on' and the 'on' to 'after' comparisons. For all three trials, including the 'completion-time window' variable in the model resulted in a better fit, but no substantial changes in the treatment effects were noted. We showed that considering the exact timing of completion within specified windows resulted in statistical and potentially clinically significant differences, but it did not alter the conclusions of treatment comparison in these studies. (shrink)

Many of the commentaries cohere around two major points of criticism. The first is that we have omitted discussion of the mechanisms that are assumed to operate at levels 2, 3, and 4.Campbell, Cloak, Dewsbury, Eckberg, Mundinger, Pulliam, Richerson & Boyd, Slobodkin, Simon, Williams, andWahlstenall make comments that bear on this point. The second point is that we have omitted discussion of the fact that "organisms change the environment by their activities" and thereby modify the selection pressures that act on (...) them. Apart from Lewontin, this point has been raised in different forms byBarkow, Chase, Hull, Perzigian, Ruyle, and less directly bySlobodkin. Stemming from these two basic omissions there is a third general criticism. Numerous commentators have pointed out that we have failed to discuss sufficiently either the extent or nature of the constraints that may or may not be operating on supraordinate evolutionary processes as a function of their nested relationships to subordinate evolutionary processes within our scheme. We start by acknowledging these three basic omissions. We agree that they exist and that they are serious. (shrink)

There is a need for person-centred approaches and empowerment of staff within the residential care for older people; a movement called ‘culture change’. There is however no single path for achieving culture change. With the aim of increasing understandings about cultural change processes and the promotion of cultural values and norms associated with person-centred practices, this article presents an action research project set on a unit in the Netherlands providing care for older people with dementia. The project is presented as (...) a case study. This study examines what has contributed to the improvement of participation of older people with dementia in daily occupational and leisure activities according to practitioners. Data was collected by participant observation, interviews and focus groups. The results show that simultaneous to the improvement of the older people’s involvement in daily activities a cultural transformation took place and that the care became more person-centred. Spontaneous interactions and responses rather than planned interventions, analysis and reflection contributed to this. Furthermore, it proved to be beneficial that the process of change and the facilitation of that process reflected the same values as those underlying the cultural change. It is concluded that changes arise from dynamic, interactive and non-linear processes which are complex in nature and difficult to predict and to control. Nevertheless, managers and facilitators can facilitate such change by generating movement through the introduction of small focused projects that meet the stakeholders’ needs, by creating conditions for interaction and sense making, and by promoting the new desired cultural values. (shrink)

This paper examines the challenges that climate change raises for animal agriculture and discusses the contributions that may come from a virtue ethics based approach. Two scenarios of the future role of animals in farming are set forth and discussed in terms of their ethical implications. The paper argues that when trying to tackle both climate and animal welfare issues in farming, proposals that call for a reorientation of our ethics and technology must first and foremost consider the values that (...) drive current livestock production. This paper sets forth and discusses the broader societal values implicit in livestock production. We suggest that a virtues approach would improve our thinking and practice regarding animal agriculture, facilitating a move from livestock production to animal husbandry. This change in animal agriculture in a time of climate change would stress virtues such as attentiveness, responsibility, competence, and responsiveness as central elements in any mitigation or adaptation program. (shrink)

The purpose of this study was to develop a Physician's Spiritual Well-Being Scale (PSpWBS). The significance of a physician's spiritual well-being was explored through in-depth interviews with and qualitative data collection from focus groups. Based on the results of qualitative analysis and related literature, the PSpWBS consisting of 25 questions was established. Reliability and validity tests were performed on 177 subjects. Four domains of the PSpWBS were devised: physician's characteristics; medical practice challenges; response to changes; and overall well-being. The explainable (...) total variance was 65.65%. Cronbach α was 0.864 when the internal consistency of the whole scale was calculated. Factor analysis showed that the internal consistency Cronbach α value for each factor was between 0.625 and 0.794 and the split-half reliability was 0.865. The scale has satisfactory reliability and validity and could serve as the basis for assessment of the spiritual well-being of a physician. (shrink)

This chapter examines questions having to do with whether and how things persist through change and how things do so If they do persist. Next, assuming that intrinsic change does take place, the chapter examines two principal views about how things persist through change of intrinsic properties, Substratism and Replacementism. It focuses on the specific but very important case of motion, or change of location. There are three major theories: Intrinsic Motion; Bertrand Russell's At/At Theory, and an Aristotelian theory (Motion (...) Intervalism). The chapter also considers the problem of the persistence of composite objects, including objects that can gain or lose parts. Replacementists might consider taking on board a metaphysically fundamental genidentity relation. Substratists have an explanation for the reflexivity, symmetry, and transitivity of genidentity, something that Classical Genidentity Theorists have to posit as a brute metaphysical necessity. This provides the Substatists with an advantage in terms of Ockham's Razor. (shrink)

Purpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools. Method: An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Results: Representatives from 61 (39%) schools responded. Thirty-two (52%) respondents were course directors; 26 (43%) were (...) deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Conclusions: Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices. (shrink)

This paper examines an issue that is becoming increasingly relevant as the pressures of a warming planet, changing climate and changing ecosystems ramp up. The broad context for the paper is the intragenerational, intergenerational, and interspecies equity implications of changing the climate and the value orientations of adapting to such change. In addition, the need to stabilize the planetary climate by urgent mitigation of change factors is a foundational ethical assumption. In order to avoid further animal and plant extinctions, or (...) at the very least, their increased vulnerability to becoming rare and endangered; the systematic assisted colonization of “at risk” species is being seriously considered by scientists and managers of biodiversity. The more practical aspects of assisted colonization have been covered in the conservation biology literature; however, the ethical implications of such actions have not been extensively examined. Our discussion of the value issues, using a novel case study approach, will rectify the limited ethical analysis of the issue of assisted colonization of species in the face of climate change pressures. Beyond sustainability ethics, both animal and environmental ethical approaches will be used and intrinsic versus instrumental value orientations in the literature shall form the basis of our discussion. After the application of all the ethical approaches to the case studies, we conclude that without mitigation and the prospect of a future stable climate, assisted colonization will be involved in an inherently unethical process and a “move and lose it” outcome. With mitigation, there is wide-ranging ethical support for assisted colonization. (shrink)

Introduction In 2007, a national review committee was instituted in The Netherlands to review cases of active ending of life for newborns. It was expected that 15–20 cases would be reported. To date, however, only one case has been reported to this committee. Reporting is essential to obtain societal control and transparency; the possible explanations for this lack of reporting were therefore explored. Methods Data on end-of-life decision-making were scrutinised from Dutch nation-wide studies (1995, 2001 and 2005), before institution of (...) the committee. Physicians received a questionnaire about their medical decision-making for stratified samples of deceased infants up to 1 year, drawn from the central death registry. Results In 2005, 58% of all deaths were preceded by an end-of-life decision, compared with 68% in 2001 and 62% in 1995. The use of drugs with a possible life-shortening effect tended to be lower. In 2005, all four cases in the study in which an infants' life was actively ended were preceded by a decision to forego life-prolonging treatment. In three cases, the infant's life expectancy was short; one case involved a longer life expectancy. Discussion The expected number of cases is probably an overestimation due to changes in medical practice such as the tendency to attribute less life-shortening effects to opioids. The lack of reports is probably also associated with requirements in the regulation; it may be difficult to fulfil them due either to time constraints or the nature of the suffering that is addressed. If societal control of active ending of life is considered useful, changes in the regulation may be needed. (shrink)

THIS paper seeks to elucidate the phenomenon known in psychology as 'the specious present,' by postulating a two-dimensional theory of the extensional aspects of time. On this theory, the usual logical and psychological difficulties, encountered in current accounts of this phenomenon, can be resolved. For, when there are two dimensions of time, the same event may be without extension in one of these dimensions ('transition-time'), while it is nevertheless finitely extended in the other of these dimensions ('phase-time'); so that in (...) a definable sense the phases of a finitely enduring event, though successive in one time-order, yet are contemporary in the other. The epistemological standpoint implicit in the paper is generally similar to the one Bertrand Russell has put forward, in his Physics and Experience (Cambridge, 1946), and his Human Knowledge: Its Scope and Limits (London, 1948) (allowing for the changes which would be required in Russell's theory to take into account a second time dimension). A 'psycho-neural parallelism,' or one-one correspondence, is postulated between features of certain 'experiential events' (namely, those experiential events normally held to be happening to some person's mind, which are describable in the language of psychology); and features of certain 'physical events' (namely, those events described in the language of physics, chemistry and physiology, which are ordinarily conceived as happenings in that same person's body). These physical events are conceived of as being causally connected with events in the physical world outside the experient's body, by means of the concepts of light waves, sound waves, chemical stimuli, and consequential processes in the nervous system (central and peripheral) and sense-organs, in the usual way. In terms of this psycho-neural parallelism the physical correlate of the finite temporal span of the specious, or experiential present, is to be found in certain consequences of the uncertainty principle in quantum physics; according to which there is a finite interval of time necessarily associated with a nearly precise determination of energy levels, and of transitions between them. Some of the physical implications of this theory, applied to processes in the material structure of the human body, are discussed qualitatively. But, for the reasons given in the last section of the paper, a quantitative treatment is not yet possible. The paper is greatly indebted in regard to the physical application of the two-dimensional theory of time, to the discussion of the pentadic group structure in Eddington's Fundamental Theory (Cambridge, 1946 and 1950); and in particular to the treatment there of the phase-variable as the 'time-analogue' in the quantum statistics of stationary states. (shrink)

Joseph Beuys was one of the most significant artists of the 20th century. He was a gunner and radio operator in the German Air Force during World War II, and was severely injured several times. In March 1943 he had a life-changing experience after the dive bomber he was assigned to crashed in the Crimean peninsula. This trauma influenced Beuys' entire artistic career, and is known in art history as the ’Tartar Legend’ or ’Tartar Myth’. Profoundly affected by the crash, (...) the severe trauma, the near-death experience and his rescue, which he perceived as a “rebirth”, Beuys no longer saw himself, other people or society as a whole in the same way as previously. With his new consciousness, he ignored boundaries and created visions whereby all mankind could experience the healing he had undergone. Beuys did not bring society far enough for the turning point towards “the healing of the world” to be visible, yet today it is important to keep his work alive as a record of his extraordinary strength, which arose from trauma and severe injury, and was carried by a passionate commitment to mankind and to life itself. (shrink)

Mrs. Warnock opens her discussion with a warning against the attempt to define existentialism, or to treat it as a single, unified position. With this warning in mind, she then proceeds to trace some of the general features of existentialist "ethics" through the philosophies of Kierkegaard, Heidegger, and Sartre. Mrs. Warnock sees the common aim of these thinkers as the attempt to "free people from illusion." She particularly stresses 1) the breakdown of the distinction between thinking and feeling, and the (...) resultant blurring of the line between an ethics and the rest of each thinker's philosophy; and 2) the breakdown of the distinction between feeling and acting—in Sartre's words "we try to change the world." Throughout the volume the import of the role of freedom, choice, and anguish are emphasized.—C. L. H. (shrink)

Basic Beliefs in Distributive Education .... Crawford Changing the Context in which Occupational Education Takes Place The Task Force on ...

During the 1970s and 1980s, political psychologists at the State University of New York at Stony Brook focused political scientists’ attention on online processing. Borrowing from the new field of social cognition in psychology, they argued that voters’ evaluations of candidates are the products of a summing up of reactions to happenings during a campaign. Voters might not remember the specific events later on, but their running tallies of reactions over the duration of the campaign would ensure that they take (...) the forgotten information into account when entering the voting booth. Later, these same scholars yet again borrowed from (a very changed) psychology, and argued that many people, especially the most politically sophisticated, try to confirm their current political evaluations—for example, by seeking out confirmatory evidence and dismissing evidence that challenges their attitudes. We ask whether online processing and motivated reasoning have the same or different implications for democratic governance, and whether the two empirical perspectives can be reconciled. (shrink)