This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.

Toxic speech inflicts damage to mental and physical health. This process can be chronic or acute, temporary or permanent. Understanding how toxic speech inflicts these harms requires both an account of linguistic practices and, because language is inherently social, tools from epidemiology. This paper explores what we can learn from two epidemiological models: a common source model that emphasizes poisons, and a propagated transmission model that better fits contagions like viruses.

This chapter examines the role played by derogatory terms (e.g., ‘inyenzi’ or cockroach, ‘inzoka’ or snake) in laying the social groundwork for the genocide of the Tutsi in Rwanda in 1994. The genocide was preceded by an increase in the use of anti-Tutsi derogatory terms among the Hutu. As these linguistic practices evolved, the terms became more openly and directly aimed at Tutsi. Then, during the 100 days of the genocide, derogatory terms and coded euphemisms were used to direct killers (...) to their victims. Understanding these speech acts helps to illuminate the important ways that power is enacted through discourse, how speech acts can prepare the way for physical and material acts, and how speech generates permissions for actions hitherto uncountenanced. Studying the role of speech acts and linguistic practices in laying the groundwork of the genocide illuminates how patterns of speech acts become linguistic practices that constitute permissibility conditions for non-linguistic behaviors. Further, the analysis presented here helps to make sense of the view that a steady, deep, and widespread derogation of a group can be part and parcel of genocide, not only an antecedent to it. (shrink)

This article shows how attention to extended metaphors provides the basis for a substantive account of what it is to understand a metaphor. Offering an analysis of extended metaphors modeled on an analysis of co-referential anaphoric chains, this article presents an account of how contexts makes metaphors. The analysis introduces the concept of expressive commitment, commitment to the viability and value of particular modes of discourse. Unlike literal interpretation, metaphorical interpretation puts the expressive commitment in the forefront of the interpretive (...) process. The analogy between extended metaphors and anaphora provides a structure for describing what it is to interpret expressions metaphorically. It generates an account that explains the affinities and differences between extension and explication, and hence of the age-old problem of paraphrase. Further, the account allows for the open-endedness of metaphor without succumbing to the view that metaphor is non-cognitive. Finally, the account developed here underscores the role of expressive commitment in metaphorical interpretation. (shrink)

Definitions of the concept of mild cognitive impairment (MCI) and suggested therapies are controversial. There are no widely acknowledged therapies and the ethical implications and methodologic issues around identifying and defining people with MCI are important concerns. The psychosocial implications for the person being labeled as having MCI have not been widely explored. This paper addresses these issues and presents data from two contrasting case studies. Key analytical themes identified in the qualitative analysis include different views about the causes of (...) dementia ("normal aging" versus disease); fear and anxiety about dementia; how such factors influence presentation to health professionals; and the effect of a label of cognitive impairment on quality of life. Our conclusion is that the usefulness and justification for early identification of cognitive impairment in a situation that has not yet been recognized by those involved should be questioned. (shrink)

In his Confessions, Augustine lamented, “What, then, is time? If no one asks me, I know: if I wish to explain it to one who asks, I know not.” In this respect, consciousness is like time. If no one asks me what consciousness is, I know. To pay attention to something is to become conscious of it. Indeed, everything with which I can be familiar ­­ from the sound of your footsteps to my own daydreams ­­ can be an object (...) of my consciousness. Yet, if I wish to explain consciousness to one who asks, I know not. I (and, I suspect, we) have little theoretical grip on the nature of consciousness. Not for nothing did Schopenhauer call the problem of consciousness ‘the world knot.’ What, then, is consciousness? (shrink)

Davidson suggests that metaphor is a pragmatic (not a semantic) phenomenon; on his view, metaphor is a perlocutionary effect prompts its audience to see one thing as another. Davidson rightly attacks speaker-intentionalism as the source of metaphorical meaning, but settles for an account that depends on audience intentions. A better approach would undermine intentionalism per se, replacing it with a social practice analysis based on patterns of extending the metaphor. This paper shows why Davidson’s perceptual model fails to stave off (...) semantic analysis, and argues that the professed virtues of Davidson's position are more readily found in an account that focuses on the nature of metaphorical interpretation. (shrink)

Freedom of expression is considered a basic human right, and yet most countries have restrictions on speech they deem harmful. Following the genocide of the Tutsi, Rwanda passed a constitution (2003) and laws against hate speech and other forms of divisionist language (2008, 2013). Understanding how language shaped “recognition harms” that both constitute and fuel genocide also helps account for political decisions to limit “divisionist” discourse. When we speak, we make expressive commitments, which are commitments to the viability and value (...) of ways of speaking. This article explores reasons a society would decide to say, “We don’t talk that way around here,” thus taking control of its own expressive commitments. Understanding the scope of the law in Rwanda promises to help clarify limits to hate speech and other forms of derogatory discourse (including images). Ultimately, the argument is that wherever recognition harms are a significant factor in social and political life, changing permissible expressive commitments is crucial to social and political repair. (shrink)

Some philosophers take personal identity to be a matter of self-narrative. I argue, to the contrary, that self-narrative views cannot stand alone as views of personal identity. First, I consider Dennett’s self-narrative view, according to which selves are fictional characters—abstractions, like centers of gravity—generated by brains. Neural activity is to be interpreted from the intentional stance as producing a story. I argue that this is implausible. The inadequacy is masked by Dennett’s ambiguous use of ‘us’: sometimes ‘us’ refers to real (...) human beings, and sometimes ‘us’ refers to selves or fictional characters. Second, I consider Schechtmann’s view that self-narratives create persons in order for there to be a self-narrative. Finally, I offer my own account of persons. (shrink)

I set out four general facts about things that we can refer to and talk about, whether they exist or not. Then, I set out an argument for the existence of God. Myargument, like Anselm’s original argument, is a reductio ad absurdum: It shows that the assumption that God does not exist leads to a contradiction. Theargument is short and in ordinary language. Each line of the argument, other than the reductio premise, is justified by one of the general facts. (...) Finally, I consider some traditional objections to Anselm’s argument, and show how my updated version avoids them. (shrink)

Many Christians who argue against Christian materialism direct their arguments against what I call ‘Type-I materialism’, the thesis that I cannot exist without my organic body. I distinguish Type-I materialism from Type-II materialism, which entails only that I cannot exist without some body that supports certain mental functions. I set out a version of Type-II materialism, and argue for its superiority to Type-I materialism in an age of science. Moreover, I show that Type-II materialism can accommodate Christian doctrines like the (...) Resurrection of the Body, the Incarnation, and the intermediate state (if there is one). (shrink)

An imperfect “politics of justice” seems to be inevitable in the aftermath of genocide. In Rwanda, this is especially true, given the scale of the atrocities, the breadth of participation, and the need to build a justice system from scratch while establishing security and restoring the rule of law. Official contexts for survivor testimony and corresponding perpetrator punishment are crucial for establishing shared norms and narratives, but these processes can destabilize social relations in important ways. Accordingly, without development, these justice (...) mechanisms can undermine social stability and emerging cohesion. The converse is also true: without official contexts of testimony and judgment, development is only material support, and has no recognitive force. Learning from Rwanda’s post-’94 transitional justice, broadly construed, I argue that without development, platforms for testimony and the meting out of punishment yield insufficient recognition and so undermine social stability and emerging cohesion. The converse is also true: without official contexts of testimony and judgment, development is only material support, and lacks crucial recognitive force. The crucial interdependence of development, which provides distributive justice, with criminal proceedings, which offer retributive and restorative justice, has the potential to secure a lasting and stable peace. (shrink)

Confronting evils pulls the minds and hearts in several directions. This chapter focuses on acute cataclysmic events that shock people into awareness, or chronic corrosive evils that damage the agency and dull the attention. It also focuses on those who commit grave wrongs, or those who suffer them. Claudia Card's work has offered a steady focus on the experiences and needs of survivors of atrocities and grave wrongs. The chapter explores what Card's most recent work suggests about perpetrators, that is, (...) about the moral risks of participating in evil. Obvious atrocities include terrorism, torture, forced starvation, slavery, rape, and genocide; these each involve many grave wrongs. Card's concepts of social vitality and social death make sense of such cases, enabling us to see a perpetrator's act as a particular destruction of a survivor's world. Social vitality is important for each of us, in all phases of the lives. (shrink)

Drawing on my recent work using inferential role semantics and elements of speech act theory to analyze the role of derogatory terms (a.k.a. ‘hate speech’, or ‘slurs’) in the 1994 genocide of the Tutsi in Rwanda, as well as the role of certain kinds of reparative speech acts in post-genocide Rwanda, this paper highlights key pragmatist commitments that inform the methods and goals of this practical analysis of real world events. In “Genocidal Language Games”, I used conceptual tools from Wittgenstein, (...) Sellars, Lewis, and Brandom, with a nod to Searle’s concept of status-functions, to develop an analysis that helps to make sense of the view that a steady, deep, and widespread derogation of a group can at least partially constitute genocide, not only be an antecedent to it. In this paper, I sketch some of the tools and lessons of this project, with an eye to highlighting their pragmatist roots and the directions to which such real-world investigations lead. (shrink)

This essay examines the Foucauldian foundations of queer theory in the work of Eve Kosofsky Sedgwick. The essay argues that Sedgwick’s increasing disappointment with Foucault’s critique of the repressive hypothesis is in part produced by the slippery rhetoric of The History of Sexuality, Vol. 1: An Introduction . Specifically, Foucault’s use of free indirect discourse in that volume destabilizes both the theory of repression and the critique Foucault mounts against it, thereby rendering ambiguous any political promise his critique might seem (...) to offer. Returning to the fraught relation between Foucault and Sedgwick, the essay concludes by reading Foucault and Sedgwick together through the lens of a reparative ethics in which the felt experience of knowing the world is also an experiment in new ways of living. (shrink)

Americans cherish the idea that good eventually triumphs over evil. After briefly arguing that a proper understanding of the moral harm of cruelty calls into question the credibility of popular American idioms of redemption, I argue that the epistemic dynamics of horror help account for the commanding grip of this rhetoric on the popular imagination, and I suggest that this idiom has morally problematic features that warrant the attention of feminists.

This volume is fourth in the series of annuals created under the auspices of The Association for Feminist Ethics and Social Theory . The topics covered herein_from peacekeeping and terrorism, to sex trafficking and women's paid labor, to poverty and religious fundamentalism_are vital to women and to feminist movements throughout the world.

Plato's Parmenides: A Principle of Interpretation and Seven Arguments SANDRA PETERSON PART I. A PRINCIPLE OF INTERPRETATION 1. THE EVIDENT STRUCTURE OF THE PARMENIDES PLATO'S Parmenides falls naturally into halves. In the first half, which is a conversation between Socrates and Parmenides initiated by the young Socra- tes' reaction to arguments of Zcno's, Socrates shows confusion as he tries to answer Parmenides' questions about forms. The second half consists of about 195 short, initially strange-looking, arguments given by Parmenides to a (...) youngster, Aris- totle, as respondent. In between the two halves, at 135d2- 3, Parmenides admires Socrates' "fine" and "divine" passion for arguments. But Parmenides has noticed, even in a conversation of Socrates with Aristotle previous to the setting of the Parmenides, that Socrates is trying to define too soon. Parmenides then recommends to Socrates some exercise. The second half of the Parmenides illustrates it. What is the manner of exercise, Parmenides? he asked. The one you heard from Zeno, he replied. Except for this: I admired you also when you said to him that you would not allow inquiry to wander among the things we see, nor even in their domain, but rather in the field of those things which one would most especially grasp by reasoning and would.. (shrink)

Cheri Lynne Carr explores the very real potential of Deleuze's clandestine use of Kantian critique for developing a new ethical practice. This new practice is built on an idea implicit in much of Deleuzian thought: the idea of critique as a way of life.

My aim in this paper is to contribute to the substantial body of feminist scholarship on the place of women in Aristotle’s psychic and political hierarchy. Whereas the traditional point of departure for such analyses is more typically Aristotle’s Politics, mine is his hylomorphic or organizational/ecological account of what defines a living thing and its powers in de Anima. My primary claim is that although his de Anima account does offer a more promising view of what defines particular kinds of (...) living things, including human beings qua the power of intellection, it does not ultimately save him from the ambiguity endemic to his account of women’s capacity to deliberate in his Politics. Such a result is significant for feminists who, in seeking nondualistic accounts of embodied human existence, have sometimes turned to Aristotle’s hylomorphism for support, but, I suggest, might be better off to seek such support elsewhere. (shrink)

This brief text assists students in understanding Marx's philosophy and thinking so that they can more fully engage in useful, intelligent class dialogue and improve their understanding of course content. Part of the "Wadsworth Philosophers Series," (which will eventually consist of approximately 100 titles, each focusing on a single "thinker" from ancient times to the present), ON MARX is written by a philosopher deeply versed in the philosophy of this key thinker. Like other books in the series, this concise book (...) offers sufficient insight into the thinking of a notable philosopher better enabling students to engage in the reading and to discuss the material in class and on paper. (shrink)

We provide an overview of the development of product placements within traditional and newer electronic media, followed by a critique of current regulations where they exist and highlight the challenges this form of brand promotion presents to regulators. We note the weaknesses in current theoretical perspectives on the way product placements impact more than awareness and argue that a failure to recognise the increasingly diverse nature of product placement within entertainment media content means that awareness campaigns and warnings regarding the (...) presence of product placements are unlikely to be effective in countering any negative effects of the practice on vulnerable groups such as children and young adults. While we focus on the impact of product placement activity on children and young adults, using primarily the examples of alcohol and tobacco products, we also raise concerns regarding a failure to act on the presence of a number of harmful products that fall beyond the current list of restricted products even in countries where some form of specific regulation exists. In order to aid those considering the necessity for, or scope of, any future restrictions on this form of marketing communication, it is important to determine not only what is known, but what also needs to be determined about the impact of product placements across the range of existing and evolving communication channels. (shrink)

Cognitive Science, Volume 46, Issue 1, January 2022.

Introduction to the Philosophy of Sport begins with the history of sport, delves into both the metaphysics and ethics of sport, and also addresses dimensions of the social and political elements of sport. This book is a comprehensive introduction to the philosophy of sport with a straightforward layout that professors can plan and build their courses around.

In this new book, Mary Lynne Ellis and Noreen O'Connor move to the heart of 21st century intertwining of psychoanalytical and philosophical critical reflections ...

Infants are unable to make their own decisions or express their own wishes about medical procedures and treatments. They rely on surrogates to make decisions for them. Who should be the decision-maker when an infant’s biological parents are also minors? In this paper, we analyse a case in which the biological mother is a child. The central questions raised by the case are whether minor parents should make medical decisions on behalf of an infant, and if so, what are the (...) limits to this decision-making authority? In particular, can they refuse treatment that might be considered best for the infant? We examine different ethical arguments to underpin parental decision-making authority; we argue that provided that minor parents are capable of fulfilling their parental duties, they should have a right to make medical decisions for their infant. We then examine the ethical limits to minor parents’ decision-making authority for their children. We argue that the restricted authority that teenagers are granted to make medical decisions for themselves looks very similar to the restricted autonomy of all parents. That is, they are permitted to make choices, but not harmful choices. Like all parents, minor parents must not abuse or neglect their children and must also promote their welfare. They have a moral right to make medical decisions for their infants within the same ‘zone of parental discretion’ that applies to adult parents. We conclude that adult and minor parents should have comparable decision-making authority for their infants. (shrink)

Understanding evil requires both addressing the grave wrongs done to the victim and addressing the perpetrator who does these wrongs. Claudia Card's concept of social vitality was developed to explain what génocidaires destroy in their victims. This essay brings that concept into conversation with perpetrator testimony, arguing that the génocidaires’ desire for their own social vitality, achieved through their destruction of the social world of their targets, in fact boomerangs to corrode the vitality of their own lives. This is true (...) whether they succeed or fail in their genocidal project. Card's recent analysis of “being a badass” is brought to bear on the cultivation of evil, and the essay suggests four strategies for meeting Card's “moral challenge of avoiding evil responses to evil.”. (shrink)

This dissertation is about the influence of the philosophy of Plato, and his description of the Idea of the Good, on the political thought of George Parkin Grant. Grant was a Canadian thinker who had an individual and idiosyncratic interpretation of Plato which he used to address the apparently irreconcilable tension that exists in modern philosophy between truths of faith and truths of reason. His attempt to reconcile what he labeled the "ethical-religious" approach to truth with the "cosmological" approach led (...) him to read Plato because Plato's Idea of the Good unified, in his opinion, the spiritual and intellectual sides of our life because it is that for which we are fitted or made. ;Grant argued that there is a fundamental disjunction or fissure in present modern thinking between how we think about God and how we think about truth as a result of the fact that we reason in a technological way for technological ends. Plato and the ancients perceived reason to be, at its highest, contemplative whereas we put our reason to use. Grant following Martin Heidegger, thought that there is an ontological position underlying modern reasoning that draws moderns almost inevitably towards the mastery of nature rather than the contemplation of what is everywhere and always good. ;This dissertation, by tracing some of the intellectual influences on Grant's thought gives an explanation for why Grant considered Martin Heidegger to be right about the ontological underpinnings of technological rationality and at the same time wrong about the continuing importance of Plato's dialogues. In so doing, I argue, he was attempting to give people of Christian faith the beginning of an argument about how to defend faith in a technological society. (shrink)

Evolution: The Basics is an engaging introduction to the history, development and science of the theory of evolution. Beginning pre-Darwin and concluding with the latest research and controversies, readers are introduced to the origins of the idea of evolution, the ways in which it has developed and been adapted over time and the science underpinning it all. Topics addressed include: • early theories of evolution • the impact of Darwin’s On the Origin of Species • the discovery of genetics and (...) Mendel’s experiments • molecular evolution and the discovery of DNA • the expansion of life and the persistence of disease • revisiting evolutionary ethics and the development of empathy. Evolution: The Basics examines the role of evolution in current debates and discusses the possible future developments in the field. This book is invaluable reading for all students and individuals seeking to understand the wide ranging sphere of evolutionary theory.  . (shrink)

The term ‘human interpretation’ itself has two interpretations: interpretation by human beings and interpretation of human beings. We are all familiar with both kinds of interpretation in ordinary life. Marie interprets Sam’s remark as a sexual invitation; Joseph interprets the famous guest’s attire as an insult to the host. But as the organizers of our conference point out, we have no systematic explanation of human interpretation—either ‘of’ or ‘by’ human beings. Before embarking on a theory of human interpretation, however, we (...) need to do some preliminary work. What is the explanandum of a theory of human interpretation? What is an explanation of human interpretation supposed to be an explanation of? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Things Are NOT OkayLynne HillardThree doctors, each with good intentions, led us to believe that everything would be all right for our son Ben. In the fall of 2008, Ben presented with two documented seizures. We first saw a doctor from our pediatrician’s office. He told us not to worry since the basic neurological physical exam showed nothing, but recommended that we see a pediatric neurologist. He gave us (...) a list of recommended doctors, and upon leaving the examining room the doctor then said, “Don’t worry. It’s not a brain tumor.”We arranged a meeting with one of the pediatric neurologists who had been practicing for a long time and had worked in one of the well–respected children’s hospitals before going into private practice. She was attentive and kind and spent a couple hours with us as we went over Ben’s medical history. She examined Ben and found nothing unusual, in fact per her notes, “his neurological examination is better than normal.” She said that she would order an EEG and a brain MRI because he had two witnessed seizures. She asked us to look into family history to see if there was anyone with a history of seizures in either one of our families. Upon leaving she said not to worry that it was probably something that he would out grow.After looking into family history, I found out that my older brother had had a couple of seizures when he was about twelve. He was put on phenobarbital. He eventually outgrew the seizures. Armed with this information I felt certain that Ben’s issues were hereditary. It was right before Christmas 2008, so I delayed on getting the EEG and brain MRI until January of that new year. The results of the EEG were unremarkable. The following week was the MRI. The day after the MRI, the receptionist at the neurologist’s office called. She requested that we come in the next day and asked that Ben not come to the appointment.“I am sorry to tell you, but Ben has a brain tumor.” What? I couldn’t even concentrate on what the doctor was saying. Ben’s tumor was located in the right temporal lobe and extensively involved the right amygdala and right hippocampus.I remember feeling completely overwhelmed with the process of choosing the individual who would ultimately perform brain surgery on our son. My husband and I interviewed three surgeons within a few weeks. On March 20 of 2009 Ben underwent surgery. The neurosurgeon was able to remove about 75 percent of the tumor. Two days after surgery Ben was released from the hospital. I remember that surreal feeling. My son had just had brain surgery and now we were going home with a list of medications and a schedule for administering the medications. I felt inept, unprepared, and yet relieved that my son had made it through; he could talk, he could move all his limbs and everything appeared to be normal. The only distinguishing feature that anything had happened was the six–inch scare on the side of his head.The pathology report said it was a DNET tumor (Dysembryoplastic Neuroepithelial Tumor), one that should not re–grow or cause any further problems. I remember the audible sigh of relief that came out of my mouth. I remember the neurosurgeon’s words: “Ben will grow up to be a fi ne young man, and you will dance with him at his wedding.” I wanted to be happy, like I had won the lottery, but I had this feeling that there must be something more to this, it couldn’t be this easy.In his second year at preschool Ben’s behavior problems became more obvious. When Ben became overwhelmed he would just sit down and not budge. Even when the director of the preschool asked us if there were any problems that were the result of his anti–seizure medication or his surgery, we said “no” because we were told “all should be good.” But all along there was that nagging feeling that not all was good in Ben’s world. [End Page 11]In... (shrink)

Australian Aboriginal cosmology is centered on The Dreaming, which has an eternal nature. It has been referred to as "everywhen" to articulate its timelessness. Starting with the assumption that "waking" reality is only one type of experienced reality, we investigate the concept of timelessness as it pertains to the Aboriginal worldview. We begin by questioning whether in fact "Dreaming" is an appropriate translation of a complex Aboriginal concept, then discuss whether there is any relationship between dreaming and The Dreaming. We (...) then discuss Aboriginal ceremonial performance, during which actors are said to become Dreaming Ancestors, using as a frame of reference the "flow" experience explicated by Mihaly Csikszentmihalyi together with Alfred Schutz's "mutual tuning-in relationship." © 2009 by the Joint Publication Board of Zygon. (shrink)

Ask any of your single female friends — and some of your married ones — about men, and they will likely complain that the men they meet avoid commitment like rats avoid electric shock. Although the therapists of these women may say that they choose men who avoid commitment, a recent television show on being single in America treated millions of viewers to scenarios one hears women repeat a thousand times: a man comes onto a woman like she's water in (...) the desert, smothers her in the first few weeks with flowers, balloon-o-grams, phone calls, and professions of love, says he's never felt so wonderful with a woman in his over-thirty life, and then, as quickly and suddenly as he came on, he disappears. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Family, Friends, and Cancer:The Overwhelming Effects of Brain Cancer on a Child’s LifeLynne ScheumannOur son was diagnosed with a medulloblastoma at the old age of 13. The “lucky” part for him was his brain was almost fully developed at this age as opposed to most “medullo” patients. While this was a benefit to him it was also one of the hardest things for him.He went into surgery a highly (...) intelligent, active, and left handed boy and came out unable to move his left side, could barely speak, and very much aware of what he just lost. We, as a family, were totally unprepared for how globally this would [End Page 23] affect the rest of his life. As we spent time in the hospital I would look at the children with other types of cancer and see them walking and talking and doing their schoolwork and God forgive me I would be jealous. The fact that the cancer was in his brain, the part of his body that makes him who he is changed everything forever.He lost all of his friends because 13–year–old boys communicate best through physical activity and that was not an option for him. He still has the same personality and sense of humor, but he will not be the architect or engineer he once dreamed of being. Math, that was once so easy for him was now like a foreign language, never to be mastered again. He was able to graduate from High School and takes classes at our local Junior College in Computer Assisted Drafting, but he can only manage one or two classes a semester due to the fatigue he still suffers from.What I most worry about and wish I had been forewarned about is his long–term quality of life. Physically he has come such a long way from how he was after the resection. It was a very slow process in which the first year of rehab was slowed by the fact that one of the chemo agents causes peripheral neuropathy. He developed contractures in his ankles and needed serial casting and ankle–foot orthotics (AFO) not just on the left leg, but now the right. He was able to switch his handedness fairly easily and his left hand will always be of limited usefulness because of ataxia. I would get angry at him that he gave up on his left side so quickly until it was finally explained to me years later that the ataxia would never get better.As far as his walking ability goes he has come a long way. At first he was unable to walk and once he started rehab he went back to learning to crawl and progressed to a walker. The first time I saw him walk with the walker brought tears to my eyes. It was so much more of an event for me than when he took his first steps as a toddler. This was so much more hard fought. He never complained, just always did what was asked of him. It had to have been such hard work and also somewhat embarrassing, as he needed help to literally do everything for months. He progressed to a cane and about two years ago decided not to use that or his AFO’s. He now wears high top boots that substitute for the AFO’s but don’t make him appear disabled. Recently he decided there are times when he would be safer if he had his cane and purchased one that looks more like a hiking stick than a cane. I think he has come to terms with the fact that physically he is as good as he is going to get and works hard to maintain what he did regain. He has a trainer and goes to the gym on a regular basis with no prompting from us. I do not know if he realizes that as he ages things will be harder for him than the average person. I think in some way he is aware of that because he did decided to use the cane if safety is an issue.His... (shrink)