This article pursues a Whiteheadian association of meals and cooking with an orienting concern for ecological well-being and planetary health. Process thought helps those who eat to recognize the real influences that our meals have upon the emerging world.

There is a growing consensus that results generated through multiplex genetic tests, even those produced as a part of research, should be reported to providers and patients when they are considered “actionable,” that is, when they could be used to inform some potentially beneficial clinical action. However, there remains controversy over the precise criterion that should be used in identifying when a result meets this standard. In this paper, we seek to refine the concept of “actionability” by exploring one proposed (...) use for genetic test results. We argue that genetic test results indicating that a patient is at risk for developing a chronic health condition should not be considered actionable if the only potential value of that result is to motivate patients to make changes in their health behaviors. Since the empirical research currently available on this question is equivocal, we explore relevant psychological theories of human motivation to demonstrate that current theory does not support the assumption that information about genetic risk will be motivating to most patients in their attempts to make changes in health behaviors. (shrink)

On April 16, 2007, Cho Seung-Hui used two semiautomatic handguns to kill 32 persons and then himself at Virginia Tech University in the largest campus shooting in U.S. history. Mr. Cho purchased his handguns from a pawnshop and a gun store in Virginia, where under state law a background check was conducted to determine whether he had any disqualifying criminal or mental health history. The paperwork for the background check was completed at the gun store, and the check itself was (...) conducted through an “instant” system facilitated by a toll-free telephone number. The entire transaction took approximately 20 minutes. At no point was Mr. Cho asked why he wished to purchase the guns. And although he had been deemed a potential danger to himself by a state magistrate in 2005 – which should have disqualified his purchase of a gun under federal law – this information never reached those conducting the background check. (shrink)

The paper by Szasz is about mental illness and its meaning, and like Procrustes, who altered hapless travellers to fit his bed, Szasz changes the meanings of words and concepts to suit his themes.1 Refuting the existence of “mental illness”, he suggests that the term functions in an apotropaic sense. He submits that in this sense it is used to avert danger, protect society, and hence justify preventive detention of “dangerous” people.But his arguments misrepresent the precise meaning of the term (...) “apotropaic”, which is an adjective, defined in Webster’s, Chambers and the New Shorter Oxford dictionaries as averting or turning aside evil. It is possible that amulets and incantations ward off evil, in the same way as garlic repels vampires, but evil and danger are different concepts. Yet Szasz talks of using phrases like ‘“dangerousness to self and others’ as apotropaics to ward off dangers we fear”, and the word “evil” does not appear in his paper.I will argue that “dangerousness to self and others” and “psychiatric treatment” have a prosaic rather than an apotropaic function.The word “danger” is familiar rather than arcane, and includes many risks. A predatory paedophile is usually both dangerous and evil, but many dangerous people are not evil. For example, a child who plays with a box of matches is dangerous, as is a demented person who drives a car, or a schizophrenic who, acting on delusional beliefs, arms herself with a knife and roams the streets believing she is an avenging angel.Suppose …. (shrink)

Patient competence, defined as the ability to reason, appreciate, understand, and express a choice is rarely discussed in patients with obsessive compulsive disorder, and coercive measures are seldom used. Nevertheless, a psychiatrist of psychologist may doubt whether OCD patients who refuse treatment understand their disease and the consequences of not being treated, which could result in tension between respecting the patient’s autonomy and beneficence. The purpose of this article is to develop a notion of competence that is grounded in clinical (...) practice and corresponds with the experiences of patients with obsessions and/or compulsions. We present a naturalistic case study giving both the patient’s and the therapist’s perspective based on in-depth interviews and a narrative analysis. The case study shows that competence is not merely an assessment by a therapist, but also a co-constructed reality shaped by the experiences and stories of patient and therapist. The patient, a medical student, initially told her story in a restitution narrative, focusing on cognitive rationality. Reconstructing the history of her disease, her story changed into a quest narrative where there was room for emotions, values and moral learning. This fitted well with the therapist’s approach, who used motivational interventions with a view to appealing to the patient’s responsibility to deal with her condition. We conclude that in practice both the patient and therapist used a quest narrative, approaching competence as the potential for practical reasoning to incorporate values and emotions. (shrink)

Some ways of defending inequality against the charge that it is unjust require premises that egalitarians find easy to dismiss—statements, for example, about the contrasting deserts and/or entitlements of unequally placed people. But a defense of inequality suggested by John Rawls and elaborated by Brian Barry has often proved irresistible even to people of egalitarian outlook. The persuasive power of this defense of inequality has helped to drive authentic egalitarianism, of an old-fashioned, uncompromising kind, out of contemporary political philosophy. The (...) present essay is part of an attempt to bring it back in. (shrink)

The major portion of this important work is the "Summary of the Republic." Coordinated with Grube’s translation, it proceeds book by book, first summarizing a chunk of text anywhere from a couple of Stephanus sections to several pages, then commenting in lettered notes of from two lines to four and a half pages. More technical material, aimed at advanced students and scholars, appears occasionally in smaller type. There is a fine bibliography. The format is successful: the book is easy to (...) use and attractive in appearance. (shrink)

1. The present paper is a continuation of my “Self-Ownership, World Ownership, and Equality,” which began with a description of the political philosophy of Robert Nozick. I contended in that essay that the foundational claim of Nozick's philosophy is the thesis of self-ownership, which says that each person is the morally rightful owner of his own person and powers, and, consequently, that each is free to use those powers as he wishes, provided that he does not deploy them aggressively against (...) others. To be sure, he may not harm others, and he may, if necessary, be forced not to harm them, but he should never be forced to help them, as people are in fact forced to help others, according to Nozick, by redistributive taxation. (shrink)