Under the pressure of governmental reform, beginning in 1740 and intensifying from the 1770s, opponents of reform in the Austrian Netherlands employed arguments derived from The Spirit of the Laws to contest the need for reform. However, reform had also been advocated by local powers using truisms publicised by The Spirit of the Laws, and during the political upheaval of 1789–1790, democrats and traditionalists clashed bitterly over the form of the new Belgian state, both citing Montesquieu to suit their purposes. (...) This article seeks to trace and account for the influence and use of Montesquieu's thought in the Belgian context. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.4 (2001) 391-400 [Access article in PDF] Bioethics Inside the Beltway A Shooting on Capitol Hill: "The Ruby Satellite System," Mental Illness, and Failure of the American Legal System Peter J. Cohen On 24 July 1998, Russell Eugene Weston, Jr., stormed the United States Capitol, forced his way through a security checkpoint, bypassed a metal detector, and entered the office complex of Representative (...) Tom DeLay (R-TX), the House Majority Whip (Weil 1998). During this period of terror, he shot and killed two officers of the Capitol Police and seriously wounded another as they attempted to end his foray. 1 Weston was severely wounded by several Capital police officers and taken into custody. After being treated for his injuries, he was incarcerated in the District of Columbia. 2On 5 May 1999, Weston was transferred to the Federal Correctional Institute in Butner, North Carolina (United States v. Weston, 69 F. Supp. 2d 99 (D.D.C. 1999), 103), where he remains to this day. He has neither been brought to trial nor received appropriate psychiatric therapy, but continues to be warehoused "in solitary confinement under constant observation... in a psychotic state (United States v. Weston, 255 F.3d 873; LEXIS 16851 (U.S. App. 2001b), 3-4 [LEXIS]). I will briefly detail the legal events responsible for this mad situation and suggest alternative actions that should have been taken at the very onset of the case. Early Chronology Although overtly the crime appeared to be senseless and without any conceivable motivation, Weston believed that his acts were justified and necessary. The story he told to the court-appointed forensic psychiatrist, Sally C. Johnson, M.D., 3 was that while working for NASA in the early 1980s, he had developed a "Ruby Satellite System," a powerful machine that could reverse time. With access to this system, nothing was permanent--the user could simply reverse time and exit from the current scene. However, the "System" was now controlled by cannibals who were developing and spreading "Black Heva," the deadliest disease known to [End Page 391] humankind, similar to HIV or the plague. It resulted from human corpses rotting and turning black. Time was running out, and Weston believed he had to return to override the "Ruby Satellite System" in the Capitol so that he could stem the spread of "Black Heva" and prevent world calamity. He believed that if he were tried, convicted, and even executed, he could simply time reverse himself, place himself in a safe within the Capitol, and subsequently resume his life at whatever point he chose (United States v. Weston, 206 F.3d 9 (D.C. Cir. 2000), 19-20).On 22 April 1999, the district court accepted Dr. Johnson's diagnosis that Weston suffered from paranoid schizophrenia, the symptoms of which were so severe that he would be incapable of understanding the proceedings against him and of assisting in his own defense. On this basis, the court had no difficulty in finding him incompetent to stand trial (U.S. v. Weston 1999, 102).At Weston's initial hearing, Dr. Johnson had testified that medication would be efficacious in treating Weston's delusions: [T]he standard of care in someone suffering from this type of symptom picture would be to treat them with medication.... [T]here is a good likelihood that he'll have a positive response, positive in the sense that his symptoms will diminish in response to treatment.... The potential benefits to treating the defendant far outweigh the risks.... (U.S. v. Weston 1999, 108) The defense presented no expert testimony refuting Dr. Johnson's presentation. The district court then ordered that Weston begin receiving medication in order to render him nondangerous and competent for trial (U.S. v. Weston 1999, 108-9). The Problem Weston refused to be medicated! 4 He has continued to claim that the administration of antipsychotic drugs against his will would violate his Fifth Amendment due process liberty interest in avoiding unwanted bodily intrusion and implicated... (shrink)

This paper explores Nietzsche’s approach to the question of illness. It develops an account of Nietzsche’s ideas in the wake of Arthur W. Frank’s discussion of the shortcomings of modern medicine and narrative theory. Nietzsche’s approach to illness is then explored in the context of On the Genealogy of Morality and his conception of the human being as “the sick animal”. This account, it is argued, allows for Nietzsche to develop a conception of suffering that refuses to reduce it to (...) modernist restitutive conceptions of well-being. Instead, Nietzsche advocates a more nuanced conception of varying degrees of health. This, it is argued, can be developed into a model that allows for a more satisfying conception of the relation between medical practitioner and patient. (shrink)

Advance care planning is a process that encourages people to identify their values, to reflect upon the meanings and consequences of serious illness, to define goals and preferences for future medical treatment and care, and to discuss these goals with family and health-care providers. Advance care planning is especially important for those who are chronically ill, as patients and their families face a variety of complex healthcare decisions. Participating in advance care planning has been associated with improved outcomes; yet, despite (...) over 25 years of public awareness campaigns, research, and interventions developed to increase participation, advance care planning completion rates for people with chronic illnesses are no different than those in the general public (approximately 25%). Advance care planning has traditionally used an individualistic approach to autonomy, which puts forward an understanding of agents as independent, rational and self-interested persons. Because this individualistic approach has been largely unsuccessful in improving advance care planning uptake, a re-examination of the philosophical underpinnings of this practice and an exploration of alternative frameworks is warranted. In offering this exploration, we briefly outline two current perspectives on autonomy: the individualistic view and the relational view as articulated by feminist philosophers. Using a critical examination of the theoretical and empirical work on this topic, we argue that the individualistic view of autonomy does not sufficiently capture the relational and social complexities of the decision-making process of advance care planning. To offer a counterpoint, we examine the relational view of autonomy and suggest that this perspective is better aligned with the process of advance care planning. Specifically, we demonstrate that a relational model of autonomy is well suited to exploring advance care planning for four main reasons: (1) it recognizes the importance of relationships, (2) it reflects the fluctuating nature of autonomy in chronic illness, (3) it recognizes vulnerability, and (4) it is consonant with empirical work examining the advance care planning process. (shrink)

End-of-life issues and questions are complex and frequently cause confusion and anxiety. In _Death with Dignity_,_ _theologian, medical ethicist, and pastoral caregiver Peter A. Clark examines numerous issues that are pertinent to patients, family members, and health care professionals, including physiology, consciousness, the definition of death, the distinction between extraordinary and ordinary means, medical futility, “Do Not Resuscitate” orders, living wills, power of attorney, pain assessment and pain management, palliative and hospice care, the role of spirituality in end-of-life care, (...) and physicians’ communication with terminal patients. Patients, family members, medical students, and health care professionals will find in _Death with Dignity _the_ _practical and ethical knowledge they need to capably and confidently cope with end-of-life challenges. (shrink)

Our growing technical capacity to keep human beings alive has brought the sanctity of life ethic to the point of collapse. The shift to a concept of brain death was already an implicit abandonment of the traditional ethic, though this has only recently become apparent. The 1993 decision of the British House of Lords in the case of Anthony Bland is an even more decisive shift towards an ethic that does not ask or seek to preserve human life as such, (...) but only a life that is worth living. Once this shift has been completed and assimilated, we will no longer need the concept of brain death. Instead we can face directly the real ethical issue: when may doctors intentionally end the life of a patient? (shrink)

Mental Illness in Ancient Medicine: From Celsus to Paul of Aeginatraces the history of conceptions of mental disorder in Graeco-Roman medical writings, from the 1st century BCE to the 7th CE, with detailed studies of all significant authors.

Typical structural universals are not just the mereological sum of their constituents. Hence, there is the Structure Problem of explaining this non-mereological structure. The Instantiation Problem is that the predicate "U is instantiated by x, y, etc., in that order" is ill-suited to be a primitive, unanalyzed predicate. The proposed solution to these problems is based on the observation that if universal U is said to supervene upon universals V, W, etc., then it is the instantiation of U that supervenes (...) on the instantiation of V, W, etc. Assuming there are few subvenient universals, which is admittedly a speculation, their instantiation may be explained in ways that would be uneconomic if there were too many. (shrink)

The most comprehensive compilation of the works of Abelard and Heloise ever presented in a single volume in English, _The Letters and Other Writings_ features an accurate and stylistically faithful new translation of both _The Calamities of Peter Abelard_ and the remarkable letters it sparked between the ill-fated twelfth-century philosopher and his brilliant former student and lover—an exchange whose intellectual passion, formal virtuosity, and psychological drama distinguish it as one of the most extraordinary correspondences in European history. Thanks to (...) this edition, Latin-less readers will be better placed than ever to see why this undisputed milestone in the intellectual life of medieval France is also a masterpiece of Western literature. In addition to the _The Calamities_ and the letters--the first complete English translation of all seven in more than eighty years--this volume includes an Introduction, a map, and a chronology, Abelard's _Confession of Faith_, letters between Heloise and Peter the Venerable, the Introduction to _The Questions of Heloise_, and selected songs and poems by Abelard, among them a previously untranslated shaped poem, Open Wide Your Eyes. Extracts of lost letters sometimes ascribed to Abelard and Heloise are given in appendixes. (shrink)

The mental illness of substance dependence or addiction is responsible for major economic, social, and personal costs. If we are to elucidate its etiology, understand its mechanisms, and eventually bring it under control, scientific investigation is essential. Research in animals and humans has enhanced our understanding of this disease through examination of genetic, neurophysiological, biochemical, and behavioral factors. But because animals cannot verbalize their subjective responses to drugs and because significant symptoms of addiction cannot be observed in non-drug-dependent humans, it (...) is not surprising that certain investigations of substance dependence have required the participation of addicted or substance-dependent humans. (shrink)

Although knowledge of torture and physical and psychological abuse was widespread at both the Guantanamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation, or signs of torture. Mounting information from many sources, including Pentagon documents, the International Committee of the Red Cross, Amnesty International, Human Rights Watch, etc., indicate that medical personnel failed to maintain medical records, (...) conduct routine medical examinations, provide proper care of disabled and injured detainees, accurately report illnesses and injuries, and falsified medical records and death certificates. Medical personnel and medical information was also used to design and implement psychologically and physically coercive interrogations. The United States military medical system failed to protect detainee's human rights, violated the basic principles of medical ethics and ignored the basic tenets of medical professionalism. (shrink)

Background: Explicating nurses’ moral identities is important given the powerful influence moral identity has on the capacity to exercise moral agency. Research objectives: The purpose of this study was to explore how nurses narrate their moral identity through their understanding of their work. An additional purpose was to understand how these moral identities are held in the social space that nurses occupy. Research design: The Registered Nurse Journal, a bimonthly publication of the Registered Nurses’ Association of Ontario, Canada, features a (...) regular column entitled, ‘In the End … What Nursing Means to Me …’ These short narratives generally include a story of an important moment in the careers of the authors that defined their identities as nurses. All 29 narratives published before June 2015 were analysed using a critical narrative approach, informed by the work of Margaret Urban Walker and Hilde Lindemann, to identify a typology of moral identity. Ethical considerations: Ethics approval was not required because the narratives are publicly available. Findings: Two narrative types were identified that represent the moral identities of nurses as expressed through their work: (1) making a difference in the lives of individuals and communities and (2) holding the identities of vulnerable individuals. Discussion: Nurses’ moral identities became evident when they could see improvement in the health of patients or communities or when they could maintain the identity of their patients despite the disruptive forces of illness and hospitalization. In reciprocal fashion, the responses of their patients, including expressions of gratitude, served to hold the moral identities of these nurses. Conclusion: Ultimately, the sustainability of nurses’ moral identities may be dependent on the recognition of their own needs for professional satisfaction and care in ways that go beyond the kind of acknowledgement that patients can offer. (shrink)

In this book, Raabe argues that philosophy can effectively inform and improve conventional methods of treating mental illness. He presents clinical evidence showing that mild and so-called clinical mental illnesses can be both prevented and alleviated with philosophical talk therapy. Raabe offers concrete case examples that support his findings.

The fact that the emergence of “technoscience,” resulting from the coalescing of science and technology, may have serious social and cultural impact has been debated in recent years particularly with regard to the field of medicine. The present article is exploring the scope and limits of the “technoscientization” of medicine using the example of rare disease patient associations. It is investigated whether and to what extent these organizations adopt technoscientific illness identities and subscribe to the research priorities and objectives of (...) biomedicine. In addition, it is analyzed whether Paul Rabinow’s highly influential concept of biosociality entails a technoscientific model of identity or, quite to the contrary, offers a framework for contesting biomedical ascriptions of identities. As the article shows, patient associations do refer to technoscientific definitions of diseases yet constantly modify and transform them based on their everyday illness experiences. Likewise, the “biosociality” of rare disease patients emerges from the shared experience of having been neglected by mainstream medical research rather than from supposedly objective biomedical classifications. (shrink)

The teleological/deontological distinction is generally considered to be the fundamental classificatory distinction for ethics. I have argued elsewhere (Vallentyne forthcoming (a), and Ch.2 of Vallentyne 1984) that the distinction is ill understood and not as important as is generally supposed. Some authors have advocated a moral radical thesis. Oldenquist (1966) and Piper (1982) have both argued that the purported distinction is a pseudo distinction in that any theory can be represented both as teleological and as deontological. Smart (1973, p.13, and (...) 1982) has also expressed views along these lines. Elsewhere (Vallentyne 1984, Ch.3) I have shown that these arguments fail because the authors draw inadequate characterizations of the teleological/deontological distinction. Here I want to consider a challenge to the logical status of the distinction that raises deep and important questions about the structure of moral theories in general. (shrink)

The author aims at answering why preserving, reading, and understanding the work of Étienne Gilson is crucial for the Western civilization if one wishes to be able to understand precisely the problems that are besetting the West and how one can best resolve them. He claims that among all the leading intellectuals of the past or present generation, no one has better diagnosed the philosophical ills of Western culture and better understood the remedy for those ills than has Étienne Gilson.

From a medical perspective, patients who do not comply with the doctor's orders are usually seen as deviant and deviance requires correction. But many chronically ill people view their behavior differently, as a matter of self‐regulation. In this light noncompliance supports people's desires for independence and autonomy, desires that align closely with the therapeutic goals of caregivers.

Background: Some members of the general public feel that patients who cause their own organ failure through smoking, alcohol use, or drug use should not receive equal priority for scarce transplantable organs. This may reflect a belief that these patients (1) cause their own illness, (2) have poor transplant prognoses or, (3) are simply unworthy. We explore the role that social acceptability, personal responsibility, and prognosis play in people's judgments about transplant allocation. Methods: By random allocation, we presented 283 prospective (...) jurors in Philadelphia county with one of five questionnaire versions. In all questionnaires, subjects were asked to distribute transplantable hearts between patients with and without a history of three controversial behaviors (eating high fat diets against doctors’ advice, cigarette smoking, or intravenous drug use). Across the five questionnaire versions, we varied the relative prognosis of the transplant candidates and whether their behavior caused their primary organ Results: Subjects were significantly less willing to distribute organs to intravenous drug users than to cigarette smokers or people eating high fat diets (p le; 0.0005), even when intravenous drug users had better transplant outcomes than other patients. Subjects’ allocation decisions were influenced by transplant prognosis, but not by whether the behavior in question was causally responsible for the patients’ organ failure. Conclusion: People's unwillingness to give scarce transplantable organs to patients with controversial behaviors cannot be explained totally on the basis of those behaviors either causing their primary organ failure or making them have worse transplant prognoses. Instead, many people believe that such patients are simply less worthy of scarce transplantable organs. (shrink)

When mental suffering and distress are diagnosed as so-called “mental illnesses” it locates the cause as within the afflicted person. A close examination of the life situation of the distressed person will most times show the cause as originating external to the sufferer. Mental distress can arise with any number of troubling life situations such as financial or relationship problems, illness or death in the family, ethical dilemmas and so on. But diagnosing the person as having a biological brain problem (...) allows the prescription of psychotropic medications that can cost thousands of dollars over their lifetime. Of course, this adds to the profit margins of the corporations that produce them. These medications not only cause harmful side-effects, they add to the suffering of the person taking them. Philosophical counselling doesn’t cause any side effects, and is often much more effective at mitigating mental distress. (shrink)

-/- Background: Nurses who provide aggressive care often experience the ethical challenge of needing to preserve the hope of seriously ill patients and their families without providing false hope. -/- Research objectives: The purpose of this inquiry was to explore nurses’ moral competence related to fostering hope in patients and their families within the context of aggressive technological care. A secondary purpose was to understand how this competence is shaped by the social–moral space of nurses’ work in order to capture (...) how competencies may reflect an adaptation to a less than ideal work environment. -/- Research design: A critical qualitative approach was used. -/- Participants: Fifteen graduate nursing students from various practice areas participated. -/- Ethical considerations: After receiving ethics approval from the university, signed informed consent was obtained from participants before they were interviewed. -/- Findings: One overarching theme ‘Mediating the tension between providing false hope and destroying hope within biomedicine’ along with three subthemes, including ‘Reimagining hopeful possibilities’, ‘Exercising caution within the social–moral space of nursing’ and ‘Maintaining nurses’ own hope’, was identified, which represents specific aspects of this moral competency. -/- Discussion: This competency represents a complex, nuanced and multi-layered set of skills in which nurses must be well attuned to the needs and emotions of their patients and families, have the foresight to imagine possible future hopes, be able to acknowledge death, have advanced interpersonal skills, maintain their own hope and ideally have the capacity to challenge those around them when the provision of aggressive care is a form of providing false hope. -/- Conclusion: The articulation of moral competencies may support the development of nursing ethics curricula to prepare future nurses in a way that is sensitive to the characteristics of actual practice settings. (shrink)

America's patchwork quilt of health care coverage is coming apart at the seams. The system, such as it is, is built upon an inherently problematic base: employment. By definition, an employment-based approach, by itself, will not assure universal coverage of the entire population. If an employment-based approach is to be the centerpiece of a system that provides universal coverage, special attention must be paid to all the categories of individuals who are not employees – children, unemployed spouses or singles, the (...) unemployable ill and disabled, persons between jobs, students, retirees, the elderly. Moreover, in a purely voluntary employment-based arrangement, some employers will not provide insurance at all, and others will provide inadequate coverage, necessitating other special provisions for coverage. As a consequence, about one out of six people now has no health coverage whatsoever, and even more have inadequate coverage. All the while, the rapidly-increasing transaction costs of sustaining this grossly inadequate pluralistic system eat up sufficient funds to provide basic benefits to the entire population. The time for systematic reforms has come and gone; what is now needed is action to prevent disaster, followed by a complete rebuilding of this country's health coverage system. Although perhaps more likely to be tried than more radical, completely nationalized, ones, stepwise reforms may not go far enough to cure the significant ills of the current employment-based system. Passage of inadequate reforms, then, could well set the stage for nationalized health care in the not too distant future. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 161-167 [Access article in PDF] Social, Cognitive, and Neural Constraints on Subjectivity and Agency:Implications for Dissociative Identity Disorder Peter Q. Deeley In this commentary, I consider Matthew's argument after making some general observations about dissociative identity disorder (DID). In contrast to Matthew's statement that "cases of DID, although not science fiction, are extraordinary" (p. 148), I believe that there are natural analogs (...) of the disorder that, when considered, make it seem less puzzling and exotic. After discussing these examples, I examine the relations between social, cognitive, and neural processes supporting subjectivity and agency, to identify sources of personal identity in cases of DID that can be used as a basis for assessing Matthew's points against Behnke and Sinnott-Armstrong. I am not proposing a comprehensive theory, but rather identifying what I believe are components of such a theory. I then outline an approach to determining criminal responsibility in DID, drawing on analogies with other psychiatric disorders. Dissociative Identity Disorder DID is a disorder described in DSM-IV, which "is characterised by the presence of two or more distinct identities or personality states that recurrently take control of the individual's behaviour accompanied by an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness" (American Psychiatric Association, p. 519). Recognizing Personal Identity How is personal identity recognized in normal cognition? If we take personhood to involve recognition of continuity of social, psychological, and physical identity for a given individual, then such judgments are routinely made rapidly and automatically as an aspect of what has come to be termed social cognition (Adolphs 2003). There is likely to be considerable redundancy in [End Page 161] the types of information used to make judgments about whether a person is the same as one who was previously encountered, or perhaps heard about—for example, facial features, movement patterns, speech prosody, dress, speech content, gender, ethnicity, social role, among other features, all provide information about individual identity, and hence personhood. When uncertainty exists, it is likely to reflect a loss or alteration of cues that would ordinarily be used in a rapid, automatic, unexamined way (Adolphs 2003). In such extreme cases (for example, severe mental illness or disfigurement), the problem of identification becomes the subject of explicit reasoning (and hence of potential disagreement, because we then engage in post hoc rationalizations to establish criteria for determining personhood, whereas normally we rely on essentially automatic, implicit abilities that work in most circumstances, some of which make little use of linguistic representations and formal reasoning—for example, individual facial identity recognition, which may occur as quickly as 170 ms after stimulus onset [Adolphs 2003]). Nevertheless, examining our judgments and intuitions in cases that force us to explicitly consider whether personal identity is preserved may provide analogies and clues for how we should proceed with DID. Let us consider, then, some natural analogs of DID. Natural Analogs of DID Method Acting I suggest that method acting is an analog of DID (Manderino 1985). Method acting refers to an approach to acting training and performance in which emphasis is placed on intensely imagining and identifying with the mental life of the character being portrayed. Training courses and manuals list many techniques and practices that can be used to facilitate absorption in a role, drawing on different kinds of memory—for example, experiential memories, memories of others, general knowledge (semantic memory), and memories of sensations and feelings, to creative a vivid sense of the subjective experience and actions of the character. Manderino, a method acting teacher, comments: "it is important to investigate the way in which your own mental makeup can improperly influence a character. Insecurities, self-consciousness, shyness or self-doubts can maintain a strong hold, and permitting any of these feelings to enter a performance is to remain the actor and not enter into the mental life of the character. For some, acting allows personal problems to be left behind, and they are thankful for the complete escape that... (shrink)

Objectives: To identify ethical attitudes about involuntary admission (known in Great Britain as formal admission) in mental health professionals and lay-people in England and Germany, especially looking at possible differences between Mental Health Professionals who are directly involved in the involuntary admission process and those who are not.Method: Three scenarios of potentially certifiable patients (known in Great Britain as sectionable patients) were presented to identify attitudes. A questionnaire asked about attitudes towards involuntary admission as well as treatment. A questionnaire analysis (...) was then performed.Results: There were similar attitudes towards involuntary admission between laypeople and mental health professionals involved in the involuntary admission process with the exception of professionals not actively involved in the involuntary admission process. Neither personal or professional experience with mental illness nor the different legal frameworks between Germany and England influenced attitudes much. Support for involuntary admission broadly increased with age.Conclusions: Psychiatrists and other mental health workers are in tune with society with regards to attitudes to involuntary admission. People involved with mentally ill patients but not in the involuntary admission process have negative attitudes towards involuntary admission. This may influence Mental Health Tribunals suggested in the new draft Mental Health Bill (2002) for England and Wales, because these Tribunals will potentially lack any involvement of professionals involved in the involuntary admission process. (shrink)

Critics of Big Tech often describe ‘surveillance capitalism’ in grim terms, blaming it for all kinds of political and social ills. This article counters this pessimistic narrative, offering a more favorable take on companies like Google, YouTube, and Twitter/X. It argues that the downsides of surveillance capitalism are overstated, while the benefits are largely overlooked. Specifically, the article examines six critical areas: i) targeted advertising, ii) the influence of surveillance capitalism on politics, iii) its impact on mental health, iv) its (...) connection with government surveillance, v) its effects on the rule of law and social trust, and vi) privacy concerns. For each area, it will be argued that concerns about surveillance capitalism are unfounded or exaggerated. The article also explores some benefits of the services provided by these technology companies and concludes with a discussion of the practical implications. Throughout, the article draws on empirical evidence relating to the societal and political impact of digital technologies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Spirometer, Whale, Slave:Breathing Emergencies, c. 1850John Durham Peters (bio)Breath dramatically starts with a slap at birth and ceases with death and yet we typically ignore it until it is under duress. Unlike marine mammals such as whales and dolphins who can never fully automate breathing—they sleep one brain hemisphere at a time so as to keep conscious watch, like yogis, over their respiration—we humans are mostly somnambulists with regard (...) to breath. Unlike our briny cousins, we won't drown if we neglect our breath. Our relatively accommodating habitat at the fold of lithosphere and atmosphere enables a Lethe of oblivion, though many elements of our world are hostile to breath: water, fire, earth, extremes of height, heat, or cold. Nothing could be more fundamental for aerobic terrestrial creatures than breathing. So its routine cloaking in impercipience must somehow be functional and require a great deal of nervous expenditure. (It always takes a lot of work to make an infrastructure invisible.)Breathing is a good test case for the notion, common to many variants of critical theory, that nature for humans is always second nature: what would it mean to find culture, history, and politics in something that is so relentlessly universal and given? The intensity of the urge for drink, food, sex, or sleep pales compared to that of taking a breath withheld or expelling a breath too long held. Here, it seems, desire and need converge. Breathing morphs into awareness, art and artifice when threat, absence or curiosity rouse it from its slumber—when we swim, have a coughing fit, sing, or challenge someone to a breath-holding contest. Under the earth in a mine, high in the air on a mountain or airplane, ill with a respiratory disease, or in other extreme situations, we need techniques and technologies to breathe. Like everything supposedly natural, we can't leave breathing in peace. We mold breath in techniques of speech, song, and prayer and in technologies of diving, medicine, and air travel. A full accounting of such would form a full encyclopedia of human ingenuity.1 [End Page 85]With typical flamboyance, Peter Sloterdijk declared that the atmosphere first ceased to be taken for granted, i.e., became technical, a matter of art, on 22 April 1915, with the German deployment of poison gas in World War I. On a world-historical scale, he takes this weaponization of the environment as an "air-quake" that launched modern air-conditioning in its most literal sense of climatization (as French and German has it) and not just interior cooling (Sloterdijk 89-110 passim). We need a history of comparative breathing emergencies! Every era, like every life, has its encounters with the precarity of breathing, even if not as conveniently dated or climate-change prognostic as 22 April 1915. The urban concentration of human population starting a few thousand years ago, for instance, made people co-breathers (con-spirators) in new ways and thus more prone to the contagious respiratory illnesses that have long ravaged our species.I want to look at one such moment—one marked by a deadly global respiratory illness, new instruments for producing data, worries about radical alterations to the atmosphere, comparative interest in nonhuman forms of life, and the politicization of breathing. 1850, like 2020, was a moment when breath awoke from its autonomic quiet. The nineteenth century was the great age of tuberculosis, the tragic and romantic lung disease. It was a time of fog, smoke, and mud, of climate-changing volcanic eruptions and a year without a summer, and of a mysterious, brooding "storm-cloud" that John Ruskin complained of so bitterly. Medical instruments, the whaling industry, and struggles for the abolition of slavery all brought the lungs into the foreground.SpirometerThe nineteenth century was also the great age of instrumentation. Light and sound were only the two most famous dynamic processes to yield to new graphic methods of inscription such as photography and phonography. The spirometer was one of many devices designed to render visual data of physiological functions, such as the myograph, the flame manometer, sphygmomanometer, and the kymograph. Many of them are still in use. The invention... (shrink)

In discussing the psychiatric diagnoses, the author explores not the “formal” diagnoses of the so-called mental illnesses, but the “informal” judgments made by psychotherapists in regard to their method or the process of their therapy. These diagnoses include transference, repression, resistance, denial, negativism, projection, and suppression. While these are not precisely the symptoms of psychopathology, they are an integral part of the language which psychotherapists use to describe and label what they see as problems in their patients. These so-called problems, (...) which are interpreted by the therapist as existing within the patient, can be reinterpreted and largely avoided in philosophical counseeling.The author argues that, when a person is observed or diagnosed by a psychotherapist as exhibiting one of these supposedly problematic traits the therapist is in fact misinterpreting what is going on. (shrink)