Background The increasing prevalence of moral distress in the stressful environment of the intensive care unit (ICU) provides grounds for nursing error and endangers patients’ health, safety, and even life. One of the most important reasons for this distress is the treatment team’s second victim syndrome (SVS), especially nurses, following errors in the treatment system. Objectives The present study aimed to determine the relationship between moral distress and SVS in ICUs. Research design This cross-sectional study involved a (...) sample size of 96 ICU nurses working in hospitals affiliated with Tehran University of Medical Sciences, Iran, in the 2021–2022 period, who were selected via a simple random sampling method. Data were collected using the Demographic Questionnaire, the second victim experience and support tool (SVEST) and Moral Distress Scale-Revised (MDS-R). Descriptive statistics (percentage, frequency, mean, and SD) and analytical tests (Spearman correlation coefficient test, independent t-test, and ANOVA) were employed for data analysis. Participants and research context This study used a sample size of 96 intensive care unit nurses working in hospitals affiliated to Tehran University of Medical Sciences selected by simple random sampling. Ethical considerations The study obtained research ethics approval, and all participants were informed of the voluntary and anonymous nature of their participation. Findings The results showed that 59.4% of nurses suffered a low level of moral distress, and 40.6% suffered from a moderate level of moral distress. The SVS score of 86.5% of the nurses was moderate. There was no significant and direct correlation between moral distress and SVS in nurses; however, there was a significant and inverse correlation between the moral distress intensity and SVS ( p = 0.011). Conclusion Despite no significant correlation between moral distress and SVS, these variables were at moderate levels. Accordingly, it is suggested to provide a proper ground for expressing morally stressful situations, counseling and training strategies to deal with moral distress, creating support resources for those suffering from SVS, and implementing empowerment programs. (shrink)

Reports of ethical violations by upper level managers continue to multiply despite increasing attention being given to ethics by firms and business schools. Much of the analysis of these violations focuses on either these managers'lack of operational principles or their willingness to abandon principles in the face ofcompetitive pressures. Much of the attention by firms and business schools focuses either on the articulation of operational principles (a deontological approach) or on the training of managers to sort their way through subtle (...) ethical dilemmas in the face of competitive pressure (a utilitarian approach). While valuable, these approaches alone are incomplete.This paper suggests that many ethical violations by upper managers are the by-product ofsuccess — not of competitive pressures. Our research suggests that many managers are poorly prepared to deal with success. First, success often allows managers to becomecomplacent and to lose focus, diverting attention to things other than the management of their business. Second, success, whether personal or organizational, often leads toprivileged access to information, people or objects. Third, with success usually comes increasinglyunrestrained control of organizational resources. And fourth, success can inflate a manager's belief in his or her personalability to manipulate outcomes. Even individuals with a highly developed moral sense can be challenged (tempted?) by the opportunities resulting from the convergence of these dynamics. We label the inability to cope with and respond to the by-products of success the Bathsheba Syndrome, based on the account of the good King David (a story familiar in a variety of traditions). Recognition of this phenomenon implies that we change or broaden our approach to the teaching of business ethics. It also implies that organizations must re-evaluate and change structures, procedures, and practices which enhance the likelihood of managers falling victim to the Bathsheba Syndrome. (shrink)

Adverse events that harm patients can also have a harmful impact on health care workers. A few health care organizations have begun to provide psychological support to these Second Victims, but there is uncertainty over whether these discussions are admissible as evidence in malpractice litigation or disciplinary proceedings. We examined the laws governing the admissibility of these communications in 5 states, and address how the laws might affect participation in programs designed to support health care workers involved in adverse (...) events. We found that privilege is uneven from stateto- state, and also unclear. Ambiguity alone could have a chilling effect on Second Victim programs. We propose legislation to protect volunteer and health care worker communications provided by peer counselors, or failing this, updating of statutory provisions to explicitly include these communications within the ambit of existing protections. Enhancing protections could help to foster an environment of healing for both patients and caregivers. (shrink)

The harmful impact of an adverse event ripples beyond injured patients and their families to affect physicians, nurses, and other health care staff that are involved. These “Second Victims” may experience intense feelings of anxiety, guilt, and fear. They may doubt their clinical competence or ability to continue working at all. Some go on to suffer post-traumatic stress disorder and depression.Medical institutions long ignored this problem, preferring to believe that adverse events, or “errors,” occur due to incompetence — the (...) unfortunate work of a few “bad” practitioners who deserve, if anything, a reprimand for their negligence. Study after study has rejected this attribution and shown that adverse events in health care stem primarily from systemic flaws, not “bad apples.” Devastating errors, in other words, can, do, and always will happen in the care of competent, well-trained, and caring practitioners. (shrink)

ZusammenfassungZwischenfälle, Behandlungsfehler und tragische Verläufe können im Medizinalltag schwerwiegende Auswirkungen auf Patientinnen und Patienten haben, aber auch auf beteiligte Gesundheitsfachpersonen. Don Berwick, ehemaliger Leiter des Institute for Healthcare Improvement in Boston, hob in einem Interview die Unterstützung von „second victims“ als „ethische Angelegenheit“ hervor. Es besteht aber keine Klarheit darüber, was darunter zu verstehen ist. Der vorliegende Beitrag unternimmt eine Klärung dieser Frage aus der Perspektive der Organisationsethik. Ausgehend von Daten aus der Literatur zur Wirksamkeit der Unterstützung von „ (...) class='Hi'>second victims“ werden Herausforderungen beschrieben und aus organisationsethischer Sicht beurteilt. Es gibt Hinweise, dass Angebote der Unterstützung von „second victims“ zwar bestehen, aber nicht wirksam genug sind, um die psychischen Folgen von unerwünschten Ereignissen zu bewältigen. Dies wirkt sich auf betroffene Fachpersonen negativ aus und kann zu einer erneuten Gefährdung der Patientensicherheit führen. Angesichts dieser Befunde bedarf es eines organisationsethischen Ansatzes, um Don Berwicks Forderung nachzukommen, den Umgang mit „second victims“ als „ethische Angelegenheit“ wahrzunehmen. Dieser Ansatz fördert die Kongruenz zwischen den deklarierten und den faktisch gelebten Werten der Organisation. Sein normatives Fundament besteht in den Fürsorgepflichten der Organisation, gegenüber Patientinnen, Patienten und Mitarbeitenden. Die Organisationsethik ermöglicht es, die Unterstützung von „second victims“ verbindlich und sichtbar in der Sicherheitskultur der Organisation zu verankern. Sie konkretisiert sich in ihrer Verpflichtung, für die Mechanismen der Entstehung des Phänomens zu sensibilisieren und Ressourcen bereitzustellen, die einen effektiven Umgang damit ermöglichen. Dazu gehören evidenzbasierte ethische Leitlinien, standardisierte Prozesse, Schulungen sowie niederschwellige Coaching-Angebote. (shrink)

Syndromic surveillance uses new ways of gathering data to identify possible disease outbreaks. Because syndromic surveillance can be implemented to detect patterns before diseases are even identified, it poses novel problems for informed consent, patient privacy and confidentiality, and risks of stigmatization. This paper analyzes these ethical issues from the viewpoint of the patient as victim and vector. It concludes by pointing out that the new International Health Regulations fail to take full account of the ethical challenges raised by (...) syndromic surveillance. (shrink)

Extreme intentional and deliberate violence against innocent people, including acts of terror and school shootings, poses various ethical challenges, some related to the practice of medicine. We discuss a dilemma relating to deliberate violence, in this case the aftermath of a terror attack, in which there are multiple injured individuals, including the terror perpetrator. Normally, the priority of medical treatment is determined based on need. However, in the case of a terror attack, there is reason to question this. Should the (...) perpetrator of extreme violence receive medical treatment on the scene before the victims if he or she is designated as the most seriously injured? Or rather, should victims receive medical care priority if they are also in some life-threatening danger, although not at the same level of severity as the perpetrator? We present two opposing approaches: the conventional ‘no-exceptions’ approach, which gives priority to the terrorist, and the justice-oriented ‘victim first’ approach, which gives priority to the victims. Invoking concepts of retributive justice, distributive justice and corrective justice, this latter approach suggests that ‘value-neutrality’ can lead to injustice. Perpetrators of terror-like violence should be treated as an act of humanism and good ethical medical practice. However, in clear and obvious terror-like situations, to treat the perpetrators of violence before their victims may be unjust. Thus, in some specific situations, the ‘victim first’ approach may be considered a legitimate alternative triage policy. (shrink)

Donald Alexander Downs, More Than Victims: Battered Women, the Syndrome Society, and the Law Chicago: University of Chicago Press, 1996. Pp. xi + 309.

The investigations on higher-order type theories and on the related notion of parametric polymorphism constitute the technical counterpart of the old foundational problem of the circularity of second and higher-order logic. However, the epistemological significance of such investigations has not received much attention in the contemporary foundational debate.We discuss Girard’s normalization proof for second order type theory or System F and compare it with two faulty consistency arguments: the one given by Frege for the logical system of the (...) Grundgesetze and the one given by Martin-Löf for the intuitionistic type theory with a type of all types.The comparison suggests that the question of the circularity of second order logic cannot be reduced to Russell’s and Poincaré’s 1906 “vicious circle” diagnosis. Rather, it reveals a bunch of mathematical and logical ideas hidden behind the hazardous idea of impredicative quantification, constituting a vast domain for foundational research. (shrink)

Philosophers have had surprisingly little to say about the concept of a victim although it is presupposed by the extensive philosophical literature on rights. Proceeding in four stages, I seek to remedy this deficiency and to offer an alternative to the two current paradigms that eliminates the Othering of victims. First, I analyze two victim paradigms that emerged in the late 20th century along with the initial iteration of the international human rights regime – the pathetic victim (...) paradigm and the heroic victim paradigm. Holocaust victims are quintessential instances of the pathetic victim paradigm. They are marked by passivity and innocence in the face of overpowering force and unspeakable humanly inflicted suffering. Aung San Suu Kyi is an exemplar of the heroic victim paradigm – prisoners of conscience, in Amnesty International’s terms. Because heroic victims face off against the repressive power of the state to fight injustice, they are by no means passive, but they must be innocent of wrongdoing – that is, they must use nonviolent means of dissent – to qualify as heroic victims. Second, I problematize the asymmetrical conceptions of innocence that underwrite the two victim paradigms. Whereas the pathetic victim paradigm identifies innocence with passivity, the heroic victim paradigm countenances agentic victims and adverts to a universalist, absolutist stance on the limits of the legitimate use of state power to ascribe innocence to heroic victims. Both conceptions of innocence are out of keeping with well established social and legal practices regarding what constitutes coercive force and innocent victimhood. Consequently, there is reason to be skeptical of the two victim paradigms. Third, I identify two kinds of human rights violations and two categories of victims that AI defends despite their failure to fit the two paradigms – women trafficked into sex work and prisoners on death row. In many cases, women forced to do sex work are not innocent girls who are ignorant of the trafficking system and who helplessly fall prey to smugglers. They are desperately poor women who for that reason are willing to take enormous risks to try to relieve their own and often their families’ deprivation and suffering. Although these women act nonviolently for irreproachable reasons, they lack the public political agendas that characterize heroic victims. Unless non-fulfillment of subsistence rights is recognized as a form of overpowering force that inflicts severe, avoidable suffering, these women do not qualify as pathetic victims either. The victim paradigms pose an even greater obstacle to recognizing that the death penalty is a human rights violation and that death row prisoners are victims. Because a jury concluded that these individuals committed heinous, violent crimes, they are excluded by the heroic victim paradigm. Only if death row prisoners can be proven (usually through DNA evidence) not to have committed the crimes for which they were convicted can these individuals qualify as pathetic victims. In the absence of any reason to believe that they are innocent and especially if they are unrepentant, they are widely regarded as brutal victimizers of others who deserve no sympathy for, let along relief from, the suffering they “brought on themselves.” Finally, I confront the Othering of victims that results from the two victim paradigms, which leads many victims to eschew the label, thereby opting out of human right discourse. I propose revisions in the victim paradigms that eliminate the real-world exclusions they sponsor as well as the Othering of victims of human rights abuses. In particular, I endorse greater attention to what people and the institutions they create do to other people, and I favor a presumption that unnecessary and severe humanly inflicted suffering is a human rights violation. Moreover, I reject the innocence criterion embedded in the two paradigms and urge that it be replaced by a burdened agency criterion. These modifications better align the concept of a victim with a realistic understanding of human subjectivity and agency and allow for a more capacious understanding of who is a bearer of human rights and under what conditions right-holders become victims of rights violations. (shrink)

Diana Meyers argues that breaking the silence of victims and attending to their stories are necessary steps towards realizing human rights. Yet using highly personal victims' stories to promote human rights raises significant moral concerns, hence Meyers suggests that before victims' stories can be accessed and used, it is morally imperative that requirements of informed consent and non-retraumatization are secured. This article argues that while Meyers' proviso is important, and necessary, it may not be sufficient. First, one potential problem with (...) seeking to secure “informed consent” is that one has to ask for the consent, and in the act of asking one is potentially retraumatizing the victim. Secondly, the assumption that victims have ownership right over their stories, which is a key premise in Meyers's argument, is much more problematic than may appear. (shrink)

_Not exercising as much as you should? Counting your calories in your sleep? Feeling ashamed for not being happier? You may be a victim of the wellness syndrome._ In this ground-breaking new book, Carl Cederström and André Spicer argue that the ever-present pressure to maximize our wellness has started to work against us, making us feel worse and provoking us to withdraw into ourselves. The Wellness Syndrome follows health freaks who go to extremes to find the perfect (...) diet, corporate athletes who start the day with a dance party, and the self-trackers who monitor everything, including their own toilet habits. This is a world where feeling good has become indistinguishable from being good. Visions of social change have been reduced to dreams of individual transformation, political debate has been replaced by insipid moralising, and scientific evidence has been traded for new-age delusions. A lively and humorous diagnosis of the cult of wellness, this book is an indispensable guide for everyone suspicious of our relentless quest to be happier and healthier. (shrink)

Tick bite induced α‐gal syndrome (AGS) following consumption of mammalian meat is a recently described intriguing disease occurring worldwide. Here we argue that AGS and delayed allergy in general is an adaptive defence method against cancer. Our hypothesis synthesizes two lines of supporting evidence. First, allergy has been shown to have direct anti‐cancer effects with unknown mechanism. Second, eating processed meat was shown to be linked to developing cancer. Humans lost their genes encoding molecules α‐gal 30 MYA and (...) Neu5Gc 2 MYA, the latter co‐occurring with the start of using fire. These molecules are acquired from external sources, as tick bite for α‐gal and mammalian meat for Neu5Gc, the latter accumulating in tumors. The resulting specific delayed allergic response is a molecular adaptation to fight cancer. By further testing and applying our hypothesis, new avenues in cancer research and therapy will open that might save lives and decrease human suffering. (shrink)

My aim is to extend and complement the arguments that others have already made for the claim that women who are citizens of economically disadvantaged states and who have been trafficked into sex work in economically advantaged states should be considered candidates for asylum. Familiar arguments cite the sexual violence and forced labor that trafficked women are subjected to along with their well-founded fear of persecution if they’re repatriated. What hasn’t been considered is that reproductive rights are also at stake. (...) I explain how reproductive rights are implicated in sex trafficking. Moreover, I contend that sex traffickers’ abuse of women’s reproductive rights is persecutory and that that this persecutory abuse obliges destination states to offer asylum to transnational sex trafficking victims. I start by sketching reproductive human rights doctrine. I then examine studies of women who are in post-trafficking recovery programs in order to ascertain the impact of their past experience of forced sex work on their reproductive freedom and health. On the basis of these findings, I maintain that, among other outrages, sex trafficking systematically violates victims’ reproductive human rights. In view of this abuse, women trafficked into sex work might seem to be prime candidates for asylum in destination states. Yet, economically well-off destination states are not particularly receptive to this idea, and international law provides some justification for their chilliness. Preliminary to challenging them, I explicate four ways in which international anti-trafficking law and international refugee law interfere with viewing women trafficked into sex work as refugees and approving their applications for asylum. The second half of my paper aims to overcome those legal obstacles. In the interest of parsimony and because there are many continuities between U.S. refugee law and anti-trafficking law and the policies of similar destination states, I focus mainly on the U.S. in this part of the paper. To anchor my argument, I spotlight two precedents in refugee law for taking reproductive human rights seriously and several precedents for treating trafficked women as members of a distinct social group as required by refugee law. I then urge that a law enforcement gestalt has gained undue influence over U.S. legal practices where anti-trafficking law intersects with refugee protection law. A human rights gestalt is needed as a counterweight, for otherwise victims of sex trafficking and the reproductive abuse they’ve suffered are erased. Taking up a human rights perspective and mobilizing the precedents I’ve identified, I show that respecting the reproductive human rights of women who have been trafficked into sex work entails that affluent destination states must recognize their right to asylum. (shrink)

Philosophers have recently argued that since there are people who are blind, but don't know it, and people who echolocate, but don't know it, conscious introspection is highly unreliable. I contend that a second look at Anton's syndrome, human echolocation, and ‘facial vision’ suggests otherwise. These examples do not support skepticism about the reliability of introspection.

In this paper, I consider the question of whether crime victims can be said to have a moral right to see their victimizers punished that could explain why they often feel wronged or cheated when the state fails to punish offenders. In the first part, I explain what I mean by a “right to punishment” and what it is for such a right to “explain” the frustrated crime victim’s reaction. In the second part, I distinguish such a right (...) from a Lockean-style right to punish, which is also shown incapable of providing the needed explanation. In the third part I argue that it is difficult to identify any benefit such that the right to punishment could plausibly be understood as a right to that benefit. I discuss two main candidates here: the vaguely Hegelian idea that punishment is itself some sort of restitution for the wrong done to the victim; and the idea, due to Victor Tadros, that punishment is a form of compensation for wrongdoing by contributing indirectly to protecting victims from future harm. In the final section, I suggest instead that the frustrated crime victim’s reaction, when justified, is best explained, not by the violation of any right to punishment, but rather by the state’s failure to treat the victim as an equal. (shrink)

As we have seen in the cases of Serbia and Israel, collectives can be mobilised to perpetrate grave wrongs on the basis of patently ideological claims about the harms they have suffered. This article seeks a theoretical understanding of this troubling phenomenon. It does so, first, by contrasting mobilisation based on vicarious victimhood with revenge. The groups in question do not exhibit the contact with reality and clear sense of agency that are prerequisites for revenge. However, these evasions of agency (...) and reality are not specific to group identities centred on victimhood. Second, therefore, the article considers the attractions of such an identity and how it reinforces groups’ tendencies to myth-making and irresponsibility. Among its more harmful effects, it obscures the realities of state power and forecloses meaningful accountability to those outside the group. It also sets in train a vicious circle, whereby the group discovers perverse incentives to harm others – and to harm itself. Yet these harms only reinforce the group’s self-anointed status as victim: as always done by, never doing to. (shrink)

Patients with right parietal lesions often deny their paralysis , but do they have "tacit" knowledge of their paralysis? I devised three novel tests to explore this. First, the patients were given a choice between a bimanual task vs a unimanual one . They chose the former on 17 of 18 trials and, surprisingly, showed no frustration or learning despite repeated failed attempts. I conclude that they have no tacit knowledge of paralysis . Second, I used a "virtual reality (...) box" to convey the optical illusion to the patient that she was moving her paralyzed left hand up and down to the rhythm of a metronome, and yet she showed no sign of surprise. Third, I irrigated patient BM′s left ear canal with cold water, a procedure that is known to shift that patient′s spatial frame of reference by stimulating the vestibular system. Surprisingly, this allowed her "repressed" memory of paralysis to come to the surface; she said she had been paralyzed continuously for several days. I suggest that the vestibular stimulation produces these remarkable effects by mimicking REM sleep. These patients also emply a whole arsenal of grossly exaggerated Freudian "defense mechanisms" to account for their paralysis. To explain this, I propose that in normal individuals the left hemisphere ordinarily deals with small, local anomalies by trying to impose consistency but, when the anomaly exceeds threshold, an interaction with the right hemisphere forces a "paradigm shift". A failure of this process, in patients with right hemisphere damage, might partially account for anosognosia. Finally, I present a new conceptual framework that may help link several psychological and neurological phenomena such as Freudian defense mechanisms, vestibular stimulation, anosognosia, memory repression, visual illusions, anterograde amnesia, REM sleep, dreaming, and humor. (shrink)

Philosophers have recently argued that since there are people who are blind, but don't know it, and people who echolocate, but don't know it, conscious introspection is highly unreliable. I contend that a second look at Anton's syndrome, human echolocation, and ‘facial vision’ suggests otherwise. These examples do not support skepticism about the reliability of introspection.

This article reviews recent arguments in contemporary political philosophy on victims' duties to resist their oppression. It begins by presenting two approaches to these duties. First, that victims' duties are self‐regarding duties that victims owe to their self‐respect or to their well‐being, and second, that victims' duties are other‐regarding duties that arise from victims' duties of justice or of assistance. The second part elaborates on what resistance consists in. The article then considers and responds to two prominent objections (...) to arguments for victims' duties: that they are too demanding, and that they are unfair and exploitative. It concludes by gesturing towards future areas of engagement, in particular, theorising the agents and mechanisms of oppression, and more explicitly engaging with methodological debates about non‐ideal theory. (shrink)

This paper is a reflection on the ethical and spiritual ambiguities of Monotheism. It proceeds through an examination of Thomas Aquinas’ concept of desire and René Girard’s notion of victimage. It is divided into two parts. In the first I examine Thomas’ ideas of desire and goodness in order to develop some key terms and concepts. In the second I employ these terms and concepts in a critique of René Girard’s victimage thesis, in an effort to shed light on (...) the ‘uses and abuses’ of Judeo-Christian Monotheism. (shrink)

Background. Imposter syndrome, associated with self-doubt and fear despite clear accomplishments and competencies, is frequently detected in medical students and has a negative impact on their well-being. This study aimed to predict the students’ IS using the machine learning ensemble approach. Methods. This study was a cross-sectional design among medical students in Bangladesh. Data were collected from February to July 2020 through snowball sampling technique across medical colleges in Bangladesh. In this study, we employed three different machine learning techniques (...) such as neural network, random forest, and ensemble learning to compare the accuracy of prediction of the IS. Results. In total, 500 students completed the questionnaire. We used the YIS scale to determine the presence of IS among medical students. The ensemble model has the highest accuracy of this predictive model, with 96.4%, while the individual accuracy of random forest and neural network is 93.5% and 96.3%, respectively. We used different performance matrices to compare the results of the models. Finally, we compared feature importance scores between neural network and random forest model. The top feature of the neural network model is Y7, and the top feature of the random forest model is Y2, which is second among the top features of the neural network model. Conclusions. Imposter syndrome is an emerging mental illness in Bangladesh and requires the immediate attention of researchers. For instance, in order to reduce the impact of IS, identifying key factors responsible for IS is an important step. Machine learning methods can be employed to identify the potential sources responsible for IS. Similarly, determining how each factor contributes to the IS condition among medical students could be a potential future direction. (shrink)

Askold Melnyczuk’s novel Ambassador of the Dead narrates the process through which a second-generation, assimilated American learns to comprehend the Ukrainian historical experience of his family and their generation. This article argues that the novel is centrally concerned with Nick’s learning process: as he begins to better understand his parents’ generation, he transforms his own identity. As a child, Nick is unable to see Ada — his friend’s mother, who is haunted by traumatic experiences — as anything other than (...) an unchanging, incomprehensible enigma: “Old World Syndrome.” Eventually, Nick comes to follow the example of Anton, a displaced Ukrainian who narrates a story-within-the-novel that returns Ada’s experiences to their historical and cultural contexts, while using magical realism to place her Ukrainian experience on a historical scale. Through Anton’s example, Nick learns how to see both Ada and his parents as complex historical actors in world history. Understanding the past then enables him to see himself as Ukrainian and claim an identity that is both Ukrainian and American. (shrink)

In this article, I first propose four guidelines that follow from understanding the project of assigning victims duties to resist oppression as an ameliorative project. That is, if we understand the project to be motivated by the urgent aim of ending or mitigating the harm that oppression imposes on the oppressed, I argue that we should focus on developing and assigning duties that satisfy what I call the ability, weighting, fairness, and overdemandingness guidelines. Second, I develop the duty to (...) be a non-normative individual, which satisfies all four guidelines. (shrink)

The paper examines three aspects of the debate over the introduction of victim impact statements (VIS) in criminal cases. The first is the challenge VIS presents to the wholly public conception of criminal justice, in which the offender is prosecuted, tried and punished in the name of the state and not the individual victim. The second is the claim by supporters of VIS that the enhancement of victim input contributes to repairing an imbalance between offender and (...) victim, created by the crime itself and exacerbated by existing criminal justice processes. The third is the claim that victim impact evidence is necessary to ensure that punishment is properly calibrated to the blameworthiness of the offender. In respect of each question, a key role is played in supporting VIS by two presuppositions: that criminal justice should be thought of as a field of conflict among individuals seeking their due, and that the courts suffer an institutional deficiency of human understanding that requires a special remedy. The paper argues that the case for VIS is seriously weakened if these presuppositions are not accepted, and draws attention to their derivation from a wider political culture characterised by the dominance of neo-liberalism or market individualism. (shrink)

This essay renews a discussion of how historians do, and should, represent atrocity. It argues that the problems of representing extreme violence remain under-conceptualized; in this context it discusses the strengths and weaknesses of minimalism, a style prevalent both in historiography and in an intellectual culture that values understatement in approaches to violence. The essay traces the general cultural preference for minimalist narratives of suffering, which, it claims, is driven by the widespread conviction that experimental and exuberant narratives convert victims' (...) suffering into kitsch. It then focuses on two works, by Saul Friedlander and by Jan Gross, on the history of Jewish victims during and after the Second World War in order to assess how each uses sophisticated minimalist understatement to represent suffering, but with radically different effects. Finally, it asks historians to reflect upon the representation of extreme events by focusing on narrative style, on questions of ethics, and on the cultural narratives within which their own work on suffering and violence is inevitably embedded-especially given that historians are paying increasing attention to violent events that generate tremendous difficulties in relation to the representation both of victims and perpetrators. (shrink)

Previous research analyzing masculinity and domestic violence has focused on men’s accounts of the violence they have committed; relatively little research has focused on men’s accounts of victimization. This article critically examines how men negotiate the competing discourses of victimization, hegemonic masculinity, and stereotypes about domestic violence when filing for a domestic violence protection order against a woman partner. Three themes related to gender and victimization emerged from the men’s narratives. First, the men’s descriptions of the violence they had experienced (...) focused on their power and control over their intimate partner. Second, the men described their active resistance to the abuse but were careful to note that their actions were not “abusive” and that they were not the “abusers.” Finally, although most of the men described both verbal and physical abuse, most did not express a fear of their partner. I discuss the results of this analysis in the context of the recent increase in men claiming victimization in a number of realms. (shrink)

South Africa has the highest rate of foetal alcohol syndrome (FAS) in the world. The problem of alcohol abuse in pregnancy has very deep historical roots that are intertwined with the injustices of both apartheid and pre-apartheid colonialism. Much of the research that is being done in these communities is focused on identifying the epidemiological variables associated with these patterns of alcohol abuse. The underlying reasons as to why these patterns continue seem to remain largely obscured from view. In (...) this article, I apply the theory proposed by Powers and Faden of social justice as a ‘moral foundation for public health and health policy’ to the problem of FAS in South Africa. The objective of this application is two-fold: first, to critically explore the additional insights and alternative perspectives to the problem of FAS that this approach may provide and second, to assess the utility of the theory when applied directly to a specific public health problem. I conclude by noting that although this approach could result in the kind of ‘public health scope creep’ that has been criticized by various authors, it does provide fresh insights to the problem of FAS in South Africa. (shrink)

In order to reach a more comprehensive understanding of the dynamics in violent situations in institutional care for elderly people the aim of this study was to explore involved parties’ positions, and to illuminate forces and moves related to these positions. One involved care provider's narrative was analysed using narrative analysis and positioning theory. In the narrative the involved parties’ positions were fluid and often overlapping, and not exclusively as victim or perpetrator. Across the narrative the narrator altered the (...) involved parties’ positions by using available discourses. We understand that the altered positions were a salient way for the care provider to make sense of her experiences. By reading the care provider's narrative we further understand that she was much more than just a perpetrator, which was the origin for her narrative. This study led us to two assumptions important for implications in nursing practice. First, it is of significance how we position ourselves and others in narratives and conversations. Second, there is a difference between being categorised in advance and getting the opportunity to narrate one's own story. (shrink)

This paper draws upon a research study of accountants and HR specialists. The study eschewed hypothetical scenarios and focused upon those situations and scenarios that the interviewees defined as causing them ethical concerns. There are two distinct but related issues arising from the paper. The first is that the singular categorisations of moral reasoning attributed to individuals when faced with hypothetical scenarios by many who write on the issue of moral reasoning, did not correspond to the fluidity in moral choices (...) faced by the interviewees as they experienced their unfolding moral dilemmas. The second issue relates to the unwillingness of the interviewees to give voice to their concerns, not only externally, but also within their employing organisations. The tensions within the two cases featured were held in check only by the diminution of the autonomy of the two principal actors. As a consequence, the exercise of moral agency was denied. (shrink)

This paper draws upon a research study of accountants and HR specialists. The study eschewed hypothetical scenarios and focused upon those situations and scenarios that the interviewees defined as causing them ethical concerns. There are two distinct but related issues arising from the paper. The first is that the singular categorisations of moral reasoning attributed to individuals when faced with hypothetical scenarios by many who write on the issue of moral reasoning, did not correspond to the fluidity in moral choices (...) faced by the interviewees as they experienced their unfolding moral dilemmas. The second issue relates to the unwillingness of the interviewees to give voice to their concerns, not only externally, but also within their employing organisations. The tensions within the two cases featured were held in check only by the diminution of the autonomy of the two principal actors. As a consequence, the exercise of moral agency was denied. (shrink)

Introduction Tourette Syndrome is a childhood onset disorder characterized by vocal and motor tics and often remits spontaneously during adolescence. For treatment refractory patients, Deep Brain Stimulation may be considered. Methods and Results We discuss ethical problems encountered in two adolescent TS patients treated with DBS and systematically review the literature on the topic. Following surgery one patient experienced side effects without sufficient therapeutic effects and the stimulator was turned off. After a second series of behavioural treatment, he (...) experienced a tic reduction of more than 50%. The second patient went through a period of behavioural disturbances that interfered with optimal programming, but eventually experienced a 70% tic reduction. Sixteen DBS surgeries in adolescent TS patients have been reported, none of which pays attention to ethical aspects. Discussion Specific ethical issues arise in adolescent TS patients undergoing DBS relating both to clinical practice as well as to research. Attention should be paid to selecting patients fairly, thorough examination and weighing of risks and benefits, protecting the health of children and adolescents receiving DBS, special issues concerning patient’s autonomy, and the normative impact of quality of life. In research, registration of all TS cases in a central database covering a range of standardized information will facilitate further development of DBS for this indication. Conclusion Clinical practice should be accompanied by ongoing ethical reflection, preferably covering not only theoretical thought but providing also insights in the views and perspectives of those concerned, that is patients, family members and professionals. (shrink)

This study was conducted in Serbian companies on licensed engineers and in its first part included a total of 336 licensed engineers who voluntarily completed the questionnaires about their ethical orientation and attitudes toward corruption and in the second part 214 engineers who participated in the first survey, who voluntarily evaluated their company’s business operations characteristics. This study has clearly shown that there is a direct significant influence of the engineer’s ethical orientations and attitudes toward corruption on their evaluation (...) of the characteristics of their respective companies regarding business operations. This research also clearly shows that only engineers with a strong deontological orientation, low ethical subjectivity, and strong readiness to fight corruption, low corruption acceptance and high awareness of corruption can successfully fight corruption, improve the business operations of their companies and make beneficial changes to society. Otherwise, they should be considered as corruption perpetrators, not just as its victims. (shrink)

During the early months of the COVID-19 pandemic, domestic violence came to be understood as a national emergency. In this paper, we ask how and why domestic violence was constructed as a crisis specific to the pandemic. Drawing from newspaper data, we show that the domestic violence victim came to embody the violation of gendered boundaries between “public” and “private” spheres. Representations of domestic violence centered on violence spilling over the boundaries of the home, infecting the home, or the (...) home imploding. While theorists of crisis have focused on the central role of temporality in crisis construction, and especially the performative invocation of “new time,” we argue that crisis rhetoric often relies on anxiety about the transgression of spatial boundaries. Our spatial approach to crisis has two components. First, we argue that crisis framings often invoke the idea that seemingly distinct arenas of social life are becoming disorganized or blurred. And second, because thresholds between social spaces are coded as sacred during crisis, this spatial reordering is rendered dangerous, resulting in calls to resecure boundaries. (shrink)

The Battered Woman Syndrome, like the Cycle Theory of Violence, helps to illuminate the situation of the person victimized by domestic violence. However, it may also contribute to the violence of the battering situation. In this paper, I explore some of the implications of the Battered Woman Syndrome for domestic violence cases wherein an abused woman kills her abuser. I begin by delineating some of the circumstances of a domestic violence situation. I then discuss the particular moral issue (...) of subjectivity or moral personhood involved in instances wherein a woman victimized by domestic violence responds by killing her batterer. Finally, I argue that the Battered Woman Syndrome and similar alternatives to or qualifications of self-defense are problematic because they strip a woman of her moral subjectivity. I conclude with a brief articulation of a proposal for reform of the criminal justice system specifically aimed at cases wherein there has been a long history of abuse or violence. This reform is unique because it does not rely on a separate standard of reasonableness particular to battered women, but arises out of consideration of the moral implications of legal proceedings involving domestic violence. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.1 (2001) 39-40 [Access article in PDF] Remembering Feminisms:A Response to the Commentary Erica Burman I am grateful to Gwen Adshead for outlining the broader arguments surrounding feminist critiques of science and their relevance for mental health, particularly in forensic contexts. As she highlights, the debates about the status of accounts of memory hinge upon contested concepts of objectivity and the problem of discursive and (...) provisional (but also necessary) claims to external reality, these being debates to which feminists have actively contributed. There are four additional points I would like to make in response to her comments.Firstly, while I am in general agreement with her presentation of feminist positions in relation to scientific theory and method--and this does largely reflect a current consensus within feminist approaches--it is important not to overstate this consensus. Feminist debates about science, method, and claims to truth are precisely debates. There is no unitary feminist approach. Key arguments between feminists concern, for example, whether to lay claim to (forms of "strong") subjectivity rather than objectivity (see Harding 1986, Hollway 1989, Griffin et al. 1998) or whether to re-work criteria for objectivity to takeaccount of well-known gender biases (Eichler 1988).In my analysis of feminist approaches to "false memory syndrome" (FMS), I wanted to highlight the diversity of feminist positions in order to indicate something of the interconnections between feminist and other political, theoretical, and cultural analyses--ranging from the modernist and empiricist to the postmodernist and constructionist. Hence, while I agree with Adshead that much feminist analysis seems unremarkable since its impact on cultural practice has been so great, I would argue that her account glosses over the many different feminist positions mobilized within the debate around "false/recovered memories." There are widely different views, for example, about the status of evidence/science. Another key area of debate is the role of psychiatric diagnosis between those who subscribe to and those who reject the "terms of art" of psychiatric diagnostic categories.This may sound like a mere effort to attest to the rigor and rationality of feminist scholarship, including feminist re-workings of these terms. However, to come to my second point, there is a material consequence of this closer attention to the conditions for, and reception of, specific feminist analyses. For the debate about "false" or "recovered" memories goes beyond questions about the circulation of the roles of victim versus perpetrator that surround claims of credibility, legitimacy, manipulation, or gullibility. [End Page 39]Thus, Laura Brown and I (1997) and Jan Haaken (1998) have suggested that in order to understand how the current debates surrounding (women's) reported memories could have come about, we need to analyze what has happened through, and what the stakes have been in, the (limited) institutionalization of feminism within models and practices of therapy. This involves attending to the particular forms of feminism that have been included and excluded: For example, how far do therapeutic models accept, and how far do they problematize, the forms and functioning of families? We also need to consider the broader societal response (or backlash?) to a feminized/therapeutic culture, including consequences of the confounding of the therapeutic with the feminized. In particular, Haaken draws attention to the gender essentialism that pervaded second wave (1960s and 1970s) U.S. feminist therapies. This essentialism, she argues, has fueled a failure to interrogate power dynamics (including therapeutic dynamics) between women that make possible displacements of transferential dynamics to an outside party, whether past or present.My third point concerns the ever closer relationship between the therapeutic and legal arenas reflected within the career of FMS. Adshead's reference to a film narrative to highlight competing versions of legal knowledge puts me in mind of how FMS--as a potent cocktail of psychiatric labeling, familial conflict and abuse, and litigation--is the U.S. television courtroom drama writ large. It may be the case that, as Adshead argues, I fail adequately to address the complexity of legal process, with its assumptions about what makes certain accounts more credible or legitimate than others... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clarifying the Relationship Between Vice and Mental Disorder: Vice as Manifestation of a Psychological DysfunctionMichael B. First (bio)KeywordsDSM-IV, psychiatric diagnosis, impulse control disorders, sexually violent predator commitmentIndividuals generally present for psychiatric evaluation for one of two reasons: either because they themselves are suffering from a psychiatric symptom that causes distress (e.g., severe panic) or impairs their ability to function effectively (e.g., memory loss), or else they are brought to (...) clinical attention because their behavior or attitudes are considered by others to be problematic. There are a wide range of behaviors that fall into this second category. In some cases, the individual is pressured to seek treatment because of the negative impact that a behavior has on a relationship partner (e.g., sexual dysfunction, anger outbursts) or an employer (e.g., excessive alcohol use). Often, however, the external trigger for a clinical evaluation falls under Sadler’s definition of vice, that is, criminal (illegal) behaviors or attitudes that could be considered “wrongful” or “immoral” in the social arena because the behavior violates the law or an important social more.Given that one of the most important goals of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is to facilitate clinical practice (First et al. 2004) and in doing so provide a diagnostic code to cover any patient that might present himself or herself to a mental health professional, the DSM has evolved over its various editions to become a veritable laundry list of psychological and behavioral ills, some of which may constitute a violation of the rights of others or society. The DSM-III (and its successors) have adopted a descriptive approach wherein disorders are defined in terms of their presenting surface symptomatology, which was necessitated by the field’s lack of knowledge about the underlying etiology of mental disorders. Given this reliance on presenting symptoms, it is therefore inevitable that some disorders are defined in terms of behaviors that can be considered vices. For example, impaired impulse [End Page 35] control often leads to acting out behavior that, at its mildest is inappropriate, and at its most severe is destructive to self and others. Many of the disorders cited by Sadler as being vice-laden fall into this category, namely, pyromania (failure to resist impulses to set fires), kleptomania (failure to resist impulses to steal), intermittent explosive disorder (failure to resist aggressive impulses), certain forms of substance abuse (i.e., those involving possession and use of illegal substances) and paraphilias (i.e., those involving nonconsenting victims).It is important to clarify from the outset that the criteria for determining whether a behavior is a “vice” (i.e., whether it is illegal or immoral) is not equivalent to the criteria for determining whether a behavior is indicative of a mental disorder. According to the DSM-IV-TR definition, a mental disorder is conceptualized as a “clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom” (American Psychiatric Association [APA] 2000, xxxi). The definition warns against considering “deviant behavior[s] (e.g., political, religious, or sexual)” and “conflicts that are primarily between the individual and society” to be evidence of mental disorder except in those cases in which the “deviance or conflict is a symptom of a dysfunction in the individual.” Thus, when considering whether a particular “vice” behavior is a component of a mental disorder, it is crucial to determine whether the behavior is a manifestation of an underlying psychological dysfunction, such as a dysfunction in impulse control. If so, it may potentially be appropriate for that individual to be treated as “medically ill” in addition to, or instead of, being treated simply as a criminal.Let us examine some illustrative examples of cases that demonstrate the relationship between vice and mental disorders and the different ways in which the legal and mental health systems might deal with such cases. Consider the case of an individual who breaks... (shrink)

Based on retrospection on the reappraisal of the past in Hungary since 1989, this text analyses the representation of the Communist era in the Magyar Nemzeti Múzeum, the Terror Háza Múzeum and the Hadtörténeti Múzeum Budapest. All three museums place the suppression of the Hungarian people at the centre of their narration, while depicting the Hungarian nation as a victim. The 1956 revolution is staged as a central turning point in the second half of the 20th century, which (...) supplies the narrative with a fresh set of martyrs. In this context, Imre Nagy not only takes the role of an icon with regard to the events of 1956, but his re-interment is also seen as a climax of the turnabout of 1989. (shrink)

Numerous scholars, representing various fields of knowledge, have studied the Holocaust and published extensively on this subject since the end of the Second World War. Many original Holocaust documents, diaries and memoirs of victims and survivors have been edited and published, along with numerous historical, philosophical and theological treaties on the Shoah. The goal of this paper is to present psychology’s contribution to the study of the Holocaust. The authors discuss results of empirical research and clinical observations concerning the (...) long-term consequences of this trauma (the KZ/survivor syndrome), adaptation and coping skills of survivors, the phenomenon of transgenerational transmission of trauma and intrapsychic and interpersonal functioning of the children of survivors (the Second Generation). They present epidemiological data and psychological mechanisms of attempted and committed suicide among the Jews during the persecutions and deportations, as well as suicide in the ghettos and concentration camps, and among the Holocaust survivors. In the paper a short description ofpsychotherapy and other forms of psychological help available to the Holocaust survivors and their children is also presented. Last but not least, it is discussed how the knowledge of the psycho-social consequences of the Holocaust can be used by psychologists in their work with victims and survivors of other genocides and traumas. (shrink)

This article is concerned with how we meet the victim of genocide in the middle of experience. François Laruelle, in Théorie générale des victimes, suggests that to think the victim is a work of resurrection rather than remembrance. To think the victim should allow us to recognize that the victim, especially the victim for who they are as such, is always human in the last instance—a repeatable victim. With this thesis, the article begins with (...) the definition of the crime of genocide adopted by the United Nations to examine how knowledge production is involved in cyclical violence. The second part of the essay thinks the victim of genocide through a subversion of Jean-Luc Marion’s limit concept of the saturated phenomenon, sans transcendence. The essay concludes that in this lived realization, weakness and compassion seize to return the victim to their suffering and instead, hope to change the world. (shrink)

Both the medical model and the social model of disability have substantial drawbacks for the project of creating better lives for people with disabilities; the first denies the value of difference and the effects of discrimination, and the second denies any place for prevention and cure. Using fictional and non-fictional parental narratives of Fetal Alcohol Syndrome, this article argues that a third model–a morphological model of disability–can best help us think about respectfully and effectively intervening in disability.

In response to crises, people sometimes prioritize fewer specific identifiable victims over many unspecified statistical victims. How other factors can explain this bias remains unclear. So two experiments investigated how complying with public health recommendations during the COVID19 pandemic depended on victim portrayal, reflection, and philosophical beliefs (Total N = 998). Only one experiment found that messaging about individual victims increased compliance compared to messaging about statistical victims—i.e., "flatten the curve" graphs—an effect that was undetected after controlling for other (...) factors. However, messaging about flu (vs. COVID19) indirectly reduced compliance by reducing perceived threat of the pandemic. Nevertheless, moral beliefs predicted compliance better than messaging and reflection in both experiments. The second experiment’s additional measures revealed that religiosity, political preferences, and beliefs about science also predicted compliance. This suggests that flouting public health recommendations may be less about ineffective messaging or reasoning than philosophical differences. (shrink)

Copyright © 2015 by the Society of Criti. Objective: Global lung stress varies considerably with low tidal volume ventilation for acute respiratory distress syndrome. High stress despite low tidal volumes may worsen lung injury and increase risk of death. No widely available parameter exists to assess global lung stress. We aimed to determine whether the volume delivered during a recruitment maneuver is inversely associated with lung stress and mortality in acute respiratory distress syndrome. Design: Substudy of an acute (...) respiratory distress syndrome clinical trial on esophageal pressure-guided positive end-expiratory pressure titration. Setting: U.S. academic medical center. Patients: Forty-two patients with acute respiratory distress syndrome in whom airflow, airway pressure, and esophageal pressure were recorded during the recruitment maneuver. Interventions: A single recruitment maneuver was performed before initiating protocol-directed ventilator management. Recruitment maneuvers consisted of a 30-second breath hold at 40 cm H2O airway pressure under heavy sedation or paralysis. VRM was calculated by integrating the flow-time waveform during the maneuver. End-inspiratory stress was defined as the transpulmonary pressure during end-inspiratory pause of a tidal breath and tidal stress as the transpulmonary pressure difference between end-inspiratory and end-expiratory pauses. Measurements and Main Results: VRM ranged between 7.4 and 34.7 mL/kg predicted body weight. Lower VRM predicted high end-inspiratory and tidal lung stress. After adjusting for Pao2/Fio2 and either driving pressure, tidal volume, or plateau pressure and positive end-expiratory pressure, VRM remained independently associated with both end-inspiratory and tidal stress. In unadjusted analysis, low VRM predicted increased risk of death. VRM remained significantly associated with mortality after adjusting for study arm. Conclusions: Low VRM independently predicts high lung stress and may predict risk of death in patients with acute respiratory distress syndrome. (shrink)

According to luck egalitarianism, inequalities are justified if and only if they arise from choices for which it is reasonable to hold agents responsible. This position has been criticised for its purported harshness in responding to the plight of individuals who, through their own choices, end up destitute. This paper aims to assess the Harshness Objection. I put forward a version of the objection that has been qualified to take into account some of the more subtle elements of the luck (...) egalitarian approach. Revising the objection in this way suggests that the Harshness Objection has been overstated by its proponents: because luck egalitarians are sensitive to the influence of unequal brute luck on individuals’ choices, it is unlikely that there will be any real world cases in which the luck egalitarian would not have to provide at least partial compensation. However, the Harshness Objection still poses problems for the luck egalitarian. First, it is not clear that partial compensation will be sufficient to avoid catastrophic outcomes. Second, the Harshness Objection raises a theoretical problem in that a consistent luck egalitarian will have to regard it as unjust if any assistance is provided to the victim of pure option luck, even if such assistance could be provided at no cost. I consider three strategies the luck egalitarian could pursue to accommodate these concerns and conclude that none of these strategies can be maintained without either violating basic luck egalitarian principles or infringing upon individual liberty. (shrink)

This response to “A rational cure for pre-reproductive stress syndrome” first suggests it is existence that is essential and prerequisite to everything good or bad, therefore it deserves to be protected and respected. Secondly, it argues that every life is worth living, even if it is worse than some other lives, if the only alternative is non-existence. Finally, it takes a critical view of and challenges Häyry’s suggestion that in a good clinical situation, the idea of the irrationality of (...) having children could be a legitimate part of the guidance given, since it is not the counsellor’s or doctor’s duty to advise a couple who wish to have children that it is irrational or even immoral to bring a child into life. (shrink)

BackgroundFibromyalgia syndrome is the second most common chronic diffuse pain disorder and can have a lasting negative impact on the quality of life, pain, and physical function of people. Exercise therapy is an important component of the treatment of fibromyalgia, but there was not a consensus understanding of the effect of various exercise programs on the quality of life, pain, and physical function of people with fibromyalgia syndrome. This study aimed to compare three exercise programs in their (...) effectiveness in improving quality of life, relieving muscle pain, and enhancing physical function in patients with fibromyalgia.MethodsA comprehensive search of databases, including China National Knowledge Internet, Wan fang, The Cochrane Library, PubMed, EMBASE, and Web of Science, was conducted to identify randomized controlled trials on exercise therapy for patients with fibromyalgia syndrome with outcome indicators including at least one of Fibromyalgia Impact Questionnaire, Tender point count, and 6-minute walk test from the date of database creation on 20 April 2022. The included studies were evaluated for literature quality according to Cochrane Handbook criteria, and a network meta-analysis was performed using STATA 14.0.ResultForty-five randomized controlled trials met all inclusion criteria and were analyzed. The network meta-analysis showed that a combination of aerobic and resistance exercise was ranked first in all three dimensions of quality of life improvement, pain alleviation, and physical function enhancement.ConclusionThe current meta-analysis demonstrates that the combination of aerobic and resistance exercise may be the best type of exercise to accentuate the quality of life, pain alleviation, and physical function for people with fibromyalgia syndrome. (shrink)

This study articulates the leitmotif of civilizational analysis (the interaction of power and culture) with regard to the relation between religion and the state within the Islamic civilization or ‘Islamdom’. In a first step, it clarifies, by reference to Marshall Hodgson, the extent to which his view of Islamdom as a transcivilizational ecumene can fit into a comparative type of civilizational analysis. The comparative approach to civilizational analysis can be enriched by reevaluating the specific Islamic pattern of mild legitimization of (...) power through culture, and by integrating into the analysis the resulting field of tension vis-à-vis Western power and its supporting normative paradigms. In a second step, in order to better grasp the forms of power governing this field of tension, the article critically reconsiders Rémi Brague’s characterization of Western European civilization as the outcome of an expansive ‘Roman road’ that matched culture with power by investing into the charisma of corporate entities: first, the church, then the state. Against this double background, the study shows that the culture—power syndrome that is proper to Islamdom as a transcivilizational ecumene does not consecrate a separation of ‘religion’ from the body politic, but promotes the building of expansive patterns of connectedness. (shrink)