The rapid accumulation of gene sequence data is allowing evolutionary inferences of unprecedented resolution. In the area of population genetics, gene trees and polymorphism data are being used to study demographic parameters. In the area of comparative biology, the shapes of phylogenetic trees provide information about patterns of speciation, coevolution, and macroevolution. A variety of statistical methods have been developed for exploiting the information contained within organismal genomes. In this paper, we emphasise the conceptual bases of the tests, rather than (...) details of their implementation. BioEssays 1999;21:148–156. © 1999 John Wiley & Sons, Inc. (shrink)

Markel is a medical historian who produced this joint biography of John Harvey Kellogg and W.K. Kellogg.

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

After centuries of neglect, the ethics of food are back with a vengeance. Justice for food workers and small farmers has joined the rising tide of concern over the impact of industrial agriculture on food animals and the broader environment, all while a global epidemic of obesity-related diseases threatens to overwhelm modern health systems. An emerging worldwide social movement has turned to local and organic foods, and struggles to exploit widespread concern over the next wave of genetic engineering or nanotechnologies (...) applied to food. Paul B. Thompson's book applies the rigor of philosophy to key topics in the first comprehensive study explore interconnections hidden deep within this welter of issues. Bringing to bear more than thirty years of experience working closely with farmers, agricultural researchers and food system activists, he explores the eclipse of food ethics during the rise of nutritional science, and examines the reasons for its sudden re-emergence in the era of diet-based disease. Thompson discusses social injustice in the food systems of developed economies and shows how we have missed the key insights for understanding food ethics in the developing world. His discussions of animal production and the environmental impact of agriculture break new ground where most philosophers would least expect it. By emphasizing the integration of these issues, Thompson not only brings a comprehensive philosophical approach to moral issues in the production, processing, distribution, and consumption of food -- he introduces a fresh way to think about practical ethics that will have implications in other areas of applied philosophy. (shrink)

Agrarian political philosophies since ancient Greece stress the role of agriculture in forming political solidarity and civic virtue. More recent transformations suggest a way to conjoin these elements of what makes a polity politically sustainable with environmental sensitivity and literacy.

Critically analyzes and revitalizes agrarian philosophy by tracing its evolution. Today, most historians, philosophers, political theorists, and scholars of rural America take a dim view of the agrarian ideal that farmers and farming occupy a special moral and political status in society. Agrarian rhetoric is generally seen as special pleading on the part of farmers seeking protection from labor reform and environmental regulation while continuing to receive direct payments and subsidies from the public till. Agrarianism should not be viewed as (...) a set of immutable claims about farming and political order, but as a tradition of moral and political philosophy that has evolved and deepened over the centuries. Agrarian naturalism--the belief that culture and conduct are conditioned by nature because they are of a piece with nature--becomes pragmatic naturalism, giving way to a new set of puzzles about how we are to understand the rural landscape and our responsibilities for its use. The agrarian idea that personality and sociability are integrated with the material transformation of the landscape can serve as the basis for a new, pragmatically grounded ethic of natural resources and rural development. The essays in this volume critically analyze and revitalize agrarian philosophy by tracing its evolution in the classical American philosophy of key figures such as Franklin, Jefferson, Emerson, Thoreau, Dewey, and Royce. Three chapters address the belief that farming peoples develop moral virtue and a taste for democracy as it evolved in the American context, and four examine how a reconstitution of agrarian themes might invigorate our nation's thinking on environment, food, and rural development policy. The Agrarian Roots of Pragmatism will be of broad interest to scholars of American philosophy, rural history, history of ideas, geography, and agricultural or natural resource policy. (shrink)

The Spirit of the Soil challenges environmentalists to think more deeply and creatively about agriculture. Paul B. Thompson identifies four `worldviews' which tackle agricultural ethics according to different philosophical priorities; productionism, stewardship, economics and holism. He examines current issues such as the use of pesticides and biotechnology from these ethical perspectives. This book achieves an open-ended account of sustainability designed to minimise hubris and help us to recapture the spirit of the soil.

We present two studies investigating the impact of causal perceptions and the moral emotions of anger, shame, and guilt on the justification of deviant workplace behavior. Study 1 tests our conceptual framework using a sample of undergraduate business students; Study 2 examines a population of practicing physicians. Results varied significantly between the two samples, suggesting that individual and contextual factors play an important role in shaping the perceptual and emotional processes by which individuals form reactions to undesirable affective workplace events. (...) Implications of these findings for the study of ethics, emotions, and attributions, as well as for promoting ethical behavior, are discussed. (shrink)

Despite growing interest in emotions, organizational scholars have largely ignored the moral emotion of schadenfreude, which refers to pleasure felt in response to another’s misfortune. As a socially undesirable emotion, it might be assumed that individuals would be hesitant to share their schadenfreude. In two experimental studies involving emotional responses to unethical behaviors, we find evidence to the contrary. Study 1 revealed that subjects experiencing schadenfreude were willing to share their feelings, especially if the misfortune was perceived to be deserved. (...) Study 2 extends this work by incorporating schadenfreude targets of different status. Consistent with the “tall poppy syndrome,” subjects were more willing to share schadenfreude concerning high status targets than low status targets when the perceived severity of the target’s misconduct was low. This status effect disappeared at higher levels of perceived deservingness, however. Reported willingness to share schadenfreude was strongest at these levels but did not differ significantly between high and low status targets. These findings build on the social functional account of emotions, suggesting that sharing schadenfreude may signal normative cues to others regarding workplace behaviors that are deemed to be unethical. (shrink)

: When may a physician legitimately offer enrollment in a randomized clinical trial (RCT) to her patient? Two answers to this question have had a profound impact on the research ethics literature. Equipoise, as originated by Charles Fried, which we term Fried's equipoise (FE), stipulates that a physician may offer trial enrollment to her patient only when the physician is genuinely uncertain as to the preferred treatment. Clinical equipoise (CE), originated by Benjamin Freedman, requires that there exist a state of (...) honest, professional disagreement in the community of expert practitioners as to the preferred treatment. FE and CE are widely understood as competing concepts. We argue that FE and CE offer separable and, in themselves, incomplete justifications for the conduct of clinical trials. FE articulates conditions under which the fiduciary duties of physician to patient may be upheld in the conduct of research. CE sets out a standard for the social approval of research by institutional review boards. Viewed in this way, FE and CE are not necessarily competing notions, but rather address complementary moral concerns. (shrink)

Franklin G. Miller and colleagues have stimulated renewed interest in research ethics through their work criticizing clinical equipoise. Over three years and some twenty articles, they have also worked to articulate a positive alternative view on norms governing the conduct of clinical research. Shared presuppositions underlie the positive and critical dimensions of Miller and colleagues' work. However, recognizing that constructive contributions to the field ought to enjoy priority, we presently scrutinize the constructive dimension of their work. We argue that it (...) is wanting in several respects. (shrink)

Heated debate surrounds the question whether the relationship between physician-researcher and patient-subject is governed by a duty of care. Miller and Weijer argue that fiduciary law provides a strong legal foundation for this duty, and for articulating the terms of the relationship between physician-researcher and patient-subject.

Bioethics is currently witnessing unprecedented debate over the moral and legal norms governing the conduct of clinical research. At the center of this debate is the duty of care in clinical research, and its most widely accepted specification, clinical equipoise. In recent work, we have argued that equipoise and cognate concepts central to the ethics of clinical research have been left unnecessarily vulnerable to criticism. We have suggested that the vulnerability lies in the conspicuous absence of an articulated foundation in (...) moral and legal theory of the physician-researcher's duty of care to the patient-subject. We have repeatedly suggested that the requisite foundation is in the ethics of trust and the law of fiduciaries.Curiously, despite the absence of a published thorough exposition of our position, some have preemptively criticized our suggestion that the relationship between physician-researcher and patient-subject is fiduciary. Others have offered their own accounts of the implications of fiduciary law for the relationship. (shrink)

Issues of social justice underlie the clamour for greater gender balance in top-management. The present study reveals that pursuit of such social justice is also value-enhancing in relation to the longer-run performance of initial public offerings stocks, especially where female board members are unencumbered by family-connection with other directors. This study examines the economic benefits of board gender diversity for state- and privately controlled firms in the Hong Kong IPO market. Gender board diversity is much less common in state-run IPO (...) firms. Within the subset of privately controlled IPO firms, distinction exists between entities that accommodate family-connected board officers and those that do not. Specifically, this study focuses on family-ties between board members. This issue allows for finer-grained assessment of family influence on firm performance. Stronger post-listing stock, return-on-assets and sales-on-assets performance arise in privately controlled firms without family-connected board members and in state-run entities. Gender diversity thus serves as a positive, but only when female director presence is untrammelled by family associations between directors. However, there is little evidence of a link between female board representation and IPO underpricing. Relative to state-backed issuers, privately controlled firm boards accommodate more women, younger officers and a broader mix of nationalities, but appear more-inclined to unify CEO and chair positions. Board duality, the fraction of independent directors and directors’ age and nationality exhibit little relation with initial and aftermarket stock returns. In prescriptive terms, minority investors gain from the inclusion of female directors, especially when IPO firm directors are unencumbered by family-affiliation with other board members. Results therefore add to the clarion of calls for greater female board presence. (shrink)

Presents a collection of essays written over a period of 15 years by agricultural ethicist Paul B. Thompson. The essays address the practical application of ethics to agriculture in a world faced with issues of increased yield, threatened environment, and the disappearance of the family farm.

Public controversy over animalbiotechnology is analyzed as a case that illustratestwo broad theoretical approaches for linking science,political or ethical theory, and public policy. Moralpurification proceeds by isolating the social,environmental, animal, and human health impacts ofbiotechnology from each other in terms of discretecategories of moral significance. Each of thesecategories can also be isolated from the sense inwhich biotechnology raises religious or metaphysicalissues. Moral purification yields a comprehensive andsystematic account of normative issues raised bycontroversial science. Hybridization proceeds bytaking concern for all these (...) elements to be a mark ofsound moral character. The advocate of hybridizationinfers that those who employ a strategy ofpurification seek to avoid accountability by dividingissues, and hence are not to be trusted. Lack of trustincreases perceived risk and challenges the legitimacyof government regulations to control social,environmental, and human health risks that areestablished under separate mandate, and administeredby separate agencies.The close alignment between government agencies, theiracademic affines, and the categories of purificationplaces the purified analysis in a favored politicalposition. Legitimation of science-based policy inareas like animal biotechnology becomes problematicbecause the concern of those who would take a hybridapproach (arguably the majority of lay persons) tounderstanding controversial science are excluded.Ironically, this exclusion heightens the perception ofrisk from animal biotechnology. The paper concludeswith a call for procedural approaches to incorporatingthe hybrid view of science‘s moral significance. (shrink)

Philosophical food ethics or deliberative inquiry into the moral norms for production, distribution and consumption of food is contrasted with food ethics as an international social movement aimed at reforming the global food system. The latter yields an activist orientation that can become embroiled in self-defeating impotency when the complexity and internal contradictions of the food system are more fully appreciated. However, recent work in intersectionality offers resources that are useful to both philosophical and activist food ethics. For activists, intersectionality (...) provides a way to preserve and strengthen the meaningfulness of protest and resistance, even in the face of complexity and uncertain outcomes. For philosophers, intersectionality chastens the tendency to regard moral problems as inherently solvable, and provides a way use tensions inherent in food system reform as a source of ethical insight. (shrink)

When may a physician enroll a patient in clinical research? An adequate answer to this question requires clarification of trust-based obligations of the state and the physician-researcher respectively to the patient-subject. The state relies on the voluntarism of patient-subjects to advance the public interest in science. Accordingly, it is obligated to protect the agent-neutral interests of patient-subjects through promulgating standards that secure these interests. Component analysis is the only comprehensive and systematic specification of regulatory standards for benefit-harm evaluation by research (...) ethics committees (RECs). Clinical equipoise, a standard in component analysis, ensures the treatment arms of a randomised control trial are consistent with competent medical care. It thus serves to protect agent-neutral welfare interests of the patient-subject. But REC review occurs prior to enrolment, highlighting the independent responsibility of the physician-researcher to protect the agent-relative welfare interests of the patient-subject. In a novel interpretation of the duty of care, we argue for a “clinical judgment principle” which requires the physician-researcher to exercise judgment in the interests of the patient-subject taking into account evidence on treatments and the patient-subject‘s circumstances. (shrink)

Risk communication poses a challenge to ordinary norms of truth-telling because it can easily mislead. Analyzing this challenge in terms of a systematic divergence between expertise and public attitudes fails to recognize how two specific features of the concept of risk play a role in managing daily affairs. First, evaluating risk always incorporates an estimate of the reliability of information. Since risk communication is an effort at providing information, audiences will naturally and appropriately incorporate their assessment of the reliability of (...) the risk communicator into their assessment of the risk as such. Second, one conceptual and grammatical feature of the concept of risk is to categorize experience as non-routine and demanding further deliberation. That is, the whole point of calling something a risk can be to distinguish it from activities or phenomena that need no further attention. Risk communications that stress relative comparisons of measured probabilities and expected utilities can be inconsistent with both features of our concept of risk. At best they mislead; at worst they undermine our society’s capacity to cope with risk. While there are no simple answers to these two conundrums, technical experts should bear them in mind when communicating with the broader public. (shrink)

Phylogenetic trees based on gene sequence data contain information about the evolutionary processes responsible for their genesis. Methods have now been developed which help to reveal those processes. The methods are based on simple models of evolutionary change but, when applied across individuals in a population, rather than across species in a higher‐level taxon, they can reveal the past history of population change. Examples from salamanders and viruses are used to illustrate how the past history of changes in speciation rate (...) and the origin of epidemics can be inferred in the absence of fossil material or historical documentation. (shrink)

What is the significance of the wicked problems framework for environmental philosophy? In response to wicked problems, environmental scientists are starting to welcome the participation of social scientists, humanists, and the creative arts. We argue that the need for interdisciplinary approaches to wicked problems opens up a number of tasks that environmental philosophers have every right to undertake. The first task is for philosophers to explore new and promising ways of initiating philosophical research through conducting collaborative learning processes on environmental (...) issues. The second task is for philosophers to recognize the value of philosophical skills in their engagements with members of other disciplines and walks of life in addressing wicked problems. The wicked problems framework should be seen as an important guide for facilitating philosophical research that is of relevance to problems like climate change and sustainable agriculture. Content Type Journal Article Category Articles Pages 1-14 DOI 10.1007/s10806-011-9344-0 Authors Paul B. Thompson, Department of Philosophy, Michigan State University, 503 S. Kedzie Hall, East Lansing, MI 48824, USA Kyle Powys Whyte, Department of Philosophy, Michigan State University, 503 S. Kedzie Hall, East Lansing, MI 48824, USA Journal Journal of Agricultural and Environmental Ethics Online ISSN 1573-322X Print ISSN 1187-7863. (shrink)

Experiential factors such as long-term deliberate practice are powerful and necessary conditions for outstanding achievement. Nevertheless, to be able to reject the role of biology based individual differences (including genetic ones) in the manifestation of talent requires designs that expose heterogeneous samples to so-called testing-the-limits conditions, allowing asymptotic levels of performance to be analyzed comparatively. When such research has been conducted, as in the field of lifespan cognition, individual differences, including biology based ones, come to the fore and demonstrate that (...) the orchestration of excellence requires joint attention to genetic–biological and experiential factors. (shrink)

Countersexual society -- Countersexual reversal practices -- Theories -- Countersexual reading exercise -- On philosophy as a better way of taking it in the ass: deleuze and "molecular homosexuality.

Open-source communities that focus on content rely squarely on the contributions of invisible strangers in cyberspace. How do such communities handle the problem of trusting that strangers have good intentions and adequate competence? This question is explored in relation to communities in which such trust is a vital issue: peer production of software (FreeBSD and Mozilla in particular) and encyclopaedia entries (Wikipedia in particular). In the context of open-source software, it is argued that trust was inferred from an underlying ‘hacker (...) ethic’, which already existed. The Wikipedian project, by contrast, had to create an appropriate ethic along the way. In the interim, the assumption simply had to be that potential contributors were trustworthy; they were granted ‘substantial trust’. Subsequently, projects from both communities introduced rules and regulations which partly substituted for the need to perceive contributors as trustworthy. They faced a design choice in the continuum between a high-discretion design (granting a large amount of trust to contributors) and a low-discretion design (leaving only a small amount of trust to contributors). It is found that open-source designs for software and encyclopaedias are likely to converge in the future towards a mid-level of discretion. In such a design the anonymous user is no longer invested with unquestioning trust. (shrink)

Although the word 'sustainability' is used broadly, scientific approaches to sustainability fall into one of two competing paradigms. Following the influential Brundtland report of 1987. some theorists identify sustainability with some form of resource availability, and develop indicators for sustainability that stress capital depletion. This approach has spawned debates about the intersubstitutivity of capitals, with many environmental theorists arguing that at some point, depletion of natural capital cannot be offset by increases in human or social capital. The alternative approach is (...) grounded in stock and flow systems systems modeling, and defines sustainability through indicators that determine whether the system structure is robust (e.g. resists perturbation), resilient (recovers after disruption) and adaptive (capable of change in response to external conditions). Both paradigms have applications in economics and ecology. (shrink)

Commodification and Secondary Rationalization.

The essays in this volume critically analyze and revitalize agrarian philosophy by tracing its evolution in the classical American philosophy of key figures such as Franklin, Jefferson, Emerson, Thoreau, Dewey, and Royce.

Many arguments for and against nuclear power can be analyzed according to a matrix of logically competing claims on the need and safety of nuclear power. Logical analysis of the arguments reveals their philosophical basis and contributes to an understanding of their explanatory appeal. The evidential value of claims made in the arguments of both supporters and opponents depends upon familiar issues in the philosophy of language and the philosophy of science.

A large part of environmental policy is based upon scientific studies ofthe likely health, safety, and ecological consequences of human actions and practices. These studies, however, are frequently vulnerable to epistemological and methodological criticisms which challenge their validity. Epistemological criticisms can be used in ethical and political philosophy arguments to challenge the applicability of scientific knowledge to environmental policy, and, in turn, to challenge the democratic basis of specific environmental policies themselves. Uncertainty arguments thus draw upon philosophy of science, epistemology, (...) ethics, and political philosophy to establish conclusions of practical relevance to environmental quality. A theory of how and when uncertainty arguments ought to be given credence in environmental decision making requires an account of how scientific research ought to be integrated into environmental policy generally, plus an account of how public environmental policy is to be set in a democracy. (shrink)

Edited by Thomas A. Shannon, this series provides anthologies of critical essays and reflections by leading ethicists in four pivotal areas: reproductive technologies, genetic technologies, death and dying, and health care policy. The goal of this series is twofold: first, to provide a set of readers on thematic topics for introductory or survey courses in bioethics or for courses with a particular theme or time limitation. Second, each of the readers in this series is designed to help students focus more (...) thoroughly and effectively on specific topics that flesh out the ethical issues at the core of bioethics. The series is also highly accessible to general readers interested in bioethics. (shrink)

Recent developments in synthetic biology are described and characterized as moving the era of biotechnology into platform technologies. Platform technologies enable rapid and diffuse innovations and simultaneous product development in diffuse markets, often targeting sectors of the economy that have traditionally been thought to have little relationship to one another. In the case of synthetic biology, pharmaceutical and biofuel product development are occurring interactively. But the regulatory and ethical issues associated with these two applications share very little overlap. As such, (...) there is some risk that focus on traditional medical applications, for which the ethical expertise is highly developed, will overshadow the ethical issues that arise in connection with land use and its attendant socioeconomic consequences, especially in the developing world. The 2010 report of the Presidential Commission for the Study of Bioethics exhibits this tendency. (shrink)

Biotechnology applied to traditional foodanimals raises ethical issues in three distinctcategories. First are a series of issues that arise inthe transformation of pigs, sheep, cattle and otherdomesticated farm animals for purposes that deviatesubstantially from food production, including forxenotransplantation or production of pharmaceuticals.Ethical analysis of these issues must draw upon theresources of medical ethics; categorizing them asagricultural biotechnologies is misleading. The secondseries of issues relate to animal welfare. Althoughone can stipulate a number of different philosophicalfoundations for the ethical assessment of welfare,most (...) either converge on Bernard Rollins principle ofwelfare conservation (Rollin, 1995), or devolve intodebates over the ethical significance of animaltelos or species integrity. The principle of welfareconservation prohibits disfunctional geneticengineering of food animals, but would permit alteringanimals biological functions, especially when (as inmaking animals less susceptable to pain or suffering)do so improves an individual animals well being.Objections to precisely this last form of geneticengineering stress telos or species integrity asconstraints on modification of animals, and thisrepresents the third class of ethical issues. Most whohave formulated such arguments have failed to developcoherent positions, but the notion of species being,derived from the 19th century German tradition,presents a promising way to analyze the basis forresisting the transformation of animal natures. (shrink)

Each of four sections in this paper sketches the philosophical problems associated with a different dimension of sustainability. The untitled introductory section surveys the oft-noted discrepancies between different notions of sustainability, and notes that one element of the ambiguity relates to the different points of view taken by a participant in a system and a detached observer of the system. The second section, “Sustainability as a System Describing Concept,” examines epistemological puzzles that arise when one attempts to assess the truth (...) or falsity of claims that attribute sustainability or non-sustainability. In particular, such claims generally presume bounded systems, but boundary conditions are value-laden. The third section, “Sustainability as a Goal Prescribing Concept,” examines puzzles that arise in attempting to define sustainability in normative terms. In particular, the question of whether sustainability is an intrinsic or instrumental value is examined. The final section, “Sustainability and Bliss,” offers an analysis of the moral responsibilities that human beings have, given the fact that knowledge of conditions for achieving sustainability can never be complete. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Excited DeliriumWhat’s Psychiatry Got to do With It?Paul B. Lieberman, MDIf in life we are surrounded by death, so too in the health of our intellect by madness.—WittgensteinDelirium is a medical syndrome defined as “a relatively acute decline in cognition that fluctuates over hours or days” whose primary manifestation is a deficit of attention. It is common, estimated to occur in 10% to more than 50% of hospitalized (...) patients, with higher prevalence rates among people in nursing homes and at the end of life. It is often fatal, with a mortality rate in the hospital estimated to be 25% to 33%. Caused by a wide variety of conditions and frequently difficult to diagnose, it lacks characteristic postmortem pathology (Josephson & Miller 2018)‘Excited delirium,’ as Byju and Friesen forcefully argue (Byju & Friesen, 2023), is, if nothing else, an excuse. The ‘diagnosis’ has not been empirically validated and remains controversial (American Psychiatric Association, 2020). And while delirium is usually treated by internists and emergency medicine physicians, psychiatrists should also be concerned about the misuse of a putative medical diagnosis and join actively in discussion about it. For one thing, patients mis-diagnosed with this condition, as Byju and Friesen’s examples suggest, may actually have another psychiatric condition and, so, be people for whose safety we should advocate. Moreover, the kinds of police interventions which Byju and Friesen document as involving excited delirium also befall patients with other psychiatric problems in whom the issue of delirium does not arise.There are at least two broad ways in which psychiatrists are qualified and obligated to engage with this issue. As physicians, we should join our medical colleagues in carefully but persistently telling the scientific, medical truth. As psychiatrists, we should bring psychiatric knowledge into the discussion, for example, by explaining what can happen when people who do not, apparently, have a diagnosable mental disorder interact under stress with other people who, apparently, do.Delirium is a clinical diagnosis, made when characteristic signs and symptoms are present which should not be made ‘by exclusion’ when, as may happen, other causes are not found. There is no evidence of delirium in any of the three clinical descriptions Byju and Friesen provide. Perhaps such evidence exists which is not in their brief reports, but these three people appear to have had, either, another psychiatric condition, such as psychosis or drug intoxication, or perhaps no [End Page 353] diagnosis at all. Psychiatrists are particularly wellpositioned to make this point since patients with mental health problems are often misdiagnosed when they seek medical attention and are told, and treated as if, “it’s all (“just”!) psychological.”Excited delirium, if it exists, is fatal in 10% of cases (Gonin, Beysard, Hersin, & Carron, 2018) and, although this is lower than the rate for delirium in general, it is still high. Medical personnel must be available to evaluate and ensure the safety of patients in custody.The potential conflict between protecting the patient and protecting the public should not be overstated. Although physical trauma and excessive administration of medications, including ketamine 500 mg IV (Orhurhu, Vashicht, Claus, & Cohen, 2023) can be lethal, mechanical restraint by itself is not (Chieze et al., 2019; Gleerup et al., 2019): something else is necessary, such as asphyxiation (Evans, Wood, & Lambert, 2003). Nor is restraint necessary in many cases in which ‘de-escalation’ techniques can be equally effective (Garriga et al., 2016; Fernández-Costa, 2020). Perhaps these points are best made by law enforcement leaders—and they have been—but psychiatrists can add that safe management of potential violence can be provided for agitated people with psychiatric conditions.Although it is not clear what kind of strength ‘superhuman’ strength might be (certainly not medical), relative imperviousness to pain is clinically described. Its locus classicus is Beecher’s observation, during World War II, that injured soldiers awaiting return home from the front, required lower than usual doses of analgesics (Beecher, 1946). And it’s a common experience, scientifically confirmed, that physical trauma may not become painful until sometime after the injury (Melzack, Wall, & Ty, 1982). But pain is a warning. Its absence is not a license, but a caution... (shrink)