Vulnerability has become a popular though controversial topic in bioethics, notably since 2000. As a result, a common body of knowledge has emerged distinguishing between different types of vulnerability, criticizing the categorization of populations as vulnerable, and questioning the practical implications. It is argued that two perspectives on vulnerability, i.e., the philosophical and political, pose challenges to contemporary bioethics discourse: they re-examine the significance of human agency, the primacy of the individual person, and the negativity of vulnerability. As a phenomenon (...) of globalization, vulnerability can only be properly addressed in a global bioethics that takes the social dimension of human existence seriously. (shrink)

Much of the debate around temporary foreign worker programs in recent years has focused on full or partial access to rights, and, in particular, on the extent to which liberal democratic states may be justified in restricting rights of membership to those who come and work on their territory. Many accounts of the situation of temporary foreign workers assume that a full set of rights will remedy moral inequities that they suffer in their new homes. I aim to show two (...) things: first, and based on experiences reported by former Live-in-Caregivers in Canada who now have access to the full set of citizenship rights, and German citizens who are descendants of Kurdish guestworkers in Germany, I have proposed that even after gaining citizenship, many of them experience social stigma and a sense of exclusion. Second, I have argued that this neglects a basic need that individuals have, which is to have access to relational resources within society in order to be protected against social deprivation. This need is seemingly immune to be effectively protected through the known catalogue of social, civic and political rights. Instead, I argue that social deprivation needs to be analyzed through the lens of institutional vulnerability to yield an analysis of the moral obligations of liberal democratic states. (shrink)

Background Although it is the moral duty of physicians to protect vulnerable patients, there are no data on how vulnerability is perceived in clinical practice. This study explores how physicians classify someone as “vulnerable”. Method Thirty-three physicians were initially questioned about resource allocation problems in their work. The results of these interviews were examined with qualitative study software to identify characteristics associated with vulnerability in patients. Data were conceptualized, classified and cross-linked to highlight the major determinants of vulnerability. The findings (...) revealed the principal factors that make patients vulnerable in clinical practice, according to our definition of vulnerability: the likelihood of having one’s interests unjustly considered. Results Vulnerability can arise as a result of a mismatch between the characteristics of patients and physicians, the healthcare system, the treatment, or the communication between physicians and patients. Vulnerability appears as a gap between a patient’s needs and the means intended to meet them. Vulnerability can further be the result of doing too little or too much for patients. This result suggests that structures provided by healthcare systems are not as differentiated as they should be to cover all situations. Our initial definition of vulnerability was illustrated and supported by our results, showing that it encompasses all factors involved, not solely personal characteristics, indicating the need for a more pragmatic approach for use in clinical practice. Conclusion Vulnerability is not due to a single factor but appears under certain circumstances when there is a discrepancy between a patient’s interests and the care provided, despite existing compensation systems. (shrink)

Obstetric violence – psychological and physical violence by medical staff towards women giving birth – has been described as structural violence, specifically as gender violence. Many women are affected by obstetric violence, with awful consequences. The phenomenon has so far been mainly investigated by the health and social sciences, yet fundamental theoretical and conceptual questions have gone unnoticed. Until now, the phenomenon of obstetric violence has been understood as one impeding autonomy and individual agency and control over the body. In (...) this article I will argue that the phenomenon of obstetric violence occurs in a specific state of embodied vulnerability and that might be destructive for subjectivity since it fails to recognize that state and instead disallows support and demolishes relationships and interdependence. This might introduce a conceptual shift and the phenomenon might be reconceptualized as a moment where vulnerability is misrecognized and ambiguity, relations and support are banned. In this case violence is recognized as cutting the original links to our bodies and the world that constitute our phenomenological condition, instead of as hurting the autonomous subject. Obstetric violence, thus, calls to be reflected upon through de Beauvoir’s ideas on ambiguity, the embodied and situated subject and the subject as essentially construed in relations. I believe that de Beauvoir’s conception of the authentic embodied subject as necessarily ambiguous – immanent and transcendent at the same time and ineludibly linked to the world and its others – will be extremely useful for construing this new understanding of how obstetric violence happens and of what precisely constitutes its damage. (shrink)

Breast cancer screening aims to help women by early identification and treatment of cancers that might otherwise be life-threatening. However, breast cancer screening also leads to the detection of some cancers that, if left undetected and untreated, would not have damaged the health of the women concerned. At the time of diagnosis, harmless cancers cannot be identified as non-threatening, therefore women are offered invasive breast cancer treatment. This phenomenon of identifying non-harmful cancers is called overdiagnosis. Overdiagnosis is morally problematic as (...) it leads to overall patient harm rather than benefit. Further, breast cancer screening is offered in a context that exaggerates cancer risk and screening benefit, minimises risk of harm and impedes informed choice. These factors combine to create pathogenic vulnerability. That is, breast cancer screening exacerbates rather than reduces women’s vulnerability and undermines women’s agency. This paper provides an original way of conceptualising agency-supporting responses to the harms of breast cancer overdiagnosis through application of the concept of pathogenic vulnerability. (shrink)

Ageism within the context of care has attracted increasing attention in recent years. Similarly, autonomy has developed into a prominent concept within health care law and ethics. This paper explores the way that ageism, understood as a set of negative attitudes about old age or older people, may impact on an older person’s ability to make maximally autonomous decisions within health care. In particular, by appealing to feminist constructions of autonomy as relational, I will argue that the key to establishing (...) this link is the concept of self-relations such as self-trust, self-worth and self-esteem. This paper aims to demonstrate how these may be impacted by the internalisation of negative attitudes associated with old age and care. In light of this, any legal or policy response must be sensitive to and flexible enough to deal with the way in which ageism impacts autonomy. (shrink)

Volume 19, Issue 9, September 2019, Page 41-43.

Endocrine-disrupting chemicals have been identified as posing risks to reproductive health and may have intergenerational effects. However, responses to the potential harms they pose frequently rely on medicalised understandings of the body and normative gender identities. This article develops an intersectional feminist framework of intergenerational justice in response to the potential risks posed by endocrine-disrupting chemicals. We examine critiques of endocrine disruptors from feminist, critical disability and queer standpoints, and explore issues of race and class in exposures. We argue that (...) responding to the risks posed by endocrine disruptors such as brominated flame retardants (BFRs) and phthalates requires developing a theory of intergenerational justice that recognises relationality and transcorporeality, and that also recognises harm in terms of suffering, not in terms of difference. (shrink)

The notion of vulnerable groups has gained relevance in international legal instruments while being criticised in philosophical literature for its disabling potential and disempowering consequences. The article argues that the category of group vulnerability should not be abandoned, being an opportunity for resistance, visibility, and a place for dissent: vulnerable groups can both function as a sounding board for claims and make demands for recognition, resetting the political agenda and the topics of public debate, and allow the level of collective (...) needs to emerge from the level of individual interests, thereby guaranteeing a fairer distribution of resources. For this purpose, the article provides two definitions of group vulnerability that avoid both the risks of essentialism and of labelling outcomes. The article also analyses the political value of vulnerable groups, highlighting that it is conceivable as an enabling condition, a source of political agency and mobilisation. (shrink)

In this paper I present a critical analysis of the English law relating to the safeguarding of vulnerable adults, in particular how the law impacts on the sexual lives of adult women with mental disabilities. I consider the discourses of vulnerability that surround the different legal regimes and whether the emerging theoretical vulnerability literature can assist in developing more nuanced legal responses. I argue that the inherent jurisdiction and Care Act 2014 provide an opportunity to move away from the focus (...) on inherent features of vulnerability such as mental disability towards a more nuanced, situational and embodied account of what it means to safeguard ‘vulnerable adults’. This has the potential to be developed in England through the new legal framework of the Care Act and can be achieved through targeting interventions against the situational causes of vulnerability, for example the perpetrators of sexual violence. (shrink)

The negative impacts of social media have given rise to philosophical questions around whether social media companies have the authority to regulate user-generated content on their platforms. The most popular justification for that authority is to appeal to private ownership rights. Social media companies own their platforms, and their ownership comes with various rights that ground their authority to moderate user-generated content on their platforms. However, we argue that ownership rights can be limited when their exercise results in significant harms (...) to others or the perpetration of injustices. We outline some of the substantive harms that social media platforms inflict through their practices of content moderation and some of the procedural injustices that arise through their arbitrary application of community guidelines. This provides a normative basis for calls to better regulate user-generated content on social media platforms. We conclude by considering some of the political and legal implications of our argument. (shrink)

Wearable robots and exoskeletons are relatively new technologies designed for assisting and augmenting human motor functions. Due to their different possible design applications and their intimate connection to the human body, they come with specific ethical, legal, and social issues, which have not been much explored in the recent ELS literature. This paper draws on expert consultations and a literature review to provide a taxonomy of the most important ethical, legal, and social issues of wearable robots. These issues are categorized (...) in wearable robots and the self, wearable robots and the other, and wearable robots in society. (shrink)

This paper is the introduction to a collection I guest-edited called Positive Duties to Wild Animals. The collection contains single-authored contributions from Catia Faria, Josh Milburn, Eze Paez, and Jeff Sebo; and co-authored contributions from Mara-Daria Cojocaru and Alasdair Cochrane, and Oscar Horta and Dayrón Terán. It was published as a special issue of Ethics, Policy and Environment.

This article explores how ethical agency, as ‘other-oriented’ caring, emerged from feelings of being ‘different’ in a cultural organization by drawing on feminist ethics of care. By analyzing interview material from an ethnographic study, we centralize the relationship between feelings of being ‘different,’ vulnerability and the development of sensibilities, practices and imaginaries of care. We elaborate on how vulnerability serves as a ground for caring with rather than for others, and illustrate how it allowed individuals to challenge both organizational, normative (...) diversity discourses and essentialization of differences. We contribute to the literature on critical diversity management by furthering problematizations of instrumental diversity management from the perspective of care, and to the organizational literature on feminist care ethics by empirically exploring how ethical agency emerges from tensions related to feeling ‘different.’ While previous studies have shown how marginalized individuals use their sense of ‘otherness’ to negotiate, conform to and resist organizational norms, practices and discourses, we provide further insights on how it also can drive concern and care for others, and thus serve as possible ground for ethical change initiatives within organizations. (shrink)

Persuasive technologies for health‐related behaviour change give rise to ethical concerns. As of yet, no study has explicitly attended to ethical concerns arising with the design and use of these technologies for vulnerable people. This is striking because these technologies are designed to help people change their attitudes or behaviours, which is particularly valuable for vulnerable people. Vulnerability is a complex concept that is both an ontological condition of our humanity and highly context‐specific. Using the Mackenzie, Rogers and Dodds’ taxonomy (...) of vulnerability, this paper identifies (a) the wrongs or harms to which a person is vulnerable, (b) the source of this vulnerability, and (c) the safeguards needed in response. Two ethical concerns with the design of persuasive technology for vulnerable people are discussed: the concerns of taking into account users' interests and their autonomy. (shrink)

This article introduces some contemporary philosophical approaches to vulnerability including that of Judith Butler, while focusing on feminist legal theorist Martha Albertson Fineman's concept of the vulnerable subject, developed out of Fineman's earlier critiques of the autonomous, self-sufficient subject of liberal political philosophy. It then looks closely at the different forms of vulnerability exhibited by the leading protagonists of Mia Hansen-Løve's All Is Forgiven, Father of My Children, Goodbye First Love, Eden and Maya, all of whom except one are men, (...) drawing on Lawrence Schehr's writing about French postmodern masculinities and work by Geneviève Sellier on the changing dynamics of heterosexual gender relations in French cinema in order to forge an account of vulnerable male bodies and masculinities appropriate to the contemporary context of the films discussed. To conclude, it returns to Fineman to suggest that her at least implicitly feminist concept of the vulnerable subject can offer a more persuasive account of the gendered character of vulnerability in Hansen-Løve's films than can Butler's recent ethical writings. (shrink)

When people argue, they are vulnerable to unwanted and costly changes in their beliefs. This vulnerability motivates the position that belief involuntarism makes argument inherently adversarial, as well as the development of alternatives to adversarial argumentation such as “invitational rhetoric”. The emphasis on involuntary belief change in such accounts, in our perspective, neglects three dimensions of arguing: the diversity of arguer intentions, audience agency, and the benefits of belief change. The complex impact of arguments on both audiences and arguers involves (...) vulnerabilities related to various forces of argument, not just the intellectual force of premise-conclusion complexes. Shifting emphasis from adversariality to vulnerability, we propose a more holistic understanding of argument, in which vulnerability reveals various sources of strength and opportunity in addition to risk. (shrink)

Little and colleagues’ paper describing a key aspect of cancer patients’ experience, that of “liminality,” is remarkable for giving articulation to a very common and yet mostly overlooked aspect of patient experience. Little et. al. offered a formulation of liminality that deliberately set aside the concept’s more common use in analysing social rituals, in order to grasp at the interior experience that arises when failing bodily function and awareness of mortality are forced into someone’s consciousness, as occurs with a diagnosis (...) of cancer. We set out the reasons as to why this analysis was so significant in 1998—but we also consider how the “liminality” described by Little and colleagues was a feature of modernity, founded on what we term “the mirage of settlement.” We argue that this mirage is impossible to sustain in 2022 amid the many forms of un-settling that have characterized late modernity, including climate change and COVID-19. We argue that many people in developed nations now experience liminality as a result of the being forced into the consciousness of living in a continued state of coloniality. We thus rejoin the social aspects of liminality to the interior, Existential form described by Little et. al. (shrink)

ABSTRACT This paper offers an account of institutional testimonial justice and describes one way that it breaks down, which we call institutional opacity. An institution is opaque when it becomes resistant to epistemic evaluation and understanding by its agents and users. When one cannot understand the inner workings of an institution, it becomes difficult to know how to comport oneself testimonially. We offer an account of an institutional ethos to explain what it means for an institution to be testimonially just; (...) we then describe how an ethos of institutional testimonial justice can break down when the institution becomes opaque. An opaque institution is especially problematic for individuals and groups already rendered epistemically vulnerable during their interactions with that institution, which we call epistemically vulnerabilised individuals. We articulate the features of an encounter between an epistemically vulnerabilised individual and an opaque institution. We end by tracing ameliorative strategies that could help repair a deteriorated institutional ethos of testimonial justice. (shrink)

In this article, I examine the legal position of those who perform caregiving work within the context of a cohabiting relationship through a novel relational vulnerability lens. I argue that the state, through privatising and devaluing caregiving labour, situates carers within an unequal and imbalanced relational framework, exposing them economic, emotional, and spatial harms. Unlike universal vulnerability, which is inherent and unavoidable, relational vulnerability can be avoided and reduced if the state were to acknowledge that humans are embodied and relational (...) rather than self-sufficient and rational. Law’s treatment of cohabiting carers reflects the state’s broader tendency to value economic self-sufficiency, while confining caregiving to the private family. I argue that the state has a duty to respond directly to relational vulnerability and should aim to make cohabiting carers resilient. Resilience must involve the provision of material resources but should also have a normative commitment to achieving autonomy and equality for those marginalised by law and state policies. (shrink)

What is the nature of evil action? My thesis is that perpetrators and victims of evil inhabit an asymmetrical relation of power; the strength of the more powerful party lies in its ability to exploit the other’s fundamental vulnerability, and the weaker party is vulnerable precisely insofar as it is directly dependent on the more powerful party for the satisfaction of its fundamental needs. The fundamental vulnerabilities that are exploited correspond to features essential to our humanity (ontological), moral personhood (personal), (...) and individuality (characteristic). These kinds of vulnerabilities are both constituted by and engender fundamental needs and give rise to direct dependencies on others to satisfy or to refrain from interfering with the satisfaction of fundamental needs. The unambiguous exploitation by the more powerful agent on whom the vulnerable directly depend is characteristic of evil action. Although I do not claim that the exploitation of ontological, personal, and characteristic vulnerabilities necessarily results in evil, it does typify it. (shrink)

In this paper, following the taxonomy developed by Mackenzie, Rogers and Dodds of different sources and states of vulnerability, I claim that wild animals are inherently and situationally vulnerable. This is because they can experience suffering as a response to certain internal and external states and have a high exposure to, and a low capacity to cope with, harmful natural processes. From this it follows that we have a moral obligation to support and assist individuals who are occurrently vulnerable and (...) to reduce the risk of dispositional vulnerabilities becoming occurrent in the future, by endorsing some form of what I call ‘environmental enhancement’. Finally, I pay critical attention to how to prevent interventions aimed at ameliorating vulnerability from paradoxically generating pathogenic vulnerabilities. (shrink)

As the COVID-19 crisis unfolded, older people in the Netherlands were framed as essentially vulnerable. In the public discourse, the figure of the “vulnerable senior” rose to unprecedented prominence. Taking a critical-phenomenological approach, we combine an empirical study with philosophical reflection, drawing on phenomenological and post-structuralist work on vulnerability and precarity to interpret quotes from daily newspapers and other media. This approach leads us to distinguish three forms of vulnerability: (1) vulnerability as discursive effect; (2) vulnerability as unrealizable; and (3) (...) vulnerability as creative appropriation. We conclude that the COVID-19 crisis has reinforced the entanglement of age and vulnerability and has led to novel social distinctions and labels. These labels harbor harmful stereotypes and are in constant need of critical evaluation. Still, the people who are affected by them are not passively dominated; rather, they exhibit a certain freedom in re-interpreting and challenging their situation. It is this attention to the entanglement of discourse and lived experience that situates our research in the broader field of critical phenomenology. (shrink)

The goal of this paper is to propose a relational turn in healthcare professionalism, to improve the responsiveness of both healthcare professionals and organizations towards care of patients, but also professionals. To this end, it is important to stress the way in which difficult situations and vulnerability faced by professionals can have an impact on their performance of work. This article pursue two objectives. First, I focus on understanding and making visible shared vulnerability that arises in clinical settings from a (...) triple perspective: patient and family, health professionals, and institutions. Second, to address this challenge for professionalism, in this paper I articulate the term "relational centered-patient professionalism", which has two main axes. The relational approach means taking into account how the relationships among professionals, patients and institutions determine the constitution and evolution of those professional values. The focus on patient centered care is indispensable, because it is the ultimate goal pursued by the development of these professional values, and must always be at the center. (shrink)

Phenomenological interviews with queer women in rural Nova Scotia reveal significant forms of trauma experienced during labour and birth. Situating the accounts of participants within both phenomenological and intersectional analyses reveals harms enabled by structurally embedded heteronormative and homophobic healthcare practices and policies. Our account illustrates the breadth and depth of harm experienced and outlines how these violate core ethical principles and values in healthcare.

Volume 19, Issue 9, September 2019, Page 39-41.

Book review of Rozmarin's Vulnerable Futures, Transformative Pasts (2017).

Being autonomous depends on the kind of relations we enjoy in the different domains of our lives, but the impact of decision-making and the power exercise that takes place in the political sphere, makes political relations crucial to our development and enjoyment of autonomy. This dissertation develops a novel view of political participation by interrogating its connection to our personal autonomy. According to this view, our political relations are partially constitutive of our personal autonomy, which in other words means there (...) is a political aspect of our autonomy. The kind of political relations we should hold to fully enjoy our autonomy is what I call Relations of Mutual Recognition. It is the mutual recognition of each agent’s autonomous standing—translated into a proper distribution of political power— that will face dominating political relations. The basis for that domination comes from our democracies’ power imbalances that condition influence over political decision-making to each individual’s economic, social or cultural standing. Consequently, there are political conditions for our autonomy to thrive. Relations of Mutual Recognition require two main conditions: non-domination and control. I take these two neo-republican ideals and redefine them to shape what a proper distribution of political power amounts to. Political participation comes in precisely to identify a way to challenge power imbalances. Therefore, my definition of political participation, which I call Collective Self-Government, requires a particular sort of implementation. Accordingly, I suggest a deliberative and inclusive arrangement that involves direct and innovative forms of decision-making, and more importantly, grants relevant shares of authority to all actors, i.e., common citizens, legislators, technocrats, etcetera. This project could rightly belong to both a relational approach to autonomy and be labelled as a version of deliberative democracy. However, relational accounts focus on our social relations, whilst I claim that we cannot be “less” or non-autonomous in the political sphere and still enjoy an autonomous life. Likewise, the participatory focus—in the sense of inclusion of all actors—of this proposal more accurately turn it into either a participatory version of deliberative democracy or a deliberative version of participatory democracy. (shrink)

Patient-centered care is now recognized as a clinical method and ideal model for patient – health professional relationships, and many definitions have influenced its evolution. Overall the patient-centered care literature has provided relatively little to define patient-centered care at the level of the patient-professional relationship. Additionally, patient-centered care lacks grounding in ethical theory. This thesis asserts that theoretical concepts from the ethics of care can provide a stronger conceptual basis for patient-centered care.This thesis begins with a critical interpretive review of (...) the patient-centered care literature, yielding 12 articles that previously introduced new theoretical and definitional work on patient-centered care and patient-centered communication. Six common themes and ideas were discovered, and include Engaging the Patient as a Whole Person, Recognizing and Responding to Emotions, Fostering a Therapeutic Alliance, Promoting an Exchange of Information, Sharing Decision Making, and Enabling Self-Management and Patient Navigation. These elements were then compared to key elements of the ethics of care. This thesis argues that feminists have good reason to consider care as a type of moral duty, and it describes how this duty functions. This thesis also argues that a duty to care is triggered when caregivers are presented with particular substantive forms of vulnerability. Specifically, this thesis argues that vulnerable subjects whose constitutive needs are at risk require particular moral obligations. The links between the ethics of care and patient-centered care are discussed, including how an ethics of care response ought to function in the health care context. Finally, the cases of J.J. and Makayla Sault, two aboriginal girls who refused chemotherapy in favour of traditional aboriginal healing practices, are analyzed. This thesis offers a short scoping review of the bioethics discourse surrounding these cases. A review of this discourse revealed several common themes, which included the peripheral importance of culture and history, the equating of best interests with survival, the supremacy of science-based medicine, and the impartial application of ethical principles. This thesis recommends that health care professionals apply an ethics of care approach to similar ethical dilemmas in the future, which involves shifting one's ethical focus to the central relationships of the case, understanding the unique perspective of the patient's narrative, and promoting a care-based rather than a justice-based approach to problem-solving. (shrink)

The aim of this dissertation is to critically investigate and problematize how museum exhibitions on Difficult Matters, like war and sexual violence, can be designed in order to contribute to teaching-learning relations between museum and visitor, which may transform existing perceptions of self, others, and the world and evoke a deepened sense of responsibility in the viewers, i.e. an ethical transformation.Based on a hermeneutic phenomenological approach the study takes three paths to shed light on the above. 1) Investigating literature on (...) museum studies on New Museology and Difficult Matters on the basis of which the research maps out current problems of understanding the pedagogical and ethical potentials. 2) From conducting case studies of two specific exhibitions to make an in-depth examination of designing exhibitions on Difficult Matters and how these are related to contextual conditions. 3) Investigating pedagogical theoretical literature inspired by the philosopher Emmanuel Levinas and literature in feminist philosophy on ethics of vulnerability all closely linked to the case studies, the study develops a conceptual basis for understanding the practice of designing exhibitions on Difficult Matters. A main finding is that designing exhibitions on Difficult Matters is related to the condition of vulnerability and this demands a pedagogical perspective sensitive to the ethical implications of exhibition making. This is because evoking ethical transformation is conditioned by a teaching-learning relation, which inspires openness on the part of the visitor to an encounter with the other and her/his life-story as being different from existing perceptions - an openness which is defined by vulnerability. As a result, vulnerability is at the heart of exhibitions on Difficult Matters.The overall conclusion to be drawn from the study is that vulnerability is a key concept in museum pedagogy and that vulnerability is an ambivalent potentiality which must be addressed from a double perspective on vulnerability as being inherent to the human condition and dependent on the particular situation. Consequently, vulnerability calls for pedagogical considerations and ethical attention from museum professionals, when designing exhibitions on Difficult Matters. (shrink)

In a series of reflections published in the wake of the Covid-19 crisis, Giorgio Agamben expresses a number of concerns related to the way the pandemic has altered the very fabric of our societies, potentially changing it forever. While maintaining a certain scepticism towards the threat represented by the virus itself, Agamben claims that the response to the contagion shows how easy it is for authorities to limit individual freedoms in the name of public health, and how readily they are (...) willing to put such limitations in place. At the same time, the pandemic shows how easy it is for individuals to accept this situation as the new normal, and how readily they are willing to give up their freedoms and relationships. In this paper I offer a brief overview of Agamben’s worries, focussing on two issues in particular: the loss of individual freedom of movement and association, and the moral and political implications of social distancing. I then approach these issues from a different angle, making use of relational theory to propose an alternative framework which relies on the notion of vulnerability. While agreeing with Agamben that there is reason to worry about the state seizing the opportunity to exercise unchecked power over its citizens, I argue that we should pay attention to the ways in which social distancing measures can be grounded in solidarity and respect for the autonomy of vulnerable individuals. (shrink)