Is it true that the suffering associated with chronic illness can be controlled in all but a few intractable cases? The bio-ethical literature gives the impression that suffering is primarily pain and that a competent physician should be able to control suffering. This perception jibes neither with my forty years of clinical experience nor with suffering as depicted in novels. Using Kenaz' novel,The Way to the Cats as a starting point, I argue that, with regard (...) to suffering and illness, fiction is closer to reality than professional literature, and suffering is far more than pain. I content that the control of suffering is a modern myth. This argument applies equally well to the control of non-insulin dependent diabetes. Patient selection, duration of follow-up, remembering what we want to remember, bias, self-fulfilled prophecy, and asking the wrong questions are offered as partial explanation for the gap between perception and reality. The complexity of suffering and the elusiveness of its control should be honestly recognized. (shrink)

Self-control is integral to successful human agency. Without it we cannot extend our agency across time and secure central social, moral, and personal goods. But self-control is not a unitary capacity. In the first part of this paper we provide a taxonomy of self-control and trace its connections to agency and the self. In part two, we turn our attention to the external conditions that support successful agency and the exercise of self-control. We argue that what (...) we call moral security is a critical foundation for agency. Parts three and four explore what happens to agency when moral security is lacking, as in the case of those subject to racism, and those living in poverty. The disadvantages suffered by those who are poor, in a racial minority or other oppressed group, or suffering mental illness or addiction, are often attributed to a lack of individual self-control or personal responsibility. In particular, members of these groups are often seen as irresponsibly focused on short-term pleasures over long-term good, a view underwritten by particular psychological theories of self-control. We explore how narratives about racism and poverty undermine moral security, and limit and distort the possibility of synchronic and diachronic self-control. Where moral security is undermined, the connection between self-control and diachronic goods often fails to obtain and agency contracts accordingly. We close with some preliminary reflections on the implications for responsibility. (shrink)

Dr Anne Merriman is the founder of Hospice Africa and Hospice Africa Uganda. She is presently Director of Policy and International Programmes. Here she tells the story of how HAU was founded. Dr Richard Harding is an academic researcher working on palliative care in Sub-Saharan Africa. This paper described Dr Merriman's experience in pioneering palliative care provision. In particular it examines the steps to achieving wider availability of opioids for pain management for those with far advanced disease. Hospice Africa Uganda (...) has been a model facility in achieving high quality clinical care embedded in a strategy of advocacy and education, using a multifaceted approach that has addressed logistical, policy and legislative barriers. Until 1990 control of severe pain in Sub-Saharan Africa was non-existent except in Zimbabwe and S Africa. Oral affordable morphine was brought to Kenya through Nairobi Hospice that year, and to Uganda through Hospice Africa Uganda in 1993. This paper offers an example of a highly effective and cost efficient model of care that has transformed the ability to humanely manage the problems of those with terminal illness, and to offer a culturally appropriate. (shrink)

Abstract:The specialty of psychiatry has a long-standing, virtually monolithic view that a desire to die, even a desire for a hastened death among the terminally ill, is a manifestation of mental illness. Recently, psychiatry has made significant inroads into hospice and palliative care, and in doing so brings with it the conviction that dying patients who seek to end their suffering by asserting control over the time and manner of their inevitable death should be provided with psychotherapeutic measures (...) rather than having their expressed wishes respected as though their desire for an earlier death were the rational choice of someone with decisional capacity. This article reviews and critiques this approach from the perspective of recent clinical data indicating that patients who secure and utilize a lethal prescription are generally exercising an autonomous choice unencumbered by clinical depression or other forms of incapacitating mental illness. (shrink)

Dissociative Identity Disorder (DID) (formerly known as Multiple Personality Disorder) is a condition in which a person appears to possess more than one personality, and sometimes very many. Some recent criminal cases involving defendants with DID have resulted in "not guilty" verdicts, though the defense is not always successful in this regard. Walter Sinnott-Armstrong and Stephen Behnke have argued that we should excuse DID sufferers from responsibility, only if at the time of the act the person was insane (typically delusional); (...) otherwise the presumption should be that persons with DID are indeed responsible for their actions. We find their interpretation of DID and of the way in which the requirements for criminal insanity relate to this condition worrying and likely to result in injustice to DID sufferers. Our thesis is that persons with DID cannot be responsible for their actions if the usual features of the condition are present. A person with DID is a single person in the grip of a very serious mental disorder. By focusing on the features of DID which have, as we argue, the effect of deluding the patient, we try to show that such a person is unable to fulfill the ordinary conditions of responsible agency (namely, autonomy and self-control). (shrink)

Philosophers and cognitive scientists alike have recently been interested in whether cognition extends beyond the boundaries of skin and skull and into the environment. However, the extended cognition hypothesis has suffered many objections over the past few decades. In this paper, I explore the option of control extending beyond the human boundary. My aim is to convince the reader of three things: (i) that control can be implemented in artifacts, (ii) that humans and artifacts can form extended (...) class='Hi'>control systems, and (iii) that perhaps extended control ought to be preferred over extended cognition. Using the objections to extended cognition as constraints on my own extended theorizing and the example of autofocus systems in cameras, I decompose and localize the components of an autofocus system that realize the central properties of control from a plausible theory of control in the literature. I then provide criteria according to which control can be extended in a system. Finally, I consider how this theory of extended control ought to be preferred to theories of extended cognition. (shrink)

Background How often does refractory suffering, which is suffering due to symptoms that cannot be adequately controlled, occur at the end of life in modern palliative care? What are the causes of such refractory suffering? Should euthanasia be offered for refractory suffering at the end of life? We sought to shed light on these questions through interviews with palliative care specialists. Methods Semi-structured interviews with six nurses and six doctors working in palliative care in five Norwegian (...) hospitals. Transcripts were analysed with systematic text condensation, a qualitative analysis framework. Results Informants find that refractory suffering is rare, and that with palliative sedation satisfactory symptom control can nearly always be achieved at the end of life. However, the process of reaching adequate symptom control can be protracted, and there can be significant suffering in the meantime. Both somatic, psychological, social and existential factors can contribute to refractory suffering and potentiate each other. However, informants also place significant weight on factors pertaining to the organization of palliative care services as contributing to insufficient symptom control. Conclusions If refractory suffering is indeed rare, then this arguably weakens a common prima facie argument for the legalization of assisted dying. However, the process of reaching adequate symptom control can be protracted and involve significant suffering. The experiences of palliative care clinicians constitute important empirical premises for the assisted dying debate. The study points to several areas in which palliative care can be improved. (shrink)

This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)

Although dual-process or divided-mind models of self-control dominate the literature, they suffer from empirical and conceptual challenges. We propose an alternative approach, suggesting that self-control can be characterized by a fragmented part versus integrated whole dynamic. Whereas responses to events derived from fragmented parts of the mind undermine self-control, responses to events derived from integrated wholes enhance self-control. We review empirical evidence from psychology and related disciplines that support this model. We, moreover, discuss the implications of (...) this work for psychology, neuroscience, economics, and philosophy. In particular, we highlight how this model addresses many of the conceptual and empirical short-comings of divided-mind models. We suggest that understanding self-control as the interplay between fragmented parts versus integrated wholes, moreover, provides novel insights and testable new hypotheses. (shrink)

The suffering of non-human animals is great and omnipresent. This is because animals are vulnerable to disease, disfigurement, injury, predation, age-related physical decline and death, and—today—it is also because human beings are subjecting animals to unprecedented violence in two different domains. Human activities and their byproducts are devastating wild animal habitats at such a fantastic rate that we are obliged to speak of a “sixth mass extinction”, and, while the crisis is typically measured in terms of the loss of (...) entire species, it plays itself out concretely on the bodies ofindividuals. At the same time, industrialized societies now objectify and “process” animals on a massive scale in a variety of settings, for instance—to mention but the numerically most significant—in CAFOs, industrial slaughterhouses and aquafarms, where each year the whole lifecycles of hundreds of billions of land and sea creatures are controlled without any consideration for their pain or terror except insofar as it threatens the economically efficient growth and harvesting of their edible tissues. How should we best respond to the awfulness, and the enormity, of animal suffering? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Suffering of Sexism:Buddhist Perspectives and ExperiencesRita M. GrossHaving been assigned the topic of suffering and sexism for this conference and celebration of Paul Knitter’s career and work, I feel qualified to address that topic. I have suffered a lot because of the work I have done on sexism, including a very diminished career. After nearly fifty years of demonstrating the presence of sexism in religious studies (...) and in Buddhism, and taking a lot of flak and criticism for bringing to light many things that many people simply don’t want to know, I would be delighted if such discussions were no longer needed. That, however, is not the case. So bringing together these two s-words—suffering and sexism—is very potent. The only effect of sexism is suffering. Forming identities and organizing society on the basis of male dominance have no redeeming benefits that offset the suffering.However, it is critical that we understand what is the real issue as we begin these reflections on suffering and sexism. I have long contended that, rather than trying to reform gender roles or discern what an ideal set of gender roles might be, the fundamental problem is the very existence of gender roles—any set of gender roles whatsoever. Does the shape of our genitals really predetermine our hearts, minds, longings, and abilities? Does it have anything to do with one’s ability to think theologically or to excel at spiritual disciplines? Gender roles severely and arbitrarily constrain people. That is the real suffering of sexism, and that, rather than male dominance, is the true problem. Male dominance is only one of the more unfortunate results of the constraint of arbitrary and binding gender roles. Thus, the suffering of sexism needs to give way to freedom from the prison of gender roles.engaged buddhism (and christianity) and the suffering of sexismUnfortunately, the engaged Buddhist movement has been very slow to recognize that the suffering of sexism is something engaged Buddhists should care about, or even that is exists. Doubly unfortunately, many engaged Christians are no more likely to take up issues of gender justice very forcefully. It is not uncommon for books on [End Page 69] engaged Buddhism or Christianity to omit the topic altogether. If it is discussed at all, a single issue, such as bhikkshuni ordination in the Buddhist case, is often the only gender issue discussed, rather than the full topic of Buddhist androcentrism and patriarchy.It is very frustrating and disappointing when those who wax eloquent on economic and political justice are completely silent on sexism and gender justice. How can they possibly imagine there could be economic or political justice when women still lack political and economic equality because they lack both equal access to all culturally valued pursuits and to reproductive freedom? Yet many engaged Buddhists and Christians seem to see no contradiction at all between advocating for economic and political “justice” at that same time as they advocate against women’s religious equality and reproductive freedom. Even if they don’t advocate against things that are essential for women, they are often silent on those issues.It’s very easy to criticize the IMF, the World Bank, or US foreign policy, things that we Buddhists don’t and can’t control, things that even Christians can’t control. But we do control our own religious institutions, whether Buddhist or Christian. So why don’t engaged Buddhists and Christians even discuss Buddhist and Christian sexism and patriarchy? We could change those institutions in a heartbeat, if we chose to do so. Why don’t we? I challenge engaged Buddhists and Christians to become much more aware of the suffering of sexism and much more serious about ending it in Buddhist and in Christian institutions.received generalities regarding buddhism and genderIf one looks at the world’s various Buddhisms, especially in Asia, superficially less so in the Western world, it would be impossible to avoid the conclusion that Buddhism is seriously infected with the sexism of male dominance. All the leaders and most of the teachers are men. Male monastics are well supported, while female monastics barely survive. Lack... (shrink)

Pest control operations andexperimentation on sentient animals such as thebrushtail possum can cause unnecessary andavoidable suffering in the animal subjects.Minimizing animal suffering is an animalwelfare goal and can be used as a guide in thedesign and execution of animal experimentationand pest control operations.The public has little sympathy for the possum,which can cause widespread environmentaldamage, but does believe that control should beas painless as possible. Trapping and poisoningprovide only short-term solutions to the possumproblem and often involve (...) methods that causesuffering. Intrusive experiments connected withthese methods of control and published in thelast 6 years are reviewed. Many of theexperiments do not attain the welfare standardsrequired by members of the public. (shrink)

Although popular, control accounts of privacy suffer from various counterexamples. In this article, it is argued that two such counterexamples—while individually resolvable—can be combined to yield a dilemma for control accounts of privacy. Furthermore, it is argued that it is implausible that control accounts of privacy can defend against this dilemma. Thus, it is concluded that we ought not define privacy in terms of control. Lastly, it is argued that since the concept of privacy is the (...) object of the right to privacy if the former cannot be defined in terms of control, neither can the latter. (shrink)

Inasmuch as unmitigated pain and suffering areoften thought to rob human beings of theirdignity, physicians and other care providersincur a special duty to relieve pain andsuffering when they encounter it. When pain andsuffering cannot be controlled it is sometimesthought that human dignity is compromised.Death, it is sometimes argued, would bepreferred to a life without dignity.Reasoning such as this trades on certainpreconceptions of the nature of pain andsuffering, and of their relationships todignity. The purpose of this paper is to laybare (...) these preconceptions. The duties torelieve pain and suffering are clearly mattersof moral obligation, as is the duty to respondappropriately to the dignity of other persons.However, it is argued that our understanding ofthe phenomena of pain and suffering and theirrelationships to human dignity will be expandedwhen we explore the aesthetic dimensions ofthese various concepts. On the view presentedhere the life worth living is both morally goodand aesthetically beautiful. Appropriate``suffering with'''' another can help to maintainand restore the dignity of the relationshipsinvolved, even as it preserves and enhances thedignity of patient and caregiver alike. (shrink)

The current Ebola virus epidemic in Western Africa appears to be spiraling out of control. The worst-case projections suggested that the unchecked spread could result in almost 1.4 million cases by the end of January 2015 with a case fatality rate of at least 50%. The United States and European nations have begun to respond in earnest with promises of supplies, isolation beds, and trained health care personnel in an effort to contain the epidemic and care for the sick. (...) However, there is neither a vaccine nor specific treatment for Ebola infection, and therapy is ideally centered on supportive care. I have previously argued that the provision of palliative care is obligatory during an overwhelming health catastrophe, notably pandemic influenza. Since affected Ebola patients have best outcomes with technologically advanced intensive care—resources in scarce supply in the area—I suggest that the only acceptable approach to large numbers of very sick, dying, and suffering Ebola patients who overwhelm the reso.. (shrink)

Up to now neither the question, whether all theoretical medical knowledge can at least be described as scientific, nor the one how exactly access to the existing scientific and theoretical medical knowledge during clinical problem-solving is made, has been sufficiently answered. Scientific theories play an important role in controlling clinical practice and improving the quality of clinical care in modern medicine on the one hand, and making it vindicable on the other. Therefore, the vagueness of unexplicit interrelations between medicine''s stock (...) of knowledge and medical practice appears as a gap in the theoretical concept of modern medicine which can be described as Hiatus theoreticus in the anatomy of medicine. A central intention of the paper is to analyze the role of philosophy of medicine for the clarification of the theoretical basis of medical practice. Clinical relevance and normativity in the sense of modern theory of science are suggested as criteria to establish a differentiation between philosophy of medicine as a primary medical discipline and the application of general philosophy in medicine. (shrink)

There is growing evidence that dopamine replacement therapy (DRT) used to treat Parkinson’s Disease can cause compulsive behaviours and impulse control disorders (ICDs), such as pathological gambling, compulsive buying and hypersexuality. Like more familiar drug-based forms of addiction, these iatrogenic disorders can cause significant harm and distress for sufferers and their families. In some cases, people treated with DRT have lost their homes and businesses, or have been prosecuted for criminal sexual behaviours. In this article we first examine the (...) evidence that these disorders are caused by DRT. If it is accepted that DRT cause compulsive or addictive behaviours in a significant minority of individuals, then the following ethical and clinical questions arise: Under what circumstances is it ethical to prescribe a medication that may induce harmful compulsive behaviours? Are individuals treated with DRT morally responsible and hence culpable for harmful or criminal behaviour related to their medication? We conclude with some observations of the relevance of DRT-induced ICDs for our understanding of addiction and identify some promising directions for future research and ethical analysis. (shrink)

This abstract presents a novel brain-computer interface (BCI) framework to control a prosthetic leg, for the rehabilitation of patients suffering from locomotive disorders, using functional near-infrared spectroscopy (fNIRS). fNIRS signals corresponding to walking intention and rest are used to initiate and stop the gait cycle and a nonlinear proportional derivative computed torque controller (PD-CTC) with gravity compensation is used to control torques of hip and knee joints for minimization of position error. The brain signals of walking intention (...) and rest tasks are acquired from primary motor cortex in the left hemisphere for nine subjects. After acquiring brain signals, in order to remove motion artifacts and physiological noises, the performance of six different filters i.e. Kalman, Wiener, Gaussian, hemodynamic response filter (hrf), Band-pass and finite impulse response, is evaluated. Afterwards, six different features are extracted from oxygenated hemoglobin signals and their different combinations were used for classification. The classification performance of five different classifiers i.e. artificial neural network, quadratic discriminant analysis, linear discriminant analysis (LDA), Naïve Bayes and support vector machine (SVM) is used. The classification accuracies obtained from SVM using hrf filter are significantly higher (p < 0.005) than the other combinations of classifier and filters. These accuracies are 77.5%, 72.5%, 68.3%, 74.2%, 73.3%, 80.8%, 65%, 76.7%, and 86.7% for all nine subjects. The control commands generated using classifier initiate and stop the gait cycle of the prosthetic leg whose knee and hip torques are controlled using PD-CTC to minimize position error. The proposed scheme can be effectively used for neurofeedback training and rehabilitation of lower limb amputation of paralyzed patients. (shrink)

Human cognition and action are intentional and goal-directed, and explaining how they are controlled is one of the most important tasks of the cognitive sciences. After half a century of benign neglect this task is enjoying increased attention. Unfortunately, however, current theorizing about control in general, and the role of consciousness for/in control in particular, suffers from major conceptual flaws that lead to confusion regarding the following distinctions: automatic and unintentional processes, exogenous control and disturbance of endogenous (...) control, conscious control and conscious access to control, and personal and systems levels of analysis and explanation. Only if these flaws are overcome will a comprehensive understanding of the relationship between consciousness and control emerge. (shrink)

There is a massive amount of severe suffering and death in the world, and much of this suffering and death is out of our control. The amount and severity of suffering and death in the world can be used to make an argument for (or elicit a reaction against) the existence of God: if God—an all-powerful, all-knowing, and all-good being—exists, God would not allow such massive amounts of suffering and death. I'll propose a line of (...) response that begins by exploring what would be involved in taking a new perspective on the suffering and death in the world. I then argue that there is no good reason not to take that new perspective. If this is correct, the argument from (or reaction to) suffering and death to the conclusion that God doesn't exist has lost much of its force; an argument that seems forceful from one perspective is weak from a different perspective that is just as reasonable, or more reasonable, to take. (shrink)

Pest control operations andexperimentation on sentient animals such as thebrushtail possum can cause unnecessary andavoidable suffering in the animal subjects.Minimizing animal suffering is an animalwelfare goal and can be used as a guide in thedesign and execution of animal experimentationand pest control operations.The public has little sympathy for the possum,which can cause widespread environmentaldamage, but does believe that control should beas painless as possible. Trapping and poisoningprovide only short-term solutions to the possumproblem and often involve (...) methods that causesuffering. Intrusive experiments connected withthese methods of control and published in thelast 6 years are reviewed. Many of theexperiments do not attain the welfare standardsrequired by members of the public.Possums also act as vectors for bovinetuberculosis. While this is not as important inthe minds of the public as environmentaldegradation, as long as people wish to continueraising cattle, this disease needs to becontrolled.Immunocontraception is a humane means ofcontrolling possums with wide publicacceptance. The use of vaccines for cows and/orpossums would also cause far less sufferingthan present eradication operations. Researchinto these methods does require some intrusiveexperimentation. This can be reduced if liveanimals are not used for secondary antibodyharvesting, if adequate analgesia is provided,and if potential vaccines or contraceptives aretested under conditions that would beexperienced in the field. (shrink)

According to the traditional Western concept of freedom, the ability to exercise free will depends on the availability of options and the possibility to consciously decide which one to choose. Since neuroscientific research increasingly shows the limits of what we in fact consciously control, it seems that our belief in free will and hence in personal autonomy is in trouble. -/- A closer look at the phenomenology of Obsessive-Compulsive Disorder (OCD) gives us reason to doubt the traditional concept of (...) freedom in terms of conscious control. Patients suffering from OCD experience themselves as unfree. The question is whether their lack of freedom is due to a lack of will power. Do they have too little conscious control over their thoughts and actions? Or could it be the opposite: are they exerting too much conscious control over their thoughts and actions? -/- In this chapter, we will argue that OCD patients testify to the general condition that exercising an increased conscious control over actions can in fact diminish the sense of agency rather than increase the experience of freedom. The experiences of these patients show that the traditional conception of freedom in terms of ‘free will’ has major shortcomings. There is an alternative, however, to be found in the work of Hannah Arendt. She advocates a conception of freedom as freedom in action. Combined with phenomenological insights on action, Arendt’s account of freedom helps us to get a more adequate understanding of the role of deliberation in the experience of freedom. We argue that the experience of freedom depends on the right balance between deliberate control and unreflective actions. (shrink)

Teresa of Avila's desire for suffering cannot be interpreted as the mere passive assumption of a feminine sacrificial role. On the contrary, Teresa was able to transform her suffering into the incarnated performance of her relationship with God: By desiring suffering and by understanding it and her ability to confront it as proof of divine love, she was able to reinforce her self‐confidence and strength. This article discusses Teresa of Avila's experience and interpretation of suffering in (...) the context of the female ascetic‐mystic Christian tradition. It criticizes Teresa's positive conceptualization of suffering but examines in depth the potential of her ability to actively manage and control it. Although Teresa was able to affirm her personality through ascetic practices such as self‐humiliation and mortification, the general applicability of such practices to the management of suffering is fraught since they leave the suffering individual in a vulnerable position. Although Teresa of Avila finds fulfillment and, paradoxically, self‐actualization through self‐denial and the surrender of her will, such practices entail the substantial risk of total self‐annihilation. (shrink)

After drug and weapon trafficking, trafficking of women is one of the most lucrative businesses in the world. According to sociologists César Rey Hernández and Luisa Hernández Angueira in People Trafficking in Puerto Rico: The Challenge of Invisibility (2010), fifty percent of the victims are women and minors. This translates to 2.7 million women and girls that are enslaved in this inhuman business. Puerto Rico is no exception. One of its main problems is the slavery of Dominican women who, in (...) search of a better life in Puerto Rico, are lured to illegally migrate to the island for better opportunities. However, once in the new territory, they are imprisoned and forced to become prostitutes. In addition, femicide is another world-wide pressing issue. The World Health Organization (WHO) affirms that violence against women, between fifteen and forty-four years of age, is the leading cause of death, more than cancer, malaria, car accidents and war combined, and the report ‘A Gendered Analysis of Violent Death’, compiled by Small Arms Survey Center, fourteen out of twenty-five countries with the highest rates of femicide in the world are in Latin America and the Caribbean. This essay focuses on Life is a Sexually Transmittable Disease (2014) by Wilfredo Mattos Cintron. In this novel, the enslaved-immigrant girls and women constitute an ‘injured body’, a body that is merely diminished. The third-world prostitute’s body is the material side of male-controlled dominance, subjugation and violence. Mattos Cintron’s text denounces the ‘suffering body of women’—rape, kidnapping, beating, femicide, their exclusion from human rights and sexual relegation. Moreover, along with patriarchy’s power and the socioeconomic variables as responsible agents of creating the injured body, globalization and capitalism objectify and make women’s bodies currency of the system. (shrink)

Unstable Accumulating Activator models for cellular size control propose an activator that accumulates in a size-dependent manner and triggers cell cycle progression once it has reached a certain threshold. Having a short half life makes such an activator responsive to changes in cell size and makes specific predictions for how cells respond to perturbation. In particular, it explains the curious phenomenon of excess mitotic delay. Excess mitotic delay, first observed in Tetrahymena in the '50s, is a phenomenon in which (...) a pulse of protein synthesis inhibition causes a delay in mitotic entry that is longer than the pulse and that gets longer the later in the cell cycle the pulse is delivered. The interpretation of this phenomenon championed by Zeuthen and Mitchison in the '60s and '70s is that an unstable activator of mitosis is degraded during the pulse and has to be resynthesized to a threshold level to trigger mitosis; small cells have more time to resynthesize the activator before mitosis and so suffer less excess delay, whereas, large cells have less time thus suffer greater excess delay. Fifty years later, with our detailed understanding of cell cycle biochemistry, we can identify and test candidate Unstable Accumulating Activators. Here I review the field and further develop this concept. Excess mitotic delay, the phenomenon in which inhibition of protein synthesis causes a longer delay than the pulse of inhibition, is consistent with cell size control by an unstable accumulating activator, but not a stable activator. (shrink)

This paper draws on research exploring how men narrate their long-term experiences of Weight Loss Surgery [WLS] and is specifically focused on findings relating to male embodiment. Whilst there is concern about increasing obesity and the possible role of bariatric [WLS] surgery in ameliorating this, there has been little research to date exploring men’s longer-term experiences of this. For the purposes of the present study, interviews were conducted with five men who had undergone bariatric surgery at least four years previously. (...) The transcribed interviews were subjected to narrative analysis with the additional incorporation of Watson’s “male body schema” into this process in order to facilitate focus on the embodied nature of the storied accounts obtained. The findings suggested two seemingly contrasting storylines: “ongoing struggles” and “success”. Struggles related mainly to control over eating habits and the visceral challenges of long-term side effects following surgery. Despite these struggles, the men ultimately presented an overriding storyline of embodied “success” in how the surgery had assisted them to live more normatively male lives. Importantly, narratives around struggles were presented as more private stories in contrast to the public emphasis on success. The silencing dynamic implicit in this suggests the likelihood that other men encountering similar experiences would be reticent to reveal their struggles, thereby perpetuating their suffering and leaving popular obesity and weight loss narratives unchallenged. (shrink)

It is generally agreed that organisms are Complex Adaptive Systems. Since the rise of Cybernetics in the middle of the last century ideas from information theory and control theory have been applied to the adaptations of biological organisms in order to explain how they work. This does not, however, explain functionality, which is widely but not universally attributed to biological systems. There are two approaches to functionality, one based on etiology (what a trait was selected for), and the other (...) based in autonomy. I argue that the etiological approach, as understood in terms of control theory, suffers from a problem of symmetry, by which function can equally well be placed in the environment as in the organism. Focusing on the autonomy view, I note that it can be understood to some degree in terms of control theory in its version called second order cybernetics. I present an approach to second order cybernetics that seems plausible for organisms with limited computational power, due to Hooker, Penfold and Evans. They hold that this approach gives something like concepts, certainly abstractions from specific situations, a trait required for functionality in its system adaptive form (i.e., control of the system by itself). Using this cue, I argue that biosemiotics provides the methodology to incorporate these quasi concepts into an account of functionality. (shrink)

This paper examines the creation and use of names that refer to a mass violence in Indonesia that occurred in May 1998 in several cities. The media has dubbed the event the May 1998 riots. Alternative names have been widely used and each represents either a different portrayal of the event or social political stance towards the event. Using discourse analysis, this paper will demonstrate how the choice of names affects presentation of the event, recognition of what actually happened and (...) the identification of parties involved, both the perpetrator and the victim. The labels assigned by the media to the event serve to promote certain points of view, shape social narrative and influence readers’ understanding of political violence. This paper found that the use of May 1998 as the token has blurred the nature of the event that is arguably politically motivated and downplayed the violence suffered by a particular group targeted during the riots. Abstrak Tulisan ini meneliti penggunaan nama untuk peristiwa kekerasan massa di Indonesia yang terjadi pada bulan Mei 1998 di beberapa kota. Media massa pada umumnya menggunakan nama Kerusuhan Mei 1998 untuk merujuk pada peristiwa tersebut. Beberapa nama alternatif juga dipergunakan secara luas dan masing-masing nama merepresentasikan gambaran atau pandangan sosial politis yang berbeda terhadap peristiwa tersebut. Penulis akan menggunakan analisa diskursus untuk menunjukkan bagaimana penamaan berpengaruhterhadap presentasi peristiwa, pengakuan atas apa yang terjadi dan pengidentifi kasian pihak-pihak yang terlibat, baik sebagai pelaku maupun korban. Label yang diberikan oleh media massa terhadap peristiwa tersebut berperan dalam membentuk narasi sosial dan mempengaruhi pemahaman pembaca akan kejadian tersebut. Tulisan ini menemukan bahwa penggunaan Mei 1998 sebagai penanda pada penamaan telah mengaburkan peristiwa yang dilatarbelakangi unsur politis tersebut dan juga menyampingkan kekerasan yang dialami oleh kelompok tertentu selama kerusuhan. (shrink)

Since the era of deinstitutionalisation, many clinical approaches have emerged to enable the care and treatment of people suffering from mental illness. In recent years, the use of coercive approaches in the community (e.g., outpatient commitment or community treatment orders) has also increased internationally. Although nurses' role regarding these coercive approaches is central and significant, few empirical and theoretical writings have tackled this controversial nursing practice. The purpose of this paper is to analyse coercive nursing care through the lens (...) of French philosopher Gilles Deleuze's concept of ‘societies of control’. Taking up Michel Foucault's work on disciplinary power, Deleuze explores how the move from the striated spaces of closed institutions to the smooth spaces of societies of control took place since the middle of the 20th century. According to Deleuze, the overall objective of ‘societies of control’ is no longer simply to govern deviant behaviour in closed environments (e.g., psychiatric hospitals and prisons) but to ensure a regime of unrelentless surveillance in the open spaces of our communities. (shrink)

This paper addresses the rift between the teacher’s sense of self as a causal agent and the experience of being in lack of control in the classroom, by way of Hans Vaihinger’s philosophy of ‘as if.’ It is argued that understanding agential control in terms of a valuable educational fiction—a practical (ethical) fiction in Vaihinger’s vocabulary—can offer a way of bridging this rift and can help teachers make sense of the tension between their felt need to strive for (...) control and their experience of suffering from lack of control. A fiction, it is argued, is different from an illusion in that fictions can be affirmed without being believed. Unlike illusions, valuable fictions can be recognized as fictions and still retain some of their affective power over us, thereby allowing us to act ‘as if.’ In education, this is helpful as it means that we can make use of valuable fictions without assuming that these have to be protected from the critical gaze of non-believers. In fact, we can openly acknowledge that we rely on fictions as this is part and parcel of being a human being with a limited cognitive ability. (shrink)

The Indian philosophers lay emphasis on mind-control. Mind-control is not only negative practice. For, we are not only required to check and curb our evil tendencies but also employ them for a better purpose. The lower constituents of human beings can not be annihilated but can only be tamed and reformed. Cessation of bad tendencies is coupled with cultivation of good tendencies and is followed by good actions. According to Jainism & Buddhism, the path of liberation from sufferings (...) starts with mind-control. The Jainas emphasize on right faith, right knowledge and right conduct which are regarded as Triratnas, three Jewels. Right conduct consists in abstinence from injury, falsehood, stealing, self-indulgence and attachment. According to Buddhism, way to Nirvan (cessation from suffering) consists in eight-fold path which is nothing but self-control. It starts from right views, right determination and right speech and proceeds through right conduct to right livelihood to right effort and to right mindfulness. This process of self-control finally culminates in right concentration. The Upanishadic thinkers and the systems based on Upanishadic traditions have also recognised the importance of self-control. In view of the importance of mind-control in familial, social, moral and spiritual lives we should consistently and constantly make endeavour to practice mind-control and should fight despondency with enthusiasm in the event of some initial failures. (shrink)

This paper makes the case for using the independent non-executive directors of a company listed in the United Kingdom exclusively as monitors and regulators of management, particularly as regulators of executive directors’ conflicts of interest, rather than as participants in management who also have a control function. It is suggested that these proposals can be accommodated within current corporate law in the United Kingdom, that they are practicable, and that they are desirable. The proposals are made against the background (...) of a continued strong emphasis in the United Kingdom on non-executive directors’ dual role both as managers of a company’s business and as monitors of its executive directors. It is suggested that this dual role for non-executive directors tends significantly to undermine the effectiveness of their control function, and that consequently the dual role should be abandoned in favor of the more focused role proposed in the paper. Improving the effectiveness of non-executive directors as regulators of executive directors’ conflicts of interest is vitally important to corporate governance in the United Kingdom: as the paper explains, other legal methods of controlling those conflicts in the United Kingdom suffer from serious deficiencies. (shrink)

Offender populations experience their incarceration through different lenses and often as a spiritual journey of suffering. During 2017 and 2018 a study was conducted by the authors with 30 men serving long-term sentences in Correctional Centre A, Zonderwater Management Area in the Gauteng province of South Africa. Following interviews and focus group sessions, the authors report on participants’ representations on how their constructed views of God assist them to find meaning in suffering while incarcerated. Narrative inquiry as a (...) philosophical framework was applied, which presupposes equality between the researcher and the participant, the unmediated representation of words as data, the researcher as auto-ethnographer and respectful submission to subjectivity. Participants’ views of God are thematised according to sets of God-images, firstly, as identified by Van der Ven in his book God Reinvented?, adapted by the authors to suit the contents of the participants’ God talk. Secondly, the ‘God-images in Africa’ were applied. The participants’ constructed God-images are divided into two categories: images that feed on the binary between divine and human and images that function in the dialogical spaces between divine and human where the incarcerated have internalised an external God. Binary images of God are presented by the apathetic God, retributive God, controlling God and the purifying God. However, a significant number of participants expressed their belief in God through the dialogical image of the compassionate God, and the suffering God as co-sufferer. The role of Africanness in constructing these God-images constitutes a special point of inquiry in this article, as reflected in the images of God defined by God the Great Ancestor and Divine Spirit, and God with whom a mystical union is formed. (shrink)

There is ongoing ethical and legal debate about withdrawing life sup- port for patients with disorders of consciousness (DOCs). Frequently fu- eling the debate are implicit assumptions about the value of life in a state of impaired consciousness, and persistent uncertainty about the quality of life (QoL) of these persons. Yet there are no validated methods for assessing QoL in this population, and a significant obstacle to doing so is their inability to communicate. Recent neuroscientific discoveries might circumvent that problem (...) and help shed light on QoL in DOCs. There is an ethical imperative to prioritize QoL research in this patient population, to provide evidence to inform treatment, research, and end of life decisions. A minimalist and pragmatic model of QoL is proposed, targeting positive and negative affect as domains for which there is po- tential to reach across the communication gap, and restore to these voiceless persons some measure of control. (shrink)

Karl Marx's Capital is critique of the capitalistically organised social relations of reproduction. It recognises economic categories as perverted social categories and asks about the manner in which human social practice manifests itself in the form of independent economic categories and laws that unfold as if governed by invisible principles. He says, the capitalist relations are beyond human control and he argues that the indi-viduals act under economic compulsion and are controlled by the products of their own labour. His (...) critique says, in the capitalist social relations the individuals act as personification of economic categories. The immense wealth of capitalist society is abstract, it appears in the form of money as more money. In these wealth-relations, time is money, the satisfaction of human needs a mere sideshow. Yet, the economic categories are purely social forms. Critique of political economy is social critique of economic inversion, it is about the sheer unrest of live as the hidden misery of economic things. (shrink)

This paper addresses the rift between the teacher’s sense of self as a causal agent and the experience of being in lack of control in the classroom, by way of Hans Vaihinger’s philosophy of ‘as if.’ It is argued that understanding agential control in terms of a valuable educational fiction—a practical (ethical) fiction in Vaihinger’s vocabulary—can offer a way of bridging this rift and can help teachers make sense of the tension between their felt need to strive for (...) control and their experience of suffering from lack of control. A fiction, it is argued, is different from an illusion in that fictions can be affirmed without being believed. Unlike illusions, valuable fictions can be recognized as fictions and still retain some of their affective power over us, thereby allowing us to act ‘as if.’ In education, this is helpful as it means that we can make use of valuable fictions without assuming that these have to be protected from the critical gaze of non-believers. In fact, we can openly acknowledge that we rely on fictions as this is part and parcel of being a human being with a limited cognitive ability. (shrink)

Wegner and colleagues have offered an explanation of the sense of agency over one’s bodily actions. If the orthodox view is correct and there is a sense of agency deficit associated with delusions of alien control, then Wegner and colleagues’ model ought to extend to an explanation of this deficit. Data from intentional binding studies opens up the possibility that an abnormality in representing the timing of mental events leads to a violation of the principle of priority in those (...) suffering from delusions of alien control. However, the model ultimately fails as it is unable to accommodate action monitoring deficits associated with delusions of alien control, in particular the theory of mind deficiencies predicted by such accounts have not materialised. There are theory of mind problems associated with schizophrenia but they are not associated with delusions of alien control. Such accounts thereby fail to adequately explain delusions of alien control. (shrink)

"And God said, Let us make man in our image, after our likeness and let them have dominion over the fish of the sea, and over the fowl of the air, and over the cattle, and over all the earth, and over every creeping thing that creepeth upon the earth." --Genesis 1:24-26 In this crucial passage from the Old Testament, God grants mankind power over animals. But with this privilege comes the grave responsibility to respect life, to treat animals with (...) simple dignity and compassion. Somewhere along the way, something has gone wrong. In Dominion , we witness the annual convention of Safari Club International, an organization whose wealthier members will pay up to $20,000 to hunt an elephant, a lion or another animal, either abroad or in American "safari ranches," where the animals are fenced in pens. We attend the annual International Whaling Commission conference, where the skewed politics of the whaling industry come to light, and the focus is on developing more lethal, but not more merciful, methods of harvesting "living marine resources." And we visit a gargantuan American "factory farm," where animals are treated as mere product and raised in conditions of mass confinement, bred for passivity and bulk, inseminated and fed with machines, kept in tightly confined stalls for the entirety of their lives, and slaughtered in a way that maximizes profits and minimizes decency. Throughout Dominion , Scully counters the hypocritical arguments that attempt to excuse animal abuse: from those who argue that the Bible's message permits mankind to use animals as it pleases, to the hunter's argument that through hunting animal populations are controlled, to the popular and "scientifically proven" notions that animals cannot feel pain, experience no emotions, and are not conscious of their own lives. The result is eye opening, painful and infuriating, insightful and rewarding. Dominion is a plea for human benevolence and mercy, a scathing attack on those who would dismiss animal activists as mere sentimentalists, and a demand for reform from the government down to the individual. Matthew Scully has created a groundbreaking work, a book of lasting power and importance for all of us. (shrink)

The current Ebola virus epidemic in Western Africa appears to be spiraling out of control. The worst-case projections suggested that the unchecked spread could result in almost 1.4 million cases by the end of January 2015 with a case fatality rate of at least 50%. The United States and European nations have begun to respond in earnest with promises of supplies, isolation beds, and trained health care personnel in an effort to contain the epidemic and care for the sick. (...) However, there is neither a vaccine nor specific treatment for Ebola infection, and therapy is ideally centered on supportive care. I have previously argued that the provision of palliative care is obligatory during an overwhelming health catastrophe, notably pandemic influenza. Since affected Ebola patients have best outcomes with technologically advanced intensive care—resources in scarce supply in the area—I suggest that the only acceptable approach to large numbers of very sick, dying, and suffering Ebola patients who overwhelm the resources available to successfully manage them is effective palliative care. However, this could hasten death in this vulnerable population and hence, while ethically and medically justifiable, is not without social risk. (shrink)

In a laboratory on a university campus in Santa Cruz, California, Ben Novak is doing everything he can to bring Ectopistes migratorius back from the dead. Using techniques now available in genome reading and gene synthesis, he and paleogenomicist Beth Shapiro hope that, by 2032, a flock of passenger pigeons ten thousand or more strong will have resumed an ecologically significant role in the mast forests of the Eastern United States. Novak knows—and the International Union for Conservation of Nature (IUCN) (...) affirms—that the challenges involved in making de‐extinction work are far from solely genetic. Novak is doing an ecological risk assessment of passenger pigeon reintroduction to figure out whether flocks of the resurrected species would pose any special hazards to ecosystems. Ecological harm is one of several worries attending the prospect of de‐extinction. Among other concerns are the possible harm that individuals born through this process might suffer and the possible introduction of disease vectors. But I want to step back from these immediate questions and think about some conceptual ones that operate in the background. Technology can be a grand shaper of cultural norms and expectations, and de‐extinction should be looked at in relation to a number of emerging technologies. This paper will examine the degree to which de‐extinction is part of a more widespread restructuring of ethical relationships to the surrounding world that are under way at the hands of emerging technologies. This restructuring is part of an ongoing shift in how to think about conservation in the new epoch of the Anthropocene. (shrink)

The McNaughton rules for determining whether a person can be successfully defended on the grounds of mental incompetence were determined by a committee of the House of Lords in 1843. They arose as a consequence of the trial of Daniel McNaughton for the killing of Prime Minister Sir Robert Peel’s secretary. In retrospect it is clear that McNaughton suffered from schizophrenia. The successful defence of McNaughton on the grounds of mental incompetence by his advocate Sir Alexander Cockburn involved a profound (...) shift in the criteria for such a defence, and was largely based on the then recently published scientific thesis of the great US psychiatrist Isaac Ray, entitled A Treatise on the Medical Jurisprudence of Insanity. Subsequent discussion of this defence in the House of Lords led to the McNaughton rules, still the basis of the defence of mental incompetence in the courts of much of the English-speaking world. This essay considers one of these rules in the light of the discoveries of cognitive neuroscience made during the 160 years since Ray’s treatise. A major consideration is the relationship between the power of self-control and irresistible impulse as conceived by Cockburn on the one hand, and by cognitive neuroscience on the other. The essay concludes with an analysis of the notion of free will and of the extent to which a subject can exert restraint in the absence of particular synaptic connections in the brain. (shrink)

D.P. It will technically be possible to get rid of all suffering within a century or two. Its abolition would be practical only if it were agreed in the sense of something like the moon program or the human genome project – if there was a degree of social consensus. There are certainly technological obstacles, but they are dwarfed by the ethical-ideological ones. Many people’s negative reaction to the idea of a world without suffering comes from a fear (...) that someone is going to be manipulating and controlling them. Partly, too, the abolition of suffering seems to make a mockery of one’s life projects. Most of us spend the greater part of our lives seeking happiness for ourself and others we care about. But we do so in extremely inefficient and in many cases self-defeating ways. This is a problem with existing human society. Even though we have made extraordinary progress technologically and medically, we aren’t any happier than our ancestors. Even if we could arrange society in the most utopian way imaginable, there would be some people who would still be depressed and anxious. There would be some people who would be consumed by jealousy or unhappy love affairs. No amount of environmental reform or manipulation is going to get rid of suffering. Only biotechnology can eradicate its neural substrates. (shrink)

Improving the resilience of urban road networks suffering from various disruptions has been a central focus for urban emergence management. However, to date the effective methods which may mitigate the negative impacts caused by the disruptions, such as road accidents and natural disasters, on urban road networks is highly insufficient. This study proposes a novel adaptive signal control strategy based on a doubly dynamic learning framework, which consists of deep reinforcement learning and day-to-day traffic dynamic learning, to improve (...) the network performance by adjusting red/green time split. In this study, red time split is regarded as extra traffic flow to discourage drivers to use affected roads, so as to reduce congestion and improve the resilience when urban road networks are subject to different levels of disruptions. In addition, we utilize the convolution neural network as Q-network to approximate Q values, link flow distribution and link capacity are regarded as the state space, and actions are denoted as red/green time split. A small network is utilized as a numerical example, and a fixed time signal control and other two adaptive signal controls are employed for the comparisons with the proposed one. The results show that the proposed adaptive signal control based on deep reinforcement learning can achieve better resilience in most of the cases, particularly in the scenarios of moderate and severe disruptions. This study may shed light on the advantages of the proposed adaptive signal control dealing with major emergencies compared to others. (shrink)

Suicide is a leading cause of death in the United States and in many other parts of the world. As such, suicide is frequently framed as a medical and public health problem for which solutions are best recommended by medical and public health authorities. While, medicalized suicide prevention strategies often resonate with traditional Christian commitments to preserve life and to discourage suicide, there is little evidence to date that medical approaches to suicide risk-reduction decrease population rates of suicide. Further, by (...) treating suicide as a phenomenon that can be eliminated through technical managerial control, modern suicide prevention efforts construe suffering persons as carriers of risk best managed by standardized and often dehumanizing environments of care. This emphasis on the medical management of risk also erodes the clinician–patient relationship and inappropriately centers medical (e.g., systematic health screenings) rather than non-medical (e.g., access to housing) forms of response. Although, medicalized suicide prevention efforts should not be dismantled, those working to prevent suicide would do well to prioritize a positive commitment to human dignity and worth and to engage social and political systems beyond medicine and public health, while drawing on specific contributions that clinicians can offer. (shrink)

This paper explores the ethical challenges involved in the ways public representation structures our experiences of atrocities and facilitates an adequate awareness of and response towards the suffering of others. It points out that such an analysis should not exhaust itself in answering what makes public representations of human suffering ethically suspicious and intolerable, but should rather extend this task by clarifying how the public forms sentiments about their social and political reality by elucidating under which conditions public (...) representation promotes broader political agendas. One of the central tenets of human rights advocacy is the widespread conviction that exposure to images and stories of human rights abuse has a mobilizing effect on western audience whose exposure to such knowledge can motivate them to intervene and prevent future atrocities. In order to assess the basic implications of such a conviction we must answer at least three principal clusters of questions. First, how do public representations of atrocities affect individuals and their capacities to conceive and respond to social injustices and the suffering of others? Under what circumstances may agents respond effectively to shocking content? Second, how do social powers operate within the field of perception in order to control how the viewing public is affected? And how do these effects inform and galvanize political support or opposition regarding concrete historical events? Finally, what can be said about the responsibilities of visual representation? Whose agency is it that images inform, and what reforms are necessary to make representations of suffering ethically effective means to encourage better acknowledgment of individual and collective responsibilities that would motivate the public to meet its moral and political obligations? This paper ultimately suggests that in order for politically implicated images to have an immediate critical effect on individuals and their agency, they need to cultivate alternative modes of perception.Article first published online: 21 DEC 2015. (shrink)

The current study is aimed at creating a psychological profile of characteristics of aggressive and self-aggressive behaviour exhibited by females with bulimia, as well as conducting a comparative analysis of the differences between bulimic females and individuals displaying no mental disorders in terms of the major characteristics of aggressive and selfaggressive behaviour. The methods: the Buss-Durkee Hostility-Guilt Inventory, the Psychological Inventory of Aggression Syndrome by Zbigniew. B. Gaś. The data analysis revealed significant differences between the females suffering from bulimia (...) and the subjects displaying no mental disorders in terms of the level of aggressive and self-aggressive tendencies. It was discovered that the control participants exhibited an appropriate level of aggressive behaviour as opposed to the subjects with bulimia. (shrink)

Nowadays, the major depressive disorder is a common disease that negatively affects the life quality of many people around the world. As MDD symptoms are closely related with the changes in food and eating, the relation between patients’ emotional responses and food tastes could be used as criteria for diagnostic. Until now, studies on the emotional response to different food tastes for patients affected by MDD have been poorly described in literature. Therefore, the aim of this study was to evaluate (...) the emotional response of patients suffering from MDD to the imagined different food tastes and to compare the results with a control group. Emotional responses in tested participants were induced by using cards with words of basic food tastes such as “sweet,” “salty,” “bitter,” “sour,” and “neutral.” The assessment of emotional response was performed with FaceReader 6 software. The outcome of this study showed that participants with MDD expressed lower “happy” and “contempt” and higher “surprised” emotions, along with a higher negative valence mean, in comparison with controls for all tested basic tastes of food. When Likert scale was used, significant differences in response were only found for “sour” and “salty” imaginary tastes between healthy group and patients with MDD. The findings of this study provide the additional data on food–associated emotion analysis of MDD patients and could be useful for the further development of the contactless method for early diagnosis of MDD. (shrink)

This paper adds to our understandings of women’s post-separation experiences of coercive control through the introduction of a new concept—custody stalking. It is defined as a malevolent course of conduct involving fathers’ use of custody and/or child protection proceedings to overturn historic patterns of care for children. The experience of custody stalking is explored through three composite narratives derived from twelve mothers who participated in an exploratory, qualitative study on the involuntary loss of maternal care time following separation. The (...) losses suffered caused these mothers tremendous grief, damaged their psychological wellbeing and had a detrimental effect on their mothering relationships. Yet custody stalking, as a form of malevolent attack, is not well recognised and mothers’ resultant losses are largely culturally invisible. This is in marked contrast to paternal filicides, another form of post-separation avenging attack committed by some fathers that also leads to maternal loss experiences, albeit more absolute. (shrink)