How humans choose their mates is a central feature of adult life and an area of considerable disagreement among relationship researchers. However, few studies have examined mate choice (instead of mate preferences) around the world, and fewer still have considered data from online dating services. Using data from more than 1.8 million online daters from 24 countries, we examined the role of sex and resource-acquisition ability (as indicated by level of education and income) in mate choice using multilevel modeling. We (...) then attempted to understand country-level variance by examining factors such as gender equality and the operational sex ratio. In every nation, a person’s resource-acquisition ability was positively associated with the amount of attention they received from other site members. There was a marked sex difference in this effect; resource-acquisition ability improved the attention received by men almost 2.5 times that of women. This sex difference was in every country, admittedly with some variance between nations. Several country-level traits moderated the effects of resource-acquisition ability, and in the case of unemployment this moderating role differed by sex. Overall, country-level effects were more consistent with evolutionary explanations than sociocultural ones. The results suggest a robust effect of resource-acquisition ability on real-life mate choice that transcends international boundaries and is reliably stronger for men than women. Cross-cultural variance in the role of resource-acquisition ability appears sensitive to local competition and gender equality at the country level. (shrink)

Various deficits in the cognitive functioning of people with autism have been documented in recent years but these provide only partial explanations for the condition. We focus instead on an imitative disturbance involving difficulties both in copying actions and in inhibiting more stereotyped mimicking, such as echolalia. A candidate for the neural basis of this disturbance may be found in a recently discovered class of neurons in frontal cortex, 'mirror neurons' (MNs). These neurons show activity in relation both to specific (...) actions performed by self and matching actions performed by others, providing a potential bridge between minds. MN systems exist in primates without imitative and ‘theory of mind’ abilities and we suggest that in order for them to have become utilized to perform social cognitive functions, sophisticated cortical neuronal systems have evolved in which MNs function as key elements. Early developmental failures of MN systems are likely to result in a consequent cascade of developmental impairments characterised by the clinical syndrome of autism. (shrink)

We have synthesized a 582,970-base pair Mycoplasma genitalium genome. This synthetic genome, named M. genitalium JCVI-1.0, contains all the genes of wild-type M. genitalium G37 except MG408, which was disrupted by an antibiotic marker to block pathogenicity and to allow for selection. To identify the genome as synthetic, we inserted "watermarks" at intergenic sites known to tolerate transposon insertions. Overlapping "cassettes" of 5 to 7 kilobases (kb), assembled from chemically synthesized oligonucleotides, were joined by in vitro recombination to produce intermediate (...) assemblies of approximately 24 kb, 72 kb ("1/8 genome"), and 144 kb ("1/4 genome"), which were all cloned as bacterial artificial chromosomes in Escherichia coli. Most of these intermediate clones were sequenced, and clones of all four 1/4 genomes with the correct sequence were identified. The complete synthetic genome was assembled by transformation-associated recombination cloning in the yeast Saccharomyces cerevisiae, then isolated and sequenced. A clone with the correct sequence was identified. The methods described here will be generally useful for constructing large DNA molecules from chemically synthesized pieces and also from combinations of natural and synthetic DNA segments. 10.1126/science.1151721. (shrink)

Fundamental problems of environmental sustainability, including climate change and fisheries management, require collective action on a scale that transcends the political and cultural boundaries of the nation-state. Rational, self-interested neoclassical economic theories of human behavior predict tragedy in the absence of third party enforcement of agreements and practical difficulties that prevent privatization. Evolutionary biology offers a theory of cooperation, but more often than not in a context of discrimination against other groups. That is, in-group boundaries are necessarily defined by those (...) excluded as members of out-groups. However, in some settings human’s exhibit behavior that is inconsistent with both rational economic and group driven cooperation of evolutionary biological theory. This paper reports the results of a non-cooperative game-theoretic exercise that models a tragedy of the commons problem in which groups of players may advance their own positions only at the expense of other groups. Students enrolled from multiple universities and assigned to different multi-university identity groups participated in experiments that repeatedly resulted in cooperative outcomes despite intergroup conflicts and expressions of group identity. We offer three possible explanations: students were cooperative because they were in an academic setting; students may have viewed their instructors as the out-group; or the emergence of a small number of influential, ethical leaders is sufficient to ensure cooperation amongst the larger groups. From our data and analysis, we draw out lessons that may help to inform approaches for institutional design and policy negotiations, particularly in climate change management. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

A collection of personal narratives and essays, Living Professionalism is designed to help medical students and residents understand and internalize various aspects of professionalism. These essays are meant for personal reflection and above all, for thoughtful discussion with mentors, with peers, with others throughout the health care provider community who care about acting professionally.

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Asset egalitarianism is a new agenda but an old idea. At its root is the notion that every citizen should be able to have an individual property stake, and it has recently been revived in Britain and in the U.S. in a number of proposals aimed at countering the huge and growing inequality in the distribution of assets. Such asset egalitarianism is fed from many streams; it has a long history in civic republican thought, beginning with Thomas Paine and (...) Thomas Jefferson, but has also featured in the distributist theories of G.K. Chesterton and Hilaire Belloc; the guild socialism of G.D.H. Cole and the ethical socialism of R.H. Tawney; the market liberalism of the Ordo Liberals and some of the Austrian School, particularly F.A. Hayek; and more recently the market socialism of James Meade, A.B. Atkinson and Julian Le Grand, and the market egalitarianism of Michael Sherraden, Samuel Bowles, Herbert Gintis, Richard Freeman and Bruce Ackerman. There are also important links to the proponents of a citizens' income as a different approach to the welfare state (White 2002) as well as to the ideas of stakeholding (Dowding et al. 2003). (shrink)

The concepts of being and order are the basic notions in all and every philosophical reflection and investigation into reality. The intention of this study is to examine the mutual relationships between order and being as found in the philosophy of Thomas Aquinas, but against the background of the age-old dispute regarding the unity and plurality of being(s) as initiated by Heraclitus and Parmenides, and developped by Plato and Aristotle, Duns Scotus and Ockham, Descartes and some contemporary metaphysicians, e.g. (...) Heidegger and Whitehead. Being and Order is the first volume of the series «Catholic Thought from Lublin». (shrink)

One of the central debates within contemporary Anglo-American political philosophy concerns how to formulate an egalitarian theory of distributive justice which gives coherent expression to egalitarian convictions and withstands the most powerful anti-egalitarian objections. This book brings together many of the key contributions to that debate by some of the world’s leading political philosophers: Richard Arneson, G.A. Cohen, Ronald Dworkin, Thomas Nagel, Derek Parfit, John Rawls, T.M. Scanlon, and Larry Temkin.

Recent developments in quantum physics postulate the existence of some form of multiverse, often considered inimical to theism. We argue that a cosmology of many worlds is not novel either to philosophy or to theism. The multiverse is not a monolithic concept and we refer to and use the four levels of categorization proposed by Max Tegmark. We trace the idea of a multiverse back to the Milesians and Epicureans in order to initially demonstrate its use of a plenitude argument. (...) We then examine the argument for possible compatibility based on a theistic principle of plenitude in three specifically Christian theists: Origen, Thomas Aquinas, and G. W. Leibniz. We conclude that this argument is sustainable so that if any level of the multiverse actually exists then it is harmonious with theism, and we argue that its fit is most successful if a multiverse is considered as a single possible world. We call this view Thomistic modal realism. (shrink)

Malebranche's Theodicy ANDREW G. BLACK LEIBNIZ'S SOLUTION tO the problem of evil, his theodicy, might be regarded as a paradigm of philosophical theology. Its pattern, as with so much of Leibniz's philosophy, is reconciliation of deep metaphysical truth with recalcitrant ap- pearance. Thus, a theodicy is not just any solution to the problem; strictly speaking it is a vindication of divine providence in the face of the challenge posed by apparent imperfections of all kinds in creation.' The preeminence of (...) Leibniz's theodicy as a modern solution to the problem of evil has helped to obscure distinguished contributions from among his contemporaries. Not least among these is that made by Nicolas Malebranche, a philosopher having much in common with Leibniz . ~ Malebranche shows a deep concern for the problem of evil throughout his philosophical writings, though nowhere more so than in his Treatise on Nature and Grace, a a book written in response to the Jansenist4 challenge to orthodox In addition to an entire and substantial book, the Theodicy , a number of Leibniz's essays contain versions of his theodicy. See, for example, articles 1- 7 of the Discourse on Metaphysics; also "A Vindication of God's Justice Reconciled with his.. (shrink)

Name der Zeitschrift: Klio Jahrgang: 97 Heft: 1 Seiten: 157-175.

Abstract:This paper examines the historiographic controversies and disagreements surrounding the figure of Septimius Severus and highlighted by Herodian in his Roman History as a means of investigating the development of history writing during and in the aftermath of that emperor's reign. Herodian cites Severus' transition to power and reign as a locus for historical and historiographical controversy and debate, and a comparison of Herodian with other Severan writers allows for an examination of Herodian's competitive relationship with his older historiographic peers (...) and of the innovative aspects of his work that set it apart from others. (shrink)

Despite the enormous influence of Michel Foucault in gender studies, social theory, and cultural studies, his work has been relatively neglected in the study of politics. Although he never published a book on the state, in the late 1970s Foucault examined the technologies of power used to regulate society and the ingenious recasting of power and agency that he saw as both consequence and condition of their operation. These twelve essays provide a critical introduction to Foucault's work on politics, exploring (...) its relevance to past and current thinking about liberal and neo-liberal forms of government. Moving away from the great texts of liberal political philosophy, this book looks closely at the technical means with which the ideals of liberal political rationalities have been put into practice in such areas as schools, welfare, and the insurance industry. This fresh approach to one of the seminal thinkers of the twentieth century is essential reading for anyone interested in social and cultural theory, sociology, and politics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Social and Moral Aspects of the WarBertrand Russell and Introduced by Andrew G. BoneAmong nine loose-leaf folders of typed transcriptions of Russell's History of Western Philosophy lectures at the Barnes Foundation1 are two copies of a fourteen-page stenographic record of a political talk he gave there on 2 March 1941.2 The bulk of this significant new accrual to the Russell Archives, bearing as it does on Russell's most (...) successful philosophical work, could stimulate much further research and textual study. But his isolated Barnes lecture, about the politics of American neutrality, Nazi Germany's brutal and expansionist dictatorship, and the causes and possible consequences of the war against it, is also of considerable interest.The transcription reads more like detailed notes than a verbatim account, and there is no evidence that Russell approved this text.3 The stenographer initially recorded Russell in the third person, dispensed with this device before the second [End Page 52] paragraph, but then occasionally returned to it.4 There is also more enumeration of Russell's points than he would have supplied in a prepared script. Even the title may not be his: there is nothing in the text on any social changes wrought by the war. But this title has been retained in the absence of a more plausible alternative in a short report of the speech (quoting sixteen sentences) in the next day's Philadelphia Evening Bulletin.5 Russell's hour-long address on the "Social and Moral Aspects of the War" appears to have been the only occasion when he "laid philosophy aside"6 at the Barnes Foundation. It was delivered on a Sunday to an audience of 160 students (and possibly some invitees, although none are mentioned in the newspaper article), sandwiched between two of his weekly philosophical lectures (on Socrates and Sparta7) in the series scheduled for each Thursday.In opening his case for the United States joining the Allied war effort, Russell challenged the arguments for the "policy of conciliation" which, by his own recent admission in the New York Times,8 he had earlier endorsed. Published two weeks before Russell spoke on a similar topic at the Barnes Foundation, this 2,000-word letter to the editor served as a very detailed and public renunciation of the pacifist viewpoint—neutrality for national governments combined with non-resistance for individuals—which Russell had promoted in Which Way to Peace? (1936) and continued to condone after the Munich Agreement (September 1938) and even the dismemberment of Czechoslovakia (March 1939).Yet Russell the "relative political pacifist"9 also admitted in this most programmatic statement of his prewar position that "In other times and other circumstances, I should be prepared to consider gains and losses, and to concede that war might be worth while" (WWP, pp. 151–2).That moment had obviously arrived and may have done so already when on 15 October 1939 Russell confided to Constance Malleson that his passionate desire for a British victory made a "thorough-going pacifism difficult" (ra Rec. Acq. 596). But six months later he still did "not feel sufficiently sure of the opposite to say anything publicly by way of recantation"—before adding in this letter to Gilbert Murray that "it may come to that" (21 April 1940, ra Rec. Acq. 71g). It clearly did shortly afterwards—when the "phoney war" in Western Europe was dramatically ended by the invasion of France and the [End Page 53] Low Countries. On 13 May Russell asked the editor of the New Statesman and Nation to notify its readers that he had abandoned his once strongly held pacifist convictions.10In his lecture to the Barnes Foundation, Russell turned next to the defence of American non-intervention by Robert M. Hutchins (see n. 16 below)—which he had already critiqued in the New York Times. Although rather precariously situated as a resident alien in the United States, Russell was hardly circumspect about pushing a policy that so sharply divided American opinion.11 He also listed the faults of the League of Nations and the most grievous diplomatic mistakes made since the end of the last war and the fatally... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Social and Moral Aspects of the WarBertrand Russell and Introduced by Andrew G. BoneAmong nine loose-leaf folders of typed transcriptions of Russell's History of Western Philosophy lectures at the Barnes Foundation1 are two copies of a fourteen-page stenographic record of a political talk he gave there on 2 March 1941.2 The bulk of this significant new accrual to the Russell Archives, bearing as it does on Russell's most (...) successful philosophical work, could stimulate much further research and textual study. But his isolated Barnes lecture, about the politics of American neutrality, Nazi Germany's brutal and expansionist dictatorship, and the causes and possible consequences of the war against it, is also of considerable interest.The transcription reads more like detailed notes than a verbatim account, and there is no evidence that Russell approved this text.3 The stenographer initially recorded Russell in the third person, dispensed with this device before the second [End Page 52] paragraph, but then occasionally returned to it.4 There is also more enumeration of Russell's points than he would have supplied in a prepared script. Even the title may not be his: there is nothing in the text on any social changes wrought by the war. But this title has been retained in the absence of a more plausible alternative in a short report of the speech (quoting sixteen sentences) in the next day's Philadelphia Evening Bulletin.5 Russell's hour-long address on the "Social and Moral Aspects of the War" appears to have been the only occasion when he "laid philosophy aside"6 at the Barnes Foundation. It was delivered on a Sunday to an audience of 160 students (and possibly some invitees, although none are mentioned in the newspaper article), sandwiched between two of his weekly philosophical lectures (on Socrates and Sparta7) in the series scheduled for each Thursday.In opening his case for the United States joining the Allied war effort, Russell challenged the arguments for the "policy of conciliation" which, by his own recent admission in the New York Times,8 he had earlier endorsed. Published two weeks before Russell spoke on a similar topic at the Barnes Foundation, this 2,000-word letter to the editor served as a very detailed and public renunciation of the pacifist viewpoint—neutrality for national governments combined with non-resistance for individuals—which Russell had promoted in Which Way to Peace? (1936) and continued to condone after the Munich Agreement (September 1938) and even the dismemberment of Czechoslovakia (March 1939).Yet Russell the "relative political pacifist"9 also admitted in this most programmatic statement of his prewar position that "In other times and other circumstances, I should be prepared to consider gains and losses, and to concede that war might be worth while" (WWP, pp. 151–2).That moment had obviously arrived and may have done so already when on 15 October 1939 Russell confided to Constance Malleson that his passionate desire for a British victory made a "thorough-going pacifism difficult" (ra Rec. Acq. 596). But six months later he still did "not feel sufficiently sure of the opposite to say anything publicly by way of recantation"—before adding in this letter to Gilbert Murray that "it may come to that" (21 April 1940, ra Rec. Acq. 71g). It clearly did shortly afterwards—when the "phoney war" in Western Europe was dramatically ended by the invasion of France and the [End Page 53] Low Countries. On 13 May Russell asked the editor of the New Statesman and Nation to notify its readers that he had abandoned his once strongly held pacifist convictions.10In his lecture to the Barnes Foundation, Russell turned next to the defence of American non-intervention by Robert M. Hutchins (see n. 16 below)—which he had already critiqued in the New York Times. Although rather precariously situated as a resident alien in the United States, Russell was hardly circumspect about pushing a policy that so sharply divided American opinion.11 He also listed the faults of the League of Nations and the most grievous diplomatic mistakes made since the end of the last war and the fatally... (shrink)

A number of aphorisms in Plutarch’s Laconian Apophthegms contain a similar verbal formulation indicating death in battle. This formulation can be traced back to Thucydides, and was likely descriptive of expected Spartan behavior from the time of Thermopylae. Its employment in the Apophthegms, masking personal and civic shortcomings, reveals both an insistence on maintaining this behavioral directive and the social anxiety surrounding its maintenance.

At the height of the Sino-Indian border dispute in 1962, Bertrand Russell, as “a lifetime friend of India” (Unarmed Victory, p. 88), appealed to Prime Minister Nehru for peace. Yet for the first 75 years of Russell’s life, India had not been an independent, developing state whose non-aligned diplomacy he could (usually) admire, but rather an economically and stra­tegically vital part of the British Empire. Thus Russell’s fraternal bond with India was formed during its protracted struggle against British rule. The (...) central purpose of this article is to reconstruct Russell’s occasionally contorted connection with that historic contest, and it will do so by drawing on a wealth of neglected textual material. More than simply fleshing out a significant but overlooked chapter in Russell’s political life, this assessment of his decades-long association, as participant and observer, with the campaign for Indian independence also strives to capture the complex essence of his thinking on questions of empire generally. (shrink)

As he neared 80 Russell was more financially secure than he had been for decades. But to remain so he needed to maintain his prodigious output as a writer, broadcaster and lecturer (see Papers 26, forthcoming). Meanwhile, the breakdown of his third marriage threatened to undermine his much-improved financial position. The monetary concerns addressed in both the text prepared by Russell and the related commentary hint at a lifetime’s scrupulous regard for his personal finances.

Jean-Numa Ducange’s recent work, La Révolution française et la social-démocratie. Transmissions et usages politiques de l’histoire en Allemagne et Autriche 1889–1934, provides an ambitious and theoretically-sophisticated analysis of the ways in which German and Austrian socialists interpreted the French Revolution from 1889 to the 1930s. Ducange shows how the different strands of Second International socialism interpreted the revolution in their own ways, and shows the impact of the Russian revolutions of 1905 and 1917 on this. His work does not only (...) focus on leading theoreticians such as Karl Kautsky, but also documents very effectively the way in which the readings of the French Revolution were disseminated widely through Social Democracy’s rank-and-file membership. It is a valuable contribution to the literature on the culture of Marxism in Central Europe in this period, as well as a rich addition to the literature on the resonance and uses of the French Revolution: the ‘echoes of the Marseillaise’. (shrink)

At the height of the Sino-Indian border dispute in 1962, Bertrand Russell, as “a lifetime friend of India” (_Unarmed Victory_, p. 88), appealed to Prime Minister Nehru for peace. Yet for the first 75 years of Russell’s life, India had not been an independent, developing state whose non-aligned diplomacy he could (usually) admire, but rather an economically and stra­tegically vital part of the British Empire. Thus Russell’s fraternal bond with India was formed during its protracted struggle against British rule. The (...) central purpose of this article is to reconstruct Russell’s occasionally contorted connection with that historic contest, and it will do so by drawing on a wealth of neglected textual material. More than simply fleshing out a significant but overlooked chapter in Russell’s political life, this assessment of his decades-long association, as participant and observer, with the campaign for Indian independence also strives to capture the complex essence of his thinking on questions of empire generally. (shrink)

The Soviet Union's successful test of an atomic bomb in 1949 altered Russell's outlook on international politics. But there was a considerable delay between this critical juncture of the Cold War and any perceptible softening of Russell's anti-Communism. Even after a muted optimism about the possibility of improvement in the foreign and domestic policies of the Soviet Union entered Russell's writing, he remained apprehensive about campaigning for peace alongside western Communists and fellow-travellers. He disliked the central thrust of pro-Soviet peace (...) propaganda but regarded ideological diversity as a vital prerequisite for meaningful peace work. Russell also understood that such an approach carried with it a risk that his efforts might be tarnished by association with the Communist-aligned peace movement. His dilemma was eased not by a shift in his own tactics, but by external factors: a crisis within western Communism and the emergence of broadly based movements for peace that could not easily be tainted by their critics as "pro-Soviet". (shrink)

During the First World War Russell frequently complained about unwarranted encroachments by the wartime state on the sphere of individual freedom. He experienced such encroachments very directly. The Defence of the Realm Act (dora) was the legal instrument through which most official reprisals were visited on him—punitive meas­ures arising from his dogged support for conscientious objectors and a negotiated peace. Under this emergency legislation he was twice convicted and had his freedom of movement curbed. This harsh treatment is well known, (...) but the literature on Russell has not yet systematically examined his relationship with this “other DORA”. Using the Russell Archives, his Collected Papers, and government records in the UK’s National Archives, this paper seeks to establish the legal, administrative and political contexts in which he was prosecuted and sanctioned extra-judicially, and where he sometimes benefitted from DORA’s formidable powers being set aside. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Operating Through HatredAndrew G. Shuman“You’re not cutting my ***ing neck. The cancer is in my ***ing mouth.”While many patient encounters are memorable, Mr. K’s introduction to the head and [End Page 20] neck surgical oncology clinic is indelibly imprinted into the minds of all of the clinicians present on that certain autumn morning. This was, quite simply, a man who resonated hate. He was rude and disruptive. He insisted (...) on an expedited workup “without any waiting.” He questioned the ethnicity and nationality of his care providers. He told me, in no uncertain terms, that he did not appreciate my Jewish heritage—the swastika tattooed on his bicep underscored the point. He bragged about his recent incarceration for armed robbery. While my colleagues and I were tempted to simply refuse to assume his care, Mr. K had a bad problem—his recurrent tongue cancer required a major operation in order to offer him any hope for cure.Mr. K initially received an abbreviated course of radiation at an outside institution, which was limited by his non–compliance. While one might debate the wisdom of this decision in retrospect—in general, surgery is preferred for his type of tumor—the die was already cast. A heroic attempt at surgical salvage was now his only curative option. He previously sought care elsewhere... only to be fired by this original surgeon when Mr. K physically threatened him in the outpatient office during preoperative consultation. [It was the doctor’s fault for insulting him in the first place, Mr. K maintained... and no charges were filed.] We were, indeed, his last resort. Other than his recurrent cancer, Mr. K was robust; he was in his sixth decade, physically fit, and on the whole, fairly healthy. In the classic surgical lexicon, he was a reasonable surgical candidate. But was it reasonable to operate on such a person?I remember thinking, at the time, about our obligation to care for such an individual. Of course, being a medical professional carries with it many obligations, including a judicious assumption of personal risk. And, working in a tertiary care center begets the responsibility to assist referring clinicians in the management of difficult cases. Although professional obligations certainly have their limits, defining their bounds is decidedly more difficult. Paramount is creating an atmosphere of mutual trust and acceptance. Naturally, this was easier said than done in regard to Mr. K.Perhaps against our better judgment, we agreed to operate under the condition that he abide by strict behavioral ground rules, on our terms. We agreed upon the extent of the necessary operation (which indeed involved cutting his ***ing neck, much to his chagrin and reluctant acceptance). Mr. K promised to follow instructions for postoperative care. He assured us that he would not swear or yell (again). And, in the presence of hospital security, who reinforced our institutional policies regarding patient behavior, he guaranteed that he would not be verbally or physically violent or inappropriate, and would not make disparaging comments to other patients or staff. It seemed, at least, that we had an understanding.Needless to say, these rules were broken shortly after he awoke from surgery. I vividly remember being summoned from the OR when he threatened to murder his impressionable and terrified nurse a few days later, who would not acquiesce to his unreasonable demands. From that point onward, hospital security was deployed to his room regularly, and anything resembling a potential weapon was safeguarded. Any semblance of a mutual doctor–patient bond was shattered. At this point, everyone’s goal was simply to get Mr. K home.My visceral reactions to his behavior, while intense, were not unexpected, and fell in line with those of the entire team of clinicians caring for him. His antics brought his healthcare team together in collective unity (and condemnation). However, my surgical colleagues and I also felt somewhat guilty and responsible. While surgeons can choose to assume some degree of inherent personal danger in caring for a violent and angry patient, we also put the safety and soundness of the entire perioperative team in jeopardy, without necessarily seeking their input. But once we had decided to... (shrink)

A thirty-year-old single mother with recurrent, metastatic, treatment-refractory cancer presents to the emergency room with severe difficulty breathing due to an obstructive tumor in her neck, compounded by progressive disease in her lungs and a new pulmonary embolism. She cannot be safely intubated and would require an emergent awake tracheotomy. Even if the airway can be successfully secured surgically, the likelihood that she will be able to be weaned from mechanical ventilation is very low. The surgeon, a young mother too, (...) appreciates the patient's desire for more time with her toddler. But the surgeon knows the significant risk of surgery, the massive responsibility she would accept in trying to get the patient through it, and the emotional toll of an intraoperative death on surgical staff. And she can imagine the second-guessing that will come during the inevitable morbidity and mortality conference if the patient should die in the perioperative window. Yet the surgeon does not want to take the “easy” way out; after all, critically ill patients undergo aggressive resuscitation all the time. What should she do? (shrink)

Suzie loves to talk. A successful mid-thirties businesswoman, she is a self-described social butterfly—which made her diagnosis of tongue cancer even more devastating. She came to the clinic complaining of a lump in her throat, which in most young healthy people turns out to be benign and easily treated. But not for Suzie, who had a very rare salivary tumor arising in the back of her tongue. Its slow growth was both a blessing and a curse; such tumors do not (...) kill people quickly, but they typically require surgery. It would slowly and relentlessly grow until and unless we removed most of her tongue. In head and neck surgery, issues of appearance, identity, function, and communication are the foremost considerations when we decide when, and whether, to operate. As the adage goes, knowing when not to operate is the sine qua non of the wise surgeon. But the inverse is also true. (shrink)