This study investigates what professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia. Ten caregivers were interviewed; special attention was paid to the way in which they deal with conflicting values. Transcripts of the interviews were analysed qualitatively according to the method of grounded theory. The results were compared with those from a similar, earlier study on ideals found in mission statements of nursing homes. The concepts that were mentioned by most interviewed (...) participants as important for a good life were ‘peace and quiet’, ‘going along with subjective experience’ and ‘no enforcement: the way the resident wants it’. A considerable overlap was found between the interviews and the mission statements; however, when compared with the mission statements, the interviews put less emphasis on individuality and on giving meaning, and more on offering residents pleasant activities. When faced with conflicting values, caregivers tend to make pragmatic and more or less intuitive decisions. Although this has its merits, it may be desirable to stimulate conscious reflection regarding conflict between different values. (shrink)

We may be at the brink of a Kuhnian paradigm shift when it comes to the categorical classification system of mental disorders. Reviewing more than 30 years of critical literature on the categorical classification of personality disorders, Kueger, Hopwood, Wright, and Markon conclude that the Diagnostic and Statistical Manual of Mental Disorders is "fundamentally broken". Just before, the director of the National Institute of Mental Health declared that the institute will no longer support research that is based on DSM categories.The (...) critique on the categorical system of mental disorders consists of several arguments that are briefly mentioned as they have been... (shrink)

Over the past twenty-five years, history of science has expanded into history of knowledge. Plurality has been the main message. Commonality, by contrast, is the main finding of the present study. It examines the knowledge practices of the full range of participants in cases of public inquiry—trials, tests, inspections—involving human bodies in contexts of criminal law, police, public health, marriage and family, claims to community aid, and regulation of trades. The cases come from the archives of three agencies of inquiry (...) and evaluation—a government, a university faculty, and a guild—in a variety of polities in the Holy Roman Empire between about 1500 and 1650. Participants of widely differing education, occupation, and experience—learned, artisanal, and domestic, as well as specialized versions of these—are found to have shared practices of observation, description, explanation, and argument. This finding opens the prospect of a history of shared empirical rationality, in contrast to the hegemony of difference, dialogue or transfer, and “expertise,” in how we understand knowing in modern as well as premodern Europe. (shrink)

After the introduction of the fifth Diagnostic and Statistical Manual of Mental Disorders, familiar voices were raised in protest. The voices stem from ideas of which, among others, and in different ways, Michel Foucault and Thomas Szasz were influential proponents: The movement was referred to as 'antipsychiatry.' This movement reacted, among other things, to the system of categorization of mental disorders. Diagnoses, in a system of classification, were thought to be vague, arbitrary, labelling, stigmatizing, and scientifically and clinically poorly validated. (...) In contemporary debates on DSM-5, similar critiques can be heard, expressed by a movement now referred to as 'critical psychiatry'... (shrink)

The comorbidity of personality disorders and mental disorders is commonly understood through three types of theoretical models: either a) personality disorders precede mental disorders, b) mental disorders precede personality disorders, c) mental disorders and personality disorders share common etiological grounds. Although these hypotheses differ with respect to their idea of causal direction, they all imply a latent variable perspective, in which it is assumed that either personality and mental disorders are latent variables that have certain causal relations [models a) and (...) b)]; or that, as in model c), the common etiology is in fact a latent variable that causes symptomatology of both personality and mental disorders. We aim to provide another perspective on the comorbidity between personality and mental disorders, namely a network perspective. To this end, we investigated Major Depression and Borderline Personality Disorder and hypothesized that symptoms of BPD and MD could interact with one another rather than being caused by a latent variable. To illustrate this theoretical network conceptualization of the comorbidity of BPD and MD we analyzed a cross-sectional clinical dataset of 376 patients who were asked to complete the Structured Clinical Interview for DSM-IV Axis II Disorders and the Beck Depression Inventory II. The results identify direct associations between symptoms of MD and BPD. If we take the links in this empirical network to be ‘substantive', this suggests a radical shift of our current conceptualization of the comorbidity of mental disorders and personality disorders. (shrink)

Zachar's commentary can be read as a sophisticated theoretical extension of the target article, and I am very pleased to see support for a relationalist turn in understanding mental disorders. Indeed, underlying causal properties are only an ingredient of essentialism and a more elaborate discussion of this issue brings us readily to the discourse on kinds and ontology. Zachar is an advocate for thinking of psychiatric constructs as practical kinds. This logically leads him to think that the problem with categorical (...) classification systems like the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases are practical problems (lack of... (shrink)

The aim of this review is to show the fruitfulness of using images of facial expressions as experimental stimuli in order to study how neural systems support biologically relevant learning as it relates to social interactions. Here we consider facial expressions as naturally conditioned stimuli which, when presented in experimental paradigms, evoke activation in amygdala–prefrontal neural circuits that serve to decipher the predictive meaning of the expressions. Facial expressions offer a relatively innocuous strategy with which to investigate these normal variations (...) in affective information processing, as well as the promise of elucidating what role the aberrance of such processing might play in emotional disorders. (shrink)

Route memory is frequently assessed in virtual environments. These environments can be presented in a fully controlled manner and are easy to use. Yet they lack the physical involvement that participants have when navigating real environments. For some aspects of route memory this may result in reduced performance in virtual environments. We assessed route memory performance in four different environments: real, virtual, virtual with directional information (compass), and hybrid. In the hybrid environment, participants walked the route outside on an open (...) field, while all route information (i.e., path, landmarks) was shown simultaneously on a handheld tablet computer. Results indicate that performance in the real life environment was better than in the virtual conditions for tasks relying on survey knowledge, like pointing to start and end point, and map drawing. Performance in the hybrid condition however, hardly differed from real life performance. Performance in the virtual environment did not benefit from directional information. Given these findings, the hybrid condition may offer the best of both worlds: the performance level is comparable to that of real life for route memory, yet it offers full control of visual input during route learning. (shrink)

In the past decades, reductionism has dominated both research directions and funding policies in clinical psychology and psychiatry. The intense search for the biological basis of mental disorders, however, has not resulted in conclusive reductionist explanations of psychopathology. Recently, network models have been proposed as an alternative framework for the analysis of mental disorders, in which mental disorders arise from the causal interplay between symptoms. In this target article, we show that this conceptualization can help explain why reductionist approaches in (...) psychiatry and clinical psychology are on the wrong track. First, symptom networks preclude the identification of a common cause of symptomatology with a neurobiological condition; in symptom networks, there is no such common cause. Second, symptom network relations depend on the content of mental states and, as such, feature intentionality. Third, the strength of network relations is highly likely to depend partially on cultural and historical contexts as well as external mechanisms in the environment. Taken together, these properties suggest that, if mental disorders are indeed networks of causally related symptoms, reductionist accounts cannot achieve the level of success associated with reductionist disease models in modern medicine. As an alternative strategy, we propose to interpret network structures in terms of D. C. Dennett's (1987) notion ofreal patterns, and suggest that, instead of being reducible to a biological basis, mental disorders feature biological and psychological factors that are deeply intertwined in feedback loops. This suggests that neither psychological nor biological levels can claim causal or explanatory priority, and that a holistic research strategy is necessary for progress in the study of mental disorders. (shrink)

Terminal kidney patients are faced with lower quality of life, restricted diets and higher morbidity and mortality rates while waiting for deceased donor kidney transplantation. Fortunately, living kidney donation has proven to be a better treatment alternative (e.g. in terms of waiting time and graft survival rates). We observed an inequality in the number of living kidney transplantations performed between the non-European and the European patients in our center. Such inequality has been also observed elsewhere in this field and it (...) has been suggested that this inequality relates to, among other things, attitude differences towards donation based on religious beliefs. In this qualitative research we investigated whether religion might indeed (partly) be the explanation of the inequalities in living donor kidney transplants (LDKT) among non-European patients. Fifty patients participated in focus group discussions and in-depth interviews. The interviews were conducted following the focus group method and analyzed in line with Grounded Theory. The qualitative data analyses were performed in Atlas.ti. We found that religion is not perceived as an obstacle to living donation and that religion actually promotes helping and saving the life of a person. Issues such as integrity of the body were not seen as barriers to LDKT. We observed also that there are still uncertainties and a lack of awareness about the position of religion regarding living organ donation within communities, confusion due to varying interpretations of Holy Scriptures and misconceptions regarding the process of donation. Faith leaders play an important educational role and their opinion is influential. This study has identified modifiable factors which may contribute to the ethnic disparity in our living donation program. We argue that we need to strive for more clarity and awareness regarding the stance of religion on the issue of living donation in the local community. Faith leaders could be key figures in increasing awareness and alleviating uncertainty regarding living donation and transplantation. (shrink)

Schellings Freiheitsschrift behandelt sowohl einen modernen, positiven Begriff von Freiheit, als auch die Nacht- und Schattenseiten der Freiheit, verbunden mit dem Begriff des Bosen und der Frage der Theodizee. Die Diskussion der Freiheitstheorie wird hier auf eine erst kurzlich wieder ins Blickfeld der Metaphysik geratene spekulative Weise vertieft. Die uberarbeitete Neuauflage erschliesst Schellings Text auf dem aktuellen Stand der Forschung.".

We address the commentaries on our target article in terms of four major themes. First, we note that virtually all commentators agree that mental disorders are not brain disorders in the common interpretation of these terms, and establish the consensus that explanatory reductionism is not a viable thesis. Second, we address criticisms to the effect that our article was misdirected or aimed at a straw man; we argue that this is unlikely, given the widespread communication of reductionist slogans in psychopathology (...) research and society. Third, we tackle the question of whether intentionality, extended systems, and multiple realizability are as problematic as claimed in the target article, and we present a number of nuances and extensions with respect to our article. Fourth, we discuss the question of how the network approach should incorporate biological factors, given that wholesale reductionism is an unlikely option. (shrink)

This paper investigates when and how children figure out the force of modals: that possibility modals (e.g., _can_/_might_) express possibility, and necessity modals (e.g., _must_/_have to_) express necessity. Modals raise a classic subset problem: given that necessity entails possibility, what prevents learners from hypothesizing possibility meanings for necessity modals? Three solutions to such subset problems can be found in the literature: the first is for learners to rely on downward-entailing (DE) environments (Gualmini and Schwarz in J. Semant. 26(2):185–215, 2009 ); (...) the second is a bias for strong (here, necessity) meanings; the third is for learners to rely on pragmatic cues stemming from the conversational context (Dieuleveut et al. in Proceedings of the 2019 Amsterdam colloqnium, pp. 111–122, 2019a ; Rasin and Aravind in Nat. Lang. Semant. 29:339–375, 2020 ). This paper assesses the viability of each of these solutions by examining the modals used in speech to and by 2-year-old children, through a combination of corpus studies and experiments testing the guessability of modal force based on their context of use. Our results suggest that, given the way modals are used in speech to children, the first solution is not viable and the second is unnecessary. Instead, we argue that the conversational context in which modals occur is highly informative as to their force and sufficient, in principle, to sidestep the subset problem. Our child results further suggest an early mastery of possibility—but not necessity—modals and show no evidence for a necessity bias. (shrink)

FOSTER J, CHIANG F, HILLARD RC, HALL P and HEATH A. Nursing Inquiry 2010; 17: 309–316 Team process in community‐based participatory research on maternity care in the Dominican RepublicA cross‐cultural team consisting of US trained academic midwife researchers, Dominican nurses, and Dominican community leaders have partnered in this international nursing and midwifery community‐based participatory research (CBPR) project in the Dominican Republic to understand the community experience with publicly funded maternity services. The purpose of the study was to understand community perceptions (...) of maternity services. This article highlights the activities that the research team carried out during each phase of the research process, and how they established team identity, team trust, and team efficacy. This research has created a platform for new avenues for health providers and community to partner to improve maternal‐newborn care. Community‐based participatory research is one way forward to address the past and present inequities constitutive of global health disparities. (shrink)

This article traces the multiple enactments of sex in clinical practices of transgender medicine to argue against the presumed singularity of ‘transexuality’. Using autoethnography to analyse my own experience as a trans patient, I describe my clinical encounters with doctors, psychiatrists and surgeons in order to theorise sex as multiple. Following recent developments in science and technology studies (STS) that advance the work of Judith Butler on sex as performatively reproduced, I use a praxiographic approach to argue that treatment practices (...) produce particular iterations of what sex (and transexuality) ‘is’ and how these processes limit and foreclose other trans possibilities. I consider the ethical, political and material-discursive implications of treatment practices and offer a series of reflections about the effects and effectiveness of current clinical practices and the possibilities for intervening in such processes in order that, following Annemarie Mol, we might (re)make sex (and transexuality) differently. (shrink)

Acknowledgments 1. Culture Is Essential 2. Culture Exists 3. Culture Evolves 4. Culture Is an Adaptation 5. Culture Is Maladaptive 6. Culture and Genes Coevolve 7. Nothing about Culture Makes Sense except in the Light of Evolution.

Patient narratives from two investigational deep brain stimulation trials for traumatic brain injury and obsessive‐compulsive disorder reveal that injury and illness rob individuals of personal identity and that neuromodulation can restore it. The early success of these interventions makes a compelling case for continued post‐trial access to these technologies. Given the centrality of personal identity to respect for persons, a failure to provide continued access can be understood to represent a metaphorical identity theft. Such a loss recapitulates the pain of (...) an individual's initial injury or illness and becomes especially tragic because it could be prevented by robust policy. A failure to fulfill this normative obligation constitutes a breach of disability law, which would view post‐trial access as a means to achieve social reintegration through this neurotechnological accommodation. (shrink)

In this paper I critically examine the implications of the uncodifiability thesis for principlism as a pluralistic and non-absolute generalist ethical theory. In this regard, I begin with a brief overview of W.D. Ross’s ethical theory and his focus on general but defeasible prima facie principles before turning to 2) the revival of principlism in contemporary bioethics through the influential work of Tom Beauchamp and James Childress; 3) the widespread adoption of specification as a response to the indeterminacy of abstract (...) general principles and the limitations of balancing and deductive approaches; 4) the challenges raised to fully specified principlism by the uncodifiability thesis and 5) finally offer a defense of the uncodifiability thesis against various critiques that have been raised. (shrink)

Patriarchal institutions govern all aspects of women's lives: their minds, their bodies, and their souls. Additionally, they govern the ways in which women are perceived by others and the ways in which women perceive themselves. (Re) Interpretations: The Shapes of Justice in Women's Experience, is a collection of essays on language, religion, war, sex trafficking, and medicine-the patriarchal structures that form the basis of western society and, thus, are in many ways inherently unjust. The essays illustrate the multitude of ways (...) that women have found to work within and without these structures to create justice. Traditional theories of justice cast it as a cardinal virtue, unbiased and impartial. The essays in this book, however, remove justice from the abstract and return it to the specific: most of the essays use personal narratives to highlight the connections all people share. The women discussed here are challenging the authority of existing patriarchal narratives by telling their versions, and, thus, calling attention to and challenging their own political and social realities. Reflecting a focus on global connectedness and interdisciplinarity, the writers of these essays aim not only to raise questions, but also to show ways in which women are creating new pathways for themselves. Only by exploring solutions will women reclaim justice. From L.A. to Zimbwabe, women have stories to tell about their experiences of justice in the inherently patriarchal institutions of Language, Religion, War, Sex Trafficking, and Medicine. This relevant and thought-provoking collection captures the trials that women across the world face and the hope they create through their courageous actions. Through both personal narrative and factual overview, these essays emphasize that as people committed to justice, women must not simply raise the questions, but they must also explore solutions in order to reclaim justice for themselves, their daughters, their sisters, and their mothers. Contributors: Yifat Bitton, Stephany Ryan Cate, Jo Scott-Coe, Susan Dewey, Carmela Epright, Carmen Faymonville, Adam Gaynor, Pauline Greenhill, Denise Handlarski, Alison Jobe, Marc J.W. de Jong, Jodie M. Lawston, Jody Lisberger, Kristy Maher, Susan Maloney, Mickias Musiyiwa, Ruben Murillo, Annemarie Profanter, Natalie Wilson, and J. Carter Wood. (shrink)

This paper explores the role of moral uncertainty in explaining the morally disruptive character of new technologies. We argue that existing accounts of technomoral change do not fully explain its disruptiveness. This explanatory gap can be bridged by examining the epistemic dimensions of technomoral change, focusing on moral uncertainty and inquiry. To develop this account, we examine three historical cases: the introduction of the early pregnancy test, the contraception pill, and brain death. The resulting account highlights what we call “differential (...) disruption” and provides a resource for fields such as technology assessment, ethics of technology, and responsible innovation. (shrink)

Healthcare priority-setting institutions have good reason to want to demonstrate that their decisions are morally justified—and those who contribute to and use the health service have good reason to hope for the same. However, finding a moral basis on which to evaluate healthcare priority-setting is difficult. Substantive approaches are vulnerable to reasonable disagreement about the appropriate grounds for allocating resources, while procedural approaches may be indeterminate and insufficient to ensure a just distribution. In this paper, we set out a complementary, (...) coherence-based approach to the evaluation of healthcare priority-setting. Drawing on Rawls, we argue that an institutional priority-setter’s claim to moral justification can be assessed, in part, based on the extent to which its many normative commitments are mutually supportive and free from dissonance; that is, on the ability to establish narrow reflective equilibrium across the normative content of a priority-setter’s policy and practice. While we do not suggest that the establishment of such equilibrium is sufficient for moral justification, we argue that failure to do so might—like the proverbial canary in the coalmine—act as a generalised warning that something is awry. We offer a theoretical argument in support of this view and briefly outline a practical method for systematically examining coherence across priority-setting policy and practice. (shrink)

What is property, and why does our species happen to have it? In The Property Species, the economist Bart Wilson explores how we acquire, perceive, and know the custom of property, and why this might be relevant to social scientists, philosophers, and legal scholars for understanding how property works in the twenty-first century.

The General Data Protection Regulation (GDPR) of the EU confirms the protection of personal data as a fundamental human right and affords data subjects more control over the way their personal information is processed, shared, and analyzed. However, where data are processed by artificial intelligence (AI) algorithms, asserting control and providing adequate explanations is a challenge. Due to massive increases in computing power and big data processing, modern AI algorithms are too complex and opaque to be understood by most data (...) subjects. Articles 15 and 22 of the GDPR provide a modest regulatory framework for automated data processing by, among other things, mandating that data controllers inform data subjects about when it is being used, and its logic and ramifications. Nevertheless, due to the phrasing of the articles and the numerous exceptions they allow, doubts have arisen about their effectiveness. In this paper, we empirically evaluate the quality and effectiveness of AI disclosures as mandated by the GDPR. By means of an online survey (N = 835), we investigated how data subjects expect to be informed about the automated processing of their data. We then conducted a content analysis of the AI disclosures of N = 100 companies and organizations. The combined findings reveal that current GDPR-mandated disclosures do not meet the expectations and needs of data subjects. Explanations drawn up following the guidelines of the generic formulations of the GDPR differ widely and are often vague, incomplete and lack transparency. In our conclusions we identify a path towards standardizing and optimizing AI information notices. (shrink)

We explore the role of episodic imagining in explaining why people both differentially report that it seems to them in experience as though time robustly passes, and why they differentially report that they believe that time does in fact robustly pass. We empirically investigate two hypotheses, the differential vividness hypothesis, and the mental time travel hypothesis. According to each of these, the degree to which people vividly episodically imagine past/future states of affairs influences their tendency to report that it seems (...) to them as though time robustly passes and to judge that time does robustly pass. According to the former, a greater degree of vividness will tend to increase the extent to which people make such reports, while according to the latter, it will tend to decrease the extent to which people make such reports. We found weak evidence in favour of the former hypothesis. We reflect on the implications of this finding for theorising about such reports. (shrink)

I am aware of the tree and its leaves, but am I aware of my awareness of these things? When I try to introspect my awareness, I just find myself attending to objects and their properties. This observation is known as the ‘transparency of experience’. On the other hand, I seem to directly know that I am aware. Given the first observation, it is not clear how I know that I am aware. Fred Dretske thought that the problem was so (...) acute that he issued the challenge of answering ‘How do you know that you are not a zombie?’ I propose that a view found in the Advaita Vedanta, that awareness is self luminous, reconciles these two observations. I understand self-luminosity as the thesis that: (1) I am implicitly aware of my awareness and (2) I am phenomenally aware of a distinct phenomenal character of my awareness. In support of the first claim, that I apparently only attend to objects in the world when introspecting perceptual experience, suggests that I do not know my awareness explicitly, but rather that I must know it implicitly. In support of the second claim, I argue that the mere fact that I am perceptually conscious is not sufficient to allow me to know that I am perceptually conscious. In particular, the qualities I am perceptually aware of do not tell me that I aware of them, rather they just seem to be properties of objects. I also assess whether strategies for responding to Cartesian sceptical scenarios can be employed against Dretske’s consciousness scepticism. I argue that these strategies either fail to distinguish me from a zombie or they do not adequately describe my epistemic situation. By contrast to other accounts, if awareness has its own distinct phenomenal character, then it cannot be considered to be a prima facie property of the world, hence the self-luminosity of awareness provides a plausible account of how I know that I’m not a zombie. (shrink)

Researchers sometimes engage in various forms of dishonesty and unethical behavior, which has led to regulatory efforts to ensure that they work according to acceptable standards. Such regulation is a difficult task, as research is a diverse and dynamic endeavor. Researchers can disagree about what counts as good and acceptable standards, and these standards are constantly developing. This paper presents and discusses recent changes in research integrity and ethics regulation in Norway, Denmark, and Sweden. Recognizing that research norms are developed (...) through practice and are therefore unsuited for comprehensive national regulation, the Scandinavian countries focus on empowering the research community to regulate itself instead, except for the most severe cases of misconduct. This empowerment takes the form of giving research institutions tools and investigatory powers while also holding them responsible for ensuring that both the institution and individual researchers are up to date on relevant norms. In this way, the Scandinavian governments seek to avoid some of the challenges found in more legalistic approaches, which risk lagging behind the continuous development of research norms and can be insensitive to the fact that different disciplines have different norms. While the new approach in Scandinavian has several potential benefits, it also involves potential trade-offs and limitations. The new laws can create confusion about what researchers are allowed to do. Another issue is that it only addresses the fundamental drivers of misconduct to a limited extent. (shrink)

Adaptive Intelligence is a dramatic reappraisal and reframing of the concept of human intelligence. In a sweeping analysis, Robert J. Sternberg argues that we are using a fatally-flawed, outdated conception of intelligence; one which may promote technological advancement, but which has also accelerated climate change, pollution, the use of weaponry, and inequality. Instead of focusing on the narrow academic skills measured by standardized tests, societies should teach and assess adaptive intelligence, defined as the use of collective talent in service of (...) the common good. This book describes why the outdated notion of intelligence persists, what adaptive intelligence is, and how it could lead humankind on a more positive path. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE GREAT GATSBY: ROMANCE OR HOLOCAUST? Thomas J. Cousineau Washington College In an otherwise appreciative response to The Great Gatsby, H. L. Mencken expressed a reservation about the plot ofthe novel, which he characterized as "no more than a glorified anecdote" (Claridge 156). Writing to Edmund Wilson, Fitzgerald suggested, in turn, that what Mencken did not find in Gatsby was "any emotional backbone at the very height of it" (...) (Turnbull 342). Critics ofthe novel, however, have tended to overlook the self-evident fact that the novel's ostensible emotional center—the reunion between Gatsby and Daisy—does not possess sufficient significance to justify the classic status that has been largely accorded to Fitzgerald's novel. We need only remember Daisy's effusive appreciation ofGatsby's "beautiful shirts," or the even more telling detail that the truly "romantic" moments in Daisy and Gatsby's relationship all occurred several years earlier in Louisville and that the period of the reunion is scarcely mentioned in the novel to convince ourselves that the putative grandeur of Gatsby's dream does not adequately account for the novel's power or its lasting significance. Reading Gatsby as a novel about its hero's dream makes of it, in fact, a precarious literary achievement, one whose numerous absurdities were perceptively delineated by the English novelist L.P. Hartley, who admired Fitzgerald's literary gifts but thought that he had squandered them in Gatsby. In a 1926 review of the novel, Hartley offered the following summary of its plot: An adventurer of shady antecedents builds a palace at a New York seaside resort, entertains on a scale which Lucullus would have marveled at but could not have approved, and spends untold sums ofmoney, all to 22Thomas J. Cousineau catch the eye ofhis one time sweetheart, who lives on an island opposite, unhappily but very successfully married. At last, after superhuman feats ofostentation and display, the fly walks into the web. A train ofdisasters follows, comparable in quantity and quality with the scale ofthe Great Gatsby's prodigies of hospitality. Coincidence leaps to the helm and throws a mistress under a motor-car. The car does not stop, which, all things considered, is the most natural thing that happens in the book. An injured husband finds the Great Gatsby in suicidal mood sitting on a raft in his artificial lake and (apparently) forestalls him; anyhowthey are both discovered dead. The elder Gatsby is unearthed and gives a pathetic account ofhis son's early years. All the characters behave as though they were entitled to grieve over a great sorrow, and the book closes with the airs oftragedy. (Claridge 178) Minor inaccuracies aside, this must be among the most cogent, disabused responses that the plot of The Great Gatsby has ever received. It is such a welcome antidote to the reams of interpretation ofthe novel produced by critics who, dutifully aping Nick Carraway in this respect, have allowed their conviction as to Gatsby's "greatness" to be matched only by their equally adamant certainty as to the moral tawdriness of Tom and Daisy Buchanan. As Hartley's exasperated summary reminds us, The Great Gatsby, read as the account ofthe eponymous hero's dream, simply cannot support the weight of morally serious interpretation that it would like to invite or that so many ofits critics, in their turn, would like to bestow upon it.1 Nor do we move any closer to appreciating the greatness of Gatsby by shiftingourattention tothe growth in moral awareness thatcountless critics have attributed toNick Carraway, whose self-evaluation as "one ofthe few honest people that I have ever known" (64) should in itself arouse our suspicions.2 As we shall see, the fruits ofNick's presumed moral education The seemingly indestructible resistance to Hartley's lucidity that has been displayed by the great majority ofthe novel's critics may be observed in the chapter that Jeffrey Hart devotes to Gatsby in his recently published Smiling Through the Cultural Catastrophe. Arguing that "magical transformation" is the novel's true subject (230), Hart credits Nick with achieving an "epiphany" whereby he recognizes Gatsby's superiority to "the whole damn bunch put together" (238) and concludes that the larger... (shrink)

In the article, “Precision Medicine for Whom? Public Health Outputs from “Genomics England” and “All of Us” to Make Up for Upstream and Downstream Exclusion,” Galasso focuses on how marginalized pe...