In this paper, we argue that our moral concern for future well-being should reduce over time due to important practical considerations about how humans interact with spacetime. After surveying several of these considerations (around equality, special duties, existential contingency, and overlapping moral concern) we develop a set of core principles that can both explain their moral significance and highlight why this is inherently bound up with our relationship with spacetime. These relate to the equitable distribution of (1) moral concern in (...) a universe that we can only causally affect in one temporal direction; (2) access to the benefits from using spacetime as a resource; and (3) the burdens of care given (1) and (2). We conclude by considering the practical implications of our argument and find that, while it is often assumed that a preference for present over future well-being weakens the case for existential risk mitigation, this likely is not the case. (shrink)

This chapter suggests that descriptive epidemiological studies like the Global Burden of Disease Study can usefully be divided into four tasks: describing individuals’ health states over time, assessing their health states under a range of counterfactual scenarios, summarizing the information collected, and then packaging it for presentation. The authors show that each of these tasks raises important and challenging ethical questions. They comment on some of the philosophical issues involved in measuring health states, attributing causes to health outcomes, choosing (...) the counterfactual against which to assess causes, aggregating and summarizing complex information across multiple domains, discounting, age-weighting, handling fetal deaths, measuring health inequalities, representing uncertainty, and assessing personal responsibility for health outcomes. (shrink)

We present a one per cent measurement of the cosmic distance scale from the detections of the baryon acoustic oscillations in the clustering of galaxies from the Baryon Oscillation Spectroscopic Survey, which is part of the Sloan Digital Sky Survey III. Our results come from the Data Release 11 sample, containing nearly one million galaxies and covering approximately 8500 square degrees and the redshift range 0.2 < z < 0.7. We also compare these results with those from the publicly released (...) DR9 and DR10 samples. Assuming a concordance Λ cold dark matter cosmological model, the DR11 sample covers a volume of 13 Gpc3 and is the largest region of the Universe ever surveyed at this density. We measure the correlation function and power spectrum, including density-field reconstruction of the BAO feature. The acoustic features are detected at a significance of over 7σ in both the correlation function and power spectrum. Fitting for the position of the acoustic features measures the distance relative to the sound horizon at the drag epoch, rd, which has a value of rd,fid = 149.28 Mpc in our fiducial cosmology. We find DV = at z = 0.32 and DV = at z = 0.57. At 1.0 per cent, this latter measure is the most precise distance constraint ever obtained from a galaxy survey. Separating the clustering along and transverse to the line of sight yields measurements at z = 0.57 of DA = and H =. Our measurements of the distance scale are in good agreement with previous BAO measurements and with the predictions from cosmic microwave background data for a spatially flat CDM model with a cosmological constant. © 2014 The Author Published by Oxford University Press on behalf of the Royal Astronomical Society. (shrink)

The Global Burden of Disease Study is one of the largest-scale research collaborations in global health, producing critical data for researchers, policy-makers, and health workers about more than 350 diseases, injuries, and risk factors. Such an undertaking is, of course, extremely complex from an empirical perspective. But it also raises complex ethical and philosophical questions. In this volume, a group of leading philosophers, economists, epidemiologists, and policy scholars identify and discuss these philosophical questions. Better appreciating the philosophical dimensions of (...) a study like the GBD can make possible a more sophisticated interpretation of its results, and it can improve epidemiological studies in the future, so that they are better suited to produce results that help us to improve global health. (shrink)

It has become increasingly difficult for individuals to exercise meaningful control over the personal data they disclose to companies or to understand and track the ways in which that data is exchanged and used. These developments have led to an emerging consensus that existing privacy and data protection laws offer individuals insufficient protections against harms stemming from current data practices. However, an effective and ethically justified way forward remains elusive. To inform policy in this area, we propose the Ethical Data (...) Practices framework. The framework outlines six principles relevant to the collection and use of personal data—minimizing harm, fairly distributing benefits and burdens, respecting autonomy, transparency, accountability, and inclusion—and translates these principles into action-guiding practical imperatives for companies that process personal data. In addition to informing policy, the practical imperatives can be voluntarily adopted by companies to promote ethical data practices. (shrink)

In this paper we examine the case of Tay, the Microsoft AI chatbot that was launched in March, 2016. After less than 24 hours, Microsoft shut down the experiment because the chatbot was generating tweets that were judged to be inappropriate since they included racist, sexist, and anti-Semitic language. We contend that the case of Tay illustrates a problem with the very nature of learning software that interacts directly with the public, and the developer's role and responsibility associated with it. (...) We make the case that when LS interacts directly with people or indirectly via social media, the developer has additional ethical responsibilities beyond those of standard software. There is an additional burden of care. (shrink)

The paper discusses the philosophical and historical doctrine of the Russian philosopher and historian George Petrovich Fedotov. The author focuses on the analysis of imperial issues in the works of G.P. Fedotov, especially of his views on the cultural history of the Russian empire and the essence of imperial project in Russia. Fedotov reconsiders the historical experience and revolutionary catastrophe of Russia and searches for the foundations of the social and cultural processes determining the events of Russian history. Fedotov’s works (...) offer a variety of interpretations of the political and cultural phenomenon of empire. This reflects his evolution as a philosopher of history: the focus of his vision shifts from the Medieval Rus to the Empire of Peter the Great, then to the collapsed empire of Nicholas II and finally to the USSR. Fedotov’s concept of Empire evolves into a timeless cultural-philosophical phenomenon but originates from the historical description of the centralization of power in the feudal monarchy of Ivan the Terrible. The evolution of the philosophical and historical views of Fedotov is influenced by the changes of his attitude to the historical conception of Klyuchevsky. In the 1940s Fedotov considers the empire as a universal idea. The concept of empire proposed by Fedotov gives an understanding of the Russian historical development, especially the causes of the decline and fall of the Russian Empire. Fedotov associates the cause of the salvation of Russia with the study of ancient Russian culture, in which he founds a moral and political ideal of the “Republic of Saint Sophia.” The paper shows heuristic potential of Fedotov’s cultural and philosophical ideas on the vocation of spiritual elite and the creative role of personality in the process of nation-building. (shrink)

All ethics has a religious dimension. This paper considers how specific Christian insights concerning death, suffering, human nature and human creatureliness can help to expose more fully the moral issues at stake in some of the dilemmas faced by doctors. It ends by acknowledging the crushing burden of decision-making which rests on many in the medical profession, and indicates the importance of religious resources in dealing with this.

COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that they are needed to maintain a noncrisis level of mortality while they are implementing reasonable public (...) health interventions. Practically, a noncrisis level of mortality is that experienced during a bad influenza season, which society considers an acceptable background risk. Governments take action to limit mortality from influenza, but there is no emergency that includes severe lockdowns. This “flu-risk standard” is a nonarbitrary and generally accepted heuristic. Mortality above the flu-risk standard justifies greater governmental interventions, including retaining vaccines for a country's own citizens over global need. The precise level of vaccination needed to meet the flu-risk standard will depend upon empirical factors related to the pandemic. This links the ethical principles to the scientific data emerging from the emergency. Thus, the FPR framework recognizes that governments should prioritize procuring vaccines for their country when doing so is necessary to reduce mortality to noncrisis flu-like levels. But after that, a government is obligated to do its part to share vaccines to reduce risks of mortality for people in other countries. We consider and reject objections to the FPR framework based on a country: having developed a vaccine, raising taxes to pay for vaccine research and purchase, wanting to eliminate economic and social burdens, and being ineffective in combating COVID-19 through public health interventions. (shrink)

Pursuant to the Doctrine of Consumer Sovereignty, we believe that tobacco companies should be compelled to disclose their ingredients so that the public health community can make more informed recommendations in order to protect consumer autonomy and sovereignty. However, a recent decision by the First Circuit precludes such a disclosure since it would be unduly burdensome to the industry, while granting only minimal gains to the public. We argue that many of the Court’s key claims rest on a misunderstanding of (...) the science and chemistry of tobacco products. In our view, a mandatory disclosure of ingredients would more effectively protect the public interest, whilst posing minimal burdens on the tobacco industry. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Royce, Racism, and the Colonial IdealWhite Supremacy and the Illusion of Civilization in Josiah Royce's Account of the White Man's Burden1Tommy J. CurryNo colony can be made by a theory of Imperialism, it can only be made by people who want to colonize and are capable of maintaining themselves as colonists.—Sir Sydney OlivierIntroductionAs with most historic white figures in philosophy, their repopularization and reintroduction into contemporary circles commits their (...) work, regardless of its initial silence, to speak to the problem of anti-Black racism in America. Josiah Royce is no different in this regard. In recent years, white scholars like Jacquelyn Kegley and Shannon Sullivan have introduced revisions to Royce's thought that make it appear multicultural and antiracist, despite the anachronism of such a contention. According to Kegley, "Royce believes, as others in the contemporary scene, that 'race' as a concept cannot be eliminated, [because] it plays too crucial a role, both positive and negative, in self- and social identification" (216). While Kegley is correct that contemporary scholars like Lucius Outlaw and Cornel West have adamantly defended the importance of race as a social and cultural entity, her claim is in stark contradiction to the racial eliminativism of other scholars like Anthony Appiah and Alain Locke, whom she also contends that Royce agrees with simultaneously.2 While it makes perfect sense for Kegley to try to put Royce in conversation with contemporary Black thinkers in race theory, her work is indicative of a trend aiming to gain currency for historic white thinkers in current race debates at the expense of historical accuracy. Black scholars who studied under Royce and applied his theories to the race problem from the mid-1900s onward, like William H. Ferris3 and William T. Fontaine,4 are ignored by white scholars because the first application of Roycean philosophy supported assimilationism. It is only today with the political and ideological [End Page 10] ethicizations of racial diversity and multiculturalism that Royce's work is interpreted as critically conserving race.5In contrast to contemporary works on Royce and race, this article seeks to evaluate the current claims for the relevance of Royce's views in contemporary debates on race. I maintain that only by taking Royce out of his historical context (late nineteenth-and early twentieth-century thought) do his ideas on race acquire a level of importance that cannot be supported by the actual evidence he himself advances. Conversely, by actually placing Royce in his historical context, this article will demonstrate that Royce's 1905 article entitled "Race Questions" (later published as "Race Questions and Prejudices" in 1906) is an unapologetic extension of his 1900 article entitled "Characteristic Tendencies of American Civilization," where Royce adamantly champions British colonialism and assimilation as the remedy to the burgeoning race problem both at home and abroad. I begin with a critical analysis that places Josiah Royce's attitudes firmly within the boundaries of his times. In what follows, I will attempt to contextualize Royce's seemingly progressive stance on Japan as part of a more general reaction whites had during the early 1900s to Russia's defeat by the Japanese. Instead of reading Royce's stance on Japan as a moment of exceptionalism, I contend that Royce's attitude was in fact a popular disposition that signaled the inevitable shift of race science away from biological determinism toward more environmentalist explanations. Secondly, and perhaps more importantly, I will show that Royce's disposition toward Blacks was firmly rooted in a colonial and assimilationist logic that ultimately sought the cultural destruction of African-descended people. A closer look at Royce's prefatory remarks on British colonialism from 1900 and his valorization of English colonial administration in Jamaica actually reveals an insidious racial dynamic in Royce's thought that is anything but antiracist. Finally, having established Royce's philosophical stake in American assimilation and Western domination, I argue that the "provincial revision" currently in vogue amongst American philosophers working with Royce is simply not enough to overturn Royce's clearly racist investments in dealing with the race question.If I Can Think It... Then I Can Do It—Reading Royce... (shrink)

Nurse practitioners (NPs) are increasingly called on to provide high‐quality health‐care particularly for people who face significant barriers to accessing services. Although discourses of social justice have become relatively common in nursing and health services literature, critical analyses of how NP roles articulate with social justice issues have received less attention. In this study, we examine the role of NPs from a critical social justice perspective. A critical social justice lens raises morally significant questions, for example, why certain individuals and (...) groups bear a disproportionate burden of illness and suffering; what social conditions contribute to disparities in health and social status; and what social mandate NPs ought to develop in response to these realities. In our analysis, we draw on lessons learned from the initial Canadian experience with the introduction of NPs in the 1970s to consider the renewed and burgeoning interest in NPs in Canada, Australia and elsewhere. As we argue, a critical social justice perspective (in addition to the biomedical foci of NP practice) will be essential to sustaining long‐term, socially responsive NP roles and achieving greater equity in health and health‐care. (shrink)

As the federal government distributed remdesivir to some of the states COVID-19 hit hardest, policymakers scrambled to develop criteria to allocate the drug to their hospitals. Our state, Michigan, was among those states to receive an initial quantity of the drug from the U.S. government. The disparities in burden of disease in Michigan are striking. Detroit has a death rate more than three times the state average. Our recommendation to the state was that it should prioritize the communities that (...) bear a disproportionate burden of suffering in the allocation of the new potential treatment. This recommendation is justified not only for new drugs with uncertain effects, but also for drugs of certain benefit or vaccines. For states with significant health disparities, such as Michigan, this allocation priority may help to repair them. In fact, any other allocation strategy may make them worse. (shrink)

One of the more draining aspects of being a clinical ethicist is dealing with the emotions of patients, family members, as well as healthcare providers. Generally, by the time a clinical ethicist is called into a case, stress levels are running high, patience is low, and interpersonal communication is strained. Management of this emotional burden of clinical ethics is an underexamined aspect of the profession and academic literature. The emotional nature of doing clinical ethics consultation may be better addressed (...) by utilizing concepts and tools from clinical psychology. Management of countertransference, the natural emotional reaction by the therapist toward the patient, is a widely discussed topic in the psychotherapeutic literature. This concept can be adapted to the clinical ethics encounter by broadening it beyond the patient-therapist relationship to refer to the ethics consultant's emotional response toward the patient, the family, or other members the healthcare team. Further, it may aid the consultant because a recognition of the source and nature of these reactions can help maintain ‘critical distance’ and minimize bias in the same way that a psychologist maintains neutrality in psychotherapy. This paper will offer suggestions on how to manage these emotional responses and their burden in the clinical ethics encounter, drawing upon techniques and strategies recommended in the psychotherapeutic literature. Using these techniques may improve consultation outcomes and reduce the emotional burden on the clinical ethicist. (shrink)

Clinician gate-keeping is the process whereby healthcare providers prevent access to eligible patients for research recruitment. This paper contends that clinician gate-keeping violates three principles that underpin international ethical guidelines: respect for persons or autonomy; beneficence or a favourable balance of risks and potential benefits; and justice or a fair distribution of the benefits and burdens of research. In order to stimulate further research and debate, three possible strategies are also presented to eliminate gate-keeping: partnership with professional researchers; collaborative research (...) design and clinician education. (shrink)

A popular and, on the whole, sympathetic introduction to Kierkegaard. The author, a leading evangelical theologian, tries to separate criticism from exposition. His interest is clearly in Kierkegaard as theologian, not as philosopher.—R. J. W.

-/- Winner of the 2020 Josiah Royce Prize in American Idealist Thought, presented by the Josiah Royce Society, for demonstrating the extent to which Josiah Royce’s ideas about race were motivated explicitly in terms of imperial conquest. -/- Another white Man’s Burden performs a case study of Josiah Royce’s philosophy of racial difference. In an effort to lay bare the ethnological racial heritage of American philosophy, Tommy J. Curry challenges the common notion that the cultural racism of the twentieth (...) century was more progressive and less racist than the biological determinism of the 1800s. Like many white thinkers of his time, Royce believed in the superiority of the white races. Unlike today, however, whiteness did not represent only one racial designation but many. Contrary to the view of the British-born Germanophile philosopher Houston S. Chamberlain, for example, who insisted upon the superiority of the Teutonic races, Royce believed it was the Anglo-Saxon lineage that possessed the key to Western civilization. It was the birthright of white America, he believed, to join the imperial ventures of Britain—to take up the white man’s burden. To this end he advocated the domestic colonization of Blacks in the American South, suggested that America’s xenophobia was natural and necessary to protecting the culture of white America, and demanded the assimilation and elimination of cultural difference for the stability of America’s communities. Another white Man’s Burden reminds philosophers that racism has been part of the building blocks of American thought for centuries, and that this must be recognized and addressed in order for its proclamations of democracy, community, and social problems to have real meaning. (shrink)

Winner of the 2020 Josiah Royce Prize in American Idealist Thought presented by the Josiah Royce Society Another white Man’s Burden performs a case study of Josiah Royce’s philosophy of racial difference. In an effort to lay bare the ethnological racial heritage of American philosophy, Tommy J. Curry challenges the common notion that the cultural racism of the twentieth century was more progressive and less racist than the biological determinism of the 1800s. Like many white thinkers of his time, (...) Royce believed in the superiority of the white races. Unlike today however, whiteness did not represent only one racial designation but many. Contrary to the view of the British-born Germanophile philosopher Houston S. Chamberlain, for example, who insisted upon the superiority of the Teutonic races, Royce believed it was the Anglo-Saxon lineage that possessed the key to Western civilization. It was the birthright of white America, he believed, to join the imperial ventures of Britain—to take up the white man’s burden. To this end he advocated the domestic colonization of Blacks in the American South, suggested that America’s xenophobia was natural and necessary to protecting the culture of white America, and demanded the assimilation and elimination of cultural difference for the stability of America’s communities. Another white Man’s Burden reminds philosophers that racism has been part of the building blocks of American thought for centuries, and that this must be recognized and addressed in order for its proclamations of democracy, community, and social problems to have real meaning. (shrink)

“Spinoza's Extended Substance: Cartesian and Leibnizian Reflections” This essay examines Woolhouse's interpretation of Spinoza's extended substance. According to that interpretation, the extended substance is a quasi‐Platonic form, and Spinoza's substance is not actually extended. This essay argues that the burden of defending such an interpretation is very great indeed, and requires that we read Spinoza's understanding of Descartes and Leibniz's understanding of Spinoza in unusual and awkward ways.

In this paper, we report results from experiments in which people read conversational arguments and then judge the convincingness of each claim and the individual speakers' burden of proof. The results showed an "anti-primacy" effect: People judge the speaker who makes the first claim as having greater burden of proof. This effect persists even when each speaker's claims are rated equally convincing. We also find that people rate claims less convincing when they appear in the first part of (...) an argument than when they appear in isolation. (shrink)

Over the last decade, my interest in Josiah Royce has been motivated by a question: What is the relationship between historical and verifiable facts and philosophical interpretation or theory? This question is of tremendous consequence in philosophy since the discipline requires no empirical or archival evidence to substantiate the arguments that are made for or against a “specific philosopher” or thinker beyond the impression the philosopher and other philosophers have made about the “specific philosopher under scrutiny.” When it comes to (...) the study of Black historical figures and the study of American racism, this question that motivated my interest in Josiah Royce and American Philosophy more generally became a... (shrink)

The basic thesis ofMichaelWilliams'book Unnatural Doubts is that sceptical doubts, at least of a Cartesian variety, are neither natural nor intuitive, but are, instead, the product of 'contentious and possibly dispensable theoretical preconceptions'. In particular, for Williams, scepticism arises because of a commitment to what he calls 'epistemic realism'. A fundamental thesis of my book Pyrrhonian Reflections on Knowledge and Justification is that scepticism (in its most challenging forms) is not based upon such prior theoretical commitments, but rather is the (...) natural outcome of unrestricted exploitation of a feature already present in our everyday concept of knowledge. Specifically, our everyday epistemic practices contain a useful mechanism that raises the level of evidential scrutiny in problematic settings. However, in the absence of psychological constraints (as in Hume) or pragmatic constraints (as in Peirce), this mechanism can generate an ever-widening range of undefeated possible defeaters- and with this, radical forms of scepticism emerge.Scepticism is not the result ofmounting the wronghorse (as Williams thinks),but the result of riding a serviceable horse too hard. With respect to Williams'own contextualist response, it is not clear whether, in the end, he avoids or embraces a strong version of scepticism. He claims that Cartesian doubts arise in a particular context, namely, the context of pursuing an epistemically realistic programme. In that context, according to Williams, Cartesian scepticism is unanswerable. His central claim, I take it, is that nothing compels us to do philosophy under these contextual constraints. In arguingthisway,however,Williamsseemsto have adopted a strongversion of relativism of just the sort traditionally exploited for sceptical purposes. To the claim 'It is all a matter of context', the correct response is, 'It had better not be- at least if you are trying to refute scepticism.'Perhaps Williams can produce a strongly contextualist position that does not slide into scepticism, and perhaps his appeal- rather late his book- to externalist consideration is intended to do this.But just as it is unclear whether contextualism can avoid scepticism, it is also unclear whether externalism has force against sensibly stated (even very strong) versions of scepticism. (shrink)

The recent political “left turn” in Latin America has led to an increased emphasis on social policy and poverty alleviation programs aimed at women. Drawing on ethnographic fieldwork and interviews in a rural village in Nicaragua, I argue that one of the consequences of such programs is an increase in women’s daily workload, which I call the gendered burden of development. By exploiting women’s unpaid community care labor, these non-governmental organizations and state-led programs entrench established gender roles and responsibilities. (...) Furthermore, through their selective interventions, these programs reinforce the neoliberal ideal of self-sufficiency in women’s everyday lives, contributing to the formation of a particular kind of developmental subject who assumes responsibility for her own hardships. Although these programs have produced some tangible improvements in women’s lives, they ultimately do little to alter the structural conditions affecting the precariousness of women’s survival. (shrink)

Working parents in are struggling to balance the demands of their occupation with those of childcare and homeschooling during the COVID-19 pandemic. Moreover, studies show that women are shouldering more of the burden and reporting greater levels of psychological distress, anxiety, and depression relative to men. However, research has yet to show that increases in psychological symptoms are linked to changes in stress during the pandemic. Herein, we conduct a small-N study to explore the associations between stress and psychological (...) symptoms during the pandemic among mothers using structural equation modeling, namely latent change score models. Thirty-three mothers completed questionnaires reporting current anxious and depressive symptoms, as well as stressful life experiences prior to-versus during the pandemic. Women endorsed significantly more stressful events during the pandemic, relative to the pre-pandemic period. Additionally, 58% of mothers scored as moderate-to-high risk for developing a stress-related physical illness in the near future because of their pandemic-level stress. Depressive symptoms were associated with the degree of change in life stress, whereas anxiety symptoms were more related to pre-pandemic levels of stress. The present study preliminarily sheds light on the nuanced antecedents to mothers’ experiences of anxious and depressive symptoms during the COVID-19 pandemic. Although further work is needed in larger, more diverse samples of mothers, this study highlights the potential need for appropriate policies, and prevention and intervention programs to ameliorate the effects of pandemics on mothers’ mental health. (shrink)

This article responds to Giubilini and Minerva’s article ‘After birth abortion: why should the baby live?’ published in the Journal of Medical Ethics. They argue for the permissibility of ‘after-birth abortion’, based on two conjoined considerations: (1) the fetus or newborn, though a ‘potential person’, is not an actual person, because it is not mature enough to appreciate its own interests, and (2) because we allow parents to terminate the life of a fetus when it is diagnosed with a deformity (...) or fatal illness because of the burden it will place on the child, parent, family or society we should also allow parents to do the same to their newborn, since it is no more a person than the fetus. The author critiques this case by pointing out (a) the metaphysical ambiguity of potential personhood and (b) why the appeal to burdens is irrelevant or unnecessary. (shrink)

Institutional review board delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in (...) the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improv... (shrink)

In two recent essays, Thomas Pogge addresses the question of how research and development of essential drugs should be incentivized. Essential drugs are drugs for diseases that ruin human lives. The current incentivizing scheme for such drugs is, according to Pogge, a significant causal factor in bringing about a state of affairs in which millions of people die or suffer from lack of access to essential drugs. Pogge, therefore, suggests a reform plan for how to incentivize research and development of (...) these drugs, and he is of the opinion that implementation of this plan will have a significant positive impact on the global disease burden. This paper is a critical examination of Pogge's reform plan. In the first part of the paper, Pogge's reasons for being dissatisfied with the current incentivizing scheme are spelled out. The reform plan is then presented, and in the final part of the paper, it is argued that the reform plan is flawed at a number of levels. (shrink)

Arguably, there is no gesture more typical to philosophy than its repudiation, the sense that philosophical endeavor is a symptom of the pathologies or dislocations of everyday life it seeks to remedy. Throughout the nineteenth century—in the writings of the German Romantics, Young Hegelians, Marx, Kierkegaard, and Nietzsche—the repudiation of philosophy is a constant. Sometimes this repudiation takes a reflective form in which traditional philosophical claims are translated into another vocabulary, or are deflated ; sometimes alternative methods are adopted that (...) attempt to undermine, explain away, what is thought of as uniquely philosophical; sometimes rhetorical strategies are adopted that aim to bring about a “conversion” in the reader away from philosophy and toward a more fully immanent or existential self-understanding; and sometimes that more everyday self-understanding that is to be the antidote to philosophical reflection is construed as not yet available but would come to be in an ideal or utopian future if particular radical transformations of current practices were accomplished. Apart from Kierkegaard, these attempts typically construe themselves as continuous with the critique of religion, as if philosophy were nothing but religious excess in rational dress, and thus continuous with modernity’s drive toward secularity. Because the stakes of repudiation are inevitably normative—the protest against philosophy for the sake of a more “realistic,” more truly natural or historical, conception of what is rational or good—the critique of philosophy becomes, despite itself, philosophical, burdened with presuppositions it can neither sustain nor forgo. In brief, this is the lesson of Daniel Brudney’s meticulous and patient excavation of the writings of the young Marx. (shrink)

Slife and Reber ask of psychologists that they recognize their prejudice against theism and the incompatibility between theistic and naturalistic worldviews. Yet, the subtext of their article is that theism and naturalism are equally valid and that psychology’s secularism is a mistake. Given that theism is not beyond reason, the only sufficient ground for charging psychologists with prejudice is if theism has survived serious attempts at conceptual and empirical test, and psychology ignores or disguises this fact. So, the grounds for (...) believing in the reality of a supernatural existent are highly relevant to the authors’ allegation. However, their concept of God affords no such grounds. They disavow the logic involved in the ordinary meaning of the term “incompatible” and they ignore a crucial distinction between conditions of existence and qualities of things or processes. The consequence is that either God is this-worldly, and there is no ontological basis to Slife and Reber’s incompatibility thesis, or God’s mode of existence is quite different from the mode of existence of ordinary things and all the problems of dualism follow. Either way, their charge of prejudice is without foundation. The burden of proof rests with the defender of theism and, for now, psychology’s secularism can be considered a mark of the discipline’s rationality. 2012 APA, all rights reserved). (shrink)

The pragmatics underlying Paul Grice’s analysis of utterance-meaning provide a powerful framework for investigating the commitments arguers undertake. Unfortunately, the complexity of Grice’s analysis has frustrated appropriate reliance on this important facet of his work. By explicating Cicero’s use of apostrophe in his famous “First Catilinarian” this essay attempts to show that a full complex of reflexive gricean speaker intentions in essentially to seriously saying and meaning something.

This article discusses the place of mystery in Christian thought and practice. Both Christians themselves and their critics have historically thought that the concept of mystery is central to Christian reflection and Christian worship. It is initially surprising, then, to find that the indices of recent important reference works contain few if any references to mystery. The most important reason for the neglect of mystery may be this. William Alston begins his recent ‘Two Cheers for Mystery’ by observing that ‘contemporary (...) Anglo-American analytic philosophy of religion’ exhibits ‘a considerable degree of confidence in’ its ability ‘to determine what God is like; how to construe his basic attributes; and what his purposes, plans, standards, values and so on are’. No one ‘thinks we can attain a comprehensive knowledge of God's nature and doings. But on many crucial points, there seems to be a widespread confidence in our ability to determine exactly how things are with God.’ And, of course, the more confident one is, the less one will see any need for according the concept of mystery a central place in one's reflections on God. But what if failing to do so distorts these reflections? The burden of this article is that it does. (shrink)

Recourse to a being’s moral status is the ‘nuclear option’ of moral theorising—it tells us not only what obligations we have and to what degree, but whether we have obligations to them in the first place and whether their moral concern trumps concern for other beings simply in virtue of the kind of being they are. As such, we should only explain obligations in terms of a being’s moral status if doing so is principled and necessary to defend that obligation. (...) In ‘Pregnancy and Superior Moral Status: A Proposal for Two Thresholds of Personhood’, Robinson1 argues that pregnant women achieve a second and therefore superior threshold of moral status to ‘mere persons’. She insists that this is not a view about the woman and the fetus together but that ‘the pregnant woman herself is more than one individual’. This gives us strong reason to re-balance the imbalanced burdens experienced by women due to pregnancy. I will argue her proposal is neither principled nor necessary. We can explain special obligations to pregnant women without appealing to a distinct moral status, without reaching for the ‘nuclear option’. First, consider Robinson’s1 claim that pregnant women ‘are performing a role which is of supreme importance: that of creating new human life, and maintaining the survival of the human species’. …. (shrink)

In 1814, Baron de Vastey wrote in The Colonial System Unveiled: “When Europeans came to the new world, their first steps were accompanied by crimes on a grand scale, massacres, the destruction of empires, the obliteration of entire nations from the ranks of the living”. Jean Louis Vastey was a Black Haytien man born in 1781, who assumed the role of an administrator in Hayti after Jean-Jacques Dessalines freed the island from European rule. The Haytien Revolution, which was fought from (...) 1791 to 1804, is the origin of Black theories of liberation from the nineteenth century. The possibility of freedom was not found in the rhetoric of American democratic proclamations, as many authors have asserted, but... (shrink)

This is a response to Macleod 2012's argument that the history of unjust property acquisitions requires rich libertarians to give away everything in excess of equality. At first, problematic questions are raised. How much property is usually inherited or illegitimate? Why should legitimate inheritance be affected? What of the burden of proof and court cases? A counterfactual problem is addressed. Three important cases are considered: great earned wealth; American slavery; land usurpation. All are argued to be problematic for Macleod (...) 2012's thesis. Various problems are explained concerning using the Nozickian argument to decide the alleged excess that rich libertarians own. The essay's main error is the presupposition that free markets do not help the worst-off. The majority of unjust holdings today are not the result of historical injustices but arise through continuing transfers enabled by taxation and state-regulation. More study of libertarian contributions to the social sciences and philosophy would appear to be desirable "personal behavior" among socialists. (shrink)

The COVID-19 pandemic has triggered much-needed reflection on family caregiver burden. This is unsurprising, given U.S. dependence on acute health care delivery and long-standing t...

Centring on John Flamsteed, the first Astronomer Royal, this paper investigates the ways in which astronomers of the late seventeenth century worked to build and maintain their reputations by demonstrating, for their peers and for posterity, their proficiency in managing visual technologies. By looking at his correspondence and by offering a graphic and textual analysis of the preface to his posthumousHistoria Coelestis Britannica, I argue that Flamsteed based the legitimacy of his life's work on his capacity to serve as a (...) skilful astronomer who could coordinate the production and proper use of astronomical sighting instruments. Technological advances in astrometry were, for Flamsteed, a necessary but not a sufficient condition for the advancement of astronomy. Technological resources needed to be used by the right person. The work of the skilful astronomer was a necessary precondition for the mobilization and proper management of astronomical technologies. Flamsteed's understanding of the astronomer as a skilled actor importantly shifted the emphasis in precision astronomical work away from the individual observer's ability to see well and toward the astronomer's ability to ensure that instruments guaranteed accurate vision. (shrink)

This work, written from a neo-Pyrrhonian perspective, is an examination of contemporary theories of knowledge and justification. It takes ideas primarily found in Sextus Empiricus's Outlines of Pyrrhonism, restates them in a modern idiom, and then asks whether any contemporary theory of knowledge meets the challenges they raise. The first part, entitled "Gettier and the Problem of Knowledge," attempts to rescue our ordinary concept of knowledge from those philosophers who have assigned burdens to it that it cannot bear. Properly understood, (...) Fogelin shows that the concept of knowledge is unproblematic. The second part of this study, called "Agrippa and the Problem of Justification," examines Agrippa's contribution to Pyrrhonism, a systematic reduction of its procedures which came to be known as the "Five Modes Leading to the Suspension of Belief." These modes present a completely general procedure for refuting any claim a dogmatist might make. Though largely unnoticed, there is, according to Fogelin, an uncanny resemblance between problems posed by Agrippa's "Five Modes" and those that contemporary epistemologists address under the heading of a theory of justification. Fogelin examines the strongest contemporary theories of justification--in both foundationalist and anti-foundationalist forms. The conclusion is that recent philosophical writings on justification have made no significant progress in responding to the Pyrrhonian problems these writings have addressed. (shrink)

Background: Direct–to–consumer genetic testing (DTCGT) offers risk estimates for a variety of complex diseases and conditions, yet little is known about its impact on actual users, including their decisions about sharing the information gleaned from testing. Ethical considerations include the impact of unsolicited genetic information with variable validity and clinical utility on relatives, and the possible burden to the health care system if revealed to physicians. Aims: The qualitative study explored primary care patients’ views, attitudes, and decision making considerations (...) regarding DTCGT. This article focuses on the disclosure decisions participants made regarding participation, testing, and results of DTCGT, a topic which arose as a secondary aim of the study. Methods: Through four longitudinal interviews (pre–test, results, 3 and 12 months post–test) we examined twenty primary care patients’ decisions, expressed intentions, and actions regarding disclosure to immediate and extended family, friends and coworkers, and physicians about participation in and results of DTCGT. Individual interviews were analyzed using qualitative content analysis and a summative approach to describe the global themes. Results: Most participants disclosed to some immediate family; less than half disclosed to extended family; approximately half talked to friends. Most participants stated they would or might disclose to physicians about DTCGT and a few did. Conceptual themes that emerged from the data analysis include ambivalence about disclosure, consistency between intention and actual disclosure behavior and decisions, and conditional information sharing. Conclusions: Participants’ intentional and actual disclosure patterns offer insight into how they view DTCGT, weigh results, and the potential impact of DTCGT. (shrink)

This article revisits long-standing questions about consent, membership and emigration in Locke’s thought. Commentators such as A John Simmons have argued that Locke opens political membership to both express consenters and some kind of tacit consenters, and not just to the former, as some have suggested. Simmons’s reading seems to render Locke more sensible in that it does not exclude large numbers of people from membership or burden the few members with all the civic duties, and also in that (...) it allows at least tacit-consenting members the right to relocate, while this right is denied to express-consenting members. Against this reading, the article shows, by resolving seemingly conflicting claims in the text, that people become members only by express consent. It also responds to the criticism that the express-consent-only reading would limit membership to a few and so would render Locke’s account implausible from a practical point of view. The article then addresses the purported restriction Locke imposes on express consenters’ right to emigrate, arguing that the restriction concerns the change of membership and not the right to relocate. (shrink)

Drawing on theoretical work on humans’ adaptive capacity, we propose that supervisors’ perception of top management’s high bottom-line mentality (BLM) has a dysfunctional effect on their ethical leadership practices. Specifically, we suggest that these perceptions hinder supervisors’ empathy, which eventuates in less ethical leadership practices. We also investigate, in a first-stage moderated mediation model, how supervisors high in trait mindfulness are resistant to the ill effects of perceptions of top management’s high BLM. Supervisors high (versus low) in this trait are (...) less likely to respond to perceptions of top management’s high BLM with reduced empathy that then hinders ethical leadership. Results from a multi-wave, multi-source sample of working adults from the Chinese high technology industry provide general support for our theoretical model. Theoretical and practical implications are discussed. (shrink)

Drawing on theoretical work on humans’ adaptive capacity, we propose that supervisors’ perception of top management’s high bottom-line mentality (BLM) has a dysfunctional effect on their ethical leadership practices. Specifically, we suggest that these perceptions hinder supervisors’ empathy, which eventuates in less ethical leadership practices. We also investigate, in a first-stage moderated mediation model, how supervisors high in trait mindfulness are resistant to the ill effects of perceptions of top management’s high BLM. Supervisors high (versus low) in this trait are (...) less likely to respond to perceptions of top management’s high BLM with reduced empathy that then hinders ethical leadership. Results from a multi-wave, multi-source sample of working adults from the Chinese high technology industry provide general support for our theoretical model. Theoretical and practical implications are discussed. (shrink)

Arguably, there is no gesture more typical to philosophy than its repudiation, the sense that philosophical endeavor is a symptom of the pathologies or dislocations of everyday life it seeks to remedy. Throughout the nineteenth century—in the writings of the German Romantics, Young Hegelians, Marx, Kierkegaard, and Nietzsche—the repudiation of philosophy is a constant. Sometimes this repudiation takes a reflective form in which traditional philosophical claims are translated into another vocabulary, or are deflated ; sometimes alternative methods are adopted that (...) attempt to undermine, explain away, what is thought of as uniquely philosophical; sometimes rhetorical strategies are adopted that aim to bring about a “conversion” in the reader away from philosophy and toward a more fully immanent or existential self-understanding; and sometimes that more everyday self-understanding that is to be the antidote to philosophical reflection is construed as not yet available but would come to be in an ideal or utopian future if particular radical transformations of current practices were accomplished. Apart from Kierkegaard, these attempts typically construe themselves as continuous with the critique of religion, as if philosophy were nothing but religious excess in rational dress, and thus continuous with modernity’s drive toward secularity. Because the stakes of repudiation are inevitably normative—the protest against philosophy for the sake of a more “realistic,” more truly natural or historical, conception of what is rational or good—the critique of philosophy becomes, despite itself, philosophical, burdened with presuppositions it can neither sustain nor forgo. In brief, this is the lesson of Daniel Brudney’s meticulous and patient excavation of the writings of the young Marx. (shrink)

The advent of personal genomics companies offering direct translation of scientific data into personal health information, calls into question traditional policies to refuse disclosure of such scientific data to research participants. This seems especially true for population biobanks, as they collect not only genotype information but also associated phenotype information, and thus may be in a unique position to translate their scientific findings into personal health information for their participants. Disclosure of such information seems mandated by the expectations raised by (...) biobanks and their participants' rights to know health information, to know clinical research results, to life and health and particularly their right to benefit. Refusals to disclose such information can be grounded in the lack of analytical validity and/or clinical utility of most findings, the need to avoid the therapeutic misconception, the complexity and costs involved in translation and disclosure and the disproportionate burden resulting from the obligation to respect participants' right not to know before any disclosure can be made. Currently, any demands by participants in population biobanks for full disclosure of all pertinent personal health information potentially resulting from the biobank's scientific findings are unlikely to be granted by a Dutch court under Dutch and international law. As the law stands now, a population biobank is neither a doctor nor a personal genomics company. However, in view of the rapid scientific, medical, technological, commercial and social developments, population biobanks must prepare to take more care of their participants' legitimate interest in receiving as much validated personal health information as reasonably possible, in a timely fashion, by developing appropriate translation and disclosure mechanisms. This paper examines whether population biobank participants have the right, under Dutch civil law and international law, to full disclosure, i.e. to all information generated by the biobank that is pertinent to their present and future health. It pioneers the format of a hypothetical court case to elucidate the legal and policy arguments" for and against full disclosure. (shrink)

If Savulescu's controversial principle of Procreative Beneficence is correct, then an important implication is that couples should employ genetic tests for non-disease traits in selecting which child to bring into existence. Both defenders as well as some critics of this normative entailment of PB have typically accepted the comparatively less controversial claim about non-disease traits: that there are non-disease traits such that testing and selecting for them would in fact contribute to bringing about the child who is expected to have (...) the best life. We challenge this less controversial claim, not by arguing deductively for its falsity, but by showing that Savulescu's central argument for this presumably less controversial claim fails. Savulescu offers intelligence as the paradigm example of a testable non-disease trait such that testing and selecting for it would increase the likelihood that the child selected would be the one who is expected to have the best life. We provide a series of arguments aimed at demonstrating that Savulescu's argument from intelligence fails. If our arguments are successful, the upshot is not that PB is false, but more modestly, that the burden of proof remains squarely with Savulescu. (shrink)

continent. 2.2 (2012): 76–81 Comments on Eugene Thacker’s “Cosmic Pessimism” Nicola Masciandaro Anything you look forward to will destroy you, as it already has. —Vernon Howard In pessimism, the first axiom is a long, low, funereal sigh. The cosmicity of the sigh resides in its profound negative singularity. Moving via endless auto-releasement, it achieves the remote. “ Oltre la spera che piú larga gira / passa ’l sospiro ch’esce del mio core ” [Beyond the sphere that circles widest / penetrates (...) the sigh that issues from my heart]. 1 The axiomatic sigh of the pessimist is in a way the pure word of philosophy, a thought that thinks without you, speaks where you are not. The live pneumatic form of the soul’s eventual exit from the dead body’s mouth, the sigh restores consciousness to the funeral of being, to the passing away that is existence. Pessimism speaks in piercing aphorisms because first it sighs. “Beyond the sphere passeth the arrow of our sigh. Hafiz! Silence.” 2 … pessimism is guilty of that most inexcusable of Occidental crimes—the crime of not pretending it’s for real. To the pessimist, the ‘real’ world—the world on whose behalf we are expected to wake up in the morning—is a ceaseless index of its own unreality. The pessimist’s day is not an illumined space for the advancement of experience and action, but a permanently and inescapably reflective zone, the vast interior of a mirror where each thing is only insofar as it is, at best, a false image of itself. Within this speculative situation, inside the doubleness of the mirror, pessimism splits into two paths, false and true, one that tries to fix pessimism (establish a relation with the mirror) and decides in favor of the apparent real, and another that totally falls for pessimism (enters the mirror) and communes with the greater reality of the unreal. These two paths are distinguished by their relation to pessimism’s guilt vis-à-vis the world’s reality-project. The first form, that which remains pessimism for the world and puts on a smiling face, stays guilty to itself (i.e. unconscious) and thus turns hypocritical, becoming at once the pessimism of the commoner who really just wants things to be better for himself and the pessimism of the elite who wants to critically refashion reality in his own image. The general form of this worldly, hypocritical pessimism is the impulse to ‘make the world a better place’, which is the global mask under which the world is diurnally made worse. The second form, that which follows pessimism away from the world and ceases to put on a smiling face, refuses guiltiness as itself theessential Occidental mode of pretense and turns honest, becoming at once the intelligent pessimism required of all ordinary action and the radical pessimism necessary for self-knowledge: seeing that no one is capable of doing good. The general form of this universal, honest pessimism is the impulse not to worry, to give up and embrace dereliction, which is the only real way the world is actually improved. Where worldly pessimism is the engine productive of interminably warring secular and sacred religions (good-projects), universal pessimism strives hopelessly for the paradise of a supremely instantiated pessimus: things are getting so bad that there is no longer any time for them to get worse; things are so constantly-instantly worst that this is BEST. Cosmic pessimism is the mode of universal pessimism which can yet discourse with the world, which has not chosen silence and can spread the inconceivably BAD NEWS in an orderly form ( kosmos ) that the world can understand (if it wanted to). … the result of a confusion between the world and a statement about the world. That is what the world is (the result of a confusion between the world and a statement about the world). … a generalized misanthropy without the anthropos. Pessimism crystallizes around this futility—it is its amor fati , rendered as musical form. Pessimism’s love of fate is a blind love, a love of the blindness of being human in a cosmos conceived around the human’s eclipse, a heavy levitation in the contradictory space between the inescapability of its having been and the impossibility of its will-be. Pessimism’s song of futility is a sensible way of loving fate, with a minimum of eros, by means of a kind of matrimonial love of the fatal. As music, pessimism stays open to the irreparable and the inexorable without the binding of affirmation, in the apparent absence of the radical, infinitely surplus will that absolute amor fati seems to require. Crying, laughing, sleeping—what other responses are adequate to a life that is so indifferent? “Unless a man aspires to the impossible, the possible that he achieves will scarcely be worth the trouble of his achieving it. We should aspire to the impossible, to absolute and infinite perfection [….] The apocatastasis is more than a mystical dream: it is a norm of action, it is a beacon for high deeds [….] For true charity is a species of invasion [….] It is not charity to rock and lull our fellow men to sleep in the inertia and heaviness of matter, but rather to arouse them to anguish and torment of spirit.” 3 … the impossibility of ever adequately accounting for one’s relationship to thought. “The paroxysm of interior experience leads you to regions where danger is absolute, because life which self-consciously actualizes its roots in experience can only negate itself [….] There are no arguments [….] On the heights of despair, the passion for the absurd is the only thing that can still throw a demonic light on chaos [….] I live because the mountains do not laugh and the worms do not sing .” 4 It took three attempts before she was fully decapitated, all the while she continued, perhaps miraculously, to sing. According to the earliest account of Cecilia’s martyrdom, the beheading turns out worse. After not severing her head in three strokes, “the cruel executioner left her half dead” (seminecem eam cruentus carnifex dereliquit). 5 Cecilia’s effortlessly powerful endurance of the three strokes—a fitting icon for pessimism as an art of dereliction—demonstrates the “passivity and absence of effort [….] in which divine transcendence is dissolved.” 6 There’s a ghost that grows inside of me, damaged in the making, and there’s a hunt sprung from necessity, elliptical and drowned. Where the moving quiet of our insomnia offers up each thought, there’s a luminous field of grey inertia, and obsidian dreams burnt all the way down. Like words from a pre-waking dream. There is no reason to think that they are not. NOTES 1. Dante Alighieri. Vita Nuova . ed. and trans. Dino S. Cervigni and Edward Vasta. Notre Dame: University of Notre Dame Press. 1995. 41:10. 2. Hafiz of Shiraz. The Divan . trans. H. Wilberforce Clarke. London: Octagon Press. 1974. 10.9. 3. Miguel de Unamuno. The Tragic Sense of Life in Men and Nations . trans. Anthony Kerrigan. Princeton: Princeton University Press. 1972. 305-6. 4. E.M. Cioran. On the Heights of Despair . trans. Ilinca Zarifopol-Johnston. Chicago: University of Chicago Press. 1992. 9-10. 5. Giacomo Laderchi. S. Caeciliae Virg[inis] et Mart[yris] Acta. . . Rome. 1723. 38. 6. Georges Bataille. On Nietzsche . trans. Bruce Boone. London: Continuum. 2004. 135. See Nicola Masciandaro. “ Half Dead: Parsing Cecilia .” A Commentary on Eugene Thacker’s "Cosmic Pessimism" Gary J. Shipley Pessimism is the refusal to seek distraction, the refusal to remodel failure into a platform for further (doomed) possibilities, the refusal of comfort, the acceptance of the sickness of healthy bodies, the cup of life overflowing with cold vomit. If, as Ligotti suggests when discussing Invasion of the Body Snatchers , 1 humans prefer the anxieties of their familiar human lives to the contentment of an alien one, then the pessimist, we could argue, represents some perverted combination of the two, preferring (presuming he has a choice) the defamiliarization of human life to the contentment of its unquestioned mundanity. The quasi-religious state of mind that Wittgenstein would mention on occasion, that of “feeling absolutely safe,” 2 is a state the pessimist could only imagine being approximated by death, or perhaps some annihilative opiate-induced stupor. This Wittgensteinian commingling of certainty and faith looks every bit the futile gesture, a mere rephrasing of collapse or partial collapse. The only certainty open to the pessimist is that of the toxic formula of life itself—a formula known and lacuna-free. Certainty, far from being the gateway to deliverance, becomes the definitive impediment; and the possibility of salvation, as long as it remains, becomes crucially reliant on postulations of ignorance, epistemic gaps, a perennial incompleteness: “the perfect safety of wooed death […] the warm bath of physical dissolution, the universal unknown engulfing the miniscule unknown.” 3 The height of Leibniz’s Panglossian insanity nurtured the idea that our knowing everything—via the universal calculus—could be accurately described a triumph, as opposed to a nightmare in which our every futility is laid bare. Stagnancy and boredom are perhaps two of the greatest ills of Western civilisation, and the most potent pessimism tells you that you’re stuck with both. The most we can hope for, by way of salvation, is to throw open our despair to the unknown. The fact that Schopenhauer’s pessimism stopped short of morality and allowed him to play the flute, as Nietzsche complained, highlights the predicament of a man who despite having adorned nothingness with a smiling face still found himself alive. The demand here is that it be felt: a cross-contamination of intellect and emotion. The safety net of numerous parentheses makes for a failed philosophy, rather than a philosophy of failure. Depressives make bad pessimists, because, unless they choose to die, living will always infect them with necessities of hope, forcing them to find something, anything (all the various “as ifs”) to make existence tolerable. For as Cioran observed, while “[d]epressions pay attention to life, they are the eyes of the devil, poisoned arrows which wound mortally any zest and love of life. Without them we know little, but with them, we cannot live.” 4 And even when cured of our depressions we’ll find ourselves consumed, eaten alive by the hyper-clinical (borderline autistic) mania that replaces them: a predicament captured all too clearly in the microscriptual fictions of Robert Walser, where spectral men and women stifle their depressive madness with protective comas of detail, their failed assimilations buried beneath thick crusts of remote data. Like Beckett’s Malone their stories may have ended, but cruelly their lives have not. Pessimism is an extraneous burden (a purposeless weight) that makes everything else harder to carry, while at the same time scooping it out and making it lighter. If pessimism had a sound it would be the harsh non-noise of tinnitus—the way that every person would hear themselves if they refused their distractions long enough to listen: a lungless scream from the extrasolar nothing of the self. The music of pessimism—if indeed we can imagine such a thing—is the reverberating echo of the world’s last sound, conjectured but never heard, audible only in its being listened for. The one consolation of this hollow paradox of audibility being, that “he will be least afraid of becoming nothing in death who has recognized that he is already nothing now.” 5 The pessimist suffers a derangement of the real, a labyrinthitis at the nucleus of his being: he’s the stumbling ghost relentlessly surprised that others can see him. If Cioran’s refusal is manifested in sleep (when even saying ‘no’ is too much of a commitment), then Pessoa’s resides in the dreams inside that sleep. Pessoa chooses to exploit the fact that he’s being “lived by some murmuring non-entity both shadowy and muddied” 6 by growing more voids to live him. His is a Gnostic breed of sleep, “sleeping as if the universe were a mistake,” 7 a sleep that dreams through Thacker’s cosmic pessimism (“a pessimism of the world-without-us.”, “the unhuman orientation of deep space and deep time” 8 ), through the critical error of there being anything at all when there could be nothing. The metaphysical pessimist is someone who, however well life treats them, still desires to wake from it, as from the poisonous air of a bad dream. Pessimism is a paradox of age, being simultaneously young and old; its youth residing in a refusal to accept the authority of existence (its rich history, its inherent beneficence), a refusal to “get over” the horror of what it sees with its perpetually fresh eyes, and its maturity in the unceremonious disposal of the philosophical playthings (those futile architectures) of adolescence. As Thacker remarks: “Pessimism abjures all pretenses towards system—towards the purity of analysis and the dignity of critique.” 9 A sentiment shared with Pessoa, who duly categorizes those that choose to enact this futile struggle: “The creators of metaphysical systems and of psychological explanations are still in the primary stage of suffering.” 10 If the pessimist has shared a womb with anyone, it’s with the mystic and not the philosopher. As Schopenhauer tells us: “The mystic is opposed to the philosopher by the fact that he begins from within, whereas the philosopher begins from without. […] But nothing of this is communicable except the assertions that we have to accept on his word; consequently he is unable to convince.” 11 The crucial difference between the mystic and the pessimist is not the latter’s impassivity and defeatism, but his unwillingness/inability to contain in any way the spread of his voracious analyticity, his denial of incompleteness, his exhaustive devotion to failure. The truth of our predicament, though heard, is destined to remain unprocessed. Like the revelations of B.S. Johnson’s Haakon (“We rot and there’s nothing that can stop it / Can’t you feel the shaking horror of that?” 12 ) the pessimist’s truths are somehow too obvious to listen to, as if something inside us were saying, “Of course, but haven’t we gotten over that?” Pessimism is simple and ugly, and has no desire to make itself more complex or more attractive. The true moral pessimist knows that the Utilitarian’s accounts will always be in the red. He can see that for all his computational containments, his only honest path is a negative one, and that such a path has but one logical destination: that of wholesale human oblivion. Thacker notes how at the core of pessimism lies the notion of “the worst,” through which death is demoted by the all-pervasive suffering of a life that easily eclipses its threat. And so with doom made preferable to gloom, death begins to glint with promise, “like beauty passing through a nightmare.” 13 But even among pessimists suicide is, for the most part, thought to be an error. Schopenhauer, for instance, regarded suicide a mistake grounded in some fundamentally naïve disappointment or other. Pessoa too thought suicide an onerous escape tactic: “To die is to become completely other. That’s why suicide is a cowardice: it’s to surrender ourselves completely to life.” 14 There is a call here to be accepting of and creative with the puppetry of your being, an insistence that it’s somehow a blunder to attempt to hide in death from the horrors you find inlife. 15 Tied up with this perseverance is the slippery notion of the good death, for maybe, as Blanchot warns, suicide is rarely something we can hope to get right, for the simple reason that “you cannot make of death an object of the will.” 16 “Even in cases where the entire corpus of an author is pessimistic, the project always seems incomplete,” 17 and this is not simply because the project itself belies something yet to be disclosed, but because the project itself is a thing waiting. It waits on a cure it knows will not come, but for which it cannot do anything (as long as it continues to do anything) but wait. NOTES 1. See Thomas Ligotti. The Conspiracy Against the Human Race . New York: Hippocampus Press. 2010. 91. 2. Ludwig Wittgenstein. “A Lecture on Ethics.” Philosophical Review . (74) 1. 1965. 8. 3. Vladimir Nabokov. Pale Fire . New York: Vintage. 1989. 221. 4. E. M. Cioran. The Book of Delusions . trans. Camelia Elias. Hyperion. 5.1. (2010): 75. 5. Arthur Schopenhauer. The World as Will and Representation. vol. 2 . trans. E .F J. Payne. New York: Dover. 1966. 609. 6. Eugene Thacker. “Cosmic Pessimism.” continent. . 2.2 (2012): 67. 7. Fernando Pessoa. The Book of Disquiet . trans. Richard Zenith. London: Penguin. 2002. 35. 8. Eugene Thacker. “Cosmic Pessimism.” continent. . 2.2 (2012): 68. 9. Ibid. 73. 10. Fernando Pessoa. The Book of Disquiet . trans. Richard Zenith. London: Penguin. 2002. 341. 11. Arthur Schopenhauer. The World as Will and Representation. vol. 2 . trans. E .F J. Payne. New York: Dover. 1966. 610-11. 12. B.S Johnson. “You’re Human Like the Rest of Them.” in Jonathan Coe. Like a Fiery Elephant: The Story of B.S. Johnson . London: Picador. 2004. 177. 13. Fernando Pessoa. The Book of Disquiet . trans. Richard Zenith. London: Penguin. 2002. 415. 14. Ibid. 199. 15. “Suicide is, after all, the opposite of the poem.” Anne Sexton. No Evil Star: Selected Essays, Interviews and Prose . ed. Steven Gould Axelrod. Ann Arbor: University of Michigan Press. 1985. 92. 16. Maurice Blanchot. The Space of Literature . trans. Ann Smock. Lincoln: University of Nebraska Press. 1989. 105. 17. Eugene Thacker. “Cosmic Pessimism.” continent. . 2.2 (2012): 75. (shrink)

Obtaining prospective written consent from women to participate in trials when they are experiencing an obstetric emergency is challenging. Alternative consent pathways, such as gaining verbal consent at enrolment followed, later, by obtaining written consent, have been advocated by some clinicians and bioethicists but have received little empirical attention. We explored women’s and staff views about the consent procedures used during the internal pilot of a trial, where the protocol permitted staff to gain verbal consent at recruitment. Interviews with staff (...) and participating women. Data were analysed thematically and interviews were cross-compared to identify differences and similarities in participants’ views about the consent procedures used. Women and some staff highlighted benefits to obtaining verbal consent at trial enrolment, including expediting recruitment and reducing the burden on those left exhausted by their births. However, most staff with direct responsibility for taking consent expressed extreme reluctance to proceed with enrolment until they had obtained written consent, despite being comfortable using verbal procedures in their clinical practice. To account for this resistance, staff drew a strong distinction between research and clinical care and suggested that a higher level of consent was needed when recruiting into trials. In doing so, staff emphasised the need to engage women in reflexive decision-making and highlighted the role that completing the consent form could play in enabling and evidencing this process. While most staff cited their ethical responsibilities to women, they also voiced concerns that the absence of a signed consent form at recruitment could expose them to greater risk of litigation were an individual to experience a complication during the trial. Inexperience of recruiting into peripartum trials and limited availability of staff trained to take consent also reinforced preferences for obtaining written consent at recruitment. While alternative consent pathways have an important role to play in advancing emergency medicine research, and may be appreciated by potential recruits, they may give rise to unintended ethical and logistical challenges for staff. Staff would benefit from training and support to increase their confidence and willingness to recruit into trials using alternative consent pathways. This qualitative research was undertaken as part of the GOT-IT Trial. Date of registration 26/03/2014. (shrink)