This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met (...) a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study’s success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. (shrink)

Hastings Center Report, Volume 52, Issue 2, Page 21-31, March‐April 2022.

Objectives:Over the past two decades, all U.S. states have incorporated alcohol ignition interlock technology into sentencing laws for individuals convicted of driving while intoxicated. This article provides the first 50-state summary of these laws to include changes in the laws over time and their effective dates. This information is critical for policy makers to make informed decisions and for researchers to conduct quantitative evaluation of the laws.Methods:Standard legal research and legislative history techniques were used, including full-text searches in the Westlaw (...) legal database and identification of state session laws. Because ignition interlock device laws often change over time, we identified the date of each law's initial enactment as well as the effective date of each law in its current form.Results:Beginning with California and Washington in 1987, all 50 states have enacted IID laws as a sentencing option for DWI offenders. Initially, most of these laws were discretionary. Today, however, 48 states mandate IID installation for at least some types of DWI offenders to maintain lawful driving privileges. Of these, 27 mandate an IID for all offenders; seven mandate an IID for repeat offenders only; and 21 for some combination of specific groups of DWI offenders, including repeat offenders, offenders with a blood alcohol content above a legislatively-specified level, and aggravated offenders.Conclusion:States have wrestled with a number of IID policy issues, including for whom to mandate IIDs and whether to suspend a license for DWI prior to reinstating driving privileges with or without an IID. By understanding how state interlock laws differ, policy makers and researchers can ultimately better ascertain the impact of these laws. (shrink)

ABSTRACT:Daniel Callahan died on July 16, 2019, just short of his 89th birthday. In the years since, we have seen the overturning of abortion rights, a concern central to his scholarship and musings about the place of religion in American civic life. Callahan’s journey from lay Catholic journalist and commentator at Commonweal to a co-founder of the Hastings Center, during his decade of doubt, is especially relevant today as America revisits established precedent governing a woman’s right to choose. His life-long (...) struggle with faith and the secularization of bioethics is a story worth telling, as it may foster dialogue across a divide between religious and laical thinkers that has fractured our political discourse. We recall Callahan’s misgivings about the marginalization of religious perspectives in public life; he sought not the denial of complexity nor of difference in views, but rather the importance of free and honest debate around deeply held beliefs, contextualized in the realities of the contemporary world. Callahan’s ambivalence about his faith remains a part of the fabric of American life, a story that Callahan chronicled to our collective benefit for over a half-century. (shrink)

When Betty Friedan published The Feminine Mystique in 1963, the book exploded into women's consciousness. Before the decade was out, what had begun as a campaign for women's civil rights transformed into a diverse and revolutionary movement for freedom and social justice that challenged many aspects of everyday life long accepted as fixed: work, birth control and abortion, childcare and housework, gender, class, and race, art and literature, sexuality and identity, rape and domestic violence, sexual harassment, pornography, and more. This (...) was the women's liberation movement, and writing--powerful, personal, and prophetic--was its beating heart. Fifty years on, in the age of #MeToo and Black Lives Matter, this visionary and radical writing is as relevant and urgently needed as ever, ready to inspire a new generation of feminists. Activists and writers Alix Kates Shulman and Honor Moore have gathered an unprecedented collection of works--many long out-of-print and hard to find--that catalyzed and propelled the women's liberation movement. Ranging from Friedan's Feminine Mystique to Backlash, Susan Faludi's Reagan-era requiem, and framed by Shulman and Moore with an introduction and headnotes that provide historical and personal context, the anthology reveals the crucial role of Black feminists and other women of color in a decades long mass movement that not only brought about fundamental changes in American life--changes too often taken for granted today--but envisioned a thoroughgoing revolution in society and consciousness still to be achieved"--Back cover. (shrink)

In order to make Mukund Lath’s thoughts on music and identity accessible to a broader audience, and to call attention to links between Hindustānī musical theory and classical Indian philosophical notions, Lath’s paper “Identity Through Necessary Change: Thinking About ‘Rāga-Bhāva,’ Concepts and Characters” is being republished here with an introduction by David Shulman and explanatory notes. Mukund Lath argues that identity is usually understood as something that remains the same despite change. His endeavor is to explore an alternative to (...) this convention. The case study for Lath’s philosophical exploration is rāga music, i.e. Hindustānī classical music. He argues that the identity of the rāga is maintained not despite change, but owing to the necessary change in every execution of “the same” rāga. But how are we to even start thinking about a notion of identity that embraces rather than rejects change, a notion of identity that is based on and is rooted in change, not in stability or perpetuity? Lath explores this alternative and its consequences for the notion of identity at large. (shrink)

Longtermists have argued that humanity should significantly increase its efforts to prevent catastrophes like nuclear wars, pandemics, and AI disasters. But one prominent longtermist argument overshoots this conclusion: the argument also implies that humanity should reduce the risk of existential catastrophe even at extreme cost to the present generation. This overshoot means that democratic governments cannot use the longtermist argument to guide their catastrophe policy. In this paper, we show that the case for preventing catastrophe does not depend on longtermism. (...) Standard cost-benefit analysis implies that governments should spend much more on reducing catastrophic risk. We argue that a government catastrophe policy guided by cost-benefit analysis should be the goal of longtermists in the political sphere. This policy would be democratically acceptable, and it would reduce existential risk by almost as much as a strong longtermist policy. (shrink)

We hypothesize that recent uses of the Internet as a public-participation mechanism in the United States fail to overcome the adversarial culture that characterizes the American regulatory process. Although the Internet has the potential to facilitate deliberative processes that could result in more widespread public involvement, greater transparency in government processes, and a more satisfied citizenry, we argue that efforts to implement Internet-based public participation have overlaid existing problematic government processes without fully harnessing the transformative power of information technologies. Public (...) comments submitted in two United States Department of Agriculture rulemaking processes—the National Organic Program’s organic standard and the Forest Service’s Roadless Area Conservation Rule—compose our data. We conclude that the Internet provides an arena for playing out three types of conflicts that have long plagued environmental decision-making processes: conflicts over trust of federal agencies, the use of science, and the role of public values. (shrink)

This essay analyzes Fred Moten’s “antipolitical” romance with the “fugitive black sociality” that he radically opposes to “politics,” defined as inescapably tied to antiblack modernity. By comparing Moten’s argument to other voices in the black radical tradition, and by triangulating Moten with Hannah Arendt and Sheldon Wolin, this essay opens inherited conceptions of the political to risk and reworking but also complicates figurations of fugitivity and resists the antagonism Moten posits between black fugitivity and democratic politics.

A cornerstone of Buddhist philosophy, the doctrine of the four noble truths maintains that life is replete with suffering, desire is the cause of suffering, nirvana is the end of suffering, and the way to nirvana is the eightfold noble path. Although the attribution of this seminal doctrine to the historical Buddha is ubiquitous, Rethinking the Buddha demonstrates through a careful examination of early Buddhist texts that he did not envision them in this way. Shulman traces the development of (...) what we now call the four noble truths, which in fact originated as observations to be cultivated during deep meditation. The early texts reveal that other central Buddhist doctrines, such as dependent-origination and selflessness, similarly derived from meditative observations. This book challenges the conventional view that the Buddha's teachings represent universal themes of human existence, allowing for a fresh, compelling explanation of the Buddhist theory of liberation. (shrink)

The _play of formulas_ is a new theory designed to explain the manner in which discourses (Suttas, Sūtras) were composed in the early Buddhist tradition, focusing at present mainly on the _Dīgha-_ and _Majjhima- Nikāyas_ (the collections of the Buddha’s Long and Middle-length discourses). This theory combats the commonly accepted views that texts are mainly an attempt to record and preserve the Buddha’s teachings and life events, and that the best way to understand their history is to compare parallel versions (...) of them. By identifying the creative, mainly the literary, vectors alive in the shaping of the texts, the theory explains how discourses are the products of formulas, which themselves are the primary texts of early Buddhism. Formulas combine in order to produce meaningful textual patterns, with little account of historical context and with much interest in aesthetic appeal and emotive potency. Formulas connect according to set narrative designs, in which different types of audiences are represented not only through unique formulas, but also with their specific narrative trajectories and complementing doctrinal emphases. It is not that the early authors were not at all interested in safeguarding the tradition. It is only that there was much more going on, and that thinking about the texts in this way misses their entertaining faces and ignores their beauty. These probably tell us more about what the early discourses actually were for the people that first produced and studied them than dry philosophical doctrine. (shrink)

Suppose that an altruistic agent who is uncertain between evidential and causal decision theory finds herself in a situation where these theories give conflicting verdicts. We argue that even if she has significantly higher credence in CDT, she should nevertheless act in accordance with EDT. First, we claim that the appropriate response to normative uncertainty is to hedge one's bets. That is, if the stakes are much higher on one theory than another, and the credences you assign to each of (...) these theories are not very different, then it is appropriate to choose the option that performs best on the high-stakes theory. Second, we show that, given the assumption of altruism, the existence of correlated decision makers will increase the stakes for EDT but leave the stakes for CDT unaffected. Together these two claims imply that whenever there are sufficiently many correlated agents, the appropriate response is to act in accordance with EDT. (shrink)

When compared with the Pāli versions of the Nanda tale—the story of the ordainment and liberation of the Buddha’s half-brother—some of the peculiar features of Aśvaghoṣa’s telling in the Saundarananda come to the fore. These include the enticing love games that Nanda plays with his wife Sundarī before he follows Buddha out of the house, and the powerful, troubling scene in which Buddha forces Nanda to ordain. While the Pāli versions are aware of fantastic elements such as the flight to (...) the Himālayas, and while each adds its own unique emphases that re-shape the events, none raise such deep ambivalence as done by Aśvaghoṣa. The Comparison of the different tellings then raises a more general theoretical point in relation to Buddhist literature—that genre defines the special features of each adaptation of the story, rather than any historical conditions regarding transmission; the versions each conform to the specific intellectual context of the text that appropriates them. This understanding allows an advancement of the idea of genre in Buddhist canonical and semi-canonical texts. (shrink)

Digital communications technology isreconfiguring democratic governance. Federalagencies increasingly rely on Internet-basedapplications to improve citizen-governmentinteraction. Early efforts in the area ofdigital government have created newparticipatory opportunities as well asformidable governance challenges. Federalagencies are working within and across theirboundaries to find an e-rulemaking format thatis cost-effective, legally appropriate,user-friendly, and well suited to diverse modesof rulemaking activities. One of the overridingissues emerging from this process is thedefinition of meaningful public participationin rulemaking. An examination of an early caseinvolving the USDA's National Organic Programproposed rule (...) summarizes comments related togenetic engineering, biosolids, irradiation,and the role of the National Organic StandardsBoard. The USDA's experience suggests a numberof complex challenges that must be met toeffectively integrate Web-based communicationsinto the federal rulemaking process. (shrink)

Maria Heim’s The Forerunner of All Things: Buddhaghosa on Mind, Intention, and Agency is a valuable contribution to the study of Buddhist philosophy and in certain respects signals a new stage in the field. This is especially true regarding the study of Theravāda Buddhist thought or the philosophy that is rooted in the Pāli Buddhist tradition. Clearly, leading Buddhist philosophers that history has chanced to include in the Mahāyāna camp, such as Nāgārjuna, Vasubandhu, Diṅnāga, Dharmakīrti, Candrakīrti and Tsongkhapa, have received (...) considerable scholarly attention, and detailed studies of their work and ideas are available, including philosophical analyses from both historical or philological and theoretical or.. (shrink)

A non-ad hoc, general theory of anthropic reasoning can be constructed based on Bostrom's Strong Self-Sampling Assumption that we should reason as if the current moment of our life were a randomly selected member of some appropriate reference class of observer-moments. We do not need to use anything other than standard conditionalization of a hypothetical prior based upon the SSSA in order to estimate probabilities. But we need to make the SSSA precise. We specify exactly what is and what is (...) not an observer, how to choose a reference class and how to select a prior probability distribution that can be used when selecting randomly from the reference class. There are both collective Dutch Book and relative frequency arguments in favor of our rules for choosing priors and reference classes. In order to handle examples like Bostrom's Lazy Adam scenario, a causal anthropic decision theory is developed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bringing Cancer Care to Those who Don't Have ItLawrence N. ShulmanI have been treating cancer patients in the Harvard Medical School hospitals since 1977, and in those 35 years we have made tremendous progress. Though work still needs to be done, and far too many patients still die of cancer, many are cured. In particular, children and young adults have a high rate of cure from such diseases as (...) Hodgkin's lymphoma, non-Hodgkin's lymphoma, acute lymphoblastic leukemia, and childhood sarcoma. Patients with breast cancer in the US have a greater than 80% chance for long-term survival. The death rate from cervical cancer in the US is very low. These results have been achieved by making diagnoses earlier, in many cases surgical excision, and often systemic therapies such as chemotherapy, hormonal therapy, radiation therapy, and more recently by using so-called "targeted" therapies—those directed at particular molecular characteristics of the cancer cells.Princess Dina Mired has said that the opportunity to survive cancer should not be an accident of geography. In cases where we already have effective and inexpensive tools to cure cancer, these treatments should be considered a basic human right, a life-saving medical service.I met Patty, a young woman living in the U.S. during November of her senior year in high school, after she discovered a small lump above her left collar bone. Though she felt entirely well, she called her primary care doctor who saw her the next day, felt the enlarged lymph node, and referred her to a surgeon, who did a biopsy later that week. Her primary care doctor also called me, and we scheduled a visit when the pathology results were available. The following week the pathologist notified Patty's pediatrician that the biopsy showed Hodgkin's lymphoma. When I met Patty, she was a bright and focused young woman, waiting to hear about her college applications and enjoying her senior year. Her cancer diagnosis was completely out of context with her life as she planned it, but with the support of her family and boyfriend, she seemed prepared to take things one step at a time. A PET CT scan demonstrated a modest mass in the mediastinum (chest), but no other disease. She was in an early stage of the disease with an excellent prognosis. We recommended and administered six months of chemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine—four chemotherapy agents that are off-patent, and relatively inexpensive. She lost her hair, not a trivial issue for her, but otherwise felt reasonably well during the treatment. She was determined to graduate with her classmates, and was able continue to attend school and keep up with her work. In June, seven months into her cancer diagnosis and treatment, she graduated with honors, and was on track to enroll in college in September.Like other 18-year-old women with Hodgkin's lymphoma, Patty had an over 80% chance for cure with the potential for a long and productive life ahead of her because we could perform a biopsy, make a diagnosis, and safely and effectively treat her with four inexpensive, off-patent, chemotherapy drugs. She had nearly the same likelihood of living a long and fruitful life as her classmates, and had the same chances for childbearing. In my line of work, with the knowledge we now possess, to allow someone like Patty to die without a chance of curative care is simply unacceptable. Treatment of curable cancers should be considered on par with the right to clean water, adequate nutrition, treatment for infectious disease, and access to maternal and child healthcare services.But in many places in the world, people with cancers we could easily eradicate in Boston have no access to cancer services, and do die unnecessarily. The local healthcare infrastructure has no [End Page E10] capacity to evaluate a patient, perform or process a biopsy, make a diagnosis, or treat the patient with potentially curative surgery, chemotherapy and radiation. I have rounded on the wards of hospitals in developing countries, stopping to talk with numerous patients like Patty: young women, some of whom might have had Hodgkin's lymphoma, but no... (shrink)

When reasoning about self-locating belief, one should reason as if one were a randomly selected bit of information. This principle can be considered to be an application of Bostrom's Strong Self-Sampling Assumption\cite{Bostrom} according to which one should reason as if one were a randomly selected element of some suitable reference class of observer-moments. The reference class is the class of all observer-moments. In order to randomly select an observer-moment from the reference class, one first randomly chooses a possible world $w$ (...) and then selects an observer-moment $z$ from world $w$. The probability that one selects $z$ given that one has chosen $w$ should be proportional to the amount of information that $z$ is capable of representing. There are both wagering arguments and relative frequency arguments that support our theory of anthropic reasoning. Our theory works best when the amount of information represented is finite. The infinite case is represented as a limit of a finite cases. We can learn from experience how best to represent the infinite case as a limit of finite cases and also learn from experience whether our theory or some other theory is the superior theory of anthropic reasoning. In order to test which theory is best, we use standard Bayesian methodology: We just need prior probabilities for the theories that are being tested and then we only have to use Bayes' rule. (shrink)

Sanskrit poeticians make the visionary faculty of pratibhā a necessary part of the professional poet’s make-up. The term has a pre-history in Bhartṛhari’s linguistic metaphysics, where it is used to explain the unitary perception of meaning. This essay examines the relation between pratibhā and possible theories of the imagination, with a focus on three unusual theoreticians—Rājaśekhara, Kuntaka, and Jagannātha Paṇḍita. Rājaśekhara offers an analysis of pratibhā that is heavily interactive, requiring the discerning presence of the bhāvaka listener or critic; he (...) also positions pratibhā in relation to Bildung (vyutpatti) and practice. For Kuntaka, pratibhā, never an ex nihilo creation by a poet, serves as the basis for the peculiar forms of intensified insight and experience that constitute poetry; these may also involve the creative scrambling and re-articulation of the object in terms of its systemic composition. At times, Kuntaka’s pratibhā comes close to a strong notion of imaginative process. But the full-fledged thematization of the imagination, and of pratibhā as its support and mechanism, is best seen in the seventeenth-century debates preserved for us by Jagannātha. A link is suggested between the discourse of poetic imagination in Jagannātha and similar themes that turn up in Indo-Persian poets such as Bedil. (shrink)

In sixteenth-century South India, the notion of the imagination was strongly thematized as perhaps the defining aspect of the human mind. We examine one striking example, an allegorical play called the Bhāvanā-puruṣottama by Ratnakheta Srinivasa Dīkṣita. Here we see a king searching frantically for his own imagination, the young woman Bhāvanā with whom he is in love, while she, for her part, is absorbed in the uneven and rather frustrating processes of imagining him. The two lovers could be said mutually (...) to determine one another’s existence. On the other hand, imagination, for this poet, is not a matter of discovering something new but of perceiving something that is already there and, by perceiving it, enhancing or intensifying its presence and its activity. At the same time, the imagination focuses on singularities, however elusive: in this period, the general faculty of imagination has become a highly personal matter. (shrink)

This paper challenges the notion that there is a complete continuity between the thought of Nāgārjuna and the thought of Candrakīrti. It is shown that there is strong reason to doubt Candrakīrti’s gloss of Mūla-madhyamaka-kārikā (MMK) 2.1, and that Candrakīrti’s peculiar reading of this verse causes him to alter the context of the discussion in the four cases in which Nāgārjuna quotes MMK 2.1 later in the text—MMK 3.3, 7.14, 10.13 and 16.7. The innovation produced by Candrakīrti is next contrasted (...) to Nāgārjuna’s style of argument, and it is shown that these two author’s notions of emptiness, as well as their particular implementation of Madhyamaka logic, significantly diverge from each other. Finally, Candrakīrti’s reading of these verses is compared with his commentary on MMK 15 so as to suggest a possible subtle metaphysical position that is at the base of his thinking. (shrink)

This paper engages with Johaness Bronkhorst’s recognition of a “correspondence principle” as an underlying assumption of Nāgārjuna’s thought. Bronkhorst believes that this assumption was shared by most Indian thinkers of Nāgārjuna’s day, and that it stimulated a broad and fascinating attempt to cope with Nāgārjuna’s arguments so that the principle of correspondence may be maintained in light of his forceful critique of reality. For Bronkhorst, the principle refers to the relation between the words of a sentence and the realities they (...) are meant to convey. While I accept this basic intuition of correspondence, this paper argues that a finer understanding of the principle can be offered. In light of a set of verses from Nāgārjuna’s Śūnyatāsaptati (45–57), it is maintained that for Nāgārjuna, the deeper level of correspondence involves a structural identity he envisions between understanding and reality. Here Nāgārjuna claims that in order for things to exist, a conceptual definition of their nature must be available; in order for there to be a real world and reliable knowledge, a svabhāva of things must be perceived and accounted for. Svabhāva is thus reflected as a knowable essence. Thus, Nāgārjuna’s arguments attacks the accountability of both concepts and things, a position which leaves us with nothing more than mistaken forms of understanding as the reality of the empty. This markedly metaphysical approach is next analyzed in light of the debate Nāgārjuna conducts with a Nyāya interlocutor in his Vigrahavyāvartanī. The correspondence principle is here used to highlight the metaphysical aspect of the debate and to point out the ontological vision of Nāgārjuna’s theory of emptiness. In the analysis of the Vigrahavyāvartanī it becomes clear that the discussion revolves around a foundational metaphysical deliberation regarding the reality or unreality of svabhāva. In this dispute, Nāgārjuna fails to answer the most crucial point raised by his opponent—what is that he defines as empty? (shrink)

Very favorable review of a wide-ranging book.

The architectural photographer Julius Shulman (1910-2009) is one of the few image makers to have documented, as well as witnessed, nearly an entire century of Los Angeles history.

Reflections on Eviatar Shulman’s Rethinking the Buddha: Early Buddhist Philosophy as Meditative Perception.

Eviatar Shulman’s Rethinking the Buddha: Early Buddhist Philosophy as Meditative Perception offers an important reminder to take early Buddhist texts seriously as meaning what they say, with regard to the four noble truths, dependent origination, and selflessness. Shulman’s book ably makes this interpretive point, but is frustratingly unclear in its more general discussion of the relationship between philosophy and meditation. Shulman’s main thesis is that the four noble truths, as they are customarily taught today, are a...

Many hold that ordinary race-thinking in the USA is committed to the 'one-drop rule', that race is ordinarily represented in terms of essences, and that race is ordinarily represented as a biological (phenotype- and/or ancestry-based, non-social) kind. This study investigated the extent to which ordinary race-thinking subscribes to these commitments. It also investigated the relationship between different conceptions of race and racial attitudes. Participants included 449 USA adults who completed an Internet survey. Unlike previous research, conceptions of race were assessed (...) using concrete vignettes. Results indicate widespread rejection of the one-drop rule, as well as the use of a complex combination of ancestral, phenotypic, and social (and, therefore, non-essentialist) criteria for racial classification. No relationship was found between racial attitudes and essentialism, the one-drop rule, or social race-thinking; however, ancestry-based and phenotype-based classification criteria were associated with racial attitudes. These results suggest a complicated relationship between conceptions of race and racial attitudes. (shrink)