Life history theory predicts that exposure to high mortality in early childhood leads to faster and riskier reproductive strategies. Individuals who grew up in a high mortality regime will not overly wait until they find a suitable partner and form a stable union because premature death would prevent them from reproducing. Cox proportional hazard models were used to determine whether women who experienced sibling death during early childhood (0–5 years) reproduced earlier and were at an increased risk (...) of giving birth to an illegitimate child, with illegitimacy serving as a proxy for risky sexual behavior. Furthermore, we investigate whether giving birth out of wedlock is influenced by individual mortality experience or by more promiscuous sexual behavior that is clustered in certain families. Models are fitted on pedigree data from the eighteenth- and nineteenth-century Krummhörn population in Germany. The results show a relationship between sibling death in early childhood and the risk of reproducing out of wedlock, and reproductive timing. The risk of giving birth out of wedlock is linked to individual mortality experience rather than to family-level effects. In contrast, adjustments in connubial reproductive timing are influenced more by family-level effects than by individual mortality experience. (shrink)

The youngest population in society is recognized as that at the healthiest stage of life but is burdened by the occurrence of premature death that should be avoidable. There is a need to use adequate statistical methods in assessing the health status of the population of developmental age. The aim of the study was to analyze trends of mortality in children and adolescents by age and gender in the Podlaskie Voivodeship in the years 2003-2012 by joinpoint regression and (...) to identify the causes of mortality. The mortality rate was analysed according to gender and the age groups: 0, 1-4, 5-9, 10-14 and 15-19 years in the Podlaskie Voivodeship. The data were obtained from the Central Statistical Office for the period 2003-2012. Differences in mortality levels between age and gender subgroups were obtained by the Wilcoxon signed-rank test. Join- point regression was used to analyze the trends in mortality. The nomenclature of ICD-10 was used to assess the causes of mortality of children and adolescents. In the Podlaskie Voivodeship in the years 2003-2012 in the 0-19-year-old age group, the highest proportion of deaths (42.4%) occurred during the first year of life. There were differences in mortality rates between boys (8.0/104) and girls (3.1/104) in the 15-19-year-old age group (p < 0.01), and also between the 1-14-year-old and 15-19-year-old age groups (p < 0.01), both among boys (2.1/104 vs. 8.0/104) and girls (1.5/104 vs. 3.1/104). Monotonous trends were shown regarding total mortality rates in infants. There was a drop in the mortality rate of infant girls (AAPC = 5.3%, p < 0.05) and boys (AAPC = 4.7%, p < 0.05). Changes in the direction of the total mortality rate trend were visible in the population of boys aged 1-14 years, in which, between 2003 and 2010, a significant reduction in mortality (AAPC = 9.5%) was observed, while in the years 2010-2012 the trend was not significant. No statistical evidence was found that mortality changed among girls in the 1-14-year-old and 15-19-year-old age groups. Deaths in infancy were due to perinatal conditions and congenital mal- formations. The main causes of mortality in the 1-19-year-old age group were external causes, mainly traffic accidents and intentional self-harm. Joinpoint regression indicated a uniform decrease of mortality in the years 2003-2012 except for boys from 1-14 years old, for whom the decreasing trend was for the years 2003-2010 with subsequent stabilization. The main problems are still infant deaths due to perinatal conditions, traffic accidents and intentional self-harm in boys in the 15-19-year-old age group. (shrink)

What are the respective roles and responsibilities of global, national, and local communities as well as individuals themselves to address health deprivations and avert health threats? This article offers the beginnings of a theory of global health justice, arguing for universal ethical norms (general duty) with shared global and domestic responsibility (specific duties) for health. It offers a global minimalist view I call ‘ provincial globalism ’ as a mean between nationalism and cosmopolitanism, in which a provincial consensus must accompany (...) a global consensus on health morality. This minimalist account asserts global and national duties to promote human flourishing and, more specifically, individuals’ central health capabilities. In this view, justice requires prioritizing responsibilities through shared health governance to reduce shortfall inequalities in central health capabilities — a general duty to reduce premature mortality and escapable morbidity. It examines the difficulties presented by the philosophical principles of connectedness, causality, remediation, partiality, and capacity in the allocation of responsibility for global health. It offers a theory of responsibility allocation based on a functional, health agency centered and homeostatic balanced understanding of the analytical components required to solve global health problems and parcels out roles and responsibilities at the global, national, local, and individual levels accordingly. Allocations of responsibility rest on the effectiveness and special obligations of different actors, respecting self-determination by groups and individuals and seeking voluntary commitments . This view understands that the remedy for global health problems must be sustainable to take nations and the global health community to a new global health equilibrium that remedies current problems and prepares for new health threats to come. (shrink)

The trade in, and private keeping of, reptiles as "pets" raises several ethical concerns regarding animal welfare (associated with handling, storage, transportation, intensive captive breeding, captivity stress, injury, disease, and high premature mortality); public health and safety (associated with zoonotic disease and animal-linked injuries); species conservation and environmental degradation (associated with wild capture); and ecological alteration (associated with invasive alien species). Also, many captive reptiles are fed other animals, raising broader ethical questions. Misperceptions about reptiles by proponents of (...) their captivity mean that these animals are subject to conditions that would likely be considered unacceptable for dogs or cats. (shrink)

This book uses an incidence approach to look at the economic repercussions of birth defects. The authors investigate eighteen of the most clinically significant birth defects affecting 35,000 newborns each year in our country. Their assessments suggest that the annual cost of these eighteen birth defects, together, is more than eight billion dollars . The authors describe in detail their methodology and data sources while providing thorough accounts of each of the eighteen birth defects. Waitzman, Scheffler, and Romano break new (...) ground by using reports from the California Birth Defects Monitoring Program in order to provide cost estimates. They illustrate to the reader how cost estimates of specific birth defects can be used to justify prevention interventions and strategies. In chapter seven, they provide an important example, showing cost-benefit analysis of a program of folate supplementation of food to prevent neutral tube defects. Contents: List of Tables; Preface; Acknowledgements; Introduction; The Application of Cost-of-Illness Methodology To Birth Defects; The Direct Medical Costs of Birth Defects; Nonmedical Direct Costs of Birth Defects: Developmental Services and Special Education; The Indirect Costs of Birth Defects; Premature Mortality and Heightened Morbidity; An Assessment of Total Costs and Policy Implications; Description of Birth Defects; Description of Major Data Sources; Index. (shrink)

An explanation of the inter-gender difference in longevity consistent with the 'disposable soma' theory of ageing is proposed. It is based on the concept of r-K selection as applied to the inter-gender situation. The concept predicts that the gender with a higher potential reproductive rate (males) should invest relatively less in somatic maintenance, which in its turn should result in a lower longevity according to the 'disposable soma' theory of ageing. In females, which are interpreted as K-selected organisms, the reproductive (...) strategy strongly depends on steady, secure constitution designed for oocyte/embryo bearing and is therefore closely related to somatic maintenance, whereas in (r-selected) males it has a greater behavioural component - risky, variable, with a greater potential reproductive success at the expense of somatic maintenance. The higher metabolic and growth rates, a higher premature mortality and a longer period of sexual competence of males also find explanation as a complex of r-selected traits. (shrink)

The Global Burden of Disease project quantifies the impact of different health conditions by combining information about morbidity and premature mortality within a single metric, the Disability Adjusted Life Year. One important goal for the GBD project has been to inform decisions about global health priorities. A number of recent studies have used GBD data to argue that global health funding fails to align with the GBD. We argue that these studies’ shared assumption that global health resources should (...) ‘align’ with the burden of disease is unfounded and has troubling implications. First, since the allocation of resources involves difficult trade-offs between different, potentially competing goals, any ‘misalignment’ of allocation and disease burdens need not necessarily indicate that the allocation of funds fails to meet recipient countries’ needs or interests. Second, using alignment as a baseline implicitly makes controversial assumptions about how harms of different magnitudes affecting different numbers of individuals should be aggregated. We discuss two alternative ways in which GBD data could help inform decisions about resource allocation, neither of which gives more than a limited role to GBD data. (shrink)

BackgroundDepression and anxiety create a large health burden and increase the risk of premature mortality. Mental health screening is vital, but more sophisticated screening and monitoring methods are needed. The Ellipsis Health App addresses this need by using semantic information from recorded speech to screen for depression and anxiety.ObjectivesThe primary aim of this study is to determine the feasibility of collecting weekly voice samples for mental health screening. Additionally, we aim to demonstrate portability and improved performance of Ellipsis’ (...) machine learning models for patients of various ages.MethodsStudy participants were current patients at Desert Oasis Healthcare, mean age 63 years. Two non-randomized cohorts participated: one with a documented history of depression within 24 months prior to the study, and the other without depression. Participants recorded 5-min voice samples weekly for 6 weeks via the Ellipsis Health App. They also completed PHQ-8 and GAD-7 questionnaires to assess for depression and anxiety, respectively.ResultsProtocol completion rate was 61% for both groups. Use beyond protocol was 27% for Group Positive and 9% for Group Negative. The Ellipsis Health App showed an AUC of 0.82 for the combined groups when compared to the PHQ-8 and GAD-7 with a threshold score of 10. Performance was high for senior participants as well as younger age ranges. Additionally, many participants spoke longer than the required 5 min.ConclusionThe Ellipsis Health App demonstrated feasibility in using voice recordings to screen for depression and anxiety among various age groups and the machine learning models using Transformer methodology maintain performance and improve over LSTM methodology when applied to the study population. (shrink)

35 million people die annually of non-communicable diseases (NCDs), 80% of them in low- and middle-income countries — representing a marked epidemiological transition from infectious to chronic diseases and from richer to poorer countries. The total number of NCDs is projected to rise by 17% over the coming decade, absent significant interventions. The NCD epidemic poses unique governance challenges: the causes are multifactorial, the affected populations diffuse, and effective responses require sustained multi-sectorial cooperation. The authors propose a range of regulatory (...) options available at the domestic level, including stricter food labeling laws, regulation of food advertisements, tax incentives for healthy lifestyle choices, changes to the built environment, and direct regulation of food and drink producers. Given the realities of globalization, such interventions require global cooperation. In 2011, the UN General Assembly held a High-level meeting on NCDs, setting a global target of a 25% reduction in premature mortality from NCDs by 2025. Yet concrete plans and resource commitments for reaching this goal are not yet in the offing, and the window is rapidly closing for achieving these targets through prevention — as opposed to treatment, which is more costly. Innovative global governance for health is urgently needed to engage private industry and civil society in the global response to the NCD crisis. (shrink)

The purpose of the study was to analyse the level and the trends of Potential Years of Life Lost due to the main causes of death in Poland in the years 2002-2011. The material for the study was the information from the Central Statistical Office on the number of deaths due to the main causes of death in Poland in the years 2002-2011. The premature mortality analysis was conducted with the use of the PYLL indicator. PYLL rate was (...) calculated following the method proposed by J. Romeder, according to which premature mortality was defined as death before the age of 70. Time trends of PYLL rate and the average annual percent change were assessed using jointpoint models and the Joinpoint Regression Program. In the years 2002-2011, PYLL rate for all-cause deaths decreased by 7.0% among men and 8.1% among women. In 2011, the main reasons for PYLL among men were: external causes, cardiovascular diseases and cancers. Among women the leading causes were: cancers, cardiovascular diseases and external causes. PYLL rate increased among men for colorectal cancer, and among women for colorectal and lung cancer. The presented epidemiological situation for premature mortality in Poland shows that in the majority of cases it is caused by preventable deaths, which highlights a need to intensify measures in primary and secondary prevention. (shrink)

Acommon theme throughout the greatest public health achievements of the 20th century is the importance of law. From the seminal successes in immunizations and motor vehicle safety to the recognition and control of tobacco as a health hazard, laws have been invaluable. More recently in this century, laws have been fundamental in public health preparedness to address environmental disasters and terrorist threats. In fact, the first National Summit on Legal Preparedness in 2007 focused on these “urgent threats.” It only seemed (...) natural that the second summit would focus on the “urgent realities” posed by the continuing epidemic of obesity — an epidemic that directly attacks our children’s health and drains our nation’s wealth.Recognized worldwide as an energy imbalance resulting from excess caloric intake and reduced energy expenditure, obesity contributes to diabetes, heart disease, other multiple chronic diseases, impaired quality of life, and premature mortality. (shrink)

Acommon theme throughout the greatest public health achievements of the 20th century is the importance of law. From the seminal successes in immunizations and motor vehicle safety to the recognition and control of tobacco as a health hazard, laws have been invaluable. More recently in this century, laws have been fundamental in public health preparedness to address environmental disasters and terrorist threats. In fact, the first National Summit on Legal Preparedness in 2007 focused on these “urgent threats.” It only seemed (...) natural that the second summit would focus on the “urgent realities” posed by the continuing epidemic of obesity — an epidemic that directly attacks our children’s health and drains our nation’s wealth.Recognized worldwide as an energy imbalance resulting from excess caloric intake and reduced energy expenditure, obesity contributes to diabetes, heart disease, other multiple chronic diseases, impaired quality of life, and premature mortality. (shrink)

Definition of the problem: While the main focus of the discussion on medical ethics concerns the physician’s conflicts as a result of rationing medical care, this paper postulates that resource allocation with indirect impact on the level of morbidity and mortality of a population also provides an important topic in medical ethics. In particular, increasing social inequalities in health are observed in many of the economically most advanced societies. Arguments: The social gradient of mortality in midlife is widening (...) despite increasing health expenditures and medical progress. Five explanations for this widening social gradient are briefly discussed. Of particular interest is the last one of these explanations, pointing to a higher prevalence of exposure to chronically stressful material and psychosocial environments, particularly work environments, among lower socio-economic status groups. One such type of stressful psychosocial work environment is characterized by violations of the norms of social reciprocity and distributive justice. The model of effort-reward imbalance has been developed by the author to test adverse effects on health produced by these violations. Selected results from three large epidemiological studies on cardiovascular morbidity and mortality in midlife are presented that support the model. Conclusion: To reduce social inequalities in health, health policy decisions about resource allocation are needed that address these specific working and living conditions that act as determinants of unequalities in health. (shrink)

The social and demographic specifics of Donbas region are analyzed in the context of understanding of the factors and possible consequences of the East Ukraine conflict. The article reveals distinctive features of the demographic composition, processes of population natural movement in this region, specific of the social situation, the basic human development indicators in the Donetsk and Lugansk regions of Ukraine on the eve of the conflict, as well as some of its social and demographic consequences.

The ancient philosophical school of Epicureanism tried to argue that death is "nothing to us." Were they right? James Warren provides a comprehensive study and articulation of the interlocking arguments against the fear of death found not only in the writings of Epicurus himself, but also in Lucretius' poem De rerum natura and in Philodemus' work De morte. These arguments are central to the Epicurean project of providing ataraxia (freedom from anxiety) and therefore central to an understanding of Epicureanism as (...) a whole. They also offer significant resources for modern discussions of the value of death--one which stands at the intersection of metaphysics and ethics. If death is the end of the subject, and the subject can not be benefited nor harmed after death, is it reasonable nevertheless to fear the ceasing-to-be? If the Epicureans are not right to claim that the dead can neither be benefited nor harmed, what alternative models might be offered for understanding the harm done by death and do these alternatives suffer from any further difficulties? The discussion involves consideration of both ethical and metaphysical topics since it requires analysis not only of the nature of a good life but also the nature of personal identity and time. A number of modern philosophers have offered criticisms or defences of the Epicureans' views. Warren explores and evaluates these in the light of a systematic and detailed study of the precise form and intention of the Epicureans' original arguments. Warren argues that the Epicureans also were interested in showing that mortality is not to be regretted and that premature death is not to be feared. Their arguments for these conclusions are to be found in their positive conception of the nature of a good and complete life, which divorce the completeness of a life as far as possible from considerations of its duration. Later chapters investigate the nature of a life lived without the fear of death and pose serious problems for the Epicureans being able to allow any concern for the post mortem future and being able to offer a positive reason for prolonging a life which is already complete in their terms. (shrink)

Low birth weight, intrauterine growth retardation, and prematurity are overwhelming risk factors associated with infant mortality and morbidity. The lack of efficacious prenatal screening tests for these three outcomes illuminates the problems inherent in bivariate estimates of association. A biocultural strategy for research is presented, integrating societal and familial levels of analysis with the metabolic, immune, vascular, and neuroendocrine systems of the body. Policy decisions, it is argued, need to be based on this type of biocultural information in order (...) to impact the difficult-to-change problems of low birth weight, intrauterine growth retardation, and prematurity. (shrink)

Throughout much of human history most people conceived of death as a transitional event. An alternative, secular, conception of death is as the permanent cessation of all life‐sustaining biological functions. The death of the physical organism is the death of the person or human being. However death be conceived, human beings are the only creatures that are aware of their mortality. The death penalty is often thought to be the most severe punishment of all, far worse than life imprisonment. (...) Attitudes towards death vary according to the acceptance or rejection of belief in an afterlife. Death in old age is generally held to be less deplorable than death in one's prime. Premature death, however, is commonly deemed to be tragic, but not because merely being alive is a good of one kind or another, let alone good in itself. Lucretius exaggerated the symmetry between prenatal and post‐ mortem events. (shrink)

In 2017, a Philadelphia research team revealed the closest thing to an artificial womb the world had ever seen. The ‘biobag’, if as successful as early animal testing suggests, will change the face of neonatal intensive care. At present, premature neonates born earlier than 22 weeks have no hope of survival. For some time, there have been no significant improvements in mortality rates or incidences of long-term complications for preterms at the viability threshold. Artificial womb technology, that might (...) change these odds, is eagerly anticipated for clinical application. We need to understand whether AWT is an extension of current intensive care or something entirely new. This question is central to determining when and how the biobag should be used on human subjects. This paper examines the science behind AWT and advances two principal claims. First, AWT is conceptually different from conventional intensive care. Identifying why AWT should be understood as distinct demonstrates how it raises different ethico-legal questions. Second, these questions should be formulated without the ‘human being growing in the AW’ being described with inherently value laden terminology. The ‘human being in an AW’ is neither a fetus nor a baby, and the ethical tethers associated with these terms could perpetuate misunderstanding and confusion. Thus, the term ‘gestateling’ should be adopted to refer to this new product of human reproduction: a developing human being gestating ex utero. While this paper does not attempt to solve all the ethical problems associated with AWT, it makes important clarifications that will enable better formulation of relevant ethical questions for future exploration. (shrink)

Preterm birth is defined as delivery occurring before 37 weeks gestation.1 Infants born prematurely have increased risks of morbidity and mortality throughout life, especially during the first year. These risks increase as the gestational age at birth decreases.2 Additionally, there are significant racial and ethnic differences in preterm birth rates. In 2022, the rate of preterm birth among non-Hispanic black women was approximately 50% higher than that observed in non-Hispanic white women.1 The outcomes for these infants are also disparate–preterm (...) birth and low birth weight are the second-leading causes of infant mortality (deaths before 1 year of age). Notably, among preterm neonates, infants born to non-Hispanic black women have a mortality rate more than double that of infants born to non-Hispanic white mothers.3 Importantly, there is a small but significant group of neonates that can be classified as severely premature (those born <28 weeks). Infants born before 28 weeks have varied and uncertain outcomes. While this group accounts for only 0.4% of preterm births, it also accounts for 40% of deaths among preterm neonates.4 As noted by Romanis and Adkins, the advent of artificial amnion and placenta technology (AAPT) holds promise for its potential to address the physiologic complications and mortality risks of extreme prematurity by introducing amniotic substitutes that mimic in vivo placental oxygenation and substrate delivery. In contrast …. (shrink)

One-third of all human lives end in early death from poverty-related causes. Most of these premature deaths are avoidable through global institutional reforms that would eradicate extreme poverty. Many are also avoidable through global health-system reform that would make medical knowledge freely available as a global public good. The rules should be redesigned so that the development of any new drug is rewarded in proportion to its impact on the global disease burden (not through monopoly rents). This reform would (...) bring drug prices down worldwide close to their marginal cost of production and would powerfully stimulate pharmaceutical research into currently neglected diseases concentrated among the poor. Its feasibility shows that the existing medical-patent regime (trade-related aspects of intellectual property rights—TRIPS—as supplemented by bilateral agreements) is severely unjust—and its imposition a human-rights violation on account of the avoidable mortality and morbidity it foreseeably produces. (shrink)

BackgroundThe state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-fertilisation between the academic (...) fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities.DiscussionTwo questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, ‘When is the worst time to die?’ A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die.ConclusionsDeprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global Burden of Disease. Finally, we suggest that the Time-Relative Interest Account may serve as an alternative to the discounting and age weighting previously applied in the Global Burden of Disease. (shrink)

Research into the mechanisms of aging has suggested the possibility of extending the human life span. But there may be evolutionary biological reasons for senescence and the limits of the cell cycle that explain the infirmities of aging and the eventual demise of all human organisms. Genetic manipulation of the mechanisms of aging could over many generations alter the course of natural selection and shift the majority of deleterious mutations in humans from later to earlier stages of life. This could (...) harm people in the distant future by making them more susceptible to premature disease and mortality. Thus there are biological and moral reasons to carefully consider the implications of exploiting this technology on a broad scale to extend the lives of people in the present and near future. (shrink)

Three negative affective dispositions—anger, anxiety, and depression—are hypothesized to increase physical disease risk and have been the subject of epidemiological studies. However, the overlap among the major negative affective dispositions, and the superordinate construct of trait negative affectivity are only beginning to be tested. Presented here is a narrative review of recent prospective studies that simultaneously tested anger, anxiety, depression, and trait NA as risk factors for cardiac outcomes. Anxiety and depression emerged as independent risk factors for premature heart (...) disease in population studies of persons nominally healthy at baseline, and for recurrence/mortality among patients with existing heart disease. General trait NA also was a cardiac risk factor in population samples. (shrink)

On the basis of PM2.5 data of the national air quality monitoring sites, local population data, and baseline all-cause mortality rate, PM2.5-related health economic benefits of the Air Improvement Action Plan implemented in Wuhan in 2013–2017 were investigated using health-impact and valuation functions. Annual avoided premature deaths driven by the average concentration of PM2.5 decrease were evaluated, and the economic benefits were computed by using the value of statistical life (VSL) method. Results showed that the number of avoided (...) premature deaths in Wuhan are 21,384 (95% confidence interval (CI): 15,004 to 27,255) during 2013–2017, due to the implementation of the Air Improvement Action Plan. According to the VSL method, the obtained economic benefits of Huangpi, Wuchang, Hongshan, Xinzhou, Jiang’an, Hanyang, Jiangxia, Qiaokou, Jianghan, Qingshan, Caidian, Dongxihu, and Hannan District were 8.55, 8.19, 8.04, 7.39, 5.78, 4.84, 4.37, 4.04, 3.90, 3.30, 2.87, 2.42, and 0.66 billion RMB (1 RMB = 0.1417 USD On 14 October 2019), respectively. These economic benefits added up to 64.35 billion RMB (95% CI: 45.15 to 82.02 billion RMB), accounting for 4.80% (95% CI: 3.37% to 6.12%) of the total GDP of Wuhan in 2017. Therefore, in the process of formulating a regional air quality improvement scheme, apart from establishing hierarchical emission-reduction standards and policies, policy makers should give integrated consideration to the relationship between regional economic development, environmental protection and residents’ health benefits. Furthermore, for improving air quality, air quality compensation mechanisms can be established on the basis of the status quo and trends of air quality, population distribution, and economic development factors. (shrink)

When should doctors seek protective custody to override a parent’s refusal of potentially lifesaving treatment for their child? The answer to this question seemingly has different answers for different subspecialties of pediatrics. This paper specifically looks at different thresholds for physicians overriding parental refusals of life-sustaining treatment between neonatology, cardiology, and oncology. The threshold for mandating treatment of premature babies seems to be a survival rate of 25–50%. This is not the case when the treatment in question is open (...) heart surgery for a child with congenital heart disease. Most cardiologists would not pursue legal action when parents refuse treatment, unless the anticipated survival rate after surgery is above 90%. In pediatric oncology, there are case reports of physicians requesting and obtaining protective custody for cancer treatment when the reported mortality rates are 40–50%. Such differences might be attributed to differences in care, a reasonable prioritization of quality of life over survival, or the role uncertainty plays on prognoses, especially for the extremely young. Nonetheless, other, non-medical factors may have a significant effect on inconsistencies in care across these pediatric subspecialties and require further examinations. (shrink)

During recent years we have seen and assisted at a significantly increased number of twin births. The main reason for this increase in the frequency of twin births is the increasing number of so called “induced pregnancies”, whether through hormonal stimulation or artificial insemination techniques.It is well known1 that twins have high mortality and morbidity rates during the perinatal and the following period. The characteristics of conception and pregnancy can determine the development of several pathologies, including prematurity and intrauterine (...) growth retardation, …. (shrink)

This paper outlines the Epicurean conception of rationality and then tries to assess the merits of the notorious contention of the Epicurean philosophers that it is irrationalto fear death. At the outset, I talk about the nature of harmful emotions or passions, of which the fear of death is an outstanding example: their dependence on one‘s disposition, their cognitive and non-cognitive components, the ways in which these elements may be related to each other, and the healthy counterparts of the passions, (...) namely the ‚bites‘. Next, I distinguish different kinds of fears involving the thought of death and I examine the Epicurean arguments against each one of them: fears about the state of being dead, others about dying prematurely, yet others concerning the dying process and especially the moment when the soul leaves the body and, finally,the fear that we must die sometime. Much of the discussion focuses on the writings of Philodemus . Philodemus offers the most sustained discussion of the fear of premature death and of the fear of dying that survive in the Epicurean literature. In addition, in the peroration of his treatise On Death, he gives a brilliant example of how we can reconcile ourselves with the fact that we shall die sometime and accept our own mortality. My provisional conclusion is that although the Epicurean philosophers often succeed in appeasing our fears about death, for the most part they fail to prove that these fears are irrational. (shrink)

continent. 1.2 (2011): 78-91. This article consists of three parts. First, I will review the major themes of Quentin Meillassoux’s After Finitude . Since some of my readers will have read this book and others not, I will try to strike a balance between clear summary and fresh critique. Second, I discuss an unpublished book by Meillassoux unfamiliar to all readers of this article, except those scant few that may have gone digging in the microfilm archives of the École normale (...) supérieure. The book in question is Meillassoux’s revised doctoral dissertation L’Inexistence divine (or The Divine Inexistence ), with its seemingly bizarre vision of a God who does not yet exist but might exist in the future. Without literally accepting this view, I will claim that it is philosophically interesting in ways that even a hardened sceptic might be able to appreciate. Third and finally, I will speculate on the possible future of Meillassoux’s speculative materialism itself. And here I mean its future development not by Meillassoux, but by those readers who might be inspired by his book. Plato could never have predicted the emergence of Aristotle’s philosophy, despite the obvious debt of the latter to the former. Nor could Descartes have predicted Spinoza and Leibniz, nor Kant the German Idealists, and neither could Husserl in 1901 have foreseen the later emergence of Heidegger. How are the works of interesting philosophers transformed by later thinkers of comparable importance? While it may seem that there are countless ways to do this, I think there are only two basic ways in which this happens: you can radicalize your predecessors, or you can reverse them. I will close this article with a few words about these two methods, and try to imagine how Meillassoux might be radicalized or reversed by some future admirer. My view is that the more important thinkers are, the easier they are to radicalize or reverse. This helps explain why the great philosophers of the West have so often appeared in clusters, succeeding one another at relatively brief intervals during periods of especial ferment. 1. After Finitude After Finitude is unusually short for such an influential book of philosophy: running to just 178 pages in the original French, and an even more compact 128 pages in the English version, despite the introduction of roughly eight pages of new material for the English edition. Rather than summarizing Meillassoux’s book in the order he intended, I will focus on six points that strike me as the pillars of his debut book. Along the way, I will offer a few criticisms as well. The first pillar of the book is Meillassoux’s own term “correlationism.”1 Although he introduces this term as the name for an enemy, it is striking that Meillassoux remains impressed by correlationism much more than his fellow speculative realists are. This continued appreciation for his great enemy influences the shape of his own ontology. Is there a world outside our thinking of it, or does the world consist entirely in being thought? Traditionally, this dispute between realism and idealism has been dismissed in continental philosophy as a “pseudo-problem,” in a strategy pioneered by Husserl and extended by Heidegger. We cannot be realists, since following Kant we have no direct access to things-in-themselves. But neither are we idealists, since the human being is always already outside itself, aiming at objects in intentional experience, deeply engaged with practical implements, or stationed in some particular world-disclosing mood. The centuries-old dispute between realism and idealism is dissolved by saying that we cannot think either real or ideal in isolation from the other. There is neither human without world nor world without human, but only a primordial correlation or rapport between the two. This is what “correlationism” means: philosophy trapped in a permanent meditation on the human-world correlate, trying to find the best model of the correlate: is it language, intentionality, embodiment, or some other form of correlation between human and world? Among other problems, this generates some friction between philosophy and the literal meaning of science. When cosmologists say that the universe originated 13.5 billion years ago, they do not mean “13.5 billion years ago for us ,” but literally 13.5 billion years ago, well before conscious life existed, and thus at a time when there was no such thing as a correlate. Meillassoux also coins the term “ancestrality” (10) for the reality that predated the correlate, and later expands this term to “dia-chronicity,” (112) to refer to events occurring after the extinction of human beings no less than to those occurring before we existed. Up to this point, Meillassoux’s focus on ancestral entities existing prior to consciousness might seem like a straightforward realist who wants to unmask correlationism as just another form of idealism. Yet Meillassoux also admires the correlationist maneuver, which can obviously be traced back to Kant. Unlike a thinker such as Whitehead, Meillassoux feels no nostalgia for the pre-critical realism that came before Kant: “we cannot but be heirs of Kantianism,” he says (29). What impresses Meillassoux about correlationism is something both simple and familiar. If we attempt to think a tree outside thought, this is itself a thought . Any form of realism which thinks it can simply and directly address the world the way it is fails to escape the correlational circle, since the attempt to think something outside of thought is itself nothing other than a thought, and thereby collapses back into the very human-world correlate that it pretends to escape. For Meillassoux this step, suggested by Kant but first refined by the ensuing figures of German Idealism, marks decisive forward progress in the history of philosophy that must not be abolished. Any attempt to break free from the correlate must first acknowledge its mighty intellectual power. Realist though he may seem, Meillassoux’s works are filled with praise of such figures as Fichte and Hegel, not of so-called “naïve realists.” It is also the case that for Meillassoux, not all correlationisms are the same. The second pillar of his book is a distinction between various positions that I have termed “Meillassoux’s Spectrum,” though of course he is never so immodest as to name it after himself. He distinguishes between at least six different possible positions, and perhaps we could add even subtler variations if we wished. But in its simplest form, Meillassoux’s Spectrum allows for just four basic outlooks on the question of realism vs. anti-realism. Three of these are easy to understand, since we have already been discussing them. At one extreme is so-called “naïve realism,” which holds that a world exists outside the mind, and that we can know this world. Meillassoux rejects this naïve realism as having been overthrown by Kant’s critical philosophy. At the other extreme is subjective idealism, in which nothing exists outside the mind. For to think a dog outside thought immediately turns it into a thought, and therefore there cannot be anything outside; the very notion is meaningless. In between these two is what we have called correlationism. And here comes a crucial moment for Meillassoux, since he distinguishes between the two forms of “weak” and “strong” correlationism, and chooses the strong form as the launching pad for his own philosophy. Weak correlationism is easy to explain, since we all know it from the philosophy of Kant. The things-in-themselves can be thought but not known. They certainly must exist, since there cannot be appearances without something that appears. And we can think about them, which idealism holds to be impossible. They are simply unknowable due to the finitude of human thought. Strong correlationism is the new position introduced by Meillassoux (though he sees it at work in numerous twentieth century thinkers), midway between weak correlationism and subjective idealism. The major difference between the three positions is as follows. Weak correlationism says: “The things-in-themselves exist, but we cannot know them.” The subjective idealist says: “This is a contradiction in terms, since when we think the things-in-themselves, we already turn them into thoughts.” But the strong correlationist says: “Just because ‘things-in-themselves’ is a meaningless notion does not mean that they cannot exist. No one has ever traveled to the world-in-itself and come back to make a report on it. Thus, the fact that we cannot think things-in-themselves without contradiction does not prove that they do not exist anyway. There may be things-in-themselves, we simply are not capable of thinking them without contradiction form within the correlational circle.” This step is crucial for Meillassoux, since strong correlationism is the position he attempts to radicalize into his own new standpoint: speculative materialism. As I see it, this step of the argument fails. Strong correlationism cannot avoid collapsing into subjective idealism, since the statements of the strong correlationist are rendered meaningless from within. All three of the other positions in the Spectrum make perfectly good sense even for those who disagree with them. The naïve realist says that things-in-themselves exist and we can know them; the meaning of this statement is clear. The weak correlationist can say that things-in-themselves exist but lie forever beyond our grasp; this too makes perfect sense, even though the German Idealists try to show a contradiction at work here. We can also understand the claim of the subjective idealist that to think anything outside thought turns it into a thought, and that for this reason we cannot think the unthought. The strong correlationist, alone among the four, speaks nonsense . This person says “I cannot think the unthought without turning it into a thought, and yet the unthought might exist anyway.” But notice that the final phrase “the unthought might exist anyway” is fruitless for this purpose. For we have already heard that to think any unthought turns it into a thought. But now the strong correlationist wants to do two incompatible things simultaneously with this unthought. On the one hand, he neutralizes the unthought by showing that it instantly changes into just another thought. But on the other hand, he wants to appeal to the unthought as a haunting residue that might exist outside thought, thereby undercutting the absolute status of the human-world correlate found in idealism. But this is impossible. If you accept the argument that thinking the unthought turns it into a thought, you cannot also add “but maybe there is something outside that prevents this conversion from being absolutely true,” because this “something outside” is immediately converted into nothing but a thought for us. In short, Meillassoux here seems to be offering a kind of Zen koan: his “strong correlationism” is reminiscent of the gateless gate, or the sound of one hand clapping, or the command to punch Hegel in the jaw when meeting him on the road. We cannot at the same time both destroy the realist challenge of the things-in-themselves in order to undercut realism and reintroduce that very realist sense in order to undercut idealism. In a world where everything is instantly converted into thought, we cannot claim that there might be something extra-mental anyway, because this “might be something” is itself converted into a thought by the same rules that condemned dogs, trees, and houses to the idealist prison. This brings us to the third pillar of Meillassoux’s argument, which is the key to all the rest: the necessity of contingency. His strategy is to transform our supposed ignorance of things-in-themselves into an absolute knowledge that they exist without reason, and that the laws of nature can change at any time for no reason at all. In this way the cautious agnosticism of Kantian philosophies is avoided, but so is the collapse of reality into thought as found in German Idealism. Meillassoux does try to prove the existence of things-in-themselves existing outside thought; he simply holds that they must be proven after passing through the rigors of the correlationist challenge, not just arbitrarily decreed to exist in the manner of naïve realism. As he puts it, “Everything could actually collapse: from trees to stars, from stars to laws, from physical laws to logical laws; and this not by virtue of some superior law whereby everything is destined to perish, but by virtue of the absence of any superior law capable of preserving anything, no matter what, from perishing” (53). If idealism thinks that the human-world correlate is absolute, for Meillassoux it is the facticity of the correlate that is absolute. He tries to show this with a nice brief dialogue between five separate characters (55-59) which is covered in detail in my forthcoming book,2 but which I will simplify here for reasons of time. In this simplified version, we first imagine a dogmatic realist arguing with a dogmatic idealist. The realist says that we can know the truth about the things-in-themselves; the idealist counters that we can only the truth about thought, since all statements about reality must be turned into statements concerning our thoughts about reality. Here the correlationist enters and proclaims that both of these positions are equally dogmatic. For although we have access to nothing but thoughts, we cannot be sure that these thoughts are all that exist; there could be a reality outside thought, there is simply no way to know for sure. And this latter position is the one that Meillassoux attempts to transform from an agnostic, skeptical point into an ontological claim about the contingency of everything. Consider it this way. How does the correlationist defeat the idealist? The idealist holds that the existence of anything outside thought is impossible. The correlationist, by contrast, holds that something might exist outside the human-world correlate. But this “something might” has to be an absolute possibility. It cannot mean that “something outside thought might exist for thought ,” because that is what the idealist already says. No, the correlationist must mean that something might exist outside thought quite independently of thought. In other words, the correlationist says that idealism might be wrong, and this means it is absolutely true that idealism might be wrong. Thus, correlationism is no longer just a skeptical position. It holds that all the possibilities of the world are absolute possibilities. We have absolute knowledge that any of the possibilities about the existence or non-existence of things-in-themselves might be true, and this means that correlationism flips into Meillassoux’s own position: speculative materialism. As Meillassoux sees it, there are only two options here. Option A is to absolutize the human-world correlate, which is what the idealist does: there absolutely cannot be anything outside thought. Option B, by contrast, is to absolutize the facticity of the correlate: its character of simply being given to us, without any inherent necessity. The correlationist cannot have it both ways by saying: “there absolutely might be something outside thought, yet maybe this is absolutely impossible.” In other words, once we escape dogmatism we can only be idealists or speculative materialists, not correlationists. The human-world correlate is merely a fact, not an absolute necessity. But this facticity itself cannot be merely factical: it must be absolute. Here Meillassoux coins the French neologism factualité , which has been suitably translated into the English neologism “factiality.” (7, 122-3) Factialty means that for everything that exists, it is absolutely possible that it might be otherwise, not just that we cannot know whether or not it might be otherwise. Just as Kant transformed philosophy into a meditation on the categories governing human finitude, Meillassoux wishes to turn philosophy into a meditation on the necessary conditions of factiality, which he calls “figures”—a new technical term for him. (80) One such figure is that the law of non-contradiction must be true, and for an unusual reason. Since everything is proven to be contingent, nothing that exists can be contradictory, for whatever is contradictory has no opposite into which it might be transformed, and thus contingency would be impossible.3 Another such figure is that there must be something rather than nothing: for since contingency exists, something must exist in order to be contingent. It is a daring high-wire act, one that sacrifices realism to the correlational circle in order to rebuild it from out of its own ashes. Some might conclude that the lack of reason in things is a byproduct of the ignorance of finite humans, Meillassoux is making precisely the opposite point. For in fact, the doctrine of finitude usually leads directly to belief in a hidden reason. The fact that it lies beyond human comprehension merely increases our belief in this arbitrarily chosen concealed ground. By defending anew the concept of absolute knowledge Meillassoux evacuates the world of everything hidden. The reason for things having no reason is not that the reason is hidden, but that no reason exists. Thus, even while insisting on the necessity of non-contradiction, he rejects the other Leibnizian principle: sufficient reason. Everything simply is what it is, in purely immanent form, without deeply hidden causes. Or as Meillassoux puts it: “There is nothing beneath or beyond the manifest gratuitousness of the given—nothing but the limitless and lawless power of its destruction, emergence, or persistence” (63).The world is a “hyper-chaos”(64). But this is not the same thing as flux. For the chaos of the world is such that stability might occur just as easily as constant, turbulent change. Let’s now digress a bit, and return to the question of ancestrality, which Meillassoux transforms later in the book into “dia-chronicity.” Correlationism holds that all talk of a world outside the correlate is immediately recuperated by the correlate. The phrase “13.5 billion years ago” becomes “13.5 billion years ago for us ,” and the phrase “the universe following the extinction of humans” becomes “the universe following the extinction of humans for humans .” But notice that whether we talk about the world before or after humans, in both cases it is time that is used to challenge the correlate. Meillassoux has no interest in challenges that might be posed by space. For example, what about a vase in a lonely country house that topples to the floor and smashes when no one is there to watch it? Isn’t this also a challenge to correlationism, no less than the Big Bang or the heat death of the universe long after humans have vanished? In an eight-page supplement to the English translation of After Finitude ,4 possibly in response to my own 2007 review of the French original,5 Meillassoux bluntly denies that space is of any relevance to the question. Spatial distance is a merely harmless challenge to the human-world correlate. After all, even though no one is there in the lonely country house to witness the shattering of the vase, we can say that had there been an observer , that observer would have witnessed the toppling and destruction of the vase. For this event still occurs in a world in which the human-world correlate already exists, whereas the diachronicity of events both before and after the existence of humans makes it impossible to say that had there been an observer they would have witnessed the Big Bang occurring in such and such a fashion. However, it seems to me that Meillassoux merely asserts that the temporal simultaneity of our existence with that of the vase in the lonely country house is enough to render it harmless. It is true that the house does not exist prior to the correlate, but nonetheless it exists outside the correlate, and that is enough to make the same challenge. It is difficult to see why the “had there been an observer” maneuver succeeds in the case of a vase in the countryside in April 2011 but fails in the case of the Big Bang. This is not just a matter of nitpicking Meillassoux’s argumentative style: the fact that he bases his argument on time has at least two important consequences for his position. For in the first place, even though Meillassoux insists that the laws of nature are absolutely contingent, this turns out to be true only in a temporal sense. That is to say, it is a paradoxical feature of Meillassoux’s philosophy that he does allow for the existence of laws of nature, and simply believes that they can change at any moment without reason. Within any given moment, laws of nature do exist. He never suggests that different parts of the universe can have different laws at the same time, nor does he have any interest in the laws of part/whole composition that take place within any given instant. Could it be the case that rather than being made of gold atoms, a small chunk of gold could be made of silver atoms, cotton, horses, or that this same small piece of gold could be made of gigantic vaults filled with even more gold? These are not topics that draw Meillassoux’s attention, since he is focused solely on how the laws of nature might change or endure from one moment to the next . Another implication for Meillassoux’s system is that his concept of things-in-themselves turns out to be to be inadequate. For when he proves that things-in-themselves can exist without humans, this turns out to be true only in a temporal sense as well. Namely, things-in-themselves existed ten billion years ago, and they will continue to exist after all humans have succeeded in exterminating themselves. However, being able to exist before our births and after our deaths is just one small part of what it means to be a thing-in-itself. The more important part is that even if a thing is sitting on a table right now, in front of me, even if I stroke it lovingly or press my face up against it directly, I am still dealing only with a phenomenal version of the thing; the thing-in-itself continues to withdraw from all access. Yet no such thing is acknowledged by Meillassoux. For him finitude is a disaster, and absolute knowledge is in fact possible. Meillassoux’s thing-in-itself exists in independence only of the human lifespan , not of human knowledge. The fifth pillar of Meillassoux’s argument is his use of Cantor’s transfinite mathematics to show that even if the laws of nature are contingent, they need not be unstable, and thus we cannot use the apparent stability of nature to disprove his metaphysics of absolute contingency. What Cantor showed is that there are different sizes of infinity, and that all these infinities cannot be totalized in a single infinite number of infinities. Meillassoux sees this as crucial, since it allows him to discredit any “probabilistic” argument against his theory. The probabilistic argument (as defended quite clearly by Jean-René Vernes)6 would say this: given that the laws of nature seem so stable, it it is extremely improbable that there is no hidden reason for their remaining so stable. As Meillassoux sees it, probability is of value only when we can index an accessible total of cases. These can even be infinite: for example, there are an infinite number of points where a rope can break when stretched tight, but this does not stop us from calculating probabilities for various sections of the rope to break. By contrast, there is no way to sum up the number of possible laws of nature. For here there is no way to totalize; we cannot stand outside of nature and calculate the possible number of laws so as to determine the probabilities that any one of them might change. Therefore, although we can speak of probability when dealing with intraworldly events such as elections, horse races, and coin-flips, we cannot use the words “probable” or “improbable” when describing alterations at the level of nature as a whole. Rather than commenting on the validity of this argument and its use of Cantor, let me simply note that it once again creates a dualistic ontology. We already saw that Meillassoux treats time differently from space. In analogous fashion, he now treats the level of world differently from that of intraworldly events. The emergence of worlds is purely contingent and virtual and governed by no probability at all, while events within the world necessarily follow laws (even if these laws can change at any moment without reason), and thus their probabilities can be calculated. It is a strategy deeply reminiscent of Badiou’s (2005) own dualism between the normal “state of the situation” and the rare and intermittent “event.” The sixth and final pillar of Meillassoux’s book can be dealt with briefly, since we have already touched on it elsewhere. It comes at the very beginning of the book, when Meillassoux says that we must revive the distinction between primary and secondary qualities, and that the primary qualities are the ones that can be mathematized. He admits that he has not yet published a proof of this idea, though in fact it is already known as one of his primary doctrines. And here we encounter the familiar problem with Meillassoux’s inadequate conception of things-in-themselves. “Primary qualities” refers to those qualities that a thing has independently of its relations with us or anything else. But if the primary qualities can be mathematized, this means that they are not entirely independent of us, since our knowledge can get right to the bottom of them. The mathematized qualities of things are independent of us only in Meillassoux’s sense that they will still have those qualities even when all humans are dead. But to repeat, autonomy from the human lifespan is not the same as autonomy from human access. Here once more Meillassoux is concerned only with independence from the human-world correlate across time, not in any given instant. 2. L’Inexistence divine In 1997, the same year in which he turned thirty years old, Meillassoux earned his doctorate at the École normale supériuere with a brazen dissertation entitled L’Inexistence divine ( The Divine Inexistence ). The work was substantially revised in 2003. But even then, with typical fastidiousness, Meillassoux decided that the work was not yet ready for press. It has now been scrapped in favor of some future, multi-volume work bearing the same title. While writing my book on Meillassoux for Edinburgh University Press, I was permitted to translate excerpts from this unpublished work for use as an appendix in my own book; in total, the appendix contains approximately twenty percent of Meillassoux’s 2003 manuscript, the first time any of it will be published in any language. Nonetheless, a portion of the argument was already tested in the article “Spectral Dilemma,” published in English in the journal Collapse (2008: 261-75). There the philosophical motives for the virtual God are already made clear. What troubles us most are early deaths, brutal deaths, deaths of especial injustice– the sorts of deaths in which the brutal twentieth century was so abundant. And here, neither the atheist nor the believer can help us. The atheist can offer nothing but a sad and cynical resignation when reflecting on the victims of these terrible crimes. The believer does little better, being unable to explain how God could have allowed such things to happen, due to the famous intractability of the problem of evil. The solution offered to this dilemma by Meillassoux is bold, and all the more so given that he emerges from such a deeply Leftist, materialist, and unreligious background. His solution is that God does not yet exist, and therefore is not blameworthy for these catastrophes. Given that everything is contingent in Meillassoux’s philosophy, this God and divine justice might never exist, but they can at least exist as an object of hope. Let’s begin by jumping to the end of L’Inexistence divine , where the alternatives are laid out so nicely. There are four basic attitudes that humans can have towards God, Meillassoux says. First, we can believe in God because he exists. This is the classical theist attitude, rejected for the simple reason that it would be amoral and blasphemous to believe in a God who allows children to be eaten by dogs, to use Dostoevsky’s example. Second, we can disbelieve in God because he does not exist: the classical atheist attitude. But this leads to sadness, cynicism, and a sneering contempt for the greatness of human capacity. The third option, rather more complex, is to disbelieve in God because he does exist: in other words, to exist in rebellion against God as the one who must be blamed for the evils of the earth. The examples here might range from Lucifer himself, to the more human figure of Captain Ahab in Melville’s Moby-Dick , to Werner Herzog’s even more recent catchphrase, “Every man for himself, and God against all.” That leaves only the fourth option: believing in God because he does not exist. Meillassoux closes his book by saying that the fourth option has now been tried (namely, in the course of his own book), and that now that all four have been specified, we must choose. The first reaction to this theory of the inexistent God will be laughter. Few readers will ever be literally convinced by it, and probably none will immediately be convinced by it. But if we ask ourselves why we laugh, the answer is because it sounds so improbable that an inexistent God might suddenly emerge and resurrect the dead. It obviously sounds more like a gullible theology than a rigorous piece of philosophical work. Yet two things need to be kept in mind. First, Meillassoux’s theories are hardly more unlikely than those of great philosophers of the past such as Plato, Plotinus, Avicenna, Malebranche, Spinoza, Leibniz, Nietzsche, or Whitehead. We read the great philosophers not because their systems are plausible in commonsense terms that can be measured by the laws of probability. Instead, we read them precisely because they shatter the existing framework of common sense and open up new window on the universe. Second, and even more importantly, Meillassoux has already rejected probability as a valid measuring stick in philosophy. Or rather, he accepts probability in the intra-worldly realm (where it is linked with potentiality), and rejects it at the level of the world itself (where potentiality is replaced with what he calls virtuality). The virtual God can appear at any moment for no reason at all, just as any other new configuration of laws of nature can appear: in a manner that the laws of probability cannot calculate. Responding to those who might ridicule the idea of a sudden emergence of God and a resurrection of the dead, Meillassoux cites Pascal, who asserts that the resurrection of the dead would be far less incredible than the fact that we were born in the first place. This shifts philosophy onto new ground. Rather than concerning ourselves with what is likely to happen in the world as we know it, we focus instead on the most important things that could happen. For this reason, the expected objection that a virtual God is no more likely to appear than a virtual unicorn or a virtual flying spaghetti monster misses the point. Unicorns and spaghetti monsters could also appear, just like any other non-contradictory thing. But these would just be novel bizarre entities among others, not the heralds of completely new worlds. For Meillassoux, the emergence of matter, life, and thought have been the three truly amazing advents of the world so far, each of them dependent on the advent(s) preceding them. As he sees it, there can be no greater intraworldly entity than the human beings who already exist, since nothing in the world is better than the absolute knowledge of which humans alone are capable. This means that the next great advent must be something that perfects human beings rather than superseding them. And this can only be the world of justice, in which the dead are resurrected and their horrible deaths partially cancelled (Meillassoux never considers the possibility of a God who would literally erase the pre-divine past so that it never happened at all). The only immortality worth having is an immortality of this life, not an existence in some ill-defined afterworld. Human existence, he holds, must always be governed by a “symbol” that gives us the “immanent and comprehensible inscription of values in a world.” And just as cosmic history made the three great contingent leaps of matter, life, and thought, with a leap to justice as the only one still to come, a similar structure occurs within human culture and its symbols, which consist so far of the cosmological, naturalistic, and historical symbols, with a “factial” symbol still to come. We can review each of these symbols briefly. The cosmological symbol refers to the ancient dualism between the terrestrial and celestial spheres. Here below everything is conflict, corruption, and decay; but in the heavens nothing is perishable, all movement is circular, and everything is arranged in mutual harmony. This symbol is ended by modern physics when Galileo discovers such blemishes as sunspots and craters on the moon, and when Newton integrates both celestial and terrestrial movement into a single gravitational law. Next comes the naturalistic or romantic symbol, in which perfection comes not from the sky but from nature itself. The world is filled with pretty flowers (Meillassoux claims that the ancients never discussed the beauty of flowers until Plotinus in the third century) and with living creatures naturally moved by pity, at least until society corrupts them. This symbol collapses in the face of reality as we know it, since pity is no more common than war, corruption, and violence. This brings us to the historical symbol, which only now is passing away. Bad things may happen, but history has an inner logic of its own, such that everything works out in the end. The ultimate form of the historical symbol is the economic symbol, whether in a Marxist or neo-liberal form. Just as the Marxist holds that the inner economic logic of the capitalists will inexorably lead them to self-destruction, the neo-liberal assumes that the sum total of individual selfish actions will lead, in the long run, to the greatest possible good. We worship the economy and let it guide history for us, just as the ancients worshipped celestial bodies and held them to be free from blemish. The final remaining symbol is the factial symbol, which Meillassoux hopes will now emerge. Factiality, we recall, is his term for the absolute contingency of everything that exists. Once we have grasped this absolute contingency, we are free to expect the dramatic advent of the coming fourth World: the world of justice, inaugurated by a virtual God and even mediated by a messianic human figure. There is the added feature, however, that this messiah must abandon all claims to special status once the messianic realm of justice is achieved. The messianic figure will then be no more special than any person on the street, since a reign of human equality will have arisen. Although this focus on human being might seem like a return to standard humanism, Meillassoux holds that human pre-eminence has never truly been maintained. Previously, humans have been treated as special only because they contemplate the Good, because they resemble their omnipotent creator, or because they happen to be the temporary victors in a cruel Darwinian death-match between millions of living species. For Meillassoux, by contrast, humans have value because they know the eternal. But it is not the eternal that is important, since this merely represents the blind, anonymous contingency of each thing. What is important is not knowledge of the eternal , but knowledge of the eternal. We should not admire Prometheus for stealing fire from the gods; Prometheus is simply as bad as all the gods, no matter how much he increased our power. Feuerbach and Marx were wrong to say that God is a projection of the human essence, since for Meillassoux the usual concept of God represents the degradation of the human essence. If the traditional God was allowed to inflict plagues and tsunamis on the human race, the Promethean human of the twentieth century simply assumes the right to inflict death camps and atomic fireballs instead. In this respect, we have simply begun to imitate the degradation of humanity that was formerly invested in an omnipotent and arbitrary God. In response to charges that absolute contingency might lead to political quietism, Meillassoux counters that the World of justice would mean nothing unless we had already hoped for it beforehand. A World of justice that came along at random would merely be an improved third World of thought: indeed, a perfect one. But it would have satisfied no craving, and would therefore have no redemptive power. For this reason, we must actively hope for the fourth World of justice for such a fourth World ever to arise. Not only justice, but beauty is dependent on such hope: for Meillassoux, who is here somewhat dependent on Kant, beauty means an accord between our human symbolization and the actual world, which could never be present in a World of the blessed any more than justice could. And just as a messianic figure is needed to incarnate our hope and then abandon power once the World of justice is realized, it is the figure of the child whose fragile contingency shows us a dignity and a demand for justice beyond all power. 3. Meillassoux Radicalized or Reversed Given the promising reception of Meillassoux’s first book, it would not be groundless to engage in early speculation about what it might take to earn him a place in the history of philosophy. Maybe this will never happen—who knows?—but quite possibly it will: his lucid argumentative methods and sheer philosophical imagination at least make him a good candidate to be read well into the future, especially following further elaboration in print of his mature system. Philosophy is often practiced as thought it were nothing more than the amassing of “knockdown arguments.” But this is no more insightful than saying that good architecture is the amassing of steal beams. It is true that poorly constructed building cannot stand for long, but sound construction is merely the first, indispensable step in building. In fact, I am inclined to say that what really makes a philosopher important is not being right, but being wrong . I mean this in a very specific sense. I once heard the interesting remark about twentieth century culture that “you have to remember that the sixties really happened in the seventies.” That is to say, it was in the 1970’s rather than the more honored 1960’s that civil rights, free love, long hair, and the rock and roll drug culture really took root. With respect to the history of philosophy, we might just as easily say: “you have to remember that Plato really happened in Aristotle,” that “Kant really happened in Hegel” or “Hume really happened in Kant,” or that “Husserl’s phenomenology first achieved its truth in Heidegger.” One becomes an important philosopher not by being right, but by attracting rebellious admirers who tell you that you are wrong , even as their own careers silently orbit around your own. To recruit faithful disciples may be comforting and flattering, but the greatest thinkers have generally had to experience refutation at the hands of their most talented heirs. For this reason, I would propose that we size up the magnitude of living thinkers not by deciding how many times they are right and wrong, but by asking instead: who would take the trouble to refute this author? For this reason I do not ask: “Is Meillassoux right?”, since I do not believe in the virtual God myself, nor am I convinced by any important aspect of Meillassoux’s philosophy. Instead, I ask if there are interesting ways to overturn him. Only by being overturned, by no longer remaining a contemporary, does one become a classic. Let’s begin with a simple model of refutation, which can be refined further at a later date once the basic point is established. One kind of refutation simply consists in saying: “This author is a complete idiot.” The refuter now walks away in celebration, and no link between the present and the future is built; all is reduced to rubble. But this sort of mediocre triumphalism is generally practiced by those who achieve little of their own, and is not especially interesting. Much more interesting is the sort of refutation that does not take its target to be a complete idiot. I would like to suggest that there are just two basic ways in which this can be done: radicalization and reversal . It has not escaped my notice that this is a fairly good match for the Deleuzian distinction between irony and humor. Whereas irony critiques and adopts the opposite principle of what it attacks, humor accepts what it confronts but pushes it into highly exaggerated form. The ironist is like the worker who sows chaos by rebeling and contradicting the boss, while the humorist is like the worker who follows orders to an absurdly literal degree, with equally chaotic results. Let’s start with a few examples. In Aristotle’s treatment of Plato, and Heidegger’s of Husserl, we find reversal. Plato’s eidei are transformed by Aristotle into mere secondary substances, and the individual worldly things despised by Plato become what is primary. For Husserl what is primary is whatever is present to consciousness, while for Heidegger this is precisely what is secondary, since the primary stuff of the world withdraws from any form of presence at all. As for radicalization, it is most easily found in the transformation of Kant by German Idealism: “Kant was right to wall off the things-in-themselves from human access, and simply should have realized that the thought of the Ding an sich is also a thought, and thereby the noumena are just special cases of the phenomena,” with much following from this discovery. It would also be easy to read Spinoza as a radicalizer of Descartes, and Berkeley and Hume as radicalized versions of Locke. Perhaps the distinction is now sufficiently clear. Admiring refutations are not those that say “Professor X is an idiot,” which is merely the flip side of the eager disciple’s fruitless “Professor X got everything right.” Instead, it will be some variant of one of the following two options: “Professor X is important, but got it backwards,” or “Professor X is important, but didn’t push things far enough.” In the history of philosophy these two latter cases have often been painful in purely human terms: Aristotle expresses sadness at refuting Plato, Kant is openly annoyed at Fichte, and Husserl feels betrayed and used by Heidegger. Rude handling from later figures almost seems to be the sine qua non of being a great philosopher. Now, it has already been claimed that Meillassoux is an emerging philosopher of the first importance, and by no less a figure than Alain Badiou: “It would be no exaggeration to say that Quentin Meillassoux has opened up a new path in the history of philosophy…” (Preface, vii). But rather than taking Badiou’s word for it, or rejecting his word, we might experiment by asking how Meillassoux could be radicalized or reversed. Are there interesting ways of doing this that might launch whole new schools of philosophy, unexpected or even condemned by Meillassoux himself? While no one can see the future, the present is poor when it is not riddled with virtual futures. The relation between philosophers and their predecessors and successors is always somewhat complicated, of course. But generally there is one central divergence at stake, which might be taken as the key to all the others. On this basis we could say that new thinkers primarily radicalize or primarily reverse the main ideas of their chief philosophical forerunner. There may be specific historical conditions and perhaps even personality traits connected with these two types, but this question can be left aside for now. More important for us is that radicalizers will generally be followed by reversers, and vice versa. Consider the textbook example of a reversal in the history of philosophy: Kant’s Copernican Revolution, which inverts the so-called dogmatic tradition that addresses the world itself, and makes the world revolve instead around the conditions by which it is known. While it is not completely impossible that Kant’s successors might have re-reversed this principle back into a new and stronger dogmatic realism, conditions were premature for such a move. Anyone doing this too early would likely have been an angry anti-Kantian reactionary rather than an original thinker in command of a genuinely new realist principle. The far more likely outcome is the one that actually happened: Kant’s reversal of his predecessors was viewed as incomplete, or as retaining lamentable bits of the traditional view, which despite his admirable breakthrough he was unable to shake off. This was the view of German Idealism, anyway. In similar fashion, Spinoza could also be viewed as a radicalizer of Descartes, who is equally accused of preserving various Scholastic dogmas in an otherwise radical project of philosophical reversal. The point is this: reversals in the history of thought tend to be followed soon thereafter by radicalizations of those reversals. The same may hold true in reverse: radicalizations might generally be followed by reversals, given that it is not always possible to be more radical than the radicals have already been. Consider the case of Husserl, who radicalizes Brentano’s early vagueness about what lies beyond immanent objectivity, and Twardowski’s assertion that there must be an external object lying outside the intentional content, by collapsing everything into the intentional sphere: there is no difference between the Berlin in my consciousness and the actual Berlin that is home to millions of people. It is difficult to see how one could be even more radical than Husserl’s idealist turn here. And thus the road is paved to Heidegger’s reversal of classical phenomenology, in which the key point is what lies deeper than any presence to consciousness: the Sein whose power and obscurity cannot be made exhaustively present, but only sends itself in historical epochs. In similar fashion we might also read Leibniz as a reverser of Spinoza’s radicalization, retrieving a strong sense of individual substance and a certain validity of what the Scholastics had said. Returning to Meillassoux, we might ask which kind of philosopher he is: a radicalizer or a reverser? At present, Meillassoux looks to me like a radicalizer (though for now his future remains shrouded in mist). He takes the correlationist tradition, which allows us to speak only of the relation between human and world, and tries to raise it into an even more extreme claim about the absolute contingency of everything. But whereas German Idealism did this by trying to collapse the distinction between thought and world entirely into the “thought” side, Meillassoux does it by trying to shift the non-absolute contingency of the thought-world correlate from epistemology to ontology. It is no longer a question of the inability of human knowledge to know what lies outside the correlate, but the inability of reality itself to be rooted in any definite laws. Furthermore, if we look at the various features of Meillassoux’s philosophy identified earlier tonight, all but one are already so radical that there is no obvious way to push them further. The one exception would be his claim that the world as a whole can change for no reason at any moment, coupled with the inconsistent claim that within a given world there are laws of nature that everything must follow. If gravitational attraction between all masses is a current law in our world, then for Meillassoux there can be no exceptions to this law for as long as it remains in force. A toppled vase will fall to the floor every time for sure,unless there is a cosmic change by which the laws of nature as a whole have altered. (This is reminiscent of the late medieval distinction between the absolute and ordained power of God, according to which God has the power to set or change the laws of nature, but not to contravene those laws locally once they are set.) On this point, to radicalize Meillassoux would simply be to say: there are no laws of nature even in the local sense. Everything that happens, even in the world here and now, is purely contingent and not governed by even a trace of law. And while this would be a more consistent development of Meillassoux’s thoughts on contingency, it is difficult to see how it could lead to a new philosophy. Instead, the admiring successors of Meillassoux are more likely to reverse one of his already sufficiently radical points. At least four candidates come to mind: *First, we have seen that Meillassoux thinks correlationism is challenged by a time before or after consciousness, but not by a space lying outside it. Perhaps this could be reversed into saying that spatial exteriority is the really crucial point. The arguments on this point are perhaps the least convincing in After Finitude (and do not even occur in the original French edition), and therefore it might be a candidate for the “blind spot” of which no philosopher is ever free. *Second, Meillassoux uses Cantor to claim that the contingency of laws of nature would not entail that they are unstable. A successor of Meillassoux might claim that it does make them unstable, and celebrate this fact. This person would then have to explain why common sense seems to encounter a relatively stable world despite its truly rampant instability. Whereas Meillassoux’s problem is to show how stability might exist despite contingency, this successor’s problem would be slightly different: to show why actual, full-blown instability might have the appearance of stability. *Third, Meillassoux claims that the primary qualities of things are those that can be mathematized. He might be reversed by a successor who says the opposite: the mathematizable qualities are the secondary ones, and the primary ones are those that elude symbolic formulation. While this is a perfectly valid possible objection to Meillassoux, it is one that is made in advance by some of his predecessors and is still made by some of his peers, making it less interesting for futurology than some of his other points. *Fourth and finally, whereas Meillassoux claims that God does not exist but might exist in the future, a successor might argue even more bizarrely that God has always existed but might vanish in the future. Let’s arbitrarily select the first of these possibilities, and imagine briefly where it might lead, if pursued in the future by admiring detractors. Meillassoux comes from the circle of Badiou, and some of Badiou’s most ardent admirers are found in Latin America. So, let’s imagine that towards mid-century some ingenious reversers of Meillassoux emerge in that portion of the Spanish-speaking world. Just for fun, let’s call them Castro and Chávez. And in order to avoid any confusion with the present-day politicians of those names, we will stipulate that Meillassoux’s great successors are both women. The philosopher Castro (we will suppose she comes from Peru) reverses Meillassoux’s argument that the ancestral or diachronic are what most threaten the human-world correlate. Instead, she claims that the diachronic does not threaten the correlate at all, and that we must instead look at space as what ruins the correlate and demands a strange new realism. What would such a philosophy look like? In order to determine this, we might ask what price Meillassoux pays for doing it the opposite way. As I see it, he pays in two separate ways. One is that laws of nature for him are contingent over time . The laws of nature apply to the universe as a whole at any given moment, and would be changed globally if they are ever changed at all. The second price he pays is that Meillassoux has no mereology , or theory of parts and wholes. Everything for him is on the level of the given, or immanent in experience, with the sole proviso that the laws governing this immanence might change without notice at any given moment. In reversing Meillassoux, Castro makes the following claims in the preface to her stunning debut book of 2045, The Cosmos and its Neighborhoods , rapidly translated from Spanish into all the languages of the world: Despite his brilliant analysis of the contingency of laws of nature over time, Meillassoux gets two important assumptions wrong. First, he allows for only one set of contingent laws to govern nature as a whole. Second, he allows laws to govern only the world that is immanent in experience, and thereby fails to explore the contingency among part-whole relations. In this book I will argue, first, that the laws of nature vary in any given instant between one region of the universe and the next; and second, that the world is made up of layers of parts and wholes that are also contingent with respect to one another. Those are the words of Castro. This may sound like a hopeless free-for-all of chaos, yet the book somehow succeeds in drawing some compelling deductions about how laws must vary from one place or level in the world to the next. Trapped in the limited horizon of 2011, and not yet inspired by the heavily balkanized political and technological situation of 2050 that somehow lends additional credence to Castro’s vision, we can only vaguely grasp what such a philosophy might look like. After this reversal of Meillassoux by Castro, the usual pattern leads us to expect a radicalization by Chávez, a young Argentine student of Castro. How could the already strange theories of Castro be radicalized? Perhaps as follows, in a disturbing new book entitled The Implosion of the Neighborhoods , which argues as follows: Castro was right to shift the Meillassouxian framework of contingency from time to space. However, in this respect she retained a surprisingly traditional opposition between the two. In this book I will show that time and space collapse into one another. This may sound too much like the discredited four-dimensional block universe of twentieth century physics and philosophy. However, the four-dimensional universe is a model biased in favor of space, merely adding an extra dimension to the commonsense spatial continuum while stipulating that the serial passage of time is an illusion. In this book I will argue instead for a one-dimensional space-time modeled after our experience of time, in which there is no simultaneous co-existence at all between different parts of the universe, or ‘neighborhoods’ as my esteemed teacher Castro has called them. Instead, the various portions of the universe link to one another by succession rather than by coexistence. Buenos Aires, New York, and Amsterdam do not exist simultaneously in the same landscape, but one after the other in the mind of some observer, and this observer can only be an observer much larger than any human. Against Meillassoux’s notion of a virtual God that does not exist now but might exist in the future, I will argue for an actual God that surveys the universe in sequence, thereby generating the illusion of spatial diversity and even the illusion of individual minds located within that diversity. Once this divine observer dies, the universe as a whole must perish. Again, these ideas are so bizarre that we of 2011 can barely comprehend them, just as Aristotle would have had a difficult time grasping the theories of Descartes. We could then perhaps imagine a further reversal of this theory, emanating from the intellectually resurgent Philippines of the twenty-second century. The Filipino School might argue that the universe is already dead, given the collapse of its spatial richness into the serial observations of a flimsy and mortal God. The virtual universe does not yet exist, but might exist in fully spatial form in the future, and this would require the death of God and the resulting liberation of God’s succession of images as independent, spatially situated realities. With a bit of sharpening, we might be able to make all of these imaginary thinkers more intuitively clear. Along with the history of philosophy, there might arise a new discipline generating imaginary futures for philosophy. The richness of Meillassoux’s system comes not from the fact that he is plausibly right about so many things, but because his philosophy offers such a treasury of bold statements ripe for being radicalized or reversed. He is a rich target for many still-unborn intellectual heirs, and this is what gives him the chance to be an important figure. NOTES 1. Quentin Meillassoux, After Finitude . Trans. R Brassier. (London: Continuum, 2008.) Page 5. The word “correlationism” does not appear in his doctoral thesis. As Meillassoux informed me in an email of February 8, 2011, he first coined this term in 2003 or 2004, while editing for publication a lecture he had given at the École normale supérieure on a day devoted to the theme of “Philosophy and Mathematics,” an event including Alain Badiou as one of the participants. 2. Graham Harman, Quentin Meillassoux: Philosophy in the Making . (Edinburgh: Edinburgh University Press, forthcoming 2011). 3. In an email of December 6, 2010, Meillassoux clarifies that in After Finitude he only deduces the impossibility of a “universal contradiction,” not of a determinate contradiction. In the same email he suggests that he can also prove the latter, though the proof is somewhat lengthier than the one found in After Finitude . 4. After Finitude (18-26), in the passage falling between the two sets of triple asterisks. These pages were sent by Meillassoux to translator Ray Brassier (in French) during the translation process, and do not appear in the original French version of the book. 5. Graham Harman, “Quentin Meillassoux: A New French Philosopher.” Philosophy Today 51.1 (2007): Pages 104-117. The passage where I raise the question of space can be found in the first column of page 107. 6. Vernes is first cited on p. 95 of After Finitude . See Jean-René Vernes, Critique de la raison aléatoire, ou Descartes contra Kant . (Paris: Aubier, 1982).  . (shrink)

This paper identifies two possible versions of the Epicurean 'Symmetry argument', both of which claim that post mortem non-existence is relevantly like prenatal non-existence and that therefore our attitude to the former should be the same as that towards the latter. One version addresses the fear of the state of being dead by making it equivalent to the state of not yet being born; the other addresses the prospective fear of dying by relating it to our present retrospective attitude to (...) the time before birth. I argue that only the first of these is present in the relevant sections of Lucretius (DRN 3.832-42, 972-5). Therefore, this argument is not aimed at a prospective fear of death, or a fear of 'mortality'. That particular fear is instead addressed by the Epicureans through the additional premise (found in the Letter to Menoeceus 125) that it is irrational to fear in prospect an event which is known to be painless when present. This still leaves unaddressed the related fear of 'premature death', which is to be removed through the acceptance of Epicurean hedonism. (shrink)

Medical Officer of Health reports for London boroughs, 1900–19, are analysed to determine the incidence of neonatal breast-feeding, duration of lactation, reasons for early supplementation and premature weaning, and their relationship with infant mortality. In a sample of 222,989 infants, breast-feeding rates were very high. Over 90% were breast-fed in the first month, almost 80% at 3 months, and over 70% at 6 months. The poorest boroughs had the highest rates of neonatal breast-feeding, but also a higher incidence (...) of early supplementation and premature weaning. There was a significant positive correlation between breast-feeding and infant mortality due to poor maternal diet and health, poor nutritional quality of supplementary and substitute foods, and the use of an unhygienic feeding bottle. Energetic campaigns to counteract these problems probably contributed to the fall of infant mortality in this period. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Sense and Sensibility: IARPT’s Four Existential OrientationsWilliam David Hart (bio)I. Introduction: IARPT’s Liberal HorizonThe concerns of the Institute of American Religious and Philosophical Thought are worlds apart from the preoccupations that animate the characters in Jane Austen’s novels. This is not to say that IARPT is disinterested in romance, love, and heartbreak. It is to say, rather, that Sense and Sensibility, the title of Austen’s 1811 novel, is a (...) good cover term for the matters that I wish to address. I say this despite the fact that many characters in the novel, especially Fanny Dashwood, are insufferable members of a British ruling class that, along with its wealth-hording, patriarchy-sustaining institution of primogeniture, needed to be expropriated by the working class. I say this despite the fact that the sensibility of the British aristocracy, as is true of all aristocracies, is off-putting. With this proviso, it is precisely the sense and sensibility of the Institute (the love, romance and, perhaps, tragedy) that I wish to survey through a focus on what I take to be its animating existential concerns. I call these orientations existential rather than merely intellectual because they go beyond ideas, professional commitments, and implicate the entire range of life dispositions. These orientations are habit-forming.Constitutive of these orientations are anxieties regarding the meaning and significance of those things for which we live and die. The sheer fact of consciousness, of conscious matter, of matter conscious of its consciousness and the wonder and awe this inspires as we consider the very existence of things is part of our existential ensemble too. For some of us wonder and awe before the groundless gratuity of existence, let’s call this ontological curiosity, compete with death anxiety and its intimations for preeminence in how we imagine the meaning and significance of our life. This is not a binary matter. For some people, perhaps for most, the joy of existence larded as it is with terrible things exceeds, as the case make be, the quiet desperation, sorrow, or terror, and the emptiness at the center of all things. My exploration focuses on the anxieties rather than the curiosity. I take it for granted that the deep source of anxiety is mortality and its various intimations. Our quest for lives of meaning and significance is threatened by the “horrid d’s”1 of death, disease, dread, despair, [End Page 5] and disappointment. Various thinkers have theorized how we cope with this anxiety. Some argue that denial is a dominant way of dealing with death, which they take to be foundational to the other meaning and significance-threatening phenomena.2 Where the answers to these threats provided by traditional religions are found lacking or otherwise no longer credible, denial expresses itself in the form of various immortality projects: typically, the puritanical, maniacal, and methodical pursuit of health and wealth, in consumerism of all kinds, from the hottest new diet, to a Peloton exercise bike, to a Tesla. And then there is the pursuit of fame and celebrity, which many people can no longer distinguish, the hope, captured so well in the theme song for the television series, Fame. “Fame / I’m going to live forever / Baby, remember my name.”3 We want to be remembered. Whether by future generations or, inside the digital clouds of Instagram or TikTok, or, as some would have it, within the consequent nature of God. Of course, for some populations, death is not so easily denied. Death has an in their face immediacy, insistence, and oppugnancy that rips through flesh and leaves its subject not merely anxious but dead. I speak, for example, of the mind-numbing repetitiveness with which police kill Black people. Or the myriad ways, including environmental racism, in which Blacks are subject to premature death. Some thinkers even theorize that death is the existential horizon for Black people in an ontologically distinctive way.4 Thus the March 2020 police-raid killing of Breonna Taylor in her home may be a statistical anomaly but is experienced as a monstrous revelation of the nature of things, of Black social life as social death. This is not a... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Message from the EditorPiers H.G. Stephens, EditorIt is now six years since this journal’s founding editor Victoria Davion sadly succumbed to premature fatal illness and I took over her editorial duties under the most unfortunate of circumstances. I stated publicly then that Vicky’s vision for the character and purpose of the journal would remain unchanged under my watch, and in keeping with that pledge, I am now (...) pleased to announce a major expansion of our editorial board to further promote that vision.Over the past two decades, the size of our board had declined significantly as a result of retirements and mortality, and so a restoration of the previous scale of editorial support was significantly overdue. In doing this, I have sought to protect and expand our international and interdisciplinary coverage in a way that honors the focus that Vicky gave the journal from the beginning, giving space to voices from the wider communities of concern impacted by ecological destruction and incorporating a broad and inclusive but critically engaged approach to the philosophical issues involved. Our new board includes members from a wider range of nations and disciplines, which should help us expand the journal’s reach while both manifesting and remaining faithful to the original mission that our founding editor set for it. In the process, we are welcoming a combination of new rising stars and well-established respected figures in environmental thought, and aiming to expand our sphere of influence well beyond our main subscriber base in North America. Our hope is that our new scholarly supporters will enable the journal to grow in tackling the newer and ever more complex issues and problems raised by climate change, biodiversity loss, and other ongoing ecological crises, while at the same time still remaining true to the spirit with which Vicky founded it.Readers, please join me in welcoming our new board members, who are listed in the front matter of this issue. We thank them immensely for their service and hope that their efforts will enable and support increased success for Ethics and the Environment. [End Page 1]Copyright © 2023 The Trustees of Indiana University... (shrink)

A high risk of morbidity-mortality caused by a harsh and unpredictable environment is considered to be associated with a fast life history strategy, commonly linked with criminal behavior. However, offenders are not the only group with a high exposure to extrinsic morbidity-mortality. In the present study, we investigated the LH strategies employed by two groups of Polish men: incarcerated offenders as well as soldiers and firefighters, whose professions involve an elevated risk of injury and premature death. The (...) subjects were asked to complete the Mini-K and a questionnaire which included a number of biodemographic LH variables. Although biodemographic and psychosocial LH indicators should be closely linked with each other, the actual connection between them is unclear. Thus, this study was driven by two aims: comparing LH strategies in two groups of men with a high risk of premature morbidity-mortality and investigating the relationship between the biodemographic and psychosocial LH dimensions. The study showed that incarcerated men employed faster LH strategies than soldiers and firefighters, but only in relation to biodemographic variables. No intergroup differences emerged regarding psychosocial LH indicators. Moreover, the correlation analysis showed a weak association between biodemographic and psychosocial LH indicators. The results strengthen the legitimacy of incorporating biodemographic LH traits into research models and indicate the need for further research on the accuracy of the Mini-K. The possible explanations for the intergroup differences in LH strategies are discussed. (shrink)

Domestic violence is one of the most common forms of violence against women. Domestic violence during pregnancy is associated with adverse perinatal and maternal outcomes. We aimed to assess whether domestic violence was associated with mode of delivery, low birthweight and preterm birth in two sites in Nepal. In this prospective cohort study we consecutively recruited 2004 pregnant women during antenatal care at two hospitals between June 2015 and September 2016. The Abuse Assessment Screen was used to assess fear and (...) violence. Having ever experienced either fear or violence was defined as any domestic violence. Obstetric outcomes were obtained from hospital records for 1381 women, selecting singleton pregnancies only. Mode of delivery was assessed as birth by cesarean section or not. A birthweight of less than 2500 g was defined as low birthweight and preterm birth as birth before completion of 37 weeks gestation. Descriptive and multiple logistic regression analyses were performed to assess associations. Twenty percent of the women reported any domestic violence. Among all 1381 women, 37.6% gave birth by cesarean section. Of those women who delivered by cesarean section, 84.7% had an emergency cesarean section. Less than 10% of the babies were born prematurely and 13.5% were born with low birthweight. We found no significant association between exposure to any domestic violence during pregnancy and risk of a low birthweight baby or birth by cesarean section. However, having experienced both violence and fear was significantly associated with giving birth to a preterm infant [aOR 2.33 ]. Domestic violence is common in Nepal. This is a potential risk factor for severe morbidity and mortality in newborns. We found that the risk of having a preterm baby was higher for pregnant women who experienced both fear and violence. This should be recognized by the health sector. In this study, no significant differences were found in the rate of cesarean section nor low birthweight for women who had experienced any domestic violence compared to those who did not. (shrink)

Mortal and immortal DNA : Craig Venter and the lure of "lamia" -- Homeopathy : Holmes, hogwarts, and the Prince of Wales -- Citizen Pinel and the madman at Bellevue -- The experimental pathology of stress : Hans Selye to Paris Hilton -- Gore's fever and Dante's Inferno : Chikungunya reaches Ravenna -- Giving things their proper names : Carl Linnaeus and W.H. Auden -- Spinal irritation and fibromyalgia : Lincoln's surgeon general and the three graces -- Tithonus and the (...) fruit fly : new science and old myths -- Swiftboating "America the beautiful" : Katharine Lee Bates and a Boston marriage -- Nothing makes sense in medicine except in the light of biology -- Apply directly to the forehead : Holmes, Zola, and Hennapecia -- Elizabeth Blackwell breaks the bonds -- Chronic lyme disease and medically unexplained syndromes -- Eugenics and the immigrant : Rosalyn Yalow and Rita Levi-Montalcini -- Science in the Middle East : Robert Koch and the cholera war -- How to win a Nobel prize : thinking inside and outside the box -- Homer Smith and the lungfish : the last gasp of intelligent design -- DDT is back : let us spray! -- Academic boycotts and the Royal Society -- Teach evolution, learn science : John William Draper and the "bone bill" -- Diderot and the yeti crab : the encyclopedias of life -- Dengue fever in Rio : Macumba versus Voltaire. (shrink)

Death.--The absurd.--Moral luck.--Sexual perversion.--War and massacre.--Ruthlessness in public life.--The policy of preference.--Equality.--The fragmentation of value.--Ethics without biology.--Brain bisection and the unity of consciousness.--What is it like to be a bat?--Panpsychism.--Subjective and objective.

Nature and Mortality is a challenging look at some of the major public issues of our time through the eyes of one of our most influential and probing liberal humanists. It is a frank account on where we stand today on such controversial matters as human embryology, genetic engineering, euthanasia and abortion. Warnock's views may seem like a red rag to a bull to some, but her contribution to the debate is always stimulating. Enlivened by autobiographical anecdote and some (...) delicious side-swipes, Nature and Mortality is Mary Warnock at her most perceptive, wise and entertaining. (shrink)

Morality, Mortality as a whole deals with certain aspects of ethical theory and with moral problems that arise primarily in contexts involving life‐and‐death decisions. The importance of the theoretical issues is not limited to their relevance to these decisions; however, they are, rather, issues at the heart of basic moral and political theory. This first volume comprises three parts. Part I, Death: From Bad to Worse, has with four chapters, and an appendix, discussing death and why it is bad (...) for the person who dies. Part II, Saving Lives: General Issues, has six chapters, and explores a cluster of moral problems that arise in saving lives. The general question raised is whether we should always, in aiding life, act so as to save the greater number of lives or to produce the greatest amount of good. Part III, Scarce Resources: Theoretical Issues, Specific Recommendations, and Organ Transplants, has five chapters, and deals with the problem of the acquisition and distribution of organs for transplantation. It allows us to apply the theoretical discussion of saving lives and relevant/irrelevant utilities presented in the previous parts. However, the discussion can be understood independently of the first two parts, and the conceptual issues and procedures on which it focuses are relevant to dealing with any scarce resource, including money and time, which are needed to use other plentiful resources. Although the book contains much theoretical and methodological argument, it is firmly grounded in practical ethical issues, and is illustrated throughout by examples. (shrink)

"In preparing this remarkable book, Ernest Hook persuaded an eminent group of scientists, historians, sociologists and philosophers to focus on the problem: why are some discoveries rejected at a particular time but later seen to be valid? The interaction of these experts did not produce agreement on 'prematurity' in science but something more valuable: a collection of fascinating papers, many of them based on new research and analysis, which sometimes forced the author to revise a previously-held opinion. The book should (...) be enthusiastically welcomed by all readers who are interested in how science works."—Stephen G. Brush, co-author of Physics, The Human Adventure: From copernicus to Einstein and Beyond "Prematurity and Scientific Discovery contains interesting and insightful papers by numerous well-known scientists and scholars. It will be of wide interest, not only to science studies scholars but also to working scientists and to science-literate general readers."—Thomas Nickles, editor of Scientific Discovery, Logic, and Rationality. (shrink)

This chapter contains sections titled: The Existential Analytic: Terminable or Interminable? Death's Representatives: Some Dead Ends The Existential Approach: Death in/from/as Life The Modalities of Mortal Existence Getting Ahead of Ourselves: Heidegger's Analysis between Angst and Conscience.

This volume continues the examination of issues of life and death which F.M. Kamm began in Morality, Mortality, Volume I. Kamm continues her development of a non-consequentialist ethical theory and its application to practical ethical problems. She looks at the distinction between killing and letting die, and between intending and foreseeing, and also at the concepts of rights, prerogatives, and supererogation. She shows that a sophisticated non-consequentialist theory can be modelled which copes convincingly with practical ethical issues, and throws (...) considerable light on some of the key distinctions and concepts of ethical discourse. (shrink)

This volume continues the examination of issues of life and death which F.M. Kamm began in 'Morality, Mortality, ' Volume I (1993). Kamm continues her development of a non-consequentialist ethical theory and its application to practical ethical problems.

Preface -- How brave a new world? : God, technology, and medicine -- A theological reflection on reproductive medicine -- Are our genes our fate? : genomics and Christian theology -- Persons, neighbors, and embryos : some ethical reflections on human cloning and stem cell research -- Extending human life : to what end? -- What is Christian about Christian bioethics? -- Revitalizing medicine : empowering natality vs. fearing mortality -- The future of the human species -- Creation, creatures, (...) and creativity : the Word and the final Word. (shrink)

In Mortal Imitations of Divine Life, Diamond offers an interpretation of De Anima, which explains how and why Aristotle places souls in a hierarchy of value. Aristotle’s central intention in De Anima is to discover the nature and essence of soul—the prin­ciple of living beings. He does so by identifying the common structures underlying every living activity, whether it be eating, perceiving, thinking, or moving through space. As Diamond demonstrates through close readings of De Anima, the nature of the soul (...) is most clearly seen in its divine life, while the embodied soul’s other activi­ties are progressively clearer approximations of this principle. This interpretation shows how Aristotle’s psychology and biology cannot be properly understood apart from his theological conception of God as life, and offers a new explanation of De Anima’s unity of purpose and structure. (shrink)

The Child Abuse Amendments of 1984 established the norms for treating disabled newborns, but they did not address the treatment of premature babies. Parents and physicians need a framework for decisionmaking. A decision handed down recently by the Texas Supreme Court is a step forward.

The Child Abuse Amendments of 1984 established the norms for treating disabled newborns, but they did not address the treatment of premature babies. Parents and physicians need a framework for decisionmaking. A decision handed down recently by the Texas Supreme Court is a step forward.