As artist-in-residence at the Zen Hospice Project Guest House, Wendy MacNaughton experienced firsthand how difficult it is to know what to do when we're sharing final moments with a loved one. In this tenderly illustrated guide to saying goodbye, with a foreword by renowned physician and author BJ Miller, MacNaughton shows how to make sure those moments are meaningful. Using a framework of "the five things" taught to her by a professional caregiver, How to Say Goodbye provides (...) a model for having conversations of love, respect, and closure: with the words "I forgive you," "Please forgive me," "Thank you," "I love you," and "Goodbye," each oriented toward finding mutual peace and understanding when it matters most. How to Say Goodbye features MacNaughton's drawn-from-life artwork from both the Zen Hospice Project Guest House and her own aunt's bedside as she died, each paired with hospice caregivers' gentle advice on creating a positive sensory experience, acknowledging what you can't control, and sharing memories and gratitude. A poignant guide to embracing the present and deepening relationships during great vulnerability, How to Say Goodbye shows that just as there is no one right way to live a good life, there is no one right way to say goodbye. Whether confused, scared, or uncertain, this book is a starting point. (shrink)

"Is it meaningful to call oneself a democrat? And if so, how do you interpret the word?" -/- In responding to this question, eight iconoclastic thinkers prove the rich potential of democracy, along with its critical weaknesses, and reconceive the practice to accommodate new political and cultural realities. Giorgio Agamben traces the tense history of constitutions and their coexistence with various governments. Alain Badiou contrasts current democratic practice with democratic communism. Daniel Bensaid ponders the institutionalization of democracy, while Wendy (...) Brown discusses the democratization of society under neoliberalism. Jean-Luc Nancy measures the difference between democracy as a form of rule and as a human end, and Jacques Rancière highlights its egalitarian nature. Kristin Ross identifies hierarchical relationships within democratic practice, and Slavoj Zizek complicates the distinction between those who desire to own the state and those who wish to do without it. -/- Concentrating on the classical roots of democracy and its changing meaning over time and within different contexts, these essays uniquely defend what is left of the left-wing tradition after the fall of Soviet communism. They confront disincentives to active democratic participation that have caused voter turnout to decline in western countries, and they address electoral indifference by invoking and reviving the tradition of citizen involvement. Passionately written and theoretically rich, this collection speaks to all facets of modern political and democratic debate. (shrink)

Patient visits are an important opportunity for general practitioners to discuss the risks of smoking and cessation strategies. In Australia, the guidelines on cessation published by the Royal Australian College of General Practitioners represent a key resource for GPs in this regard. The predominant message of the Guidelines is that pharmacotherapy should be recommended as first-line therapy for smokers expressing an interest in quitting. This, however, ignores established evidence about the success of unassisted quitting. Our analysis of the Guidelines identifies (...) a number of potential conflicts of interest which may have affected the advice provided. These include extensive funding by the pharmaceutical industry of sources cited to support the recommendations, and relations between members of the Guidelines Content Advisory Group and the pharmaceutical industry. Recommendations issued by professional bodies have enormous potential impact upon public health and there is a need for the highest levels of scrutiny and transparency in their development. Information about research cited in guidelines should include funding sources, and developers should be free of obvious conflicts of interest. Smoking remains the leading preventable cause of global mortality. Concerns related to pharmaceutical industry funding of research, scientific integrity and recommendations on smoking cessation by medical advisory groups clearly have implications beyond Australia. (shrink)

Although the right to health is universal, many nations that honor it fail to do so in the case of non-citizen immigrants. In this essay, we argue that the reasons typically given for not extending the right to health to immigrants are without merit and that there are good reasons for nations to protect, respect and fulfill the health right of all immigrants. Contrary to the standard view, we argue that health can be understood as a global public good. Two (...) important points follow: because health is non-excludable and non-rivalrous, it is in the health interests of nations to respect, protect and fulfill immigrants’ right to health. Furthermore, meeting the health needs of immigrants is an important way for receiving nations to meet the duties that may be generated by the benefits they incur as a result of health’s global public good dimension, thus ensuring that receiving nations are not free riders. We then argue that because citizens and immigrants dwell together, nations have duties of solidarity to immigrants with respect to health. Using the insights of social psychology, we show that solidarity among diverse people is both a reasonable expectation and a morally desirable one. (shrink)

The second of five commentaries on “Bloomberg's Health Legacy: Urban Innovator or Meddling Nanny?” from the September‐October 2013.

Bringing together the expertise of rhetoricians in English and communication as well as media studies scholars, Arguments about Animal Ethics delves into the rhetorical and discursive practices of participants in controversies over the use of nonhuman animals for meat, entertainment, fur, and vivisection. Both sides of the debate are carefully analyzed, as the contributors examine how stakeholders persuade or fail to persuade audiences about the ethics of animal rights or the value of using animals.

Cancer cells seem to exploit mechanisms that evolve as part of physiological tolerance, which is a complementary and often beneficial form of defense. The study of physiological systems of tolerance can therefore provide insights into the development of a state of host tolerance of cancer, and how to break it. Analysis of these models has the potential to improve our understanding of existing immunological therapeutic targets, and help to identify future targets and rational therapeutic combinations. The treatment of cancer with (...) immune checkpoint inhibitors aims to reverse the progression to tolerance of cancer, and achieve an immunogenic, rather than tolerogenic, homeostasis. Broadening the efficacy and durability of checkpoint inhibitors focuses on reversing tolerance and stimulating immunogenicity in the cancer, host, and environment. Two examples of important physiological states of tolerance that may inform tolerance of cancer are microbial infection and placental reproduction. These states of tolerance result from bilateral shaping of host and non‐self, akin to immunoediting in cancer, and offer reliable models to study the immune tolerance paradigm. (shrink)

Conflicts of interests are typically divided into those that are financial and those that are not. While there is general agreement that financial COIs have a significant impact on decisions and need to be declared and managed, the status of non-financial COIs continues to be disputed. In a recentBMJfeature article it was proposed that religious beliefs should be routinely declared as an interest. The article generated over 41 responses from the medical community and health researchers, which put forward diverse and (...) opposing views. In this paper, we analyse the discourse to shed further light on the reasons put forward for and against declaring religious beliefs. We argue for a middle path in which only material beliefs should be declared, and then only when there are no extenuating circumstances. To this end, we present a framework to help evaluate the materiality of interests that can be used for both financial and non-financial interests. (shrink)

Since its founding in 1943, Medievalia et Humanistica has won worldwide recognition as the first scholarly publication in America to devote itself entirely to medieval and Renaissance studies. Since 1970, a new series, sponsored by the Modern Language Association of America and edited by an international board of distinguished scholars and critics, has published interdisciplinary articles. In yearly hardbound volumes, the new series publishes significant scholarship, criticism, and reviews treating all facets of medieval and Renaissance culture: history, art, literature, music, (...) science, law, economics, and philosophy. (shrink)

This chapter argues that ethics plays an extremely important role in decision making and lawmaking in bioethics issues. These decisions are not simple case-by-case judgments; rather, they rest upon deeply considered ethical opinions. It also discusses the implications of this epistemic grounding for bioethics and its use of case law materials as an ethical resource. Finally, since many people base their moral judgments on religious beliefs, the religious implications of this legal-moral relationship are considered.

Lloyd (2009) contends that climate models are confirmed by various instances of fit between their output and observational data. The present paper argues that what these instances of fit might confirm are not climate models themselves, but rather hypotheses about the adequacy of climate models for particular purposes. This required shift in thinking—from confirming climate models to confirming their adequacy-for-purpose—may sound trivial, but it is shown to complicate the evaluation of climate models considerably, both in principle and in practice.

To study Earth’s climate, scientists now use a variety of computer simulation models. These models disagree in some of their assumptions about the climate system, yet they are used together as complementary resources for investigating future climatic change. This paper examines and defends this use of incompatible models. I argue that climate model pluralism results both from uncertainty concerning how to best represent the climate system and from difficulties faced in evaluating the relative merits of complex models. I describe how (...) incompatible climate models are used together in ‘multi-model ensembles’ and explain why this practice is reasonable, given scientists’ inability to identify a ‘best’ model for predicting future climate. Finally, I characterize climate model pluralism as involving both an ontic competitive pluralism and a pragmatic integrative pluralism. (shrink)

Breath is invisible and yet ever present and vital for living beings. The concept of invisibility in relation to breath operates in concrete and metaphorical ways to extend ideas about breath and breathlessness across disciplines, in clinical spaces and in life experience. Using a critical medical humanities approach, I demonstrate that the poverty of narrative accounts and language for breath outside the health context have had a crucial influence enabling clinically mediated interpretations and accounts to dominate. These third-person accounts are (...) important in the articulation of the ‘lived body’, but I balance this with a consideration of the subjective sensation of interoception, which has important implications for the visibility of breathlessness in both clinical and lay contexts. This article illustrates the rich potential of the subjects of breath and breathlessness within body studies and this special issue is a key step in making breath such an emergent topic. (shrink)

Doctors may be thrust into the difficult situation of treating friends and colleagues. A doctor's response to this situation is strongly influenced by his or her emotions and by medical tradition. Such patients may be treated as 'special cases' but the 'special' treatment can backfire and lead to an adverse outcome. Why does this happen and can doctors avoid it happening? These issues are discussed in this commentary on Dr. Crisci's paper, 'The ultimate curse.'.

We invoke the ideal of tolerance in response to conflict, but what does it mean to answer conflict with a call for tolerance? Is tolerance a way of resolving conflicts or a means of sustaining them? Does it transform conflicts into productive tensions, or does it perpetuate underlying power relations? To what extent does tolerance hide its involvement with power and act as a form of depoliticization? Wendy Brown and Rainer Forst debate the uses and misuses of tolerance, an (...) exchange that highlights the fundamental differences in their critical practice despite a number of political similarities. Both scholars address the normative premises, limits, and political implications of various conceptions of tolerance. Brown offers a genealogical critique of contemporary discourses on tolerance in Western liberal societies, focusing on their inherent ties to colonialism and imperialism, and Forst reconstructs an intellectual history of tolerance that attempts to redeem its political virtue in democratic societies. Brown and Forst work from different perspectives and traditions, yet they each remain wary of the subjection and abnegation embodied in toleration discourses, among other issues. The result is a dialogue rich in critical and conceptual reflections on power, justice, discourse, rationality, and identity. (shrink)

Whether in characterizing Catharine MacKinnon's theory of gender as itself pornographic or in identifying liberalism as unable to make good on its promises, Wendy Brown pursues a central question: how does a sense of woundedness become the basis for a sense of identity? Brown argues that efforts to outlaw hate speech and pornography powerfully legitimize the state: such apparently well-intentioned attempts harm victims further by portraying them as so helpless as to be in continuing need of governmental protection. "Whether (...) one is dealing with the state, the Mafia, parents, pimps, police, or husbands," writes Brown, "the heavy price of institutionalized protection is always a measure of dependence and agreement to abide by the protector's rules." True democracy, she insists, requires sharing power, not regulation by it; freedom, not protection.Refusing any facile identification with one political position or another, Brown applies her argument to a panoply of topics, from the basis of litigiousness in political life to the appearance on the academic Left of themes of revenge and a thwarted will to power. These and other provocations in contemporary political thought and political life provide an occasion for rethinking the value of several of the last two centuries' most compelling theoretical critiques of modern political life, including the positions of Nietzsche, Marx, Weber, and Foucault. (shrink)

Once a term used primarily by moral philosophers, “moral distress” is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? “Plight” encompasses not (...) only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of “efficiency,” is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals’ moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim. (shrink)

This article seeks to open up a new avenue for feminist technology studies—gender-aware research on engineers and engineering practice—on the grounds that engineers are powerful symbols of the equation between masculinity and technology and occupy significant roles in shaping new technologies. Drawing on the disparate evidence available, the author explores four themes. The first asks why the equation between masculinity and technology is so durable when there are such huge mismatches between image and practice. The second examines this mismatch in (...) the detail of engineering knowledge and practice to reveal that fractured and contradictory constructions of masculinity frequently coexist. The third theme addresses the suggestion that women and men might bring different styles to engineering. Finally, the author explores subjective experiences of engineering to argue that engineers’ shared pleasures in and identification with technology both define what it means to be an engineer and provide appealing symbols of power that act to compensate for a perceived lack of power or competence in other arenas. (shrink)

In Sleeping with Extra-Terrestrials , Wendy Kaminer argues that we are a society intoxicated by the irrational: religion, spirituality, and popular therapies threaten to replace rational thought with supernaturalism and impassioned but unexamined personal testimony. Ranging from our fascination with angels, aliens, and near- death experiences to the rise of junk science, the recovery movement, and the digital culture, Kaminer points out the amusing and ominous effects of our deference to spiritual authorities and resistance to critical thinking. She questions (...) conventional wisdom about the association of religious belief with virtue, identifying the sectarianism of efforts to establish religion in the public square. With both wit and empathy, Kaminer takes on what many people hold sacred. Kaminer is an eloquent and incisive critic and rationalist living in a superstitious, evangelical age. In Sleeping with Extra-Terrestrials she challenges us to exercise skepticism, reason, and irreverence and to appreciate the pleasures of free inquiry. (shrink)

Increasingly there are calls for climate services to be “co-produced” with users, taking into account not only the basic information needs of users but also their value systems and decision contexts. What does this mean in practice? One way that user values can be incorporated into climate services is in the management of inductive risk. This involves understanding which errors in climate service products would have particularly negative consequences from the users’ perspective (e.g., underestimating rather than overestimating the change in (...) an impact variable) and then prioritizing the avoidance of those errors. This essay shows how inductive risk could be managed in climate services in ways that serve user values and argues that there are both ethical and practical reasons in favor of doing so. (shrink)

On the 24th June 2015, Feminist Legal Studies and the London School of Economics Law Department hosted an afternoon event with Professor Wendy Brown, Class of 1936 First Professor of Political Science, University of California. Professor Brown kindly agreed to discuss her scholarship on feminist theory, and its relationship to both the law and neoliberalism. The event included an interview by Dr Katie Cruz and a Q&A session, which are presented here in an edited version of the transcript. Sumi (...) Madhock, Professor of Gender Studies, LSE chaired the interview and discussion and introduced Professor Brown’s work. Katie Cruz asked Wendy Brown to reflect upon topics that span her scholarship and activism, including the state of critical, feminist, and Left approaches to rights, neoliberalism, despair and utopianism, and the future of feminist theory and practice in the context of neoliberalism and current debates about intersectionality. Participants in the discussion asked questions on a wide range of issues, including the limits of feminist engagement with law as a tool for social change, the dominance of neoliberalism, imperialist feminism, Islamophobia, secularism, and our attachment to the figure of homo politicus. (shrink)

ABSTRACT In this paper we argue that sex‐selective abortion (SSA) cannot be morally justified and that it should be prohibited. We present two main arguments against SSA. First, we present reasons why the decision for a woman to seek SSA in cultures with strong son‐preference cannot be regarded as autonomous on either a narrow or a broad account of autonomy. Second, we identify serious harms associated with SSA including perpetuation of discrimination against women, disruption to social and familial networks, and (...) increased violence against women. For these reasons, SSA should be prohibited by law, and such laws should be enforced. Finally, we describe additional strategies for decreasing son‐preference. Some of these strategies rely upon highlighting the disadvantages of women becoming scarce, such as lack of brides and daughters‐in‐law to care for elderly parents. We should, however, be cautious not to perpetuate the view that the purpose of women is to be the consorts for, and carers of, men, and the providers of children. Arguments against SSA should be located within a concerted effort to ensure greater, deeper social and cultural equality between the sexes. (shrink)

Across the Euro-Atlantic world, political leaders have been mobilizing their bases with nativism, racism, xenophobia, and paeans to “traditional values,” in brazen bids for electoral support. How are we to understand this move to the mainstream of political policies and platforms that lurked only on the far fringes through most of the postwar era? Does it herald a new wave of authoritarianism? Is liberal democracy itself in crisis? In this volume, three distinguished scholars draw on critical theory to address our (...) current predicament. Wendy Brown, Peter E. Gordon, and Max Pensky share a conviction that critical theory retains the power to illuminate the forces producing the current political constellation as well as possible paths away from it. Brown explains how “freedom” has become a rallying cry for manifestly un-emancipatory movements; Gordon dismantles the idea that fascism is rooted in the susceptible psychology of individual citizens and reflects instead on the broader cultural and historical circumstances that lend it force; and Pensky brings together the unlikely pair of Tocqueville and Adorno to explore how democracies can buckle under internal pressure. These incisive essays do not seek to smooth over the irrationality of the contemporary world, and they do not offer the false comforts of an easy return to liberal democratic values. Rather, the three authors draw on their deep engagements with nineteenth–and twentieth–century thought to investigate the historical and political contradictions that have brought about this moment, offering fiery and urgent responses to the demands of the day. (shrink)

Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within “dysfunction-requiring” accounts of disease, such as (...) those of Christopher Boorse and Jerome Wakefield. We then provide several detailed examples to establish that biological dysfunction cannot provide a boundary. We examine potential ways of resolving the line-drawing problem, either by dropping one of the claims that generates it, or by appealing to additional criteria. We argue that two of these options are plausible, and that each of these can be applied with regard to different diseases. (shrink)

DIVA reader aimed at revitalizing left legal and political critique./div.

A number of recent discussions comparing computer simulation and traditional experimentation have focused on the significance of “materiality.” I challenge several claims emerging from this work and suggest that computer simulation studies are material experiments in a straightforward sense. After discussing some of the implications of this material status for the epistemology of computer simulation, I consider the extent to which materiality (in a particular sense) is important when it comes to making justified inferences about target systems on the basis (...) of experimental results. (shrink)

Wendy Brown's work commands widespread attention and respect, and there has been considerable interest as to how it would develop after "States of Injury." This book will not disappoint.

First published in 1982. Routledge is an imprint of Taylor & Francis, an informa company.

We call attention to an underappreciated way in which non-epistemic values influence evidence evaluation in science. Our argument draws upon some well-known features of scientific modeling. We show that, when scientific models stand in for background knowledge in Bayesian and other probabilistic methods for evidence evaluation, conclusions can be influenced by the non-epistemic values that shaped the setting of priorities in model development. Moreover, it is often infeasible to correct for this influence. We further suggest that, while this value influence (...) is not particularly prone to the problem of wishful thinking, it could have problematic non-epistemic consequences in some cases. (shrink)

Can computer simulation results be evidence for hypotheses about real-world systems and phenomena? If so, what sort of evidence? Can we gain genuinely new knowledge of the world via simulation? I argue that evidence from computer simulation is aptly characterized as higher-order evidence: it is evidence that other evidence regarding a hypothesis about the world has been collected. Insofar as particular epistemic agents do not have this other evidence, it is possible that they will gain genuinely new knowledge of the (...) world via simulation. I illustrate with examples inspired by uses of simulation in meteorology and astrophysics. (shrink)