A lot of subordinating speech has moved online, which raises several questions for philosophers. Can current accounts of oppressive speech adequately capture digital hate? How does the anonymity of online harassers contribute to the force of their speech? This paper examines online abuse and argues that standard accounts of licensing and accommodation are not up to the task of explaining the authority of online hate speech, as speaker authority often depends on the community in more ways than these accounts suggests. (...) Instead I argue that online abusive speech is best understood as collective subordinating speech acts, as their authority is drawn from an ad hoc collective. I argue that anonymity and shared language offer online abusers a path to a type of group-authority that explains the harm their speech is capable of. I close by suggesting that similar considerations are in play for IRL subordinating speech, and that online abuse helps to reveal key features of subordinating speech across mediums that are under-emphasized in the existing literature. (shrink)

RésuméDans cet article, j'explore les intimités épistémiques de l'amitié, en m'inspirant à la fois de la philosophie de Steven Burns et des nouvelles d'Alice Munro. J'identifie trois formes distinctes de ce que j'appelle « l'intimité épistémique ». Les amis peuvent refléter qui nous sommes ou ils peuvent façonner qui nous sommes selon la compréhension qu'ils ont de nous. Au-delà de ces rôles miroirs et constructifs, nous vivons l'expérience d'une intimité épistémique avec des amis simplement par les manières distinctes dont nous (...) nous occupons d'eux, et dont ils s'occupent de nous. De plus, la reconnaissance des disparités entre les diverses formes d'intimités épistémiques nous permet d'expliquer pourquoi certaines amitiés perdurent alors que d'autres échouent. (shrink)

The rapid diffusion of computers and information technology into organizational settings is bringing profound changes to employee-employer relationships.Managers and employees are faced with challenges of electronic monitoring of communications and collection and use of information about employees (Mello, 2003). This paper proposes to discuss several issues related to electronic workplace monitoring. Specifically, the purpose of this paper is to explore the interplay between privacy and ethical issues with processes related to the initiation and formation of trust between management and employees.

Jaswal & Akhtar offer evidence against lack of social motivation in “autistic people,” providing no further phenotypic details as to the autism spectrum disorder subgroups that they refer to. I will argue that given the extensive behavioral and neurobiological heterogeneity among people who receive the diagnosis, reference to “autistic people” is misleading. As a consequence, J&A's claims are difficult to interpret.

Some critics have understood environmental egalitarianism to imply that human and animal lives are generally equal in value, so that killing a human is no more objectionable than killing a dog. This charge should be troubling for anyone with egalitarian sympathies. I argue that one can distinguish two distinct versions of equality, one based on the idea of equal treatment, the other on the idea of equally valuable lives. I look at a lifeboat case where one must choose between saving (...) a human and saving a dog, and using the work of Peter Singer and Tom Regan, I show why equality understood as equal treatment does not entail that lifeboat cases are moral toss-ups. But the view that all lives are equally valuable does entail this, and so egalitarians should reject this alternative account of equality. The upshot is that egalitarians need to be more careful about distinguishing between these two versions of equality. The failure to insist on this distinction has led many to believe that egalitarianism generally has counter-intuitive implications when in fact only one version of egalitarianism has this problem. (shrink)

Loss of personal identity in dementia can raise a number of ethical considerations, including the applicability of advance directives and the validity of patient preferences that seem incongruous with a previous history of values. In this chapter, we first endorse the self-concept view as the most appropriate approach to personal continuity in healthcare. We briefly describe two different types of dementia, Alzheimer’s dementia (AD) and behavioral-variant frontotemporal dementia (bv-FTD). We identify elements considered important for the continuation of a self-concept, including (...) continuation of memories, consistency in personality traits and personal preferences, and continued endorsement of certain moral tenets. We show that, depending on which element is considered most important for personal identity, continuity of a self-concept for individuals with distinct types of dementia will be affected and assessed differently. Utilizing a variety of empirical evidence, we argue that persistence of memory, personality traits, and preferences are not the most important for the maintenance of personal identity. Instead, as studies aimed to capture the folk-psychological view of personal continuity demonstrate, judgements about continuity depend primarily on the persistent commitment to widely shared moral beliefs. Because of that, we argue that individuals with bv-FTD are more likely to lose their sense of self than individuals whose dementia primarily affects memory, such as Alzheimer’s disease. We end the chapter by showing how the importance of moral beliefs for continuity of self can be used to provide guidance to health-care professionals when considering changes in preference by individuals with dementia. (shrink)

A unique study of the earliest recorded "discourses" of the Buddha, taking an approach that is at once psychological, philosophical, and literary. The book is a series of essays on specific passages from the Buddha's original Discourses and is an introduction to the Buddha's radical empiricism for all people who like to read, think, and investigate.

The fact that there are different cultures in the world is too obvious for words. COnsidering thus cultural differences in the light of the phenomenological concept of life-world may raise the following questions: Do we live in the same life-world regardless of such cultural differences? Or do we live in different life-worlds because of cultural differences? The first question presupposes a singular life-world, whereas the second question entails a plurality of life-worlds. IN any case, how is the notion of cultural (...) difference related to that of the life-world? Edmund Husserl (1859-1938), the founder of phenomenology seems to conceive the life-world as the bare ground of the natural sciences. THe life-world therefore acquires a universal validity regardless of cultural differences. IN contrast, for Alfred Schutz (1899-1959), who is more concerned with the foundation of human and social sciences than that of natural sciences, the life-world understood as field of praxis with social and cultural characteristics unavoidably assumes cultural differences. Besides critically discussing these two radically diverging positions, the book also discusses what Bernhard Waldenfels sees as a common denominator: the idea of grounding (Grundlegungsidee). BOth Husserl and Schutz develop in their own ways a foundationalist interpretation of the life-world. IN whatever case, the book seeks to overcome any foundationalism whether in the form of universalism or culturalism by suggesting to refocus and inquire into the status of cultural objects. UNiversals are ill-suited for cultural matters. COrrelatively, considering cultural objects from alien cultures requires acknowledging difference with a sense of humility that does not preclude the possibility of understanding. (shrink)

The paper focuses on the consumer side of consumption tax evasion (CTE), a subcategory of the shadow economy. The ethical dimensions of tax evasion have been effectively captured by the existent literature on tax morale, yet it fails to address the role consumers can play in CTE. Further, there is a shortage of tax morale studies that explore ethical decision making as a process composed of multiple steps and determinants. To bridge these gaps, we turned to the consumer ethics literature (...) and Jones’ issue-contingent model of ethical decision making. We developed the conceptual model of consumer ethical decision making for CTE by incorporating four key elements from the issue-contingent model, i.e. moral recognition, moral judgement, moral intention and moral intensity, while personal moral philosophies were introduced as an antecedent to the consumer ethical decision-making process. The study was conducted on a sample of consumers from Slovenia, where CTE is a widespread phenomenon. The findings confirm that consumers’ recognition of CTE as a moral issue is influenced by their moral philosophy and perceptions regarding the magnitude of CTE’s consequences, their visibility, probability, and temporal immediacy. These perceptions also play an important role in determining consumers’ moral judgements and intentions regarding CTE. Moreover, through the process of moral recognition and moral judgement, consumers form intentions to participate in, or avoid CTE. The study holds important implications for public policy makers who are trying to reduce the tax gap in times of economic instability and fiscal crisis. (shrink)

In this paper, I develop a way to conceive of free speech that begins by redefining speech. My definition affirms the fact that speaking is an activity that goes on among people in a community. Speaking, I will suggest, is an activity that involves not only the present speaker, but also others who act as listeners and potential speakers. I contend that liberal conceptions of free speech have often proven ill equipped to address certain free speech issues, precisely because they (...) have tended to conceive of speech not as a collective activity in which participation involves both speaking and listening, but as an individualized activity in which only speakers and their utterances are relevant.Of course not all liberal notions of speech are radically individualistic; a useful distinction might be made between "solipsistic" liberal models, and "two-or-more-person" models. The latter sort do ascribe some sort of role to those who hear and respond to speech. John Stuart Mill's arguments for the value of free speech, for example, display a significant emphasis on the role of the community. Mill's model emphasizes the importance of free debate and discussion as a means by which to improve one's ideas. One of his chief arguments in support of free speech is that collecting others' responses to one's speech enables one to develop clearer, stronger ideas. But such a view only addresses others' roles as speakers--as producers of ideas. My position recognizes an even broader role for these others; I shall suggest that listening/potential speaking are themselves aspects of speaking. Thus, others' interests are do not become relevant (and eligible for protection) only when others themselves become speakers; the interests of listeners (and even "ignorers") as listeners must be taken into account in evaluating whether speech in a particular situation is free.¯ The conception I develop defines speaking as collective, thereby illuminating the role played in it by listeners/potential speakers. In the bulk of activities that go under the name "speech", a community of "others" (listeners, potential listeners, "ignorers") plays some sort of role. Those instances of speaking in which there are no relevant others may be defined in terms of their relation to speech-with-listeners. That is, they are exceptions to the general cases, and their presence in the category "speaking" can be understood by reference to one of these general cases. My original motivation for developing this conception of speech was to provide a way to illuminate those forms of sexual harassment that consist of sexist speech. I intend for the conception to characterize free speech in such a way that preventing someone from using sexist language does not (at least automatically) constitute a violation of their free speech rights, but in fact may increase the level of freedom of the community. I develop my account by first providing a critical outline of one version of a liberal conception of free speech.In the course of this outline, I examine two central liberal justifications for protecting speech; the argument from individual rights and the argument from utility. I conclude this section by making explicit my criticisms of this liberal conception. Following this, I turn to develop an alternative collective conception of speaking and of free speaking. I argue that this conception is preferable for two reasons; first, because speaking is a collective activity, and to treat it otherwise is to mask its powers and disguise the benefit or harm it may bring to users. Second, a collective conception of speaking preserves the values of free speech advanced in liberal views better than does a liberal conception. (shrink)

Sometimes I think: I'm flying. And why am I flying? Because of the dress. The flesh, I think, is multiplying itself. Here are the children, I think, going away from me and coming to me. If all is one, I think, why this split?My body of thought is likewise made of a womb of wombs. Whatever it begets begets its own body [in this sense I may be said to be multiparous].I am beautiful like a snip of ivory. My face (...) is like the negative of another woman's face. Whatever she does I do moving backward.I spread a hundred fingers up against the wind and the wind dries the lacquer. At these parties I have no given name. I may be called Flora and I may be called Rosamund. The images of color that I set up in space redeem me.In the morning. After the dreams. I see the white body stitched in bed. My corporal body. The veins that store the precious fluid. What I think have they hauled up there from the deep?I get up as in the miracle that Our Teacher Rabbi Loew worked upon a lump of clay and turn on the stove.Sometimes the light bounces off of forks and knives into the eyes. The light of the fork into the eye of the fork and the light of the knife into the eye of the knife.What am I what am I I am thinking flattening out knives and forks on those wooden headstones they call a table?The bread is the showbread and the butter is the clot of my blood. What are they looking for in these blue thighs?The kitchen windows [as in the ancient Icelandic language] are the wind's eye. This is the house and these are the children's table-napkins.... Now. When everything is in place. I am waterboiling. Water pours out of the mouth of the tap into the mouth of the kettle and I am thinking about these hairs that I have. About the hundreds of thousands of fine threads that rise at night in utter silence from the skin. The walls close in on me but my head. As in the Book of Creation. Extracts from nothingness black streams.Through the drinking glasses I see a great field of ice. A white antelope eating a fish.... What am I with a round shoulder and milk muttering prices of chemicals. The cash registers cut the boundaries of my skin.In supermarkets with thousands of tins of canned peas ought to ambulate people covered with hair. Let them block one another's cart like they once did in the hippodromes of Byzantium.Let them speak—with those colorful rags that they tie around their necks—into mouthpieces of telephones. Let their voices run crisscross like stifled crow calls between wires inside the earth. Why have they enclosed me—I, who can cover entire fields like Bermuda grass—within the confines of an electric bell?At 7:20. As if down the ladder of angels painted by Raphael. The child descends the wooden staircase. His toes are depressed precisely according to the divine image of grief. Each toe and its mirror reflection in the other foot.The forest creatures on the pajama fabric with their mouths gaping open as in the sudden vision seen by our primogenitor when they spread the coat of many colors before him and said: Surely he has been torn to pieces.... When the child turned inside me and stood in the placental fluid with his head to the ground, the two of us were the complete converse figure. One head toward the outer boundary, the other head toward the middle point.It was unnatural how the head emerged. Why did it pierce the membrane in which it was enfolded and discharge the water?Windows previously shut were torn apart. Lids of cookware dropped to the floor. This rupture [Michael. Michael.] gave birth to unreason.The child [in my imaginations he is chasing gadflies] is sitting at the table waiting for his cornflakes. He is eating them flake by flake and inside every flake are little crystals of sugar.This game [being able to hold shreds of sugar inside tiny dents] fills his heart.... The light that radiates in every thing is the light of late autumn. I play with it the age-old game. Ask for its name and it replies.The kitchenware too bear their names [just as they bear the form].... I can write an inner play about The Non-Intervention of Time in Kitchenware. Time will get the leading role.In Act One it will set out [like Ulysses] on a journey. The kitchenware will stay put, each ware in its respective place, within daily life.In Acts Two and Three time will travel so far that one or two wares should drop out of place.Act Four will be called Fatal Incidence and Act Five, The Return of Time.... I shout [an inner shout] Dolores Dolores as if I had a friend whose name were like that.How do you do Dolores [I say in my heart] and exchange recipes for dresses with her.Then Dolores sets out in both directions at once. The direction of the great bird in the sky and the direction of Nachlat Binyamin St.... I can see [by means of two mirrors] my silk dressing gown.The silk dressing gown enfolds me and prepares me for verbal exchange. It enables me to communicate information. If it slides down I kneel down until it slides up [and then I kneel down].... When I think of recollection I wonder how the image of myself gets duplicated.The bathtub gets duplicated and the light above the bathtub. Time sends a facsimile of itself.In the black margins outside the sheet of paper hides my mother. Come out come out she is calling to me like you would to a snail.At that time were created the archetypes of things.The complete washbasin. The complete mirror. Next to every sound was inscribed the right clef.Every movement was a perfectum mobile: I jump and by force of this jump I jump again.... Through the window I see the crow called Salpeter.Good morning Old Salpeter. Did you get your black robe back from the dry cleaner?Sometimes you see me obliquely from the right and sometimes obliquely from the left. What am I? A very strange female crow?I adore your rich language. This single word of yours that has in it all the verb stems.... What is so logical about the sky? The window frame.The window frame is like the twelve apostles. Three in each lintel and in their midst [behind the nebula] is sitting the child Michael.The motion of a doll turned over and the motion of the trains sent by him flying in the air are the divine edict. Get'p get'p he tells me all of you and go'ver there.... See Dolores how simple everything is: There is the kitchen. There is the child. There is the wooden staircase.Whom are we to thank for this grace. The colors are so right Dolores and the shapes precise. Every thing I spell out is cut with utmost perfection for the space allotted to it and for the sequence of time.... My biography may easily be canceled.First cancel the alienation. Then cancel the kneeling in the dark. The joy of the assigned date. The bridal veil and the porcelainware.If a medical ground is required I can say I have edema.... I like the words earth quake.Sometimes I think the earth is quaking and the words are not and sometimes the words are quaking and the earth is not.The great catfish know the earth is about to quake and the Chinese who paint the words with a fine paintbrush six lines for the earth and fifteen for this quake set guards to watch the great catfish who knows what is about to take place.... As if after a very severe accident I have to practice life anew.My physiotherapist tells me: Now a slight movement with the right hand. Now a shake of the head.I learn to press handles. To turn sharply in this or that direction.Lately when they ask me anything I pretend that the reply answers the question.Look Dolores how I refute the theory about the formation of species:I take a bubble of soap from the sink and elevate it to the sun.... There is a thing Dolores and it is infinitely good and I shall not tell you what it is.You can hear it in the first hours of the night when darkness is gaping. It has the property of withdrawing into a point tiny as a tittle.Or you can search for it in places where there appears to be something and there is not. (shrink)

This article sketches the broad outlines of Matthew's ironic portrayal of children, examining first the 'lower level' of the narrative and then the 'upper level' of the narrative. When viewed from the 'lower level' of Matthew's narrative, the everyday circumstances of children reflect the nurture of their parents as well as significant challenges: debilitating physical conditions, serious illnesses, military violence and premature childhood death. In addition, children occupy the lowest rung on the 1st-century Mediterranean social ladder, a status they share (...) with slaves. But on the 'upper level' of his narrative, from the 'God's-eye' perspective, Matthew turns everyday reality for children on its head in ironic fashion. Emmanuel, the 'God who is with us', appears as a 'child' who has just 'been born' and who exhibits all the powerlessness and vulnerability of such a 'child'. In a violent showdown between 'King Herod' and the one 'who has been born king of the Jews', it is Herod, the powerful ruler, who dies, while the vulnerable 'child' ends up safely in Nazareth. Throughout his ministry, Jesus heals children along with adults. To the apparent chagrin of his disciples, Jesus lays hands on children in an act of blessing. He commends the messianic praises of children, in contrast to the outrage of the Jewish leadership. Moreover, Jesus proclaims that it is 'to such as these [children] that the kingdom of heaven belongs'. (shrink)

Then UK Labour Party leader Jeremy Corbyn’s attendance at a Passover Seder organised by the radical leftist group, Jewdas, in April 2018, led to a brief but vitriolic controversy involving Anglo-Jewish umbrella organisations concerning who qualifies to speak as a Jew. This article uses this controversy to engage with Judith Butler’s attempt to address this question, suggesting that in decentring Zionist claims to Jewish subjectivity she fails to take account of how different Jewish subjectivities are formed, and thus ends up (...) proposing a ‘good Jew/bad Jew’ binary that dissolves Jewishness into universal humanism. Drawing on the work of the German-Jewish mystical anarchist Gustav Landauer (1870–1919), the article proposes a different way of understanding subjectivity that retains ontological inherency as a plausible precondition for ethical solidarity. As such, the article’s argument has implications not merely for a reworked understanding of Jewish subjectivity but for the politics of subject formation more broadly. (shrink)

This commentary argues that the problems identified in Kenneth V. Iserson’s Essay, “Do you Believe in Magic? Shove, Don’t Nudge: Advising Patients at the Bedside,” are perennial difficulties to which there is no single simple solution. In particular, recent work in psychology offers little help to caregivers, who are in the difficult position of guiding the decisions of their patients while respecting them and ultimately deferring to their wishes.

Recently, there has been an increased interest in folk intuitions about freedom and moral responsibility from both philosophers and psychologists. We aim to extend our understanding of folk intuitions about freedom and moral responsibility using an individual differences approach. Building off previous research suggesting that there are systematic differences in folks’ philosophically relevant intuitions, we present new data indicating that the personality trait extraversion predicts, to a significant extent, those who have compatibilist versus incompatibilist intuitions. We argue that identifying groups (...) of people who have specific and diverse intuitions about freedom and moral responsibility offers the possibility for theoretical advancement in philosophy and psychology, and may in part explain why some perennial philosophical debates have proven intractable. (shrink)

Your phone and its apps know a lot about you. Who you are talking to and spending time with, where you go, what music, games, and movies you like, how you look, which news articles you read, who you find attractive, what you buy with your credit card and how many steps you take. Personal information about individual preferences, characteristics, and actions has turned digital. Nearly everything you might want to know about a person is available or can be inferred (...) from stored 1s and 0s. This information is already being exploited to sell us products, services, or politicians. Online traces allow companies like Google or Facebook to infer your political opinions, consumer preferences, whether you are a thrill-seeker, a pet lover, or a small employer, how probable it is that you will soon become a parent, or even whether you are likely to suffer from depression or insomnia. With the use of artificial intelligence and the further digitalization of human lives, it is no longer unthinkable that AI might come to know you better than you know yourself. Since knowing yourself and improving your life choices is advantageous in many ways, it might seem that an AI that lets you know who you are and what you should do would be great. I want to raise two reasons why it is not. (shrink)

Research in zoos is an important scientific endeavor that requires several complex considerations in order to occur. Among those many considerations are the ethics involved in conducting zoo research. However, it is not always clear how zoo researchers should go about resolving any research ethics matters, even determining when some type of research ethics committee should be involved in those deliberations. Our paper attempts to provide some resolutions for these issues, namely in three sections: (1) a brief history of human (...) and animal research ethics, (2) general guidelines for zoo research ethics applications, and (3) theoretical, ethical dilemmas at the zoo. In each section, we consider pragmatic attempts to resolve any issues, as well as provide examples to illustrate our points. The primary focus of the paper is to facilitate consideration of the wide array of ethical factors any zoo researcher might encounter, as well as provide a basic set of ethical guidelines for zoo research. We also emphasize the importance of the welfare of the animals for all zoo research projects. (shrink)

This paper examines sustainable agriculture’s steady rise as a legitimate farm management system. In doing this, it offers an account of social change that centers on trust and its intersection with networks of knowledge. The argument to follow is informed by the works of Foucault and Latour but moves beyond this literature in important ways. Guided by and building upon earlier conceptual framework first forwarded by Carolan and Bell (2003, Environmental Values 12: 225–245), sustainable agriculture is examined through the lens (...) of a “phenomenological challenge.” In doing this, analytic emphasis centers on the interpretative resources of everyday life and the artful act of practice – in other words, on “the local.” Research data involving Iowa farmers and agriculture professionals are examined to understand how social relations of trust and knowledge are contested and shaped within and between agricultural social networks and organizational configurations. All of this is meant to further our understanding of what “sustainable agriculture” is and is not, who it is, and how these boundaries change over time. (shrink)

"The world's leading expert on the unconscious mind reveals the hidden mental processes that secretly govern every aspect of our behavior. For more than three decades, Dr. John Bargh has been conducting revolutionary research into the unconscious mind--not Freud's dark, malevolent unconscious but the new unconscious, a helpful and powerful part of the mind that we can access and understand through experimental science. Now Dr. Bargh presents an engaging and enlightening tour of the influential psychological forces that are at work (...) as we go about our daily lives--checking a dating app, holding a cup of hot coffee, or getting a flu shot. Dr. Bargh takes you into his labs at New York University and Yale where his ingenious experiments have shown how the unconscious guides our actions, goals and motivations in areas like race relations, parenting, business, consumer behavior, and addiction. He reveals the pervasive influence of the unconscious mind on who we choose to date or vote for, what we buy, where we live, how we perform on tests and in job interviews, and much more. Before You Know It is full of surprising and entertaining revelations as well as tricks to help you remember to-do items, shop smarter, and sleep better. Before You Know It will profoundly change the way you understand yourself by introducing you to a fascinating world only recently discovered, the world that exists below the surface of your awareness and yet is the key to unlocking new ways of thinking, feeling and behaving."--Jacket. (shrink)

This article is an amalgam of four talks given over several days at The Community of Women and Men in Mission Conference. The overall title `Who do you say that I am?' covers the subjects of Jesus the Liberator, The Healer, The One Who Empowers, and The One Who Sends Us. The author explores these issues in the context of Africa and opens a very illuminating set of questions.

The criminal law declines to punish merely for bad attitudes that are not properly manifested in action. One might try to explain this on practical grounds, but these attempts do not justify the law’s commitment to never punishing unmanifested mental states in worlds relevantly similar to ours. Instead, a principled explanation is needed. A more promising explanation thus is that one cannot be criminally culpable merely for unmanifested bad attitudes. However, the leading theory of criminal culpability has trouble making good (...) on this claim. This is the theory that an action is criminally culpable to the extent that it manifests insufficient regard for legally protected interests. The trouble is that this theory’s defenders have not adequately explained what it is for an action to manifest insufficient regard. In this paper, I aim to provide the required account of manifestation, thereby rendering the insufficient regard theory more defensible. This, in turn, allows the view to explain the broad range of doctrines that treat unmanifested mental states as irrelevant. The resulting theory of criminal culpability is both descriptively plausible and normatively attractive. Moreover, it highlights the continuity between criminal culpability and moral blameworthiness by showing how the former functions as a stripped-down analogue of the latter. (shrink)

What do professional wrestling, Pot Noodle and Feng Shui have in common? Well, not much - but they all appear in this book.Critic and cultural philosopher Peter Trifonas and art historian Effie Balomenos explore the curious concept of good - and bad - taste. At once an absurd and yet entirely everyday concept, taste defines us. Our choices, from the most personal (our friends or lovers) to the most general (our politics), are all partly dependent on it.But where does taste (...) come from? Is there a true standard of taste? Are we slaves to the cruel whims of fashion? Who's in control?Good Taste is an enthralling exploration of the cultural history of an idea. In this enticing book - divided into chapters exploring cultural artefacts of absolutely all kinds - Trifonas and Balomenos warn: you are what you choose!Highlights include: TV chefs · Ozzy Osbourne and Reality TV · The 70s fashion conspiracy · Disney · Madonna · Lamborghini · The history of cleavage · High heels · Elvis · Body piercing · Hip-hop · Oprah Winfrey · Ageing rock bands · Turn-ups · Harry Potter · Fake tans and much, much more ... (shrink)

The tension between the authority of states and the authority of international institutions is a persistent feature of international relations. Legitimacy assessments of international institutions play a crucial role in resolving such tensions. If an international institution exercises legitimate authority, it creates binding obligations for states. According to Raz’s well-known service conception, legitimate authority depends on the reasons for actions of those who are subject to it. Yet what are the practical reasons that should guide the actions of states? Can (...) states be bound by international institutions on all kinds of issues or are certain issues exempted because of sovereignty considerations? This paper argues that self-regarding reasons cannot ground political authority with the respective demand for compliance. Since reasons for states concern individuals both inside and outside of their jurisdiction and other state peoples, self-regarding reasons for states, which form a domain of personal pursuits or sovereign decisions, are highly restricted. (shrink)

The ability of patients to trust physicians to act in their best interests is a critical aspect of a welfare-maximizing relationship. This commentary discusses physician trustworthiness within the framework of the Affordable Care Act and considers steps to reinforce trustworthy behavior.

There are significant differences in the way that regulators treat lawyers and doctors who are found dishonest. Paula Case has found that lawyers are much more likely than doctors to be struck off after a dishonesty finding. This article considers why dishonesty by lawyers is treated more seriously than that of doctors. Analyses of 'trust' in professions make comparisons between doctors and lawyers and invariably report that lawyers are less trusted, but on a flawed basis. However, in the context of (...) interpreting individual cases, practices, and what they say about regulatory approaches or policy, the practical differences between what lawyers and doctors do are rarely commented upon. This undermines the relevance of comparisons that do not recognise the differences and risks missing a deeper understanding of how professions are regulated or how they should be regulated. Ultimately, morality tests are applied. (shrink)

One common reaction to criticism is to try to deflect it by calling into question the motivations of the person doing the criticizing. For example, if I feel like you are blaming me for something that you yourself are guilty of having done in the past, I might respond with the retort, "Who are you to blame me for this?", where this retort is meant to serve not as an excuse but rather as a challenge to the standing of the (...) blamer. The notion of standing has taken center stage in much recent literature on the ethics of blame, though there is no consensus on how best to understand the precise force of the "who are you" retort. In this paper, I look at a different sort of retort, one that also calls into question the motivations of the criticizer. Instead of accusing the criticizer of being motivated by self-righteousness, however, this retort accuses the criticizer of being motivated by envy. How are these two retorts related to each other? If the accusation of envy isn't a challenge to the blamer's standing, then what sort of challenge is it and what normative force does it carry (if any)? Taking my cue from the ethics of blame literature, I try to address these and other questions about the interaction between envy and blame. (shrink)

When you gaze out at the night sky with its awe-inspiring display of stars and galaxies, do you ever ask yourself if it could be possible that you are actually looking into a mirror? What if we inhabit a universe that perfectly fits our needs here on Earth -- a truly human universe? That's the bold thesis author Deepak Chopra and physicist Menas Kafatos set out to prove: quite literally, "You are the universe." The startling truth is that the everyday (...) world of physical objects "out there" disguises a hidden dimension. By turning our investigation "in here" to the world of consciousness, the real reality emerges. You Are the Universe guides the reader into a realm in which each of us has the power to transform our personal existence, while at the same time fashioning a new story about how time, space, matter, and energy came into existence. Looking to overturn the traditional model of scientific reality, Chopra and Kafatos hold that each of us is a cocreator of reality and we can uncover the hidden dimensions where consciousness is a field of infinite possibilities. This seemingly impossible proposition follows from the cutting-edge modern thinking of the quantum universe and the great mysteries that must be unriddled before human beings actually know who they are. These include but are not limited to questions such as What came before the big bang? Why does the universe fit together so perfectly? Where did time come from? And do we live in a conscious universe? These mysteries are part and parcel of everyone's life. "All of us live in a participatory universe," the authors write. "Once you decide that you want to participate fully with mind, body, and soul, the paradigm shift becomes personal. The reality you inhabit will be yours to either embrace or change. (shrink)

Black Entertainment Television (BET) talk show host Tavis Smiley, in an impassioned call to arms, sets forth the tools we can use to stand up for what we believe in and help transform our communities, our lives, and our world. Tavis Smiley isn't alone in pointing out that our neighborhoods are unsafe, our communities are unraveling, and our most basic values--civility, a sense of justice, integrity, and responsibility--are under attack, from the Oval Office to the corner office. But we don't (...) have to put up with a world gone awry, claims Smiley. We don't need to play the blame game. We are neither helpless nor victims. In Doing What's Right , Smiley shows how each and every one of us can take up arms against complacency and fight for the causes in which we believe. We don't have to accept things as they are. By choosing the battles that matter most to us, and organizing a plan to bring about the changes we feel are necessary, we can make a difference--in fact we can transform the world around us. Smiley knows whereof he speaks--it was his lifelong determination to make a difference that helped shape Smiley's career, first as a member of former L.A. mayor Tom Bradley's staff, helping to fight for the rights of residents in South Central, and later in radio and television. He has long been known as a powerful advocate of social and political issues. Through his nightly television show and in his radio commentaries, he has helped to galvanize public opinion and initiate national grassroots campaigns on everything from corporate responsibility to voter turnout. For everyone who wants to be a voice for change, Doing What's Right is a must-read. Visit the author's website at www.tavistalks.com or www.blackvoices.com. In DOING WHAT'S RIGHT, Smiley shows how each and every one of us can take up arms against complacency and fight for the causes in which we believe. We don't have to accept things as they are. By choosing the battles that matter most to us, and organizing a plan to bring about the changes we feel are necessary, we can make a difference--in fact we can transform the world around us. Smiley knows whereof he speaks--it was his lifelong determination to make a difference that helped launch his career in radio and television. And through his advocacy of issues on his nightly television show and in his radio commentaries, Smiley persuaded Christie's auction house to change its policies on selling slave artifacts, and encouraged President Clinton to award the Congressional Gold Medal to Rosa Parks. For everyone who wants to be a voice for change, DOING WHAT'S RIGHT is a must-read. -->. (shrink)

The use of the Internet in conducting psychological research has become increasingly common over the past few decades, as Internet access has become more widespread. Although web-based work has a number of benefits, including lower cost, easy access to large samples, and strict standardization of administration, the limitations must also be considered. Among these limitations are the ethics concerns related to conducting psychological research online. These concerns include limitations in maintaining confidentiality, conducting thorough informed consent, and conducting valid assessment. Particular (...) focus is given to the limitations inherent in conducting a fully automated online study. All of these limitations are discussed in detail through both a review of existing literature and the brief review of a recent study. The recent study identified areas in which participants struggled with completing a fully automated online task. This article discusses the ethics implications of Internet research as well as offering suggestions for researchers who intend to conduct web-based research, and thoughts on future directions as psychology moves forward in web-based research and assessment. (shrink)

Settler colonialism has contributed to disproportionate health disparities for Indigenous women, however their health experiences during pregnancy are understudied. The first author used qualitative description methodology to conduct life-course semi-structured interviews with 31 women who were members of a state-recognized Gulf Coast Indigenous tribe in the United States. Participants most often described these types of pregnancy experiences: How and From Who Learned About Pregnancy and Birth; Experiences with Miscarriage; Complications During Pregnancy; Working During Pregnancy and Lack of Post-Partum or Maternity (...) Leave and Generational Changes in Pregnancy. We discuss research implications and areas of future research based on participants' experiences. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:In, Out Me, You Mental, Moral Where Do I Begin?Mark D. Rego (bio)I once attended a Buddhist meditation retreat, led by an American meditation teacher. The instructor had studied and practiced is Asia for many years and was well versed in the practices and teachings of Buddhism. Among his opening remarks was something along the line of the following: "One question that is asked on every retreat is, 'if (...) there is no true self, then who is it who has come here to become free of the illusion of a self?' The answer is, I don't know, but we can start anyway."This sense of practicality in the face of unanswerable questions is built into Buddhism, as is the relationship among the particularities of each individual, a process akin to externality, mental well-being, and morality.I raise Buddhism both because of its central interest into the nature of the self (an obviously germane consideration in the papers under discussion) and because of this second feature noted, namely the comfortable integration of individuality, character building, ethical action, and mental well-being (the issue of the true self will, thankfully, have to wait). It is this theme that I raise via the discussion of externality.The commentaries of Talmadge and Graham, unintentionally I think, pull me toward a beguiling observation in my daily practice of psychiatry. Namely, patients commonly report their clinical improvements in terms of how they deal better with others, how they are more thoughtful and even handed (with themselves included), and how they better cope with the demands of their individual lives. In senses both highly individual and highly principled, and in ways both explicit and implicit, when patients feel better they often feel that they are better people (all the kinds of treatment mentioned in my paper equally apply; there is no exclusivity in this result).There is also an interesting consistency in a dual manner in which this is expressed. In one way people report the improved coping, handling, and so on mentioned. In the next breath the same person commonly says, "I feel like myself."The meditation instructor would be pleased; it appears that through a process of becoming aware of and letting go of some form of negativity an individual feels better, acts better, and feels more unified. (As the instructor was psychologically sophisticated, he would not mistake the "like myself" sentiment as a Buddhist heresy. Rather, he would understand it as a reflection of being more at ease with and aware of disparate parts of himself.) And all this without figuring out who the real self is. [End Page 331]I mention these observations about Buddhism and clinical care because when I consider the processes of evaluating, deciding, and forging identity and volition it seems to me that somewhere between the lines the individual is aligning himself with some sense of what is good. The resultant experience of volition and cohesive identity is, often but not always, experienced as good both psychologically and morally.Change, Others, and ValuesIn the two commentaries that follow my paper on Frankfurtian externality and therapeutic change (Rego 2004), Talmadge (2004) and Graham (2004) highlight different aspects of externality and therapeutics. Talmadge, an addiction psychiatrist, expands the theme of volitional change in recovery from addiction. For Talmadge, as for most in the field, the question of when and how an addict has truly committed to change (hitting "rock bottom"? accepting the first of the twelve steps?) is perennially in the air. Such knowledge would be invaluable in guiding addicts along their rocky paths.Although still far short of the mark, Talmadge finds some illustrative guidance in Frankfurt. The shift that takes place within the addict to place him on the road to recovery is not necessarily "rock bottom," or conformity to a program's dictates or a state of new knowledge. Rather, it is a shift in will. By whatever process (and Talmadge is quite aware that there seem to be many paths) the addict has come to care about sobriety in a way he or she did not before. He or she now cares in a way that is part of him or her... (shrink)

You 遊 is a crucial term for understanding the Zhuangzi . Translated as “play,” “free play,” and “wandering,” it is usually defined as an ideal, playful Zhuangzian way of being. There are two problems with this definition. The first is logical: the Zhuangzi cannot consistently recommend playfulness as an ideal, since doing so vitiates the essence of you —it becomes an ethical imperative instead of an activity freely undertaken for its own sake. The second problem is performative: arguments for playful (...) Zhuangzi as exemplar resemble those of the logicians and philosophers who appear to come in for Zhuangzian criticism. This essay addresses these tensions by demonstrating how the Zhuangzi ambiguates the nature and value of you . Apparent endorsements of you are not freestanding, instead occurring in grudging replies of teachers to overly zealous students. In light of this recontextualization, a new version of you is offered that accommodates “non-playful” ways of being. (shrink)

You recognize when you know something for certain, right? You "know" the sky is blue, or that the traffic light had turned green, or where you were on the morning of September 11, 2001--you know these things, well, because you just do. In On Being Certain , neurologist Robert Burton challenges the notions of how we think about what we know. He shows that the feeling of certainty we have when we "know" something comes from sources beyond our control and (...) knowledge. In fact, certainty is a mental sensation, rather than evidence of fact. Because this "feeling of knowing" seems like confirmation of knowledge, we tend to think of it as a product of reason. But an increasing body of evidence suggests that feelings such as certainty stem from primitive areas of the brain, and are independent of active, conscious reflection and reasoning. The feeling of knowing happens to us; we cannot make it happen. Bringing together cutting edge neuroscience, experimental data, and fascinating anecdotes, Robert Burton explores the inconsistent and sometimes paradoxical relationship between our thoughts and what we actually know. Provocative and groundbreaking, On Being Certain , will challenge what you know (or think you know) about the mind, knowledge, and reason. ROBERT BURTON, M.D. graduated from Yale University and University of California at San Francisco medical school, where he also completed his neurology residency. At age 33, he was appointed chief of the Division of Neurology at Mt. Zion-UCSF Hospital, where he subsequently became Associate Chief of the Department of Neurosciences. His non-neurology writing career includes three critically acclaimed novels. He lives in Sausalito, California. Visit his website at http://www.rburton.com/ “What do we do when we recognize that a false certainty feels the same as certainty about the sky being blue? A lesser guide might get bogged down in nail-biting doubts about the limits of knowledge. Yet Burton not only makes clear the fascinating beauty of this tangled terrain, he also brings us out the other side with a clearer sense of how to navigate. It's a lovely piece of work; I'm all but certain you'll like it. “ --David Dobbs, author of Reef Madness; Charles Darwin, Alexander Agassiz, and the Meaning of Coral “Burton has a great talent for combining wit and insight in a way both palatable and profound.” --Johanna Shapiro PhD, professor of Family Medicine at UC Irvine School of Medicine “A new way of looking at knowledge that merits close reading by scientists and general readers alike.” -- Kirkus “This could be one of the most important books of the year. With so much riding on ‘certainty,’ and so little known about how people actually reach a state of certainty about anything, some plain speaking from a knowledgeable neuroscientist is called for. If Gladwell's Blink was fascinating but largely anecdotal, Burton's book drills down to the real science behind snap judgments and other decision-making.” -- Howard Rheingold, futurist and author of Smart Mobs “A fascinating read. Burton’s engaging prose takes us into the deepest corners of our subconscious, making us question our most solid contentions. Nobody who reads this book will walk away from it and say ‘I know this for sure’ ever again.” --Sylvia Pagán Westphal, science reporter, The Wall Street Journal “Burton provides a compelling and though-provoking case that we should be more skeptical about our beliefs. Along the way, he also provides a novel perspective on many lines of research that should be of interest to readers who are looking for a broad introduction to the cognitive sciences.” -- Seed Magazine. (shrink)

Blatantly observable in the U.S. currently, the political chasm grows, representing a prototype of political polarization in most if not all western democratic political systems. Differential political psychology strives to trace back increasingly polarized political convictions to differences on the individual level. Recent evolutionary informed approaches suggest that interindividual differences in political orientation reflect differences in group-mindedness and cooperativeness. Contrarily, the existence of meaningful associations between political orientation, personality traits, and interpersonal behavior has been questioned critically. Here, we shortly review (...) evidence showing that these relationships do exist, which supports the assumption that political orientation is deeply rooted in the human condition. Potential reasons for the premature rejection of these relationships and directions for future research are outlined and implications for refinements and extensions of evolutionary informed approaches are derived. (shrink)

Do you persist as the same person over time because you keep the same mind or because you keep the same body? Philosophers have long investigated this question of personal identity with thought experiments. Cognitive scientists have joined this tradition by assessing lay intuitions about those cases. Much of this work has focused on judgments of identity continuity. But identity also has practical significance: obligations are tagged to one's identity over time. Understanding how someone persists as the same person over (...) time could provide insight into how and why moral and legal obligations persist. In this paper, we investigate judgments of obligations in hypothetical cases where a person's mind and body diverge (e.g., brain transplant cases). We find a striking pattern of results: In assigning obligations in these identity test cases, people are divided among three groups: “body‐followers,” “mind‐followers,” and “splitters”—people who say that the obligation is split between the mind and the body. Across studies, responses are predicted by a variety of factors, including mind/body dualism, essentialism, education, and professional training. When we give this task to professional lawyers, accountants, and bankers, we find they are more inclined to rely on bodily continuity in tracking obligations. These findings reveal not only the heterogeneity of intuitions about identity but how these intuitions relate to the legal standing of an individual's obligations. (shrink)

Some of the most difficult consultations for an ethics consultant to resolve are those in which the patient is ready to leave the acute-care setting, but the patient or family refuses the plan, or the plan is impeded by deficiencies in the healthcare system. Either way, the patient is “stuck” in the hospital and the ethics consultant is called to help get the patient “unstuck.” These encounters, which we call “complex discharges,” are beset with tensions between the interests of the (...) institution and the interests of the patient as well as tensions within the ethics consultant whose commitments are shaped both by the values of the organization and the values of their own profession. The clinical ethics literature on this topic is limited and provides little guidance. What is needed is guidance for consultants operating at the bedside and for those participating at a higher organizational level. To fill this gap, we offer guidance for facilitating a fair process designed to resolve the conflict without resorting to coercive legal measures. We reflect on three cases to argue that the approach of the consultant is generally one of mediation in these types of disputes. For patients who lack decision making capacity and lack a surrogate decision maker, we recommend the creation of a complex discharge committee within the organization so that ethics consultants can properly discharge their duties to assist patients who are unable to advocate for themselves through a fair and transparent process. (shrink)

What causes unethical behavior and what can we learn from those individuals who have had spectacular ethical lapses? The profiles of six prominent individuals, including Dennis Levine, Charles Keating, and Robert Citron are examined to try to provide some insight into what lead them down the slippery slope to criminal and unethical behavior. What we found is that all six certainly knew that they were breaking the law and most went to extra-ordinary lengths to cover up what they were doing. (...) Additionally, we found that each individual had attained a position of authority that enabled them to break the law without being seriously challenged by others who knew, or suspected, what was being done. Each person was highly compensated for their efforts, yet, they choose to engage in unethical and illegal activities in the pursuit of just a little more money or power. (shrink)

We are often encouraged to forgive those who have wronged us. Before we can decide whether this is what we ought to do, we had better figure out what forgiveness amounts to. This article surveys recent philosophical disagreements over the nature of forgiveness. Is it only victims who can forgive the wrongs that were done to them, or can third parties also forgive? Is it possible to forgive yourself? When you forgive, what is that you are forgiving? Do you forgive (...) morally wrong actions, or do you forgive wrongdoers? Can you forgive things that were not actually morally wrong? How do you forgive? Do you forgive by having a change of heart towards the perpetrator, by losing your anger and resentment? Or do you forgive by changing the way you treat the wrongdoer, by withholding punishment, or by achieving reconciliation? Or do you forgive by declaring “I forgive you” to the wrongdoer? (shrink)

My Back Is To A Life Passed. A year, maybe more, in liminal space. Waiting. For a vaccine. For better therapeutics. For a political climate to shift. All the while, the actual climate turns against us.The waters rise in the East. Fires rage in the West.My back is to a life passed. Retirement, just before the pandemic. Post-retirement and lockdown, simultaneous. A turn to a writing life—solitary, self-directed, coming at a time when my options are limited. My go-to places for (...) connection and inspiration—museums, coffeehouses, lectures, and readings—all off-limits. The natural world, my cathedral, also inaccessible. The fires rage, and the air is unbreathable.Over morning coffee, in our quiet house, the windows shut against dangerously high particulates and a darkened sky, I read an article by Julian Lucas in The New Yorker, “When a Virus Becomes a Muse.” He reviews the work of Hervé Guibert, the French writer who died from AIDS in 1991. Guibert focused on the body. His young, sexual body, with its confounding insistence. His failing body, ravaged by disease. AIDS was his muse, blasting him into a wildly creative few years, writing four books in the last three years of his life (Lucas).How will this virus, the novel coronavirus, serve as muse? The pandemic sets limits: Where can I go? Who can I see? I live within constructs and limitations imposed much like the rules of poetic form. Within those—the sonnet, the haiku—how is language wrought? How sharp, how bright, its expression? If I cannot hug you, how do I show my devotion? In my separate state, how do I live connection? I have a new expression. Mouth and nose covered, only my eyes showing, framed by glasses I need in order to see, I punctuate exchanges at the checkout counter, and with the health-check staff at the entrance to my daughter's physical therapy facility, by forcing my eyes into a warm, glad squint. I want them to beam. From people's responses—the moment of recognition, the tender mirroring, the body tilting to the side, eyes crinkled, head nodding—I can tell that the beam is working. It took time to develop this new way. I learned that I have to smile with my mouth, with my whole face, even when it can't be seen, for my feelings to show.Life, like art, requires structure, the boundaries of form. How to structure a day? It could be embodied. Filled. Wasted. Or used. My back is to a life where hours and minutes had a particular meaning. I am no longer expected at work by a certain hour, nor to put in three hours before my morning break. The collective future, where we tossed plans, goals, places we would see—again, or for the first time!—cannot be reached over the smoothed and worn stepping-stones of, say, weeks until a holiday. The broad swaths of the day become the new metric. The slow, mounting morning. A walk, or a longer one, before getting to the bulk of the day's writing. The noontime pivot, heat of the day rising, the birds quiet. Lunch, and a few chores. Essential errands. Medical appointments.The downslope of afternoon, with its nagging refrain, in the time you have left... The swirling, heated world. Greta Thunberg, 16 years old, sails from Europe to the United States to address a conference on climate change. She sails, rather than flies, so as not to add to her carbon footprint. It takes time, that voyage. She waits on deck while moving toward her future. The past recedes. The stormy Atlantic rises.Is it any clearer now that the food chain originates not in boardrooms but in hot fields, that the first essential worker drops from the back of a truck before sunup with a knife and a crate held in roughened, swollen hands?At night, sitting on the sofa, we watch television, the police procedurals that offer entertainment. Escape and relief. The day has passed. These are the rewards for getting through another day of uncertainty, managing the anxiety of risking exposure in order to get groceries and prescriptions and to bring my daughter to physical therapy. The TV detectives we favor work in teams as they interview suspects, talk to witnesses, confer with one another as they refine their theories and move photographs and bits of evidence around on the bulletin board. Our shows always tie up nicely in the end. In my life now, without the team or the interviews or the meetings that keep the detectives connected, I pretend that I am one of them, that my notebooks and plot maps and drawings and time lines are all clues to a mystery that I will solve. Despite my enervated state, I get up, I work, I look at and handle all the materials I have acquired. The day passes. Each night, a reward for getting through the day. Another day. Standing between worlds. Waiting. (shrink)

A PICTURE MAY BE WORTH A THOUSAND WORDS-- BUT A FEW CHOICE WORDS CAN SPEAK VOLUMES! _ If Ignorance Is Bliss, Why Aren't More People Happy? Bottled Water Is for Suckers Clones Are People Too At Least the War on the Environment Is Going Well Don't Believe Everything You Think The Revolution Will Be Tweeted _ Long before blogs, tweets, and sound bites, people were telling the world how they felt in brief, blunt bursts of information plastered on the backs (...) of their cars. Whether they're political or religious, passionate or proud, controversial or corny, these brightly colored, boldly lettered mini manifestos are declarations of who we are, where we stand, and what we'd rather be doing. But as bestselling author and noted philosopher Jack Bowen reveals, there's much more to the pop-culture phenomenon of bumper stickers than rolling one-liners and drive-by propaganda--no less, in fact, than a wise, funny, poignant, contentious, and truthful discourse on the human condition. _ Mixing pop culture with the ideas of historically prominent philosophers and scientists, If You Can Read This exposes the deeper wisdom couched behind these slogans--or, as need be, exposes where they have gone wrong. If you brake for big ideas, now's the time. _. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:If You’re Not Part of the Solution...Sarah GilesI worked on an island that lured people to their deaths. I have come to realize that there are certain resources that every population must have in order to continue to exist. Health care providers are needed if a group is to continue to reside in one place. Without nurses and doctors, people tend to refuse to go to a location or (...) choose not to stay. Perhaps if doctors like me refused to work in places where people have their basic human rights ignored, those places would cease to exist. It’s wishful thinking, but it’s the only way I can imagine the events of December 15th, 2010, could have been prevented. [End Page E11]Australia has a large offshore detention center on Christmas Island, a tiny dot in the middle of the Indian Ocean. Housed in a collection of prison–like facilities are men, women, and children who have come to an Australian Island claiming they are refugees. They have paid an average of $10,000 (U.S. dollars) to be smuggled by boat from nearby Indonesia and are then, usually, intercepted by the Australian navy or coast guard, and brought to the island to await processing. This processing can take two to four years and, even then, it can end with deportation. The asylum seekers spend years in a massively overcrowded and unstimulating purgatory.To say that I was not familiar with the political situation on the island would be a farcical under-statement. As a Canadian family doctor, I went to work on Christmas Island because of its exotic location and reputation for world–class SCUBA diving. It sounded like a dreamy place to do a locum. The little research I had done told me that there was a detention center on the island, but I had been told that I would only deal with those patients if they were sick enough to come into hospital. I didn’t imagine that I would end up feeling culpable for the deaths of 48 people who dreamed of restarting their lives in Australia.On December 15th, 2010, a rickety boat carrying approximately 100 asylum seekers somehow slipped past the navy and coast guard into the water just off of Christmas Island. The weather was foreboding and the waves were massive. As the boat approached the island, it lost power and, horrifically, smashed into the cliffs, leaving an estimated 48 men, women, and children to drown and an almost equal number in need of rescue and medical attention. My name was on the call schedule that day. All survivors were brought to the hospital. Our worlds collided.At the time, I thought it was good luck there was an extra doctor on the island that day. I was relieved that we were able to cope with the mass casualty situation and that only few survivors were sick or injured enough to require evacuation to the main land. Three years later, I wonder if the accident would have happened at all had we not been there.I had felt smug providing care in the public hospital, believing it was morally superior to working as a mercenary at the detention center. But I now realize that all of the health care providers had a role in allowing the tragedy to occur. What would have happened if all of the doctors refused to work with people held under those conditions? If that critical infrastructure of health care were not available on the island, the detention center could not be there. If the detention center weren’t there, the government would stop processing people there and perhaps desperate people would stop risking their lives to get to Christmas Island. Maybe the women and men who lost their children or the children who lost their parents would never have gotten on that boat. Maybe.Parts of that awful day stay with me. My job as a doctor prevented me from offering the compassionate care I wanted to provide and forced me to turn into a medical conveyor belt. When a young patient was laid in front of me, I assessed her, started... (shrink)