Taking inspiration from the vast breadth of Castoriadis’ oeuvre, this article provides an ongoing elucidation of the being of human as creation ex nihilo. It does so by engaging with Castoriadis’ reflections on the vis formandi pertaining to the human condition and his tentative introduction to the concept of the ‘human Nonconscious’. Across many of his essays, Castoriadis refers to the vis formandi of the being of human as an ‘a-causal’ and as a corporeal power of formation and of creation. (...) Associated with the defunctionalized and the corporeal dimensions of the radical imagination, these two domains of formation and of creation are, for Castoriadis, fundamental to the ontology of the being of human. By exploring Castoriadis’ theoretical and practical reflections on the vis formandi of the being of human and the role he accords the two dimensions of the radical imagination, this article offers a new mode of thinking about the being of human as creation ex nihilo – one that addresses the mind body divide by proposing that the human Nonconscious can be envisaged as the dominion of the embodied imagination. (shrink)

By offering an original elucidation of the notion of the imagination in the writings of Immanuel Kant, Johann Fichte, and Cornelius Castoriadis, this book addresses and brings to the fore the significance of the imagination as the ontological source of human creation.

Is a human more conscious than an octopus? In the science of consciousness, it’s oftentimes assumed that some creatures (or mental states) are more conscious than others. But in recent years, a number of philosophers have argued that the notion of degrees of consciousness is conceptually confused. This paper (1) argues that the most prominent objections to degrees of consciousness are unsustainable, (2) examines the semantics of ‘more conscious than’ expressions, (3) develops an analysis of what it is for a (...) degreed property to count as degrees of consciousness, and (4) applies the analysis to various theories of consciousness. I argue that whether consciousness comes in degrees ultimately depends on which theory of consciousness turns out to be correct. But I also argue that most theories of consciousness entail that consciousness comes in degrees. (shrink)

This paper examines the idea of "objective phenomenology," or a way of understanding the phenomenal character of conscious experiences that doesn’t require one to have had the kinds of experiences under consideration. My central thesis is that structural facts about experience—facts that characterize purely how conscious experiences are structured—are objective phenomenal facts. I begin by precisifying the idea of objective phenomenology and diagnosing what makes any given phenomenal fact subjective. Then I defend the view that structural facts about experience are (...) objective. I also argue that structural facts about experience, despite being objective, nevertheless still give rise to an explanatory gap. (shrink)

Base of the pyramid ventures seek to create “mutual value” for themselves and poor communities, but often use business models unadapted for the BoP context, and have been less successful than hoped. Sustainable business models’ multi-stakeholder lens offers a promising alternative path to mutual value, but BoP-based SBM studies are scarce. This single case study explores whether and how SBM characteristics manifest in the business model and value outcomes of Habi, a Manila footwear company successfully creating mutual value with BoP (...) suppliers. We find SBM characteristics underpin Habi’s dual-structure business model and success in four ways: viewing profits as a tool for community development resulted in designing both product and business model around community strengths; understanding communities as systems helped Habi address the complexities of poverty; balancing short-term business needs with a long-term, slow-growth approach led to their choice of investors; and implementing community value capture mechanisms ensured enduring community benefit. (shrink)

Totalitarianism is perhaps unanimously regarded as one of the greatest political evils of the last century and has been the grounds for much of Anglo-American political theory since. Confucianism, meanwhile, has been gaining credibility in the past decades among sympathizers of democratic theory in spite of criticisms of it being anti-democratic or authoritarian. I consider how certain key concepts in the classical Confucian texts of the Mencius and the Xunzi might or might not be appropriated for ‘legitimising’ totalitarian regimes. Under (...) an Arendtian approach to understanding totalitarianism, it is precisely an unproblematised relation to a normative History and Nature that underlies the potential compatibility or incompatibility. I argue against a longstanding prejudice that if any form of Confucianism would be totalitarian, it would have to be Xunzian. Against this, I hope to show that if any form of Confucianism would be totalitarian, it might well be a naturalistic Mencian Confucianism instead of a constructivist Xunzian one. (shrink)

Social philosophers often invoke the concept of false consciousness in their analyses, referring to a set of evidence-resistant, ignorant attitudes held by otherwise sound epistemic agents, systematically occurring in virtue of, and motivating them to perpetuate, structural oppression. But there is a worry that appealing to the notion in questions of responsibility for the harm suffered by members of oppressed groups is victim-blaming. Individuals under false consciousness allegedly systematically fail the relevant rationality and epistemic conditions due to structural distortions of (...) reasoning or knowledge practices, undermining their status as responsible moral agents. But attending to the constitutive mechanisms and heterogeneity of false consciousness allows us to see how having it does not eo ipso render someone an inappropriate target of blame. I focus here on the 1889 anti-suffragist manifesto “An Appeal Against Female Suffrage,” arguing that its signatories, despite false consciousness, satisfy both conditions for ordinary blameworthiness. I consider three prominent signatories, observing that the irrationality characterisation is unsustainable beyond group-level diagnoses, and that their capacity to respond appropriately to reasons was not compromised. Following recent work on epistemic injustice, I also argue that culpable mechanisms constituted their false consciousness, rendering them blameworthy for the Appeal. (shrink)

This study explored the influence of personal values on destructive leader behavior. Student participants completed a managerial assessment center that presented them with ambiguous leadership decisions and problems. Destructive behavior was defined as harming organizational members or striving for short-term gains over long-term organizational goals. Results revealed that individuals with self-enhancement values were more destructive than individuals with self-transcendence values were, with the core values of power (self-enhancement) and universalism (self-transcendence) being most influential. Results also showed that individuals defined and (...) structured leadership problems in a manner that reflected their value systems, which in turn affected the problem solutions they generated. (shrink)

Background Retraction is a mechanism for alerting readers to unreliable material and other problems in the published scientific and scholarly record. Retracted publications generally remain visible and searchable, but the intention of retraction is to mark them as “removed” from the citable record of scholarship. However, in practice, some retracted articles continue to be treated by researchers and the public as valid content as they are often unaware of the retraction. Research over the past decade has identified a number of (...) factors contributing to the unintentional spread of retracted research. The goal of the Reducing the Inadvertent Spread of Retracted Science: Shaping a Research and Implementation Agenda (RISRS) project was to develop an actionable agenda for reducing the inadvertent spread of retracted science. This included identifying how retraction status could be more thoroughly disseminated, and determining what actions are feasible and relevant for particular stakeholders who play a role in the distribution of knowledge. -/- Methods These recommendations were developed as part of a year-long process that included a scoping review of empirical literature and successive rounds of stakeholder consultation, culminating in a three-part online workshop that brought together a diverse body of 65 stakeholders in October–November 2020 to engage in collaborative problem solving and dialogue. Stakeholders held roles such as publishers, editors, researchers, librarians, standards developers, funding program officers, and technologists and worked for institutions such as universities, governmental agencies, funding organizations, publishing houses, libraries, standards organizations, and technology providers. Workshop discussions were seeded by materials derived from stakeholder interviews (N = 47) and short original discussion pieces contributed by stakeholders. The online workshop resulted in a set of recommendations to address the complexities of retracted research throughout the scholarly communications ecosystem. -/- Results The RISRS recommendations are: (1) Develop a systematic cross-industry approach to ensure the public availability of consistent, standardized, interoperable, and timely information about retractions; (2) Recommend a taxonomy of retraction categories/classifications and corresponding retraction metadata that can be adopted by all stakeholders; (3) Develop best practices for coordinating the retraction process to enable timely, fair, unbiased outcomes; and (4) Educate stakeholders about pre- and post-publication stewardship, including retraction and correction of the scholarly record. -/- Conclusions Our stakeholder engagement study led to 4 recommendations to address inadvertent citation of retracted research, and formation of a working group to develop the Communication of Retractions, Removals, and Expressions of Concern (CORREC) Recommended Practice. Further work will be needed to determine how well retractions are currently documented, how retraction of code and datasets impacts related publications, and to identify if retraction metadata (fails to) propagate. Outcomes of all this work should lead to ensuring retracted papers are never cited without awareness of the retraction, and that, in public fora outside of science, retracted papers are not treated as valid scientific outputs. (shrink)

False consciousness requires a general explanation for why, and how, oppressed individuals believe propositions against, as opposed to aligned with, their own well-being in virtue of their oppressed status. This involves four explanatory desiderata: belief acquisition, content prevalence, limitation, and systematicity. A social constructionist approach satisfies these by understanding the concept of false consciousness as regulating social research rather than as determining the exact mechanisms for all instances: the concept attunes us to a complex of mechanisms conducing oppressed individuals to (...) mistake social understandings of themselves as natural self-understandings—the limits lie where these overlap (sometimes), or are entirely absent. (shrink)

Shun Kwong-loi argues that the distinction between first- and third-person points of view does not play as explanatory a role in our moral psychology as has been supposed by contemporary philosophical discussions. He draws insightfully from the Confucian tradition to better elucidate our everyday experiences of moral emotions, arguing that it offers an alternative and more faithful perspective on our experiences of anger and compassion. However, unlike the distinction between first- and third-person points of view, Shun’s descriptions of anger and (...) compassion leave unarticulated what would be necessary to differentiate these responses from non-moral responses. Here, I make a friendly suggestion on how this explanatory gap might be filled, providing complementary grounding for Shun’s observations by way of K. C. Bhattacharyya’s phenomenological analysis of feeling. It fills the gap by means of a gradation in the possible depth of emotional responses found in the a priori structure of a feeling experience for any subject. The payoff of such a comparison between Shun’s explication of Confucian moral psychology and Bhattacharyya’s explication of rasa theory is not only a possible phenomenological grounding for the former but also a potential way to articulate a missing ethics in Bhattacharyya’s thought. (shrink)

Dorothy Edgington’s work has been at the centre of a range of ongoing debates in philosophical logic, philosophy of mind and language, metaphysics, and epistemology. This work has focused, although by no means exclusively, on the overlapping areas of conditionals, probability, and paradox. In what follows, I briefly sketch some themes from these three areas relevant to Dorothy’s work, highlighting how some of Dorothy’s work and some of the contributions of this volume fit in to these debates.

This book offers an in-depth analysis of the cognitive and ethical role of emotion, particularly empathy, in medical practice. The author explains how doctors can use empathy in diagnosing and treating patients without jeopardizing their objectivity or projecting their own values on to patients.

A background assumption of this paper is that the repertoire of inference schemes available to humanity is not fixed, but subject to change as new schemes are invented or refined and as old ones are obsolesced or abandoned. This is particularly visible in areas like health and environmental sciences, where enormous societal investment has been made in finding ways to reach more dependable conclusions. Computational modeling of argumentation, at least for the discourse in expert fields, will require the possibility of (...) modeling change in a stock of schemes that may be applied to generate conclusions from data. We examine Randomized Clinical Trial, an inference scheme established within medical science in the mid-20th Century, and show that its successful defense by means of practical reasoning allowed for its black-boxing as an inference scheme that generates (and warrants belief in) conclusions about the effects of medical treatments. Modeling the use of a scheme is well-understood; here we focus on modeling how the scheme comes to be established so that it is available for use. (shrink)

In recent years, autopoietic enactivism has been used to address persistent conceptual problems in psychiatry, such as the problem of demarcating disorder, that other models thus far have failed to overcome. There appear to be three main enactive accounts of psychopathology with subtle, although not incompatible, differences: Maiesecharacterizes disorder as distinct disruptions in autonomy and agency; Nielsen characterizes disorder as behaviors that relevantly conflict with the functional norms of an individual; De Haan emphasizes patterns of disordered sense-making, that are transformed (...) through the existential dimension. Given that these accounts are intended to provide not only an ontologically richer account of psychopathology but also reduce the stigma experienced by individuals with mental disorders by accounting for lived experience, a critical analysis of these approaches is needed. I will provide a problematization of enactive accounts of mental disorder, showing that this particular framework does not, as it stands, necessarily reduce the harm and suffering experienced by individuals with mental disorder because of its ontological openness; enactivism leaves much to be interpreted and applied by the clinician (or patient) such that practical and ethical problems in its use arise. (shrink)

The present research isolates the fairness assessment of the process used by the retailer to set a price, as well as the distributive fairness of the price compared to the price that others are offered, and examines the combined effect of procedural fairness and distributive fairness on overall price fairness. Two experimental studies examine procedural and distributive fairness effects on overall price fairness. In study 1, procedural fairness and distributive fairness are manipulated and found to interact to bring about overall (...) price fairness. In study 2, suspicion toward the seller is found to mediate the relationship between procedural fairness and overall price fairness when the price is disadvantageous. (shrink)

We have conducted a home-based study of children′s dream reports in which parents used open-ended interviewing styles to collect 88 dream reports from their 4- to 10-year-old children in the comfortable and supportive environment of their own homes. Particular attention was paid to formal properties including characters , settings, self-representation, and bizarreness. In contrast to previous studies, our data indicate that young children are able to give long, detailed reports of their dreams that share many formal characteristics with adult dream (...) reports. Because this wide range of dream mentation is only revealed to trusted confidants in a familiar and comfortable environment, an important implication is that the sleep laboratory may not be the best source of naturalistic dream data. (shrink)

Most accounts of integrity agree that the person of integrity must have a relatively stable sense of who he is, what is important to him, and the ability to stand by what is most important to him in the face of pressure to do otherwise. But does integrity place any constraints on the kind of principles that the person of integrity stands for? In response to several recent accounts of integrity, I argue that it is not enough that a person (...) stand for what he believes in, nor even that he is committed to and stands for what, in his best judgement, is morally right. In our web of moral concepts integrity is internally related to a host of virtues which exclude weakness of will and dogmatism, and presuppose trustworthiness. Integrity requires that the principles stood for must be those that a morally good, morally trustworthy agent would stand for, and that the agent himself is morally trustworthy. (shrink)

Proactive policing strategies produce a range of harms to African Americans in poor urban communities. We know little, however, about how aggressive policing is experienced across gender by adolescents in these neighborhoods. The authors argue that important insights can be gained by examining the perspectives of African American youths and draw from in-depth interviews with youths in St. Louis, Missouri, to investigate how gender shapes interactions with the police. The comparative analysis reveals important gendered facets of African American adolescents' experiences (...) with and expectations of law enforcement. Young men described being treated routinely as suspects regardless of their involvement in delinquency and also reported police violence. Young women typically described being stopped for curfew violations but also expressed concerns about police sexual misconduct. This study highlights the differential harms of urban policing for African American young women and men and highlights the need for systematic attention to the intersections of race and gender in research on criminal justice practices. (shrink)

Times of crisis bring about increased demands on businesses as shortages, or unexpected but significant, business costs are encountered. Passing on such costs to consumers is a challenge. When faced with a retail price increase, consumers may rely on cues as to the motive behind the increase. Such cues can raise suspicion of alternative motive (e. g., taking advantage of the consumer) affecting consumers' judgments of price fairness. This research investigates two triggers of suspicion: salience of alternative motives, and behavior (...) judged to be out-of-character for the business. Results of the two studies within crisis contexts indicate that suspicion is created when alternative motives are salient and when a retailer acts out-of-character. Multiple group analyses revealed that suspicion induced negative affect and subsequent perceptions of price fairness. When suspicion was present, more negative feelings toward the retailer and judgments of price unfairness resulted. (shrink)

The book illustrates how the human ability to adapt to the environment and interact with it can explain our linguistic representation of the world as constrained by our bodies and sensory perception. The different chapters discuss philosophical, scientific, and linguistic perspectives on embodiment and body perception, highlighting the core mechanisms humans employ to acquire knowledge of reality. These processes are based on sensory experience and interaction through communication.

This article examines the potential of Action Research informed by Dewey’s pragmatism as a research methodology in the social sciences. Not only a philosophical orientation, pragmatism is also a powerful mode of inquiry. When combined with the democratic research approach of Action Research, Deweyan pragmatism has great potential to shed light on educational and other social science questions, forward social change, and enact Dewey’s vision of radical social democracy. Although Dewey’s philosophy, one could argue, has never been mainstream in education (...) and in research, the combination of Deweyan philosophy and Action Research has the potential to revive interest in Dewey’s work and serve as an example of Deweyan .. (shrink)

Assisted reproductive technologies and abortion prompt serious questions about how we should understand the complex relationship between money, markets, choice, and the care relationship. This essay defines “patient” and “consumer,” and then describes how they are less important than their attributes. Then it describes theories of commodification and consumption in reproductive contexts and their consequences, from compliance and coercion to resistance and creativity. It also examines whether ART and abortion are “markets.” Finally, this essay explores how the attributes which comprise (...) the patient/consumer roles can be incorporated into health care reform, and the implications of health care reform models on ART and abortion. (shrink)

In this thesis I develop an account of how processes of social understanding are implicated in experiences of mental disorder, critiquing the lack of examination of this phenomena along the way. First, I demonstrate how disorder concepts, as developed and deployed by psychiatric institutions, have the effect of shaping the cognition of individuals with psychopathology through setting expectations. Such expectation-setting can be harmful in some cases, I argue, and can perpetuate epistemic injustices. Having developed this view, I criticise enactive accounts (...) of mental disorder for failing to consider how such terms like ‘dysfunction’ are open to interpretation and can come embedded with normative expectations. Enactive accounts consequently run the risk of perpetuating injustices in their account of the sociality of mental disorder. Similar concerns arise when we consider the attachment of enactivism to the medical model, I argue. But by adapting enactivism to consider other experiences of disorder, such as those described as ‘madness’, enactive psychiatry may genuinely provide ethical groundwork for a better conception of disordered experience. Then, I consider a further concern with a distinctly medicalised conception of mental disorder from the perspective of self-illness ambiguity, arguing that self-illness ambiguities appear to form a special class of ambiguities due to their proximity to disorder concepts which mark them as appropriate targets for therapeutic treatment. However, I argue further that we should be critical of the idea that self-illness ambiguities necessitate disambiguation, as, in cases where self and illness are demarcated, individuals may still experience distress because simply having a mental disorder can be socially alienating. The medicalised focus in self-illness ambiguity, and the explicit need from the medical perspective to disambiguate it, might then exacerbate the distress someone experiences in mental disorder. Moreover, drawing on Mad Studies, I suggest that one might not need a coherent self-narrative to live well. Because of this, one may not need to adopt a medicalised view of the self in the case of selfillness ambiguity. In order to support this analysis, I provide a phenomenological account of language and argue that the very thoughts implicated in mental disorder shape the individual’s perception of the world due to the way that language foregrounds particular aspects of our world. This demands a critical examination of the language adopted and used by both clinicians and disordered individuals. I thus conclude with some thoughts on how to approach research and developing understanding of mental disorder given that we, as people, are always implicated in this process and therefore socialisation of some kind will always be taking place. (shrink)

Claims to sisterhood are premised on women’s experiences with gender oppression, and many have argued that such claims ignore differences among women. Many have therefore dismissed sisterhood as a legitimate claim to solidarity, failing to examine the ways that sisterhood continues to be utilized by feminist activists. This article examines qualitative data from a study of a white, middle-class, feminist, antiracist organization that uses the language of sisterhood in its work on behalf of incarcerated women, who are predominantly of color (...) and poor. The author finds not only that sisterhood is simultaneously rooted in women’s experiences with oppression and pride and pleasure but that such language serves complex functions in feminist organizations that seek to work across difference. Beyond its use in creating and sustaining solidarity, sisterhood is utilized to bridge differences in race, class, and life experiences between women and to generate feelings of legitimacy amongst white, middle-class activists. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On Sharing BreathJody Sperling (bio)My work as choreographer dwells on the inseparability between breath and atmosphere. There are no firm boundaries between the air we breathe in, the air surrounding us, and the air enveloping the planet. This is as true for air as it is for water—there is only one global ocean, although by convention we divide the seas into named regions. When you move through the ocean (...) of air enveloping you, you displace it and create dynamic unseen wakes in your midst.Beginning with my dance, "Turbulence" (2011),1 I sought to visualize such patterns of air disturbance into kinetic sculptural forms. To do so, the six dancers deployed Loie Fuller-style costumes, disquieting the air and materializing its gyrations. An early innovator of performance technology, Fuller danced in robes fashioned from hundreds of yards of silk with embedded wands that extended her body's motion into space. Serendipitously introduced to Fuller's work in 1997, I became seduced by the genre for the way it imbues the doer with an expanded sense of self. Whirling in the Fuller-style garments, I felt, and still feel, integrated into the atmosphere as an eddy or gust.With "Wind Rose" (2019),2 a collaboration with composer Matthew Burtner, I focused on making the connections between breath and wind palpable. Wind is said to be the breath of the planet, a driver of earthly life. A windrose is a meteorological tool that graphically represents wind speed, direction and variability at a particular time and place. I thought, what if I designed choreography with the intention not to create human motion, but in order to create a windrose—an atmospheric snapshot—in the performing space? At the start of "Wind Rose," the five dancers stand shoulder to shoulder and circle the stage so as to forge a human turbine. As the dancers accelerate their cyclonic motion, they push a swelling air wave towards the audience.For another section, I choreographed eight motions, each of which was connected with a sound. The sounds were made either by the dancers whipping their Fuller-style costumes through the air or by the dancers' breathy vocalizations. Matthew took my eight sound-breath-moves and composed a fugue. The dancers perform this music-motion score so that [End Page 155] they stir up a breeze pattern—a fugue that can be felt, as well as seen and heard.Wind has been changing along with climate. Locally, winds are becoming more chaotic. Globally, the high winds are slowing down and the polar jet stream is becoming wonky. But we are not in the habit of listening to the changing winds. One of the root causes of climate inaction has been a deep disconnect between people and their atmosphere. Many among the privileged live out their lives in climate-controlled habitats. Recently, though, even wealthy nations and the elite are starting to feel the heat. These days, no matter how deeply you bury your head in the sand, your butt will still get scorched.As a way of grappling with life in the Anthropocene, I have been formulating an open inquiry called ecokinetics. I conceived ecokinetics as a choreographic corollary to ecoacoustics, an environmental mode of music composition pioneered by Matthew Burtner, my long-time musical collaborator. According to Matthew, "ecoacoustics embeds environmental systems into musical and performance structures using new technologies" (Burtner). Ecokinetics asks, how can we relate human movement to environmental systems? How can choreography (aesthetically patterned human motion) illuminate, echo, expand upon the movement vectors present at a site and help us better understand local ecologies? How can dance entwine with media technologies to embody the processes of natural systems? Ecokinetics is part personal movement practice, part pedagogical tool, and part performance methodology.In its essence, ecokinetics repudiates the separation of humans from nature, a pervasive Colonialist mindset that needs constant undoing. In order to make progress on climate change, we must feel—truly and deeply—that we are part of the planet and not apart from it. This is the opposite of what the billionaires' space club aims to accomplish. Bezos, Branson, and Musk, et al. view distance from Earth as a... (shrink)

If we must take mathematical statements to be true, must we also believe in the existence of abstract eternal invisible mathematical objects accessible only by the power of pure thought? Jody Azzouni says no, and he claims that the way to escape such commitments is to accept true statements which are about objects that don't exist in any sense at all. Azzouni illustrates what the metaphysical landscape looks like once we avoid a militant Realism which forces our commitment to anything (...) that our theories quantify. Escaping metaphysical straitjackets, while retaining the insight that some truths are about objects that do exist, Azzouni says that we can sort scientifically-given objects into two categories: ones which exist, and to which we forge instrumental access in order to learn their properties, and ones which do not, that is, which are made up in exactly the same sense that fictional objects are. He offers as a case study a small portion of Newtonian physics, and one result of his classification of its ontological commitments, is that it does not commit us to absolute space and time. (shrink)

Ask a philosopher what a proof is, and you’re likely to get an answer hii empaszng one or another regimentationl of that notion in terms of a finite sequence of formalized statements, each of which is either an axiom or is derived from an axiom by certain inference rules. (Wecan call this the formal conception of proof) Ask a mathematician what a proof is, and you will rbbl poay get a different-looking answer. Instead of stressing a partic- l uar regimented (...) notion of proof, the answer the mathematician will give ilikl.. (shrink)

Unrealistic therapeutic beliefs are very common—the majority of patient-subjects enrol in phase 1 trials seeking and expecting significant medical benefit, even though the likelihood of such benefit has historically proven very low. The high prevalence of therapeutic misestimation and unrealistic optimism in particular has stimulated debate about whether unrealistic therapeutic beliefs in early-phase clinical trials preclude adequate informed consent. We seek here to help resolve this controversy by showing that a crucial determination of when such therapeutic beliefs are ethically problematic (...) turns on whether they are causally linked and instrumental to the motivation to participate in the trial. Thus, in practice, it is ethically incumbent on researchers to determine which understanding and beliefs lead to the participant’s primary motivation for enrolling, not to simply assess understanding, beliefs and motivations independently. We further contend that assessing patient-subjects’ appreciation as a component of informed consent—it is already an established component of decision-making capacity assessments—can help elucidate the link between understanding-beliefs and motivation; appreciation refers to an individual’s understanding of the personal significance of both the medical facts and the experience of trial participation. Therefore, we recommend that: in addition to the usual question, ‘Why do you want to participate in this trial?’, all potential participants should be asked the question: ‘What are you giving up by participating in this trial?’ and researchers should consider the settings in which it may be possible and practical to obtain ‘two-point consent’. (shrink)