Physical activity, and likely the motivation for it, varies throughout the day. The aim of this investigation was to create a short assessment (CRAVE: Cravings for Rest and Volitional Energy Expenditure) to measure motivation states (wants, desires, urges) for physical activity and sedentary behaviors. Five studies were conducted to develop and evaluate the construct validity and reliability of the scale, with 1,035 participants completing the scale a total of 1,697 times. In Study 1, 402 university students completed a questionnaire inquiring (...) about the want or desire to perform behaviors “at the present moment (right now).” Items related to physical activity (e.g., “move my body”) and sedentary behaviors (e.g., “do nothing active”). An exploratory structural equation model (ESEM) revealed that 10 items should be retained, loading onto two factors (5 each for Move and Rest). In Study 2, an independent sample (n= 444) confirmed these results and found that Move and Rest desires were associated with stage-of-change for exercise behavior. In Study 3, 127 community-residing participants completed the CRAVE at 6-month intervals over two years- two times each session. Across-session interclass correlations (ICC) for Move (ICC = 0.72–0.95) and Rest (ICC = 0.69–0.88) were higher than when they were measured across 24-months (Move: ICC = 0.53; Rest: ICC = 0.49), indicating wants/desires have state-like qualities. In Study 4, a maximal treadmill test was completed by 21 university students. The CRAVE was completed immediately pre and post. Move desires decreased 26% and Rest increased 74%. Changes in Move and Rest desires were moderately associated with changes in perceived physical fatigue and energy. In Study 5, 41 university students sat quietly during a 50-min lecture. They completed the CRAVE at 3 time points. Move increased 19.6% and Rest decreased 16.7%. Small correlations were detected between move and both perceived energy and tiredness, but not calmness or tension. In conclusion, the CRAVE scale has good psychometric properties. These data also support tenets of the WANT model of motivation states for movement and rest (Stults-Kolehmainen et al., 2020a). Future studies need to explore how desires to move/rest relate to dynamic changes in physical activity and sedentarism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Recovering One's Self from PsychosisA Philosophical AnalysisThe author reports no conflicts of interest.Rosanna Wannberg (2024) has given us a dense but helpful introduction to certain philosophical questions raised by the fact that many patients recovering from psychotic illnesses describe their recovery in terms of gaining or regaining a 'sense of self' and a 'sense of agency,' which often involves acceptance of the 'fact' of being mentally ill, for example, (...) of 'having schizophrenia.' She raises two important questions: How should we understand what is going on in these accounts? and What are the implications of these reports for our understanding of what it is to have a 'sense of self' or a 'sense of agency'—of 'subjectivity' generally—which might have, both, clinical and nonclinical implications?What does it mean to have a self or a sense of having one, agency or a sense of having it? One might think these are the possession or experience of something 'inner' such as feelings of confidence or assurance, perhaps having a kind of inner structure or a set of deeply held ideas which give us coherence, motivate us and justify our actions, and which we can know by 'looking inward,' in an introspective act which provides direct, privileged acquaintance.Yet Wittgenstein called this a dangerously misleading 'picture' which 'held us captive,' and needed always to be 'gotten rid of' (Wittgenstein, 1958). One way of seeing the problem is to consider that no inner 'object,' no thing inside us, can be, or give us a sense of having, a self or agency, because no mere thing (whether an experience of confidence, or having an inner structure) can have any meaning or provide any explanation. A thing (like a word on a page) is just a thing—inert, dead— and must be interpreted, that is used, before it can play a role in our 'forms of life' (Wittgenstein, 1958) including explaining our sense of self or agency.Semantic externalists (Burge, 1979; Putnam, 1975), have argued that even what is internal to our minds—like thoughts—have contents which are determined by experiences in the 'outside' world in which we have lived and learned: if our experiences in the world, they have shown, were different, then so, also, would be the contents of our thoughts. It has even been argued that internal mental experiences which appear to be purely phenomenological (such as an image or a thought-token, so-called narrow content) can only [End Page 67] be identified and thought about using concepts having references in the external world: there is, so it is claimed, no narrow content (Yli-Vakkuri and Hawthorne, 2018); or, if there is, it is of no explanatory use in psychology (Fodor, 1994).If this is the philosophical background from which Wannberg confronts first-person accounts of recovery from psychosis which include (re)gaining a sense of self or agency, and if this philosophy is right, what becomes of the accounts? How are they to be understood?To meet this challenge, Wannberg invokes an alternative account of self-possession and firstperson authority provided by Richard Moran (2001). Moran's position is that we find or possess ourselves when we find or hold beliefs about the world which we do not merely believe but endorse or avow, where to endorse or avow a belief about the world is to find and endorse reasons in the world, which support that belief. Thus, I can avow that it's raining if I can look outside and see that it is raining. This Moran calls the transparency condition. Endorsing or avowing both a belief and the external reasons for it gives the self what Moran refers to as authenticity and which also might be said to provide cohesion, consistency and intelligibility—plausibly, a 'sense of self.'The transparency condition also applies to beliefs that justify actions. We act intentionally when we can give good reasons for what we do (Anscombe, 1957; Moran, 2001) and we can give good reasons for what we do when we can identify facts in the world that support those reasons. Thus, the transparency condition can explain both a sense of self and a sense... (shrink)

Four strands of research in the philosophy of technology have made important contributions to environmental philosophy. First, critical theory of technology emphasizes the environmentally exploitative tendencies of capitalist technological innovation. Second, phenomenologyhas examined how technologies shapeperception and orientation to the world with implications for our treatment of and regard for nature. Third, concurrent with the environmental movement itself, an empirical turn in philosophy of technology resulting in philosophers focusing their attention on particular tools and techniques. Empirical studies have emphasized environmentally (...) significant technologies. Finally, work inspired by philosophy of science has adopted scientific reasoning and methods in environmental policy with tools such as risk analysis and environmental impact assessment. These four strands of work have often merged with the work of sociologists, geographers, and political theorists interested in the connections between science and democracy. (shrink)

Don Ihde has characterized his philosophy as "phenomenology + pragmatism." This article argues that Ihde's pragmatism can be understood as consistency with two philosophical commitments from the first generation of American pragmatists (e.g. Peirce, James, Dewey and Addams). First, Ihde's notion of embodiment relations for tools and techniques is consistent with the organism-environment relational epistemology of these thinkers. Second, his desire to dissociate himself from romantic and neo-idealist readings of the phenomenological tradition link him with their naturalism.

The chapter discusses two points of intersection between the communication of science-based information about risk and philosophical ethics. The first is a logically unnecessary bias toward consequentialist ethics, and a corresponding tendency to overlook the significance of deontological and virtue based ways to interpret the findings of a scientific risk analysis. The second is a grammatical bias that puts scientific communicators at odds with the expectations of a non-scientific audience.

The emergence of individuality during the evolutionary transition from single cells to multicellularity poses a range of problems. A key issue is how variation in lower‐level individuals generates a corporate (collective) entity with Darwinian characteristics. Of central importance to this process is the evolution of a means of collective reproduction, however, the evolution of a means of collective reproduction is not a trivial issue, requiring careful consideration of mechanistic details. Calling upon observations from experiments, we draw attention to proto‐life cycles (...) that emerge via unconventional routes and that transition, in single steps, individuality to higher levels. One such life cycle arises from conflicts among levels of selection and invokes cheats as a primitive germ line: it lays the foundation for collective reproduction, the basis of a self‐policing system, the selective environment for the emergence of development, and hints at a plausible origin for a soma/germ line distinction. (shrink)

After centuries of neglect, the ethics of food are back with a vengeance. Justice for food workers and small farmers has joined the rising tide of concern over the impact of industrial agriculture on food animals and the broader environment, all while a global epidemic of obesity-related diseases threatens to overwhelm modern health systems. An emerging worldwide social movement has turned to local and organic foods, and struggles to exploit widespread concern over the next wave of genetic engineering or nanotechnologies (...) applied to food. Paul B. Thompson's book applies the rigor of philosophy to key topics in the first comprehensive study explore interconnections hidden deep within this welter of issues. Bringing to bear more than thirty years of experience working closely with farmers, agricultural researchers and food system activists, he explores the eclipse of food ethics during the rise of nutritional science, and examines the reasons for its sudden re-emergence in the era of diet-based disease. Thompson discusses social injustice in the food systems of developed economies and shows how we have missed the key insights for understanding food ethics in the developing world. His discussions of animal production and the environmental impact of agriculture break new ground where most philosophers would least expect it. By emphasizing the integration of these issues, Thompson not only brings a comprehensive philosophical approach to moral issues in the production, processing, distribution, and consumption of food -- he introduces a fresh way to think about practical ethics that will have implications in other areas of applied philosophy. (shrink)

Agrarian political philosophies since ancient Greece stress the role of agriculture in forming political solidarity and civic virtue. More recent transformations suggest a way to conjoin these elements of what makes a polity politically sustainable with environmental sensitivity and literacy.

The Spirit of the Soil challenges environmentalists to think more deeply and creatively about agriculture. Paul B. Thompson identifies four `worldviews' which tackle agricultural ethics according to different philosophical priorities; productionism, stewardship, economics and holism. He examines current issues such as the use of pesticides and biotechnology from these ethical perspectives. This book achieves an open-ended account of sustainability designed to minimise hubris and help us to recapture the spirit of the soil.

: When may a physician legitimately offer enrollment in a randomized clinical trial (RCT) to her patient? Two answers to this question have had a profound impact on the research ethics literature. Equipoise, as originated by Charles Fried, which we term Fried's equipoise (FE), stipulates that a physician may offer trial enrollment to her patient only when the physician is genuinely uncertain as to the preferred treatment. Clinical equipoise (CE), originated by Benjamin Freedman, requires that there exist a state of (...) honest, professional disagreement in the community of expert practitioners as to the preferred treatment. FE and CE are widely understood as competing concepts. We argue that FE and CE offer separable and, in themselves, incomplete justifications for the conduct of clinical trials. FE articulates conditions under which the fiduciary duties of physician to patient may be upheld in the conduct of research. CE sets out a standard for the social approval of research by institutional review boards. Viewed in this way, FE and CE are not necessarily competing notions, but rather address complementary moral concerns. (shrink)

Heated debate surrounds the question whether the relationship between physician-researcher and patient-subject is governed by a duty of care. Miller and Weijer argue that fiduciary law provides a strong legal foundation for this duty, and for articulating the terms of the relationship between physician-researcher and patient-subject.

Bioethics is currently witnessing unprecedented debate over the moral and legal norms governing the conduct of clinical research. At the center of this debate is the duty of care in clinical research, and its most widely accepted specification, clinical equipoise. In recent work, we have argued that equipoise and cognate concepts central to the ethics of clinical research have been left unnecessarily vulnerable to criticism. We have suggested that the vulnerability lies in the conspicuous absence of an articulated foundation in (...) moral and legal theory of the physician-researcher's duty of care to the patient-subject. We have repeatedly suggested that the requisite foundation is in the ethics of trust and the law of fiduciaries.Curiously, despite the absence of a published thorough exposition of our position, some have preemptively criticized our suggestion that the relationship between physician-researcher and patient-subject is fiduciary. Others have offered their own accounts of the implications of fiduciary law for the relationship. (shrink)

When may a physician enroll a patient in clinical research? An adequate answer to this question requires clarification of trust-based obligations of the state and the physician-researcher respectively to the patient-subject. The state relies on the voluntarism of patient-subjects to advance the public interest in science. Accordingly, it is obligated to protect the agent-neutral interests of patient-subjects through promulgating standards that secure these interests. Component analysis is the only comprehensive and systematic specification of regulatory standards for benefit-harm evaluation by research (...) ethics committees (RECs). Clinical equipoise, a standard in component analysis, ensures the treatment arms of a randomised control trial are consistent with competent medical care. It thus serves to protect agent-neutral welfare interests of the patient-subject. But REC review occurs prior to enrolment, highlighting the independent responsibility of the physician-researcher to protect the agent-relative welfare interests of the patient-subject. In a novel interpretation of the duty of care, we argue for a “clinical judgment principle” which requires the physician-researcher to exercise judgment in the interests of the patient-subject taking into account evidence on treatments and the patient-subject‘s circumstances. (shrink)

Presents a collection of essays written over a period of 15 years by agricultural ethicist Paul B. Thompson. The essays address the practical application of ethics to agriculture in a world faced with issues of increased yield, threatened environment, and the disappearance of the family farm.

Critically analyzes and revitalizes agrarian philosophy by tracing its evolution. Today, most historians, philosophers, political theorists, and scholars of rural America take a dim view of the agrarian ideal that farmers and farming occupy a special moral and political status in society. Agrarian rhetoric is generally seen as special pleading on the part of farmers seeking protection from labor reform and environmental regulation while continuing to receive direct payments and subsidies from the public till. Agrarianism should not be viewed as (...) a set of immutable claims about farming and political order, but as a tradition of moral and political philosophy that has evolved and deepened over the centuries. Agrarian naturalism--the belief that culture and conduct are conditioned by nature because they are of a piece with nature--becomes pragmatic naturalism, giving way to a new set of puzzles about how we are to understand the rural landscape and our responsibilities for its use. The agrarian idea that personality and sociability are integrated with the material transformation of the landscape can serve as the basis for a new, pragmatically grounded ethic of natural resources and rural development. The essays in this volume critically analyze and revitalize agrarian philosophy by tracing its evolution in the classical American philosophy of key figures such as Franklin, Jefferson, Emerson, Thoreau, Dewey, and Royce. Three chapters address the belief that farming peoples develop moral virtue and a taste for democracy as it evolved in the American context, and four examine how a reconstitution of agrarian themes might invigorate our nation's thinking on environment, food, and rural development policy. The Agrarian Roots of Pragmatism will be of broad interest to scholars of American philosophy, rural history, history of ideas, geography, and agricultural or natural resource policy. (shrink)

Franklin G. Miller and colleagues have stimulated renewed interest in research ethics through their work criticizing clinical equipoise. Over three years and some twenty articles, they have also worked to articulate a positive alternative view on norms governing the conduct of clinical research. Shared presuppositions underlie the positive and critical dimensions of Miller and colleagues' work. However, recognizing that constructive contributions to the field ought to enjoy priority, we presently scrutinize the constructive dimension of their work. We argue that it (...) is wanting in several respects. (shrink)

Philosophical food ethics or deliberative inquiry into the moral norms for production, distribution and consumption of food is contrasted with food ethics as an international social movement aimed at reforming the global food system. The latter yields an activist orientation that can become embroiled in self-defeating impotency when the complexity and internal contradictions of the food system are more fully appreciated. However, recent work in intersectionality offers resources that are useful to both philosophical and activist food ethics. For activists, intersectionality (...) provides a way to preserve and strengthen the meaningfulness of protest and resistance, even in the face of complexity and uncertain outcomes. For philosophers, intersectionality chastens the tendency to regard moral problems as inherently solvable, and provides a way use tensions inherent in food system reform as a source of ethical insight. (shrink)

Recent developments in synthetic biology are described and characterized as moving the era of biotechnology into platform technologies. Platform technologies enable rapid and diffuse innovations and simultaneous product development in diffuse markets, often targeting sectors of the economy that have traditionally been thought to have little relationship to one another. In the case of synthetic biology, pharmaceutical and biofuel product development are occurring interactively. But the regulatory and ethical issues associated with these two applications share very little overlap. As such, (...) there is some risk that focus on traditional medical applications, for which the ethical expertise is highly developed, will overshadow the ethical issues that arise in connection with land use and its attendant socioeconomic consequences, especially in the developing world. The 2010 report of the Presidential Commission for the Study of Bioethics exhibits this tendency. (shrink)

Bioethics coverage of the recent Ebola outbreak neglected the ethical issues associated with aspects of the outbreak having environmental significance. The neglect of environmental dimensions is symptomatic of the way that the current institutionalization of bioethics as a field of inquiry separates medical and environmental expertise. As visionaries who are recognizing the need for better integration of human and veterinary medicine with environmental health are starting to call for “One Health”, it is now time to recognize the need for “One (...) Bioethics.”. (shrink)

Issues of social justice underlie the clamour for greater gender balance in top-management. The present study reveals that pursuit of such social justice is also value-enhancing in relation to the longer-run performance of initial public offerings stocks, especially where female board members are unencumbered by family-connection with other directors. This study examines the economic benefits of board gender diversity for state- and privately controlled firms in the Hong Kong IPO market. Gender board diversity is much less common in state-run IPO (...) firms. Within the subset of privately controlled IPO firms, distinction exists between entities that accommodate family-connected board officers and those that do not. Specifically, this study focuses on family-ties between board members. This issue allows for finer-grained assessment of family influence on firm performance. Stronger post-listing stock, return-on-assets and sales-on-assets performance arise in privately controlled firms without family-connected board members and in state-run entities. Gender diversity thus serves as a positive, but only when female director presence is untrammelled by family associations between directors. However, there is little evidence of a link between female board representation and IPO underpricing. Relative to state-backed issuers, privately controlled firm boards accommodate more women, younger officers and a broader mix of nationalities, but appear more-inclined to unify CEO and chair positions. Board duality, the fraction of independent directors and directors’ age and nationality exhibit little relation with initial and aftermarket stock returns. In prescriptive terms, minority investors gain from the inclusion of female directors, especially when IPO firm directors are unencumbered by family-affiliation with other board members. Results therefore add to the clarion of calls for greater female board presence. (shrink)

Open-source communities that focus on content rely squarely on the contributions of invisible strangers in cyberspace. How do such communities handle the problem of trusting that strangers have good intentions and adequate competence? This question is explored in relation to communities in which such trust is a vital issue: peer production of software (FreeBSD and Mozilla in particular) and encyclopaedia entries (Wikipedia in particular). In the context of open-source software, it is argued that trust was inferred from an underlying ‘hacker (...) ethic’, which already existed. The Wikipedian project, by contrast, had to create an appropriate ethic along the way. In the interim, the assumption simply had to be that potential contributors were trustworthy; they were granted ‘substantial trust’. Subsequently, projects from both communities introduced rules and regulations which partly substituted for the need to perceive contributors as trustworthy. They faced a design choice in the continuum between a high-discretion design (granting a large amount of trust to contributors) and a low-discretion design (leaving only a small amount of trust to contributors). It is found that open-source designs for software and encyclopaedias are likely to converge in the future towards a mid-level of discretion. In such a design the anonymous user is no longer invested with unquestioning trust. (shrink)

Agricultural crops developed using the tools of genetic engineering have become socially institutionalized in three ways that substantially compromise the inherent potential of plant transformation tools. The first is that when farming depends upon debt finance, farmers find themselves in a competitive situation such that efficiency-enhancing technology fuels a trend of bankruptcy and increasing scale of production. As efficiency increasing tools, GMOs are embedded in controversial processes of social change in rural economies. The United States, at least, has chosen not (...) to undertake policy interventions to slow or reverse this trend. The second institutionalization of GMOs is found in the way that agricultural science has become divided between two camps, one focused on efficiency and total global production, the other focused on maintaining soil and water ecosystems in the face of both population growth and climate change. GMOs have been strongly supported by the first camp and regarded as irrelevant to the goals of the second. Finally, GMOs have become symbolic markers in the global debate over neoliberal institutions for trade and the protection of intellectual property. While there may be agronomic arguments for favoring GMO technology, the way that it has become situated in each of these social debates insures that it will be subject to strong opposition without regard to its biological risks and potential benefits. (shrink)

Countersexual society -- Countersexual reversal practices -- Theories -- Countersexual reading exercise -- On philosophy as a better way of taking it in the ass: deleuze and "molecular homosexuality.

Risk communication poses a challenge to ordinary norms of truth-telling because it can easily mislead. Analyzing this challenge in terms of a systematic divergence between expertise and public attitudes fails to recognize how two specific features of the concept of risk play a role in managing daily affairs. First, evaluating risk always incorporates an estimate of the reliability of information. Since risk communication is an effort at providing information, audiences will naturally and appropriately incorporate their assessment of the reliability of (...) the risk communicator into their assessment of the risk as such. Second, one conceptual and grammatical feature of the concept of risk is to categorize experience as non-routine and demanding further deliberation. That is, the whole point of calling something a risk can be to distinguish it from activities or phenomena that need no further attention. Risk communications that stress relative comparisons of measured probabilities and expected utilities can be inconsistent with both features of our concept of risk. At best they mislead; at worst they undermine our society’s capacity to cope with risk. While there are no simple answers to these two conundrums, technical experts should bear them in mind when communicating with the broader public. (shrink)

What is the significance of the wicked problems framework for environmental philosophy? In response to wicked problems, environmental scientists are starting to welcome the participation of social scientists, humanists, and the creative arts. We argue that the need for interdisciplinary approaches to wicked problems opens up a number of tasks that environmental philosophers have every right to undertake. The first task is for philosophers to explore new and promising ways of initiating philosophical research through conducting collaborative learning processes on environmental (...) issues. The second task is for philosophers to recognize the value of philosophical skills in their engagements with members of other disciplines and walks of life in addressing wicked problems. The wicked problems framework should be seen as an important guide for facilitating philosophical research that is of relevance to problems like climate change and sustainable agriculture. Content Type Journal Article Category Articles Pages 1-14 DOI 10.1007/s10806-011-9344-0 Authors Paul B. Thompson, Department of Philosophy, Michigan State University, 503 S. Kedzie Hall, East Lansing, MI 48824, USA Kyle Powys Whyte, Department of Philosophy, Michigan State University, 503 S. Kedzie Hall, East Lansing, MI 48824, USA Journal Journal of Agricultural and Environmental Ethics Online ISSN 1573-322X Print ISSN 1187-7863. (shrink)

The canonical function game is a game of length ω1 introduced by W. Hugh Woodin which falls inside a class of games known as Neeman games. Using large cardinals, we show that it is possible to force that the game is not determined. We also discuss the relationship between this result and Σ22 absoluteness, cardinality spectra and Π2 maximality for H(ω2) relative to the Continuum Hypothesis.

Paul Thompson’s excellent book, From Field to Fork: Food Ethics for Everyone, argues that contemporary food ethics persistently ignores the nature and actual impact of GMOs, Concentrated Animal Feeding Operations, food aid to developing countries, and more. On Thompson’s view, such philosophical analyses must incorporate empirical knowledge. Additional strengths of Thompson’s book: its attention to quality-of-life issues, its openness to the concerns of the marginalized, and its emphasis on the interconnectedness of problems in food ethics. I raise one area (...) of disagreement with Thompson: his treatment of GMOs is, I argue, insufficiently skeptical. I suggest a three-fold revision of the book’s treatment of the precautionary principle, and I levy an additional argument against GMOs, the Inductive Argument. Using the herbicide Roundup as a case study of the ways in which industry urges the use of technologies that have not been fully vetted or monitored, I argue that products originally seen as safe often turn out instead to be harmful to the environment and health. Significant inductive experience with similar cases gives people additional reason to be even more suspicious of GMOs than Thompson suggests. (shrink)

: In response to the preceding commentary by Jerry Menikoff in this issue of the Journal , the authors argue that Fried's central concern is not that randomized clinical trials (RCTs) are conducted without consent, but rather that various aspects of the design and conduct of RCTs are in tension with physicians' duties of personal care to their patients. Although Fried does argue that the existence of equipoise cannot justify failure to obtain consent from research subjects, informed consent by itself (...) does not supplant ill subjects' rights to personalized judgment and care embodied in Fried's equipoise. (shrink)

Agricultural crops developed using the tools of genetic engineering have become socially institutionalized in three ways that substantially compromise the inherent potential of plant transformation tools. The first is that when farming depends upon debt finance, farmers find themselves in a competitive situation such that efficiency-enhancing technology fuels a trend of bankruptcy and increasing scale of production. As efficiency increasing tools, GMOs are embedded in controversial processes of social change in rural economies. The United States, at least, has chosen not (...) to undertake policy interventions to slow or reverse this trend. The second institutionalization of GMOs is found in the way that agricultural science has become divided between two camps, one focused on efficiency and total global production, the other focused on maintaining soil and water ecosystems in the face of both population growth and climate change. GMOs have been strongly supported by the first camp and regarded as irrelevant to the goals of the second. Finally, GMOs have become symbolic markers in the global debate over neoliberal institutions for trade and the protection of intellectual property. While there may be agronomic arguments for favoring GMO technology, the way that it has become situated in each of these social debates insures that it will be subject to strong opposition without regard to its biological risks and potential benefits. (shrink)

Although the word 'sustainability' is used broadly, scientific approaches to sustainability fall into one of two competing paradigms. Following the influential Brundtland report of 1987. some theorists identify sustainability with some form of resource availability, and develop indicators for sustainability that stress capital depletion. This approach has spawned debates about the intersubstitutivity of capitals, with many environmental theorists arguing that at some point, depletion of natural capital cannot be offset by increases in human or social capital. The alternative approach is (...) grounded in stock and flow systems systems modeling, and defines sustainability through indicators that determine whether the system structure is robust (e.g. resists perturbation), resilient (recovers after disruption) and adaptive (capable of change in response to external conditions). Both paradigms have applications in economics and ecology. (shrink)

Commodification and Secondary Rationalization.

In lieu of an abstract, here is a brief excerpt of the content:Excited DeliriumWhat’s Psychiatry Got to do With It?Paul B. Lieberman, MDIf in life we are surrounded by death, so too in the health of our intellect by madness.—WittgensteinDelirium is a medical syndrome defined as “a relatively acute decline in cognition that fluctuates over hours or days” whose primary manifestation is a deficit of attention. It is common, estimated to occur in 10% to more than 50% of hospitalized (...) patients, with higher prevalence rates among people in nursing homes and at the end of life. It is often fatal, with a mortality rate in the hospital estimated to be 25% to 33%. Caused by a wide variety of conditions and frequently difficult to diagnose, it lacks characteristic postmortem pathology (Josephson & Miller 2018)‘Excited delirium,’ as Byju and Friesen forcefully argue (Byju & Friesen, 2023), is, if nothing else, an excuse. The ‘diagnosis’ has not been empirically validated and remains controversial (American Psychiatric Association, 2020). And while delirium is usually treated by internists and emergency medicine physicians, psychiatrists should also be concerned about the misuse of a putative medical diagnosis and join actively in discussion about it. For one thing, patients mis-diagnosed with this condition, as Byju and Friesen’s examples suggest, may actually have another psychiatric condition and, so, be people for whose safety we should advocate. Moreover, the kinds of police interventions which Byju and Friesen document as involving excited delirium also befall patients with other psychiatric problems in whom the issue of delirium does not arise.There are at least two broad ways in which psychiatrists are qualified and obligated to engage with this issue. As physicians, we should join our medical colleagues in carefully but persistently telling the scientific, medical truth. As psychiatrists, we should bring psychiatric knowledge into the discussion, for example, by explaining what can happen when people who do not, apparently, have a diagnosable mental disorder interact under stress with other people who, apparently, do.Delirium is a clinical diagnosis, made when characteristic signs and symptoms are present which should not be made ‘by exclusion’ when, as may happen, other causes are not found. There is no evidence of delirium in any of the three clinical descriptions Byju and Friesen provide. Perhaps such evidence exists which is not in their brief reports, but these three people appear to have had, either, another psychiatric condition, such as psychosis or drug intoxication, or perhaps no [End Page 353] diagnosis at all. Psychiatrists are particularly wellpositioned to make this point since patients with mental health problems are often misdiagnosed when they seek medical attention and are told, and treated as if, “it’s all (“just”!) psychological.”Excited delirium, if it exists, is fatal in 10% of cases (Gonin, Beysard, Hersin, & Carron, 2018) and, although this is lower than the rate for delirium in general, it is still high. Medical personnel must be available to evaluate and ensure the safety of patients in custody.The potential conflict between protecting the patient and protecting the public should not be overstated. Although physical trauma and excessive administration of medications, including ketamine 500 mg IV (Orhurhu, Vashicht, Claus, & Cohen, 2023) can be lethal, mechanical restraint by itself is not (Chieze et al., 2019; Gleerup et al., 2019): something else is necessary, such as asphyxiation (Evans, Wood, & Lambert, 2003). Nor is restraint necessary in many cases in which ‘de-escalation’ techniques can be equally effective (Garriga et al., 2016; Fernández-Costa, 2020). Perhaps these points are best made by law enforcement leaders—and they have been—but psychiatrists can add that safe management of potential violence can be provided for agitated people with psychiatric conditions.Although it is not clear what kind of strength ‘superhuman’ strength might be (certainly not medical), relative imperviousness to pain is clinically described. Its locus classicus is Beecher’s observation, during World War II, that injured soldiers awaiting return home from the front, required lower than usual doses of analgesics (Beecher, 1946). And it’s a common experience, scientifically confirmed, that physical trauma may not become painful until sometime after the injury (Melzack, Wall, & Ty, 1982). But pain is a warning. Its absence is not a license, but a caution... (shrink)

The essays in this volume critically analyze and revitalize agrarian philosophy by tracing its evolution in the classical American philosophy of key figures such as Franklin, Jefferson, Emerson, Thoreau, Dewey, and Royce.