This article examines the significance of Friedrich Nietzsche to Albert Camus’ concepts of absurdity and revolt. It rests on three related claims. First, that Nietzsche’s critique of metaphysics is the point of departure for Camus’ absurdist inquiries. Second, that Camus’ philosophy of revolt is informed in crucial ways by Nietzsche’s views on the sources of moral and intellectual authority in the modern world. Finally, that Camusian revolt is an attempt to deal with the political crisis of foundationalism in a way (...) that preserves Nietzsche’s anti-essentialism while also avoiding the excesses of absolutist politics. Ultimately, I suggest that the origins and implications of Camus’ project cannot be grasped apart from an account of its engagement with Nietzsche. (shrink)

This article examines the significance of Friedrich Nietzsche to Albert Camus’ concepts of absurdity and revolt. It rests on three related claims. First, that Nietzsche’s critique of metaphysics is the point of departure for Camus’ absurdist inquiries. Second, that Camus’ philosophy of revolt is informed in crucial ways by Nietzsche’s views on the sources of moral and intellectual authority in the modern world. Finally, that Camusian revolt is an attempt to deal with the political crisis of foundationalism in a way (...) that preserves Nietzsche’s anti-essentialism while also avoiding the excesses of absolutist politics. Ultimately, I suggest that the origins and implications of Camus’ project cannot be grasped apart from an account of its engagement with Nietzsche. (shrink)

In this engaging study, Sean Illing examines the impact of Fyodor Dostoevsky and Friedrich Nietzsche on the development of Albert Camus's political philosophy. It innovatively attempt to offer a substantive examination of Camus's dialogue with Nietzsche and Dostoevsky. The connections among these writers have been discussed in the general context of modern thought or via overlapping literary themes. This project emphasizes the political dimensions of these connections. In addition to re-interpreting Camus's political thought, the aim is to clarify (...) Camus's struggle with transcendence and to bring renewed attention to his unique understanding of the relationship between nihilism, ideology, and political violence in the twentieth century. The book focuses on Camus's dialogue with Nietzsche and Dostoevsky for three reasons. First, these are the thinkers with whom Camus is most engaged. Indeed, the problems and themes of Camus's work are largely defined by Dostoevsky and Nietzsche; a full account of this dialogue will therefore enhance our understanding of Camus while also reinforcing the enduring importance of Nietzsche and Dostoevsky. Second, it allows a recasting of Camus' political philosophy as both a synthesis of and a response to Nietzsche and Dostoevsky's projects. Finally, this approach allows for a reassessment of Camus's broader political significance, which I contend has been undervalued in the literature. Ultimately, I argue that Camus remains among the most important moral and political voices of the twentieth century. Although limited, his philosophy of revolt offers a humane portrait of justice and articulates a meaningful alternative to the extremes of ideological politics. (shrink)

The question "What is mental illness?" raises many issues in many contexts, personal, social, legal, and scientific. This chapter reviews mental health problems as they appear to the person with the problems, and to family and friends-before the person attends the clinic and is given a diagnosis-a time in which whether there really is a problem, as opposed to life's normal troubles and variations, is undecided, as also the nature of the problem, if such it be, and the related matter (...) what kind of expert advice should be sought. Once at the clinic, a diagnosis may be given-using criteria well-worked-out in the diagnostic manuals. The chapter discusses the conceptualizations of mental disorder in the diagnostic manuals, their rationale, and what can and cannot be reasonably expected of them. There are more position statements than definitions, and while they signal many dilemmas, they do not resolve them. Attempts to do so in the surrounding literature on the concept of mental illness are reviewed in the chapter, with conclusions favoring the features emphasized in the diagnostic manuals: distress and impairment. Finally the chapter considers how far the science may help draw boundaries around mental illness. (shrink)

The effects of mental disorder are apparent and pervasive, in suffering, loss of freedom and life opportunities, negative impacts on education, work satisfaction and productivity, complications in law, institutions of healthcare, and more. With a new edition of the 'bible' of psychiatric diagnosis - the DSM - under developmental, it is timely to take a step back and re-evalutate exactly how we diagnose and define mental disorder. This new book by Derek Bolton tackles the problems involved in the definition (...) and boundaries of mental disorder. It addresses two main questions regarding mental illness. Firstly, what is the basis of the standards or norms by which we judge that a person has a mental disorder - that the person's mind is not working as it should, that their mental functioning is abnormal? Controversies about these questions have been dominated by the contrast between norms that are medical, scientific or natural, on the one hand, and social norms on the other. The norms that define mental disorder seem to belong to psychiatry, to be medical and scientific, but are they really social norms, hijacked and disguised by the medical profession? Secondly, what is the validity of the distinction between mental disorder and order, between abnormal and normal mental functioning? To what extent, notwithstanding appearances, does mental disorder involve meaningful reactions and problem-solving? These responses may be to normal problems of living, or to not so normal problems - to severe psycho-social challenges. Is there after all order in mental disorder? With the closing of asylums and the appearance of care in the community, mental disorder is now in our midst. While attempts have been made to define clearly a concept of mental disorder that is truly medical as opposed to social, there is increasing evidence that such a distinction is unviable - there is no clear line between what is normal in the population and what is abnormal. 'What is Mental Disorder?' reviews these various crucial developments and their profound impact for the concept and its boundaries in a provocative and timely book. (shrink)

Athenaeus of Attalia distinguishes two types of exercise or training (γυμνασία) that are required at each stage of life: training of the body and training of the soul. He says that training of the body includes activities like physical exercises, eating, drinking, bathing and sleep. Training of the soul, on the other hand, consists of thinking, education, and emotional regulation (in other words, 'philosophy'). The notion of 'training of the soul' and the contrast between 'bodily' and 'psychic' exercise is common (...) in the Academic and Stoic traditions Athenaeus is drawing from; however, he is the earliest extant medical author to distinguish these kinds of training and to treat them as equally important aspects of regimen. In this paper, I propose some reasons why he found this distinction useful, and I examine how he justified incorporating it into his writings on regimen, namely by attributing Plato's beliefs about regimen to Hippocrates, a strategy Galen would adopt well over a century later. (shrink)

This new edition of Mind, Meaning, and Mental Disorder addresses key issues in the philosophy of psychiatry, drawing on both philosophical and scientific theory. The main idea of the book is that causal models of mental disorders have to include meaningful processes as well as any possible lower-level physical causes, and this propsoal is illustrated with detailed discussion of current models of common mental health problems. First published in 1996, this volume played an important role in bridging the gap between (...) philosophy and psychiatry, and introducing those in psychiatry to philosophical ideas somewhat neglected in their field. Completely updated, the new edition of this acclaimed volume draws on the strengths of the first edition, and will be a central text in the burgeoning field of philosophy of psychiatry. (shrink)

Do psychological traits predict philosophical views? We administered the PhilPapers Survey, created by David Bourget and David Chalmers, which consists of 30 views on central philosophical topics (e.g., epistemology, ethics, metaphysics, philosophy of mind, and philosophy of language) to a sample of professional philosophers (N = 314). We extended the PhilPapers survey to measure a number of psychological traits, such as personality, numeracy, well-being, lifestyle, and life experiences. We also included non-technical ‘translations’ of these views for eventual use in other (...) populations. We found limited to no support for the notion that personality or demographics predict philosophical views. We did, however, find that some psychological traits were predictive of philosophical views, even after strict correction for multiple comparisons. Findings include: higher interest in numeracy predicted physicalism, naturalism, and consequentialism; lower levels of well-being and higher levels of mental illness predicted hard determinism; using substances such as psychedelics and marijuana predicted non-realist and subjectivist views of morality and aesthetics; having had a transformative or self-transcendent experience predicted theism and idealism. We discuss whether or not these empirical results have philosophical implications, while noting that 68% of our sample of professional philosophers indicated that such findings would indeed have philosophical value. (shrink)

The general expectation that patients should be willing to trust nurses is rarely explored or challenged despite claims of diminishing public trust in social and professional institutions. Everyday meanings of trust take account of circumstance and suggest that our understanding of what it means to trust is contextually bound. However, in the context of health care, to trust implies a particular understanding which becomes apparent when abuses of this trust are reported and acknowledged as scandals. The predominant assumption in the (...) literature that trust is something that occurs between equally competent adults cannot explain trust in nursing precisely because of the unequal power relationships between patients on the one hand and healthcare professionals on the other. Moreover, the tendency to conflate terms such as trust, reliance, confidence and so on suggests that confusion permeates discussions of trust in nursing. In this paper, I argue in support of Annette Baier’s requirement of good will (or lack of ill will) as the essential feature of trust, and outline how this account (i) enables us to make the necessary distinctions between trust on the one hand and ‘trust pretenders’ on the other; and (ii) lays the foundations for understanding trust in relationships, such as those between patients and nurses, where power differentials exist. (shrink)

With the tertiary education mantra of creativity, critical thinking and innovation in mind, we consider the critical-creativity of error. Taking the university to model social orthography, or ‘correct writing’, according to the norms of disciplines, we consider the role of error in the classroom. Looked at another way, error questions the norms governing norms and the instability of disciplinary grounds. Beyond correction, error involves a mis-taking, or taking another way. Tracing the origin of error we are able to reconstruct the (...) social world in terms of which it is conceivable for a mistake of any kind to have been made. The university, we find, withholds worlds which are not new but are sources of creativity, and constitutes a pluriversity or poly-versity. (shrink)

Debates about the concept of mental disorder involve social values, the medical model, and the sciences. It is generally agreed that the concept involves values, though how it does this continues to be disputed, and it is also recognized that the label of mental disorder or illness is stigmatizing. Wakefield's proposed definition of mental disorder in terms of harmful dysfunction locates the concept in an evolutionary theoretic framework. However, recent commentaries on Wakefield's analysis have suggested that research programs in evolutionary (...) biology and psychology envisage a broader class of "treatable conditions" that may involve no dysfunction, and hence no disorder in this sense. (shrink)

This paper offers an economic rationale for compulsory licensing of needed medicines in developing countries. The patent system is based on a trade-off between the “deadweight losses” caused by market power and the incentive to innovate created by increased profits from monopoly pricing during the period of the patent. However, markets for essential medicines under patent in developing countries with high income inequality are characterized by highly convex demand curves, producing large deadweight losses relative to potential profits when monopoly firms (...) exercise profit-maximizing pricing strategies. As a result, these markets are systematically ill-suited to exclusive marketing rights, a problem which can be corrected through compulsory licensing. Open licenses that permit any qualified firm to supply the market on the same terms, such as may be available under licenses of right or essential facility legal standards, can be used to mitigate the negative effects of government-granted patents, thereby increasing overall social welfare. (shrink)

Many recent discussions of psychopaths have centered on the question of whether they can express ill-will when they act, a capacity which is generally taken to be required for moral blameworthiness. However, the debate over ill-will currently stands at an impasse; the participants are in substantial agreement as to which attitudes psychopaths can express, but disagree as to which attitudes count as ill-will. I argue that this impasse reflects an underlying, implicit disagreement as to which features of actions are wrong-making. (...) By uncovering this implicit disagreement and addressing it head-on, we should be able to break the impasse. (shrink)

This chapter argues that standard accounts of health are ill-suited to constructing a plausible theory of health justice, particularly a sufficientarian theory. The problem in these accounts is revealed by their treatment of disability. Theorists of health justice need to define “health” more narrowly to capture the legitimate claims of people with disabilities. Following Ronald Amundson and Peter Hucklenbroich, this chapter proposes such a definition. Health, as defined in this chapter, is the absence of conditions that directly cause, or threaten (...) to directly cause, certain kinds of bodily harm, such as pain and premature death. It is concluded that on a plausible sufficientarian theory of health justice, a society that achieves health justice is one that ensures that none of its members face too much of those kinds of bodily harm. (shrink)

Philosophy of epidemiology has recently emerged as a distinct branch of philosophy. The field will surely benefit from pluralism, reflected in the broad range of topics and perspectives in this special issue. Here, I argue that a healthy pluralistic field of philosophy of epidemiology has social responsibilities that require the field as a whole to engage actively with research on social determinants of health and health disparities. Practicing epidemiologists and the broader community of public health scientists have gradually acknowledged that (...) much of their attention ought to be paid to these, i.e. inequitable between-population health variations that largely reflect the world’s inequitable distribution of resources and social conditions. The paper illustrates how and why health disparities and social determinants of health, through no ill will, become de facto secondary concerns in Alex Broadbent’s field-defining Philosophy of Epidemiology, showing the ease with which these topics can be incidentally sidelined. As means for philosophy of epidemiology to meet its social responsibility obligations, I suggest philosophy of epidemiology expand its attention to two particular lines research. First, the paper discusses Geoffrey Rose’s concept of “causes of incidence”—causes of disparities between populations—and argues for the importance of engaging with these causes. Second, the paper argues for the value of engaging with Bruce Link and Jo Phelan’s “fundamental causes” model of how flexible social resources serve as buffers from harms, generating a plethora of shifting and locally-contingent health effects. (shrink)

Victor Tadros, in this chapter, draws attention to significant overlap in our practices of providing treatment to irresponsible wrongdoers, on the one hand, and our practices of holding the responsible to account, on the other. Alternately, how little space there is between treatment and holding accountable. This should be surprising. Much of Strawson’s argument presupposes that we have implicit familiarity with the difference, and with how significant it is. We become angry with the responsible; whereas we take a more detached (...) perspective to children, the seriously impaired, or mentally ill, whom we regard as objects of treatment or management. These are supposed to represent two fundamentally distinct forms of engagement. If Tadros is right, this sense of a massive gulf in how it is appropriate to treat the responsible versus the exempt is an illusion. The actual difference is subtle. (shrink)

Modern critics often regard Goya's etchings and black paintings as satirical observations on the social and political conditions of his times. In a study of Goya first published in 1950, which seldom receives the attention it merits, the French author and art theorist André Malraux contends that these works have a much deeper significance. The etchings and black paintings, Malraux argues, represent a fundamental challenge to the humanist artistic tradition that began with the Renaissance - a tradition founded on the (...) pursuit of a transcendent world of nobility, harmony and beauty. Following an illness that left him deaf for life, Goya developed an art of a fundamentally different kind - an art, Malraux writes, ruled by ‘the unity of the prison house’ which replaced transcendence with a pervasive feeling of dependence and from which all trace of humanism has been erased. Foreshadowing modern art's abandonment of the Renaissance ideal, the etchings and black paintings are the first announcement of the death of beauty in Western art. (shrink)

When social reformers blame the current ills of Western culture on the loss of community, they often evoke an ideal past in which societies were characterized by shared values, respect for tradition, commitment to the common good, and similar attributes. Communitarians assert that community was prominent in the past, and argue that reclaiming the role community formerly played is necessary to counter the negative effects of individualism and liberal thinking. Considering the relevance of community for our moral and political life (...) today, Derek Phillips offers the first thorough critique of the historical, often nostalgic, claims that underlie dominant versions of communitarian philosophy. Originally published in 1993. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

The following is excerpted from Sean Gurd’s translation of Euripides’ Hippolytus published with Uitgeverij this year. Though he was judged “most tragic” in the generation after his death, though more copies and fragments of his plays have survived than of any other tragedian, and though his Orestes became the most widely performed tragedy in Greco-Roman Antiquity, during his lifetime his success was only moderate, and to him his career may have felt more like a failure. He was regularly selected (...) to have his plays performed in the annual festival of Dionysus at Athens. But the plays were performed in a competition, and in the competitions he lost and lost, winning first place only five times in a career that spanned more than forty years. His corpus reads like the remains of a life spent trying to get a few things right and never being quite satisfied: scenes and schematized combinations of elements recur again and again, each time slightly changed. Hippolytus itself is an example: it contains two scenes in which a sick or dying character lies on a couch or a stretcher and is surrounded by silence and grief; he had experimented with such scenes in Alcestis, and would work with them again in Herakles and Orestes. Nor, judging from appearances, was he immune to the desire to score a hit, or to satisfy the audiences and the judges at the competition. Hippolytus is a rewrite of another Hippolytus, performed several years earlier, which scandalized the audience and certainly did not take first place. In that earlier Hippolytus (called by later writers Hippolytus Veiled), Euripides fashioned a Phaedra who was neither ashamed of loving her stepson nor incapable of taking steps to satisfy her desire. The forwardness of her approach to Hippolytus so outraged him that he covered his head with a robe (hence the play’s later title). Euripides liked to write energetic and self-confident women like this. He staged his Medea in 431, just three years before he revised Hippolytus, and in it the jilted title character murders her children in revenge for Jason’s new marriage to a more politically advantageous wife. Another flop: the play came in third of three. Evidently the judges did not like their women showing agency, especially when the consequences were transgressive. “The ornament of women,” wrote another great Athenian a little earlier, “is silence.”i Euripides’ Medea and his first Phaedra had other decorations. So three years after Medea crashed and burned and some time after the first Hippolytus suffered the same fate, he produced another Hippolytus play with a different setting and story. How could this one not have been a reaction to the failure of the first? “Second thoughts are always better,” he has one of his characters say, as though he were offering an apology for his first thoughts on the same story. In this new version, Phaedra is suicidally ashamed of her love, choosing to die rather than have it discovered, and willing to bring down her beloved Hippolytus in the service of the same end. Now it is Phaedra herself who covers her head in shock and horror at her desire. Only an intermediary, a slave of the house and an old crone with her fingers in all sorts of illicit pots, communicates Phaedra’s secret – against orders – and in consequence brings about the demise of two resolutely moral figures. It worked. For his tale of two well-born nobles with an unswerving commitment to moral action, destroyed by the meddling of a slave (and by the hostility of some particularly uncaring divinities), the judges crowned Euripides winner. It was the first time he had won, after almost thirty years of work. *** What Hippolytus wants more than anything else, as he protests with outrage just before leaving Trozen for the last time, is the benefit of due process – oaths, witnesses, an investigation that would reveal who really lusted after whom. Ironic, given that in the first Hippolytus, as far as we can make out, he did get a trial – but too late, and Theseus’ successful processing of Hippolytus failed to prevent his death. I cannot help hearing in the second Hippolytus’ complaints the anger of his authorial semblable who lost year after year by a process of judging that might have seemed brutal to him. Judges took no cognizance of how he worked, how long or hard or why; they just voted, and Euripides lost. But then I hear, in the fate of the first Hippolytus, an even grimmer commentary. Processed or not, we lose. We run aground. At the very least, this might cast a darker shadow on the business of watching or reading a play: in that twilight, things move too fast to make a fair assessment and, in any case, the reasonably high definition of what you see and hear belies the truth of indistinction, the multiplicities just below the surface. Watching is a constrained activity, a form of captivity, but reading is plastic. This translation was begun to supply the script for an audio version of the play, recorded in the spring of 2012, and here and there it sacrifices literalness for sayability and the voices and passions of the actors on that occasion. But it was finished to be read, and engineered to create a reading caught between the poles of specificity and non-specificity that the play itself conjures and relies on at its generative core. Thus two texts: the one clear, perhaps overprecise, respectably modern in its presentation, and the other ancient, a reasonable approximation of the classical reading process, and indistinct in vital ways. Like early modern dramatic texts, the exact provenance and original function of the scripts that have made it down to us are unknown. We do know that the ultimate survival of Hippolytus was thanks to its wide-spread use as a school text. But its relation to the first performance in 428 BCE is a matter only of speculation. Euripides presumably had a fair copy before production began; it was probably modified during rehearsals. The actors may have had copies, too (probably the young men who served in the chorus did not). The chor?gos, a wealthy Athenian who paid for the production, might have been presented with or just made sure to get his hands on a high-quality text, to commemorate the play’s success. Fans might have been able to buy copies. Any one of these sources might have provided the ultimate progenitor of our text. Several of them might have, in fact, if later editors compared and conflated traditions. The plays toured extensively in the Greek-speaking world, and were restaged as repertoire for centuries afterwards. In the process they were subjected to enough modifications by producers and actors that in the later fourth century the Athenian statesman Lycurgus had a law passed prohibiting performances at Athens from deviating from the official “city” text of the tragedies (which he had commissioned). It is unlikely that the city text was the last word; but it marks an important moment in Athens’ role in their dissemination, since after this the major sites of textual curatorship moved overseas, to Alexandria, Pergamum, Rome, Antioch, Constantinople. Any single text of any single play is thus no more than a moment of clarity and stability, crossed and subtended by multiple vectors of change, including that of textual flux (from Euripides’ first drafts to the latest printed text) and that of Euripides’ life work as a writer, in the light of which the Hippolytus is just one attempt to produce something exactly right, to win the prize or finally satisfy himself or prove to himself that all this longing for perfection was a waste of time. I am intrigued by the possibility that a single text might somehow serve as a lens onto this wider zone of indistinction, representing a small region clearly but nonetheless containing a blurred image of the whole, like a Leibnizian monad. After all, no text is a witness: it is, rather, a perception and a performance, and what every Hippolytus must perform is the awkward overlay of singular and plural, social practise and subliminal drive, that structures the tragedy. Modern critical editions can do this by juxtaposing a (relatively) clean and simple text with a textual apparatus reporting variants and theorizing the relationship between textual instantiations. A translation lacks the resolution to catch the fine variations which feed into the construction of an apparatus. But there are other means to hand. Guessing at the exact words of the original text is always just that – guessing – though Hippolytus is less problematic than plays like Iphigenia at Aulis. But we can make a pretty secure guess at what such a text looked like. Texts read by fifth-century readers were fundamentally different from what is presented in the best medieval MSS and printed in modern publications. The texts of Euripides’ time and for many centuries afterwards did not indicate word division with spaces (or by any other means) and were extremely sparing in punctuation, often avoiding it altogether. There was only one “case” of letters – what we call “capitals.” Musical sections were inscribed as though they were prose, without line endings to reflect their rhythm or their rhetorical structure. There was no indication of the speakers within a dramatic text, either. The earliest surviving dramatic texts, which come from over a century after Euripides’ death and a time which was much more elaborate and precise in its textual culture, indicated speaker-change with a little line or paragraphos below the line and a double-point [:] at its end. This convention almost certainly does not date back to Euripides’ own time; it may not even date to Lycurgus. In any case, such indications were understood to be readers’ marks: they did not have the same authority as the text and they were subject to readers’ revisions. At least ideationally, if not in concrete and distinguishable fact, a dramatic text was understood as containing no indication of speaker-change (and certainly none of who was saying what). The reader had to figure that out for him-/herself. The clear, legible, easy texts we are accustomed to reading are the fabrications of medieval and modern reading cultures. The first text, then, presents the translation as the text would have been in the mid-fourth century, perhaps decades after Euripides’ death. The second text processes Hippolytus, makes sense of it and makes it “readable.” That is: too distinct, dangerously so. It gets in your way, conjures fantoms, tries to make you see. Fragments of the Hippolytus Veiled, otherwise almost entirely lost, are juxtaposed with similar passages in the text – not to suggest a reconstruction, but a dialogue and a complex set of reassessments. I have not tried to represent the full variety of textual variants, but I have signalled where, for one reason or another, the text is soft and different editions propose excisions or changes. The two texts must be read together: you, reader, form the bridge between the distinctly seen and the indistinct invisible. You, in the end, will be its mask. *** illsandhateddiseaseswhatcanidoforyouwhatshouldinotdohereisthelightandthebrightairyoursickbedisnowout s idethehouseyoureverywordwastocomeherebutyouwillrushbacktoyourbedroomagainyoufadequicklyyoudelig htinnothingyoudislikewhatyouhaveyoulovewhatyoudontitsbettertobesickthantendthesickthefirstissimpleto the secondattachesheartspainandhandsworkeveryhumanlifeispainfulthereisnoendtotoildarknesshidesbehindclo udswhateverisdearerthanlifeweproveunhappyloversofwhatshineshereforlackofknowledgeofanotherlifethere isnoproofforthingsbeneaththeearthonlystoriessustainus liftmybodystraightenmyheadthebondsofmylimbsareloosenedtakemyhandsandmypalearmsthishatistooheavy formyheadtoweartakeitoffspreadmyhairovermyshoulders couragechilddonttossandturnsoviolentlyyouwillbearyoursicknessmoreeasilywithpeaceandanoblemindallmort alssuffer aiaiiwanttodrinkpurewaterfromadewyspringiwanttoliebackandrestunderthetreesinsomegrassymeadowchildw hycrydontsaythesethingsnearthecrowdhurlingwordsmountedonmadness sendmetothemountainiwillgototheforestwherebeastkillingdogspressthespotteddeergodsilongtoshouttothedo gstoshootthethessalianjavelinpastmyblondhairtoholdthebarbeddartinmyhandwhythisanxietychildwhatdoyouc areabouthuntingwhydoyoulustforflowingspringstheresahillwithwaterjustnexttothetowerwecangetyouadrinkt h ereartemismistressofthesaltlakeandthecoursethunderingwithhorseshoovesiwishiwereonyourplainsbreakings t uds whythrowthesefrenziedwordsaboutjustnowyouweresettingoutforthemountaintohuntandnowyoulongforhorses onthewavelesssand thesethingsneedanoracletotellwhichgodreinsyouinanddrivesyoufromyoursenseschild whathaveidonehowfarhaveibeendrivenfromgoodthoughtsiwascrazyiwascursedbysomepowerpheupheualasn ursecovermyheadagainimashamedofwhativesaidcovermeatearmovesdownfrommyeyeanditembarrassesm eithurtstostraightenourmindanditisterribletobeinsanebesttodiebeforeyoubecomelucidagain illcoveryoubutwhenwilldeathcovermeimoldivelearnedalotmortalsshoulddrinkoffriendshipmoderatelynotfrom th edeepestmarrowofthesoulamindslovecharmsshouldbeeasytoundoorthrustawayortiemoretightlyitisaverydiffic ultweightforonesoultolaborovertwopeopleasiamwrackedbypainforhertoomuchdisciplinecausesmoreharmthan pleasureandwarswithhealthipraisetoomuchlessthannothinginexcessandthewiseagreewithme *** Scene 1 Enter Phaedra and the Nurse; the former is recumbent on a couch while the latter bustles about her with gestures that might be those of a caregiver or a guard. NURSE Ills and hated diseases! What can I do for you? What should I not do? Here is the light, and the bright air; your sick bed is now outside the house. Your every word was to come here, but you will rush back to your bedroom again. You fade quickly. You delight in nothing. You dislike what you have. You love what you don’t. It’s better to be sick than tend the sick – the first is simple. To the second attaches heart’s pain and hand’s work. Every human life is painful. There is no end to toil. Darkness hides behind clouds whatever is dearer than life. We prove unhappy lovers of what shines here for lack of knowledge of another life. There is no proof for things beneath the earth. Only stories sustain us. PHAEDRA Lift my body, straighten my head: the bonds of my limbs are loosened. Take my hands and my pale arms. This hat is too heavy for my head to wear. Take it off, spread my hair over my shoulders. NURSE Courage, child; don’t toss and turn so violently. You will bear your sickness more easily with peace and a noble mind. All mortals suffer. PHAEDRA Aiai. I want to drink pure water from a dewy spring. I want to lie back and rest under the trees in some grassy meadow. NURSE Child, why cry? Don’t say these things near the crowd, hurling words mounted on madness. PHAEDRA Send me to the mountain. I will go to the forest where beast-killing dogs press the spotted deer. Gods! I long to shout to the dogs, to shoot the Thessalian javelin past my blond hair, to hold the barbed dart in my hand. NURSE Why this anxiety, child? What do you care about hunting? Why do you lust for flowing springs? There’s a hill with water just next to the tower; we can get you a drink there. PHAEDRA Artemis, mistress of the salt lake and the course thundering with horse’s hooves: I wish I were on your plains breaking studs! NURSE Why throw these frenzied words about? Just now you were setting out for the mountain to hunt – and now you long for horses on the waveless sand. These things need an oracle to tell which god reins you in and drives you from your senses, child. PHAEDRA What have I done? How far have I been driven from good thoughts? I was crazy, I was cursed by some power. Pheu pheu. Alas. Nurse, cover my head again. I’m ashamed of what I’ve said. Cover me – a tear moves down from my eye and it embarrasses me. It hurts to straighten your mind and it is terrible to be insane. Best to die before you become lucid again. NURSE I’ll cover you. But when will death cover me? I’m old; I’ve learned a lot. Mortals should drink of friendship moderately, not from the deepest marrow of the soul. A mind’s love-charms should be easy to undo, or thrust away, or tie more tightly. It is a very difficult weight for one soul to labor over two people, as I am wracked by pain for her. Too much discipline causes more harm than pleasure and wars with health. I praise “too much” less than “nothing in excess,” and the wise agree with me. ***. (shrink)

This article is a commentary on Alana Jelinek's book, This Is Not Art. It broadly agrees with Jelinek in her diagnosis of the current ills of the artworld, who is to blame for this, and the need for an endogenous value of art. Furthermore, it agrees with her that the value of art lies in its status as a ‘knowledge-forming discipline’. However, it takes issue with the very notion of an ‘avant-garde’ art, with Jelinek's claims concerning truth, and raises questions (...) as to what it is for the discipline of art to be ‘knowledge-forming’. It ends with a sceptical doubt as to whether it is the nature of art to favour politically progressive messages. (shrink)

The current study investigated age differences in the use of attentional deployment, positive reappraisal and suppression while regulating responses to sadness-eliciting content. We also tested to what extent these emotion regulation strategies were useful for each age group in managing response to age-relevant sad information. Forty-two young participants (Mage = 18.5, SE =.15) and 48 older participants (Mage = 71.42, SE = 1.15) watched four sadness-eliciting videos (about death/illness, four to five minutes long) under four conditions—no-regulation (no regulation instructions), attentional (...) deployment (divert attention away), positive reappraisal (focus on positive outcomes) and suppression (conceal emotional expressions). We assessed negative emotional experience, expression, skin conductance level (SCL) and visual fixation duration while participants watched the emotional clips and followed the instructions for each condition. Results suggest that older adults were more successful than younger adults at implementing both attentional deployment and positive reappraisal. Ability to suppress emotions appears to remain stable with age. Within age-group comparisons suggested that for the older adults, positive reappraisal was a more useful emotion regulation strategy than the others, while the pattern among younger adults was less conclusive. Age-relevant differences in motivation and successful emotion regulatory efforts based on theoretical and empirical literatures are discussed. (shrink)

The dominant discourse on dementia promotes a view that as individuals progress with the disease, they experience a neurological decline causing a loss of self. This notion, grounded in a Cartesian representation of selfhood, associates a loss of self as directly related to cognition. This paper presents an alternative anthropological framework, embodied selfhood, that challenges this representation. It then examines a potential tool, graphic medicine, to translate this theory into caregiving practice. Through analyzing three graphic novels—Wrinkles, Tangles, and Aliceheimer’s—this paper (...) demonstrates how tension exists between different conceptions of selfhood and associated implications for caregivers and patients alike. (shrink)

This paper argues that Information Theoretic Redundancy (ITR) is fundamentally a composite concept that has been continually misinterpreted since the very inception of Information Theory. We view ITR as compounded of true redundancy and partial redundancy. This demarcation of true redundancy illustrates a limiting case phenomenon: the underlying metric (number of alternatives) differs only by degree but the properties of this concept differ in kind from those of partial redundancy. Several other studies are instanced which also imply the composite nature (...) of ITR. We thus provide broadly based but particular support for earlier generalized suggestions that it is the underlying calculus of Information Theory rather than the ill-named concepts themselves that provides something of a unitary language for the description of phenomena. (shrink)

In this paper, I offer an argument for cultivating cheerfulness as a remedy to sadness and other emotions, which, in turn, can provide some relief to certain cases of depression. My thesis has two tasks: first, to establish the link between cheerfulness and sadness, and second, to establish the link between sadness and depression. In the course of accomplishing the first task, I show that a remedy of cultivating cheerfulness to counter sadness is supported by philosophers as diverse as Thomas (...) Aquinas, Baruch Spinoza, and David Hume in their writings on the passions. I also show that my argument can generalize to promote the cultivation of other emotions. In the course of accomplishing the second task, I consider different models of depression and how the emotions are related to depression. The purpose of this paper is to offer conceptual, philosophical support that is consistent with the most current empirical data on depression. (shrink)

In “Doing Without Morality” Richard Kraut argues that Aristotle does not work with moral concepts such as moral rightness and duty. One of his arguments is that Aristotle treats wit as a virtue of character but not a moral virtue in Nicomachean Ethics IV.8 and that this treatment should be extended to all the virtues of character. Though sympathetic to his conclusion, I offer three reasons for thinking that wit is ill-suited to play the role in which Kraut casts it: (...) first, what Aristotle says about wit elsewhere in the NE calls its status as a character virtue into question; second, the taxonomy of virtue and vice implicit in NE IV suggests that wit is not a full-fledged character virtue; and third, in Eudemian Ethics III.7 Aristotle holds that wit is not a virtue of character. Along the way I discuss some intriguing complexities in Aristotle’s taxonomy of virtues and vices and suggest that Aristotle has the resources to make a principled distinction between personality and character traits. (shrink)

In “Doing Without Morality” Richard Kraut argues that Aristotle does not work with moral concepts such as moral rightness and duty. One of his arguments is that Aristotle treats wit as a virtue of character but not a moral virtue in Nicomachean Ethics IV.8 and that this treatment should be extended to all the virtues of character. Though sympathetic to his conclusion, I offer three reasons for thinking that wit is ill-suited to play the role in which Kraut casts it: (...) first, what Aristotle says about wit elsewhere in the NE calls its status as a character virtue into question; second, the taxonomy of virtue and vice implicit in NE IV suggests that wit is not a full-fledged character virtue; and third, in Eudemian Ethics III.7 Aristotle holds that wit is not a virtue of character. Along the way I discuss some intriguing complexities in Aristotle’s taxonomy of virtues and vices and suggest that Aristotle has the resources to make a principled distinction between personality and character traits. (shrink)

Schelling has been exploited for a variety of psychoanalytical projects, from Marquard’s revision of Freud, to various readings of Jung, to Žižek’s interpretation of Lacan. What we have not seen is an elaboration of the psycho-therapeutical implications of Schelling’s metaphysics on its own terms. What we find when we read Schelling as metapsychologist is a nonpathologizing theory of dissociation. Like anything that lives, the psyche dissociates for the sake of growth. The law of productive dissociation is the source of psyche’s (...) adaptive power and an explanation of the structure of its illnesses. (shrink)

In the wake of the Stoneman Douglas School shooting, Republican and Democratic leaders—like the American electorate they represent—remain sharply divided in their responses to gun violence. They are united in their condemnation of these mass shootings, but they disagree about whether stricter or looser gun control laws are the answer. Those on the right side of the political aisle suggest that the issue is one of mental illness rather than gun control. Conversely, those who are more liberal or progressive in (...) their political learnings are quick to condemn attempts to reframe the issue of mass shootings as a mental health problem. Both sides are wrong. Mass shootings are indeed partially a mental health problem, albeit one poorly addressed by our current laws and policies. But the solution to mass shootings also needs to consider strategies that may reduce gun violence in general. (shrink)

Critical care is in an emerging crisis of conflict between what individuals expect and the economic burden society and government are prepared to provide. The goal of critical care support is to prevent suffering and premature death by intensive therapy of reversible illnesses within a reasonable timeframe. Recently, it has become apparent that early support in an intensive care environment can improve patient outcomes. However, life support technology has advanced, allowing physicians to prolong life (and postpone death) in circumstances that (...) were not possible in the recent past. This has been recognized by not only the medical community, but also by society at large. One corollary may be that expectations for recovery from critical illness have also become extremely high. In addition, greater numbers of patients are dying in intensive care units after having receiving prolonged durations of life-sustaining therapy. Herein lies the emerging crisis – critical care therapy must be available in a timely fashion for those who require it urgently, yet its provision is largely dependent on a finite availability of both capital and human resources. Physicians are often placed in a troubling conflict of interest by pressures to use health resources prudently while also promoting the equitable and timely access to critical care therapy. In this commentary, these issues are broadly discussed from the perspective of the individual clinician as well as that of society as a whole. The intent is to generate dialogue on the dynamic between individual clinicians navigating the complexities of how and when to use critical care support in the context of end-of-life issues, the increasing demands placed on finite critical care capacity, and the reasonable expectations of society. (shrink)

The Heythrop Journal, Volume 63, Issue 2, Page 315-316, March 2022.

Early in the COVID-19 pandemic there was widespread concern that healthcare systems would be overwhelmed, and specifically, that there would be insufficient critical care capacity in terms of beds, ventilators or staff to care for patients. In the UK, this was avoided by a threefold approach involving widespread, rapid expansion of critical care capacity, reduction of healthcare demand from non-COVID-19 sources by temporarily pausing much of normal healthcare delivery, and by governmental and societal responses that reduced demand through national lockdown. (...) Despite high-level documents designed to help manage limited critical care capacity, none provided sufficient operational direction to enable use at the bedside in situations requiring triage. We present and describe the development of a structured process for fair allocation of critical care resources in the setting of insufficient capacity. The document combines a wide variety of factors known to impact on outcome from critical illness, integrated with broad-based clinical judgement to enable structured, explicit, transparent decision-making founded on robust ethical principles. It aims to improve communication and allocate resources fairly, while avoiding triage decisions based on a single disease, comorbidity, patient age or degree of frailty. It is designed to support and document decision-making. The document has not been needed to date, nor adopted as hospital policy. However, as the pandemic evolves, the resumption of necessary non-COVID-19 healthcare and economic activity mean capacity issues and the potential need for triage may yet return. The document is presented as a starting point for stakeholder feedback and discussion. (shrink)

We are printing, by kind permission of the Law Commission, two sections of the report of the Law Commission on injuries to unborn children. This report was the result of a request to the Law Commission by the Lord Chancellor at the time (Lord Hailsham of Saint Marylebone) to advise on `what the nature and extent of civil liability for antenatal injury should be'. The Law Commission followed its usual practice in such circumstances of consulting various bodies and obtaining expert (...) advice on the subject and then embodying the results in a working paper (Working Paper No. 47 - injuries to unborn children) published on 19 January 1973, which preceded their report (Cmnd 5709). Meanwhile a Royal Commission is considering much wider issues of civil liability for injury (including antenatal injury) but the terms of reference for the Law Commission were much narrower and confined to the position of children injured before birth. In the section relating to the present law the report makes it clear that it is probable that liability under the common law already exists. The Scottish Law Commission has also issued a report (Cmnd 5371). They were given different terms of reference and came to somewhat different conclusions. We are printing from this long report the paragraphs discussing the medical background and the summary of recommendations. As will be evident on reading the paragraphs on the medical background to injuries to the unborn child, events are moving very rapidly, particularly in the study of congenital defects and the effects of drugs but the problems of proof present great difficulty. Other causes of injury to the unborn child are better known to the general public: for example, those following the illness, infection and disease of the mother during pregnancy, injury caused in attempted termination of pregnancy and the risks resulting from the mother's condition. The summary of the recommendations sets out very clearly the legal position of the unborn child, as the Law Commission sees it, arising from injury before birth, the final conclusion being that `legislation is desirable'. These extracts from the report, apart from their intrinsic interest, lead on to the paper by Mr Kennedy and Dr Edwards in which they set out their criticisms of it, and provide quick references to the original document. (shrink)

We read with interest the extended essay published from Riisfeldt and are encouraged by an empirical ethics article which attempts to ground theory and its claims in the real world. However, such attempts also have real-world consequences. We are concerned to read the paper’s conclusion that clinical evidence weakens the distinction between euthanasia and normal palliative care prescribing. This is important. Globally, the most significant barrier to adequate symptom control in people with life-limiting illness is poor access to opioid analgesia. (...) Opiophobia makes clinicians reluctant to prescribe and their patients reluctant to take opioids that might provide significant improvements in quality of life. We argue that the evidence base for the safety of opioid prescribing is broader than that presented, restricting the search to palliative care literature produces significant bias as safety experience and literature for opioids and sedatives exists in many fields. This is not acknowledged in the synthesis presented. By considering additional evidence, we reject the need for agnosticism and reaffirm that palliative opioid prescribing is safe. Second, palliative sedation in a clinical context is a poorly defined concept covering multiple interventions and treatment intentions. We detail these and show that continuous deep palliative sedation is a specific practice that remains controversial globally and is not considered routine practice. Rejecting agnosticism towards opioids and excluding CDPS from the definition of routine care allows the rejection of Riisfeldt’s headline conclusion. On these grounds, we reaffirm the important distinction between palliative care prescribing and euthanasia in practice. (shrink)

The U.S. National Institute of Allergies and Infectious Diseases and the National Institute of Mental Health have a new research priority: inclusion of terminally ill persons living with HIV in HIV cure-related research. For example, the Last Gift is a clinical research study at the University of California San Diego for PLWHIV who have a terminal illness, with a prognosis of less than 6 months. As end-of-life HIV cure research is relatively new, the scientific community has a timely opportunity to (...) examine the related ethical challenges. Following an extensive review of the EOL and HIV cure research ethics literature, combined with deliberation from various stakeholders and our experience with the Last Gift study to date, we outline considerations to ensure that such research with terminally ill PLWHIV remains ethical, focusing on five topics: 1) protecting autonomy through informed consent, 2) avoiding exploitation and fostering altruism, 3) maintaining a favorable benefits/risks balance, 4) safeguarding against vulnerability through patient-participant centeredness, and 5) ensuring the acceptance of next-of-kin/loved ones and community stakeholders. EOL HIV cure-related research can be performed ethically and effectively by anticipating key issues that may arise. While not unique to the fields of EOL or HIV cure-related research, the considerations highlighted can help us support a new research approach. We must honor the lives of PLWHIV whose involvement in research can provide the knowledge needed to achieve the dream of making HIV infection curable. (shrink)

. Early microbiome research found numerous associations between microbial community patterns and host physiological states. These findings hinted at community-level explanations. “Top-down” experiments, working with whole communities, strengthened these explanatory expectations. Now, “bottom-up” mechanism-seeking approaches are dissecting communities to focus on specific microbes carrying out particular biochemical activities. To understand the interplay between methodological and explanatory scales, we examine claims of “dysbiosis,” when host illness is proposed as the consequence of a community state. Our analysis concludes with general observations about (...) how methodologies relate to explanations, and the implications for microbiome research. (shrink)

The allocation of any scarce health care resource, especially a lifesaving resource, can create profound ethical and legal challenges. Liver transplant allocation currently is based upon urgency, a sickest-first approach, and does not utilize capacity to benefit. While urgency can be described reasonably well with the MELD system, benefit encompasses multiple dimensions of patients’ well-being. Currently, the balance between both principles is ill-defined. This survey with 502 participants examines how urgency and benefit are weighted by different stakeholders. Liver transplant patients (...) favored the sickest-first allocation, although all other groups tended to favor benefit. Criteria of a successful transplantation were a minimum survival of at least 1 year and recovery of functional status to being ambulatory and capable of all self-care. An individual delisting decision was accepted when the 1-year survival probability would fall below 50%. Benefit was found to be a critical variable that may also trigger the willingness to donate organs. The strong interest of stakeholder for successful liver transplants is inadequately translated into current allocation rules. (shrink)

Background The allocation of any scarce health care resource, especially a lifesaving resource, can create profound ethical and legal challenges. Liver transplant allocation currently is based upon urgency, a sickest-first approach, and does not utilize capacity to benefit. While urgency can be described reasonably well with the MELD system, benefit encompasses multiple dimensions of patients’ well-being. Currently, the balance between both principles is ill-defined. Methods This survey with 502 participants examines how urgency and benefit are weighted by different stakeholders. Results (...) Liver transplant patients favored the sickest-first allocation, although all other groups tended to favor benefit. Criteria of a successful transplantation were a minimum survival of at least 1 year and recovery of functional status to being ambulatory and capable of all self-care. An individual delisting decision was accepted when the 1-year survival probability would fall below 50%. Benefit was found to be a critical variable that may also trigger the willingness to donate organs. Conclusions The strong interest of stakeholder for successful liver transplants is inadequately translated into current allocation rules. (shrink)

Moral imagination is a central component of moral agency and person‐centred care. Becoming moral agents who can sustain attention on patients and their families through their illness and suffering involves imagining the other, what moral possibilities are available, what choices to make, and how one wants to be. This relationship between moral agency, moral imagination, and personhood can be effaced by a focus on task‐driven technical rationality within the multifaceted challenges of contemporary healthcare. Similarly, facilitating students' moral agency can also (...) be obscured by the task‐driven technical rationality of teaching. The development of moral agency requires deliberate attention across the trajectory of nursing education. To prepare nursing students for one practice challenge, workplace violence, we developed a multimodal education intervention which included a simulated learning experience (SLE). To enhance the realism and consistency of the educational experience, 11 nursing students were trained as simulated participants (SP). As part of a larger study to examine knowledge acquisition and practice confidence of learners who completed the SLE, we explored the experience of being the SP through interviews and a focus group with the SP students. The SP described how their multiple performances contributed to imagining the situation ‘on both sides’ prompting empathy, a reconsideration of their moral agency, and the potential to prevent violence in the workplace beyond technical rational techniques, such as verbal de‐escalation scripts. The empirical findings from the SP prompted a philosophical exploration into moral imagination. We summarise the multimodal educational intervention and relevant findings, and then, using Johnson's conception of moral imagination and relevant nursing literature, we discuss the significance of the SP embodied experiences and their professional formation. We suggest that SLEs offer a unique avenue to create pedagogical spaces which promote moral imagination, thereby teaching for moral agency and person‐centred care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Guibert of Tournai's Letter to Lady Isabelle:An Introduction and English TranslationLarry F. Field, Jacques Dalarun, Sean L. Field, and Guibert of TournaiIntroductionGuibert, from the noble family of As-Piès, was born near Tournai around 1200. From his hometown he traveled to Paris for his art degree, and completed the curriculum in theology there before entering the Franciscan Order around 1240. He may have participated in Louis IX's crusade of (...) 1248, but, if so, was surely back in Paris by 1254 at the latest, since he preached a cycle of sermons de dominicis et de sanctis to the university community before summer 1255.1 His regency as Franciscan master of theology at Paris was probably around 1259–1261,2 about the time he [End Page 31] completed his Eruditio regum et principum for Louis IX,3 and began his most substantial work, the Erudimentum doctrinae.4 Other significant treatises include his De pace et animi tranquillitate (ca. 1275)5 written for Marie de Dampierre, and the Collectio de scandalis ecclesiae, prepared for the Second Council of Lyon.6 Guibert died in Tournai on 7 October 1284.7Sometime around 1254, Guibert wrote a long letter of spiritual advice to Isabelle (1225–70), the sister of King Louis IX.8 Isabelle was herself a remarkable figure. She had rejected several proposals of marriage, including that with Conrad, the heir to Emperor Frederick II, in 1243, in spite of pressure from her family and Pope Innocent IV. But following a bout of serious illness at about that time,9 her family accepted her [End Page 32] decision to remain unwed. There is no evidence, however, that Isabelle ever pronounced a formal vow of virginity. Through the 1250s she simply remained at the Capetian court as a virgin princess with an increasing reputation for piety and indeed holiness, praised in lavish terms by Innocent IV in 1253 and Alexander IV in 1256.10 This piety took a distinctly Franciscan turn by 1254, when Pope Innocent IV granted her request for Franciscan confessors,11 which would ultimately result in her foundation of Longchamp, a house of Sorores minores just west of Paris, by 1260.12 Guibert's letter shows no awareness of such a project, indicating that it must have been written before spring 1255, by which time the land for Longchamp was being purchased on Isabelle's behalf.13 Guibert thus wrote at the moment when Isabelle was forming her first ties to the Franciscans, but well before her move to Longchamp, where she lived out the 1260s as resident lay patron (but never a nun).Guibert's Letter is really a short treatise of spiritual and moral advice, tailored to a celibate princess. It is organized around Psalm 44:14–15, All the glory of the king's daughter is within in golden fringes, clothed around with varieties. In a five-part structure, the king's daughter stands for a heavenly inheritance; glory within represents internal purity; gold indicates virginity; the fringes are a sign of humility; and clothed around with varieties points to honest comportment. The resulting "royal garment," however, is rather unequally woven together, with section one on the "heavenly inheritance" and the intertwined sections three and four on virginity and humility receiving by far the most space. In fact, section one forms a sort of treatise-within-a-treatise, organized as a ten-step ascent to the heavenly inheritance awaiting the daughter of the king. [End Page 33]The Letter to Lady Isabelle was first edited by Alphonse de Poorter in 1931, from a manuscript which contained only part of the text.14 The full text was brought into print by Sean Field in 2003,15 and translated into French by Jacques Dalarun in 2014.16 Yet in spite of these advances, the Letter has remained little noticed by scholars. Anne-Hélène Allirot offered several perceptive pages in 2010, stressing the way Guibert's treatment of hereditas implies that female members of the royal family might be particularly able to embody Capetian claims to holiness.17 That same year, in the only recent article dedicated specifically to this Letter, Rina Lahav... (shrink)

It is commonplace in discussions of modern cosmology to assert that the early universe began in a special state. Conventionally, cosmologists characterize this fine-tuning in terms of the horizon and flatness problems. I argue that the fine-tuning is real, but these problems aren't the best way to think about it: causal disconnection of separated regions isn't the real problem, and flatness isn't a problem at all. Fine-tuning is better understood in terms of a measure on the space of trajectories: given (...) reasonable conditions in the late universe, the fraction of cosmological histories that were smooth at early times is incredibly tiny. This discussion helps clarify what is required by a complete theory of cosmological initial conditions. (shrink)