A critique of the principle of ‘respect for autonomy’, grounded in African thought

I give an account how the principle of ‘respect for autonomy’ dominates the field of bioethics, and how it came to triumph over its competitors, ‘respect for persons’ and ‘respect for free power of choice’. I argue that ‘respect for autonomy’ is unsatisfactory as a basic principle of bioethics because it is grounded in too individualistic a worldview, citing concerns of African theorists and other communitarians who claim that the principle fails to acknowledge the fundamental importance of understanding persons within the nexus of their communal relationships. I defend the claim that ‘respect for persons’ is a more appropriate principle, as it is able to acknowledge both individual decision making and the essential relationality of persons. I acknowledge that my preference for ‘respect for persons’ is problematic because of the important debate around the definition of ‘personhood’ in bioethics discourse. Relying on Thaddeus Metz's conception of moral status, I propose a relational definition of personhood that distinguishes between persons with agency and persons without agency, arguing that we have different moral obligations to these distinct categories of persons. I claim that this conception of personhood is better able to accommodate our moral intuitions than conventional approaches, and that it is able to do so without being speciesist or question‐begging.     

Precarious Subjects: Anticipating Neoliberalism in Northern Italy's Workplace

ABSTRACT  In Italy, the term precarizzazione (precarious-ization) refers to the process of implementing neoliberal policies to transition toward a semipermanent and privatized labor regime but also to the normalization of psychic uncertainty and hypervigilance of worker-citizens. In this article, I examine "precarious workers" and a psychological harassment called "mobbing," specifically, and suggest that these practices of labor exclusion of a transitional work regime produce emergent subjectivities through an analytics of anticipation. I illustrate the social, political, and psychic effects of imagining neoliberalism, as Italians do in this context, not as complete but, rather, as a metadiscursive object of emotionally charged apprehension and anticipation.     

The centre cannot hold: tales of hierarchy and poetic composition from modern Rajasthan

In this article I examine Bhat myths and legends concerning kings and bards. Bhats are low-status praise-singers from the Indian state of Rajasthan. In exploring these tales, I examine my informants' ideas about an issue which has long been seen as a central conundrum of Indian caste theory: how best to characterize the status of those with priestly standing in relation to those classed as warriors and kings. In their stories, Bhats demonstrate the ways in which high-caste persons such as kings are utterly dependent on bardic services – thus rendering performers like themselves central, and kings peripheral. With respect to the debate about whether kings or priests rank first in South Asian schemes of rank and primacy, Bhats themselves think in terms of a third class of persons: bards. Further, I suggest that, in arguing for the social centrality of linguistically talented bards, my informants display a consciousness that is particularly attuned to the discursive construction of social hierarchies. Finally, I seek to explain why Bhats, who are bards of former untouchables now living in an ostensibly modern, casteless democracy, still speak so persistently of kings and royal bardship. My answer to this is that, in fabricating fictive royal bardic identities, present-day Bhats are able to appropriate roles and statuses now abandoned by the former elite bards of post-Independence Rajasthan.     

In the matter of Stephen Dawson: right v. duty of health care.

In cases like that of Stephen Dawson the ethics of proxy decision-making are at stake. As long as patients are persons they have rights, the incompetent ones no less than those who are competent. The only difference is that in the case of incompetent persons the rights must be exercised by proxy. The import of the Stephen Dawson case is that by this precedent Canadian law now radically alters the status of incompetent minors in such a way that their rights are curtailed in two fundamental ways. First, the parameter of qualitative considerations that is available to any other person is removed from the armory of the decision-making criteria of incompetent minors and can no longer be employed by the proxy decision-makers. Second, what are rights in the case of competent individuals--the right to life and the right to health care--become duties. Ethically this dénouement is deplorable. The medical profession now not only faces the pragmatically unenviable task of having to save or sustain all incompetent minors so long as medical science will permit but will have to do so even at the cost of quality of life. I shall pass over in silence the ethics of the resource-allocation problem that now arises. As a medical ethicist I can only hope that the medical profession will soon see fit to challenge this decision on a formal basis.     

The significance of unrecognized feedback stimuli in cognitive activity

In adult emotionally excitable persons the role was studied of unrecognized reinforcement forms in the function of differentiation of time microintervals. As feedback stimuli the word "good" (positive reinforcement) and a word connected with negative emotions of the subject (negative reinforcement) were applied. Experimental confirmation was obtained of the hypothesis that unrecognized phenomena of environment can influence conscious psychic activity, the process of man learning. Unrecognized semantic stimuli can function as a reinforcing factor and in this way participate in the process of learning of cognitive activity realized at conscious level.     

The continuous and discontinuous person: two dimensions of ethical life

Whereas early liberal thinkers developed the concept of the ethically accountable continuous forensic modern European person in contrast to what they saw as the discontinuous and hence unaccountable mimetic person, I argue that forensic and mimetic are better understood both as ideologies of personhood and as dimensions of all persons rather than as fully distinctive kinds of persons. I present an account of persons as accountable for their acts but show that this is not limited to the maximally continuous and autonomous person of liberal ideology. I review other forms of personhood encountered cross‐culturally and suggest that the mimetic dimension offsets some of the problems inherent in an exclusively forensic model.     

A second life in science--working after the age of 65

I was born in January, 1921 and was fortunate in working for a research organization that had no fixed retirement age. I was permitted to continue Science as long as there were some resources to support research that had some relevance to the organization's goals. A number of projects on which I worked were continuations of ones begun before the age of 65 (1986) and several new ones were based on both previous interests and ideas and some on new ideas. A number of the ideas arose from participation on Committees of the US National Research Council. I was able to extend my earlier interests in DNA repair to include experiments on the variations in DNA repair among apparently normal humans. In collaborations with other researchers we showed that the repair abilities following exposures to chemicals or to ionizing or ultraviolet (UV) radiation did not follow Poisson distributions. I participated in experiments, using a fish model to estimate the wavelength ranges in sunlight responsible for inducing melanoma and another fish model to estimate the germ cell mutations that might arise from exposures to the heavily ionizing particles in cosmic rays beyond low Earth orbit. A transgenic fish model was used to investigate the possibilities of using the fish to assay for mutagens in sediments in Long Island Sound. These Reflections summarize the atmosphere necessary for a second life and the scientific results of this life.     

Metabolic changes in blood in pulmonary tuberculosis patients from various blood groups

285 Patients suffering from the respiratory tract organs primary tuberculosis were subjected to the tests on definition of blood groups according to AB0 system, as well as its total proteolytic activity, alpha 1-antitrypsin, ceruloplasmin, general haptoglobin, lysozyme, malonic dialdehyde and diene conjugates levels were estimated. The sick persons as compared with the healthy ones were defined to reveal a tendency to increase of the persons with 0(I)- and B(III)-blood groups and decrease of those ones with A(II)-groups. Independently on the pulmonary tuberculosis patients phenotypic index their tested blood biochemical indices levels increase. As an exception is the proteolytic activity of the persons with B(III)- blood group, and also alpha 1-antitrypsin and lysozyme--with 0(I) and AB(IV) groups, in this case their rates failed to exceed the norm confidential interval. The blood metabolic parameters were defined as independent on its group.     

Ecological cultivation ark (ECA) project--mutation and evolution of micro-organisms in space.

Ecological cultivation capsules (ECC), that is a materially sealed microcosm. composed of primary producers, consumers and bacteria as a decomposer were developed in order to cultivate bacteria without any artificial operation for long duration more than 10 years in space. It is planned to be left on the space station to study the process that bacteria in MIR space station had acquired their resistance to cosmic ray radiation as well as ultra-violet light. As contrasted with the space experiment, bacteria are cultivating in the ECC on the ground to trace the changes of bacteria under the simulated radiation dose in Earth orbit.     

The human body response to factors related to solar activity variations

The effect of nonstationary solar processes on human organism was studied. Daily measurements of electrical conductivity of 22 biologically active points on human skin, arterial pressure, and pulse frequency of 30 persons were performed, and their subjective sensations were registered. A comparative analysis of the data and variations in environment parameters, such as local A-index, atmospheric pressure, temperature, and indices of cosmic rays indicated a coincidence of their main periods. The conclusion is made that the reaction of the human organism on abrupt solar disturbances is biphasic and that there is a semiannual wave of synchronization of work of internal organs. The results are confirmed by simultaneous measurements in different cities.     

Justice for children: the child as organ donor

I argue that parents ought to be allowed to authorize their child's participation as an organ donor for another family member. I introduce a model of decisionmaking for children in intimate families which I call Constrained Parental Autonomy. This model permits wide parental discretion which is constrained absolutely by a broadly defined principle of respect for persons. In general, parental authorization alone is sufficient but I argue that the respect for persons constraint prevents certain donations and requires the child's assent for other donations. I also consider two controversial implications of the application of this model: the objection that the model does not respect the child's right to bodily integrity, and the objection that the model does not and is unable to address intrafamilial disgreement.     

Biological and psychological rhythms: An integrative approach to rhythm disturbances in autistic disorder

Biological rhythms are crucial phenomena that are perfect examples of the adaptation of organisms to their environment. A considerable amount of work has described different types of biological rhythms (from circadian to ultradian), individual differences in their patterns and the complexity of their regulation. In particular, the regulation and maturation of the sleep–wake cycle have been thoroughly studied. Its desynchronization, both endogenous and exogenous, is now well understood, as are its consequences for cognitive impairments and health problems. From a completely different perspective, psychoanalysts have shown a growing interest in the rhythms of psychic life. This interest extends beyond the original focus of psychoanalysis on dreams and the sleep–wake cycle, incorporating central theoretical and practical psychoanalytic issues related to the core functioning of the psychic life: the rhythmic structures of drive dynamics, intersubjective developmental processes and psychic containment functions. Psychopathological and biological approaches to the study of infantile autism reveal the importance of specific biological and psychological rhythmic disturbances in this disorder. Considering data and hypotheses from both perspectives, this paper proposes an integrative approach to the study of these rhythmic disturbances and offers an etiopathogenic hypothesis based on this integrative approach.     

Sciences of appetite in the Enlightenment, 1750-1800

Advice about diet has been an important part of Western medicine from its inception. Although based partly on the presumed qualities and effects of foodstuffs, such advice rested chiefly on the constitution and circumstances of individual patients, including their unique appetites and eating habits. In the eighteenth century the nature of appetite itself came to be a subject of growing interest in the sciences, especially in medicine, natural history, and physiology. Within these sciences attention to the eating proclivities of individuals began to be displaced by interest in uniform processes of ingestion and digestion. In turn dietary advice came increasingly to rely on general standards of health and the digestibility of foodstuffs. Central to the promotion of uniform standards was the increasing credence given to experimental procedures that claimed to offer new certainties about the digestive process. As experimental science took hold, appetite, long regarded as a perplexing blend of psychic and somatic elements, assumed subordinate status as an object of inquiry to phenomena thought readily susceptible to laboratory manipulation. These eighteenth-century developments stand at the origin of the modern nutritional science that denigrates individual appetites in favor of universal rules of 'healthy eating.'     

Statement on Cancer Cures by the Cancer Commission of the C.M.A

In recent months there has been a recrudescence in the daily press of claims for certain alleged cancer cures. Most of these receive the scant attention which they deserve and are soon forgotten. A few receive sensational publicity and are a source of considerable distress, both psychic and economic, to patients with cancer. In order to bring up to date the opinion of the Cancer Commission on this general question, it was resolved at the regular meeting of the Commission held in Los Angeles, May 1951, that a suitable statement bearing on this subject be prepared and issued to the press or to interested persons. The following is the statement as approved by the Commission:     

The Politics and Regulation of Anger in Urban China

Negative emotions such as anger, and community responses to their expression are culturally and politically conditioned, including by dominant medical discourse on anger’s somatic and psychic effects. In this article I examine local genres of anger expression in Beijing, China, particularly among marginalized workers, and address culturally specific responses to them. Through majie (rant), xiangpi ren (silenced rage), and nande hutu (muddledness as a more difficult kind of smartness), workers strategically employ anger to seek redress for injustices and legitimate their moral indignation while challenging official psychotherapeutic interventions. Those who seek to regulate anger, mostly psychosocial workers acting as arm’s-length agents of the state, use mixed methods that draw on Western psychotherapy and indigenous psychological resources to frame, medicalize or appease workers’ anger in the name of health and social stability. I demonstrate how the two processes—anger expression and responses to it—create tensions and result in an ambiguous and multivalent social terrain which Chinese subjects must negotiate and which the state attempts to govern. I argue that the ambivalence and multi-valence of anger expressions and state-sponsored reactions to them render this emotion both subversive vis-à-vis power and subject to manipulations that maintain social order.     

The dialogical collective: mediumship,pain, and the interactive creation of Ndyuka Maroon subjectivity

This article explores how pain ritually assists in producing Afro‐Surinamese Ndyuka Maroon understandings of subjectivity and the self. Ndyuka discourses conceive persons as composites of multiple human and spirit others. I describe how these discourses emerge dialogically during oracular interactions between possessed mediums and their patients. Beginning as inarticulate sensations, personal pain is ritually transformed into identifiable spirits who expose their hosts as embodiments of past and present social relations. Over the course of oracular interactions, the qualities of physical pain are made to communicate that the pain is both an identity and a vital part of the sufferers’ embodied self. In parallel to this process, spirit mediums perform pain in possession to establish the origins of their authority in relations with spirits. Ritually transforming pain into identities of relation, Ndyuka oracular mediumship persuades patients to re‐evaluate their subjective experiences as innate evidence of Ndyuka social ideology.     

L'adolescence: une épreuve psychique particulière

The problematics of adolescence brings into play, through what we have termed the body circle, the family circle, and the social circle, a series of paradoxes conflicts/oppoisitions, where each time a conquest is possible but where also there is potential risk. This permanent conflictuality, is characteristic of adolescence. confronted with this conflictuality, the capacity to assume the psychic conflict is therefore an essential factor in the development of the adolescent. From this point of view, cathexis of the internal psychic space is an essential element of an adolescent's capacity to deal with this psychic working-through. It is this cathexis that allows a reinforcement of the internal working-through and a better tolerance to expectation and psychic conflictuality. On the other hand, anything that runs in the sence of a diminution of this psychic functioning: projection, acting out, etc … reduces the adolescent's capacities of adaptation with regard to his internal psychic world as well his environment.     

Sick Again,Well Again: Sorcery,Christianity and Kinship in Northern Aboriginal Australia

This article concerns the ways in which Yolngu people of the Galiwin'ku settlement in northern Australia employ contemporary constructions of sorcery doctrines and Christian practices to rearticulate their kinship relations. In particular, I discuss the adaptation of sorcery ideas and accusations to present-day circumstances and the Christian healing processes that have emerged alongside traditional healing behaviours and biomedicine. Sorcery and Christianity at Galiwin'ku, I argue, are intertwined ethical models that enable the person and community to heal over and over again in accordance with the vicissitudes of postcolonial life. They continue the moral imperative of ‘looking after’ kin even as the net of ‘looking after’ has expanded to encompass new experiences, behaviours, and persons.     

Declarations of dependence: labour,personhood, and welfare in southern Africa

Dependence on others has often figured, in liberal thought, as the opposite of freedom. But the political anthropology of southern Africa has long recognized relations of social dependence as the very foundation of polities and persons alike. Reflecting on a long regional history of dependence ‘as a mode of action’ allows a new perspective on certain contemporary practices that appear to what we may call ‘the emancipatory liberal mind’ simply as lamentable manifestations of a reactionary and retrograde yearning for paternalism and inequality. Instead, this article argues that such practices are an entirely contemporary response to the historically novel emergence of a social world where people, long understood (under both pre‐capitalist and early capitalist social systems) as scarce and valuable, have instead become seen as lacking value, and in surplus. Implications are drawn for contemporary politics and policy, in a world where both labour and forms of social membership based upon it are of diminishing value, and where social assistance and the various cash transfers associated with it are of increasing significance.