bluuebunny/crossref_metadata_2025 huggingface dataset:
When a Dopamine Agonist Is the First and Primary Drug: Early Problems
Authors: Ahlskog J Eric
Published: November 2023

With dopamine agonist monotherapy (pramipexole, ropinirole, or rotigotine), the problems that surface often differ from those encountered with carbidopa/levodopa as the initial drug. This chapter focuses on situations that may arise when an agonist is the initial and primary therapy for PD.
Orthostatic Hypotension and Other Causes of Dizziness
Authors: Ahlskog J Eric
Published: November 2023

Patients use the word “dizziness” to mean one of four distinct medical conditions: Seniors, and especially seniors with PD, frequently experience more than one type of dizziness. In fact, it is common for PD patients to experience all of the first three forms listed above. This makes the history-taking both challenging and crucial; mistaking one form of dizziness for another will translate into inappropriate treatment.
Dementia
Authors: Ahlskog J Eric
Published: November 2023

Dementia can be a substantial problem in Parkinson’s disease (PD), although many are spared. The prevalence of dementia in clinical series generally ranges from one-quarter to a third of all PD patients. It is age-related, and after age 85, the dementia risk has been estimated at over 65 percent. Even in early PD, subtle evidence of cognitive dysfunction has been documented in about a quarter of patients, affecting memory, executive function, or psychomotor speed.
Dysphagia, Drooling, and Dysarthria
Authors: Ahlskog J Eric
Published: November 2023

The dysphagia of Parkinson’s disease (PD) is primarily a problem of swallowing initiation, that is, dysfunction of the oropharyngeal motor apparatus. In PD, it is rarely a severe problem and common dysphagic complaints may include relatively minor problems such as difficulty swallowing pills or slowed eating and drinking. Thus, it is the very exceptional PD patient who requires a feeding gastrostomy and even then, only after many years of progressive PD.
Other Common Problems: Edema, Rashes, and Visual Symptoms
Authors: Ahlskog J Eric
Published: November 2023

Since the mean age of Parkinson’s disease (PD) onset is in the seventh decade, the typical medical issues of seniors often overlap with those of PD. Although most are beyond the scope of this book, a few common medical problems uniquely associated with PD deserve discussion.
The Tree Of Life:Stephen Jay Gould’S Contributions To Systematics
Authors: Yacobucci Margaret M
Published: November 2023

All of the varied subjects that Steve Gould took up during his career fall into a few coherent and interrelated themes (see fig. 13.1). Steve challenged us to see beyond the conventional view of evolution as gradual, predictable progress in a world governed entirely by selective forces. Instead, he emphasized the roles of constraint and contingency—those unique circumstances and historical moments that shape and limit the evolutionary patterns we observe. Steve advanced his view of evolution as a hierarchy of individuals and agents operating at different taxonomic, spatial, and temporal scales as a way to expand our understanding of the causes of evolution. This chapter illustrates some of the ways in which Steve’s research and writing on systematics reflect these fundamental agendas. I focus on four topics: the iconography of evolutionary trees, Steve’s own systematic work on the Caribbean land snail Cerion, his complex views on the systematic approach of cladistics, and the reality of species as evolutionary entities.
Genetics and Development:Good as Gould
Authors: Dorit Robert L
Published: November 2023

Steve Gould frequently reminded all of us of just how uninteresting hagiography was as history of science. He would justly rail against “Whig history”—the tendency to look back from our present vantage point and pass judgment on predecessors based on how close they had come to getting it right (right, of course, meaning “as we understand it today”). Steve wouldn’t let us forget that scientists and their work need to be judged in their proper historical and intellectual context. He would also insist that the trajectory of science was influenced more than imagined by factors outside of objective dispassionate inquiry: the warts and blemishes of the profession and its practitioners matter too.
General Appearance, Skin, and Lymph Nodes
Authors: Barness Lewis A , Gilbert-Barness Enid , Fauber Dean
Published: November 2023

The General Appearance of a child may reveal much more than subtle physical findings. On first seeing the child, sit down and slowly observe the child. Does the child look well or ill? Does the child appear comfortable or uncomfortable, and if uncomfortable, in what way? Is the breathing easy or difficult? Is the child in any type of physical or emotional distress? Is the child’s appearance alert or lethargic? Is the child clean or dirty? Is the child’s attitude cooperative or belligerent? Does the child have any gross abnormalities or anomalies? Is the child fat or thin or tall or short? Does the child appear to be malnourished? Is the child apprehensive and, if so, is the apprehension due to new surroundings, to the parents, to the examiner, or to the disease? Is the child interested in the new instruments presented by the physician? Does the child obey the parent and the physician or fight them? If the child obeys, is the obedience due to fear? Is the child excited or calm? Does the child twitch and fidget? In essence, is the child similar to peers or different from them, and if different, in what way?
Nutrition
Authors: Barness Lewis A , Gilbert-Barness Enid , Fauber Dean
Published: November 2023

The Mission OF this text is to describe techniques of the physical examination and the ability of the physical exam to provide accurate diagnoses. The emphasis of this chapter is more to highlight common nutrition-related states. This chapter is not intended to be a comprehensive review of childhood nutrition. This is covered more extensively in the usual pediatric textbooks and publications from the American Academy of Pediatrics (Website www.aap.org). The appendix contains various growth charts. An individual patient’s growth chart in a gross manner may either suggest a healthy nutritional status or a possible nutritional disorder (Table 4.1).
Heart
Authors: Barness Lewis A , Gilbert-Barness Enid , Fauber Dean
Published: November 2023

The normal systolic blood pressure of an infant is between 60 and 80 mmHg in both the arm and the leg. The four methods of measuring blood pressure are (1) auscultatory, (2) palpatory, (3) visual (flush), and (4) Doppler. Certain basic information must be part of every examination of the heart: rate, rhythm, size, shape, quality of sounds, murmurs and thrills, femoral pulses, and blood pressure (Table 9.1). In the routine examination of the heart, it is advantageous to evaluate the patient in several different positions if possible.
Infections
Authors: Barness Lewis A , Gilbert-Barness Enid , Fauber Dean
Published: November 2023

Botulism Clostridium botulinum causes neurotoxin production (A, B, E, and F). Its spores are ingested from contaminated food products. Infection is acquired from honey (if < 1 year old), canned foods, and corn syrup. Clinical manifestations include weak cry, respiratory failure, constipation, hypotonia, poor feeding, and decreased gag reflex. Laboratory diagnosis is based on stool culture and on toxin detection in stool. Treatment includes botulism immune globulin intravenous and avoidance of antibiotics.
Child Abuse
Authors: Barness Lewis A , Gilbert-Barness Enid , Fauber Dean
Published: November 2023

Head injuries are the number one cause of morbidity and mortality from child abuse. Soft tissue injuries include a torn oral frenulum, periorbital ecchymoses, traumatic alopecia, and subgaleal hematoma. Simple linear skull fractures are the most common type of skull fractures but are nonspecific for abuse. On the other hand, comminuted, depressed, stellate, diastatic, multiple, bilateral, or nonparietal skull fractures are more suspicious for abuse. Subdural, subarachnoid, and retinal hemorrhages are intracranial hemorrhages uncommonly seen with accidental injury but commonly seen with inflicted injury. Subdural and retinal hemorrhages require significant force, comparable to that experienced in motor vehicle accidents or falls from a significant height.
A Bridge Over Troubled Water, 1968–1971
Authors: Smith Chris
Published: November 2023

Music in 1960s’ America will forever be linked with the hippie phenomenon that spilled out of San Francisco and onto the world stage between 1965 and 1970—even the term ‘‘the sixties’’ reflects less the actual calendar decade and more the peace-and-love movement it is known for. The Human Be-In and the Monterey Pop Festival of 1967 brought about a rash of concert festivals through the remainder of the decade, as amplification technology allowed large crowds to gather for performances, creating a communal atmosphere most famously exemplified by the Woodstock Music and Art Fair in upstate New York in 1969.
Take it to the Limit, 1972–1976
Authors: Smith Chris
Published: November 2023

In July, 1972, the rock musical Hair closed on Broadway after 1,741 performances that made it one of the most successful productions in Broadway history. Hair was the first rock musical, spawning numerous imitators and cultural battles straight out of the 1960s hippie songbook. By the time the play closed, the good vibes of 1967 San Francisco seemed like a distant memory as harder drugs, skyrocketing divorce rates, and the distancing of rock stars from their audiences brought about a schizophrenic battle between the intimate and the universal in American music. The former found a home in the massive popularity of sensitive singer-songwriters such as James Taylor, Carly Simon, and Joni Mitchell, while the latter was represented by an L. A. Memorial Coliseum concert in November 1972 (ushering in the age of stadium rock) and the Watkins Glen, New York concert in July 1973, which set records with 600,000 fans in attendance.
Welcome to the Jungle, 1986–1990
Authors: Smith Chris
Published: November 2023

By the mid-1980s, the album format was pushing forty, rock and roll began graying around the temples, and music journalism had graduated college and was finally moving out of its parents’ basement. American popular music that had been centered around the LP had matured to the point that it seemed to serve largely as a reflection of its own past—much of what was hailed as new was actually a rediscovery of what had been forgotten or had gone unappreciated for too long. Jazz had long since loosed itself from the moorings of scales and modes and sailed on to meet new genres; the blues had been electrified, amplified, abandoned, and then welcomed home; the magic of electronica had been watered down to harmless new-age music or simplistic dance-pop; country had finally broken free of the Nashville system and was discovering itself in Austin; and rock and roll had found gospel with Elvis, folk with Dylan, psychedelia with the Beatles, metal with Zeppelin, art with Pink Floyd, antiart with the Ramones, and ironic self-mockery with everything that came after—a string of short marriages that were not meant to last, but left behind memories both good and bad and many bastard children too numerous to recount.
Basic Definitions: Disease, Symptoms, Signs, Syndromes, and Diagnosis
Authors: DeMyer William E
Published: November 2023

Definition: Disease means any abnormality in a person that causes undue discomfort, deformity, dysfunction, or death (Humber and Almeder, 1997). Literally the term disease means a state of dis-ease (dis = negation or lack of, ease = ease— therefore a state of lacking ease or of un-ease). Many states of discomfort, such as grief, reactive depression, or anxiety, only qualify as a disease if they exceed normal limits.

The concept of “normality” and “abnormality”: The concept of disease and its diagnosis rests on the assumption that human beings exist in definable states of health or disease, but health and disease exist in a continuum. No strict dichotomy separates them, particularly in regard to mental illness. Some unusual, often creative people, like the mathematician Paul Erdös (Hoffman, 1998), defy a simple normal/abnormal dichotomy. Nevertheless, we can assume that a standard healthy “normal” or “average” person exists, normal in mind and body, to the degree that we could enshrine the person in the Bureau of Standards in Washington, D.C., along with the standard meter bar and standard kilogram. By matching the findings in a given patient against normal persons of like age, race, sex, and culture, physicians recognize abnormal states of body and mind that constitute disease.
The Importance of the Clinical History
Authors: DeMyer William E
Published: November 2023

The knowing process and resultant trust is the pivotal and most important outcome of the clinical history. The clinical history enables the physician to know and empathize with the patient, but equally important is that the patient comes to know and decides whether or not to trust the physician (Inui, 2003). The result is a medical partnership of understanding, with as much unspoken as spoken between patient and physician (Frank, 2004). For the development of this trust, nothing can ever replace the history. The quality of the history and physical examination determines the quality of the patient–physician relationship and the quality of the outcome for the patient.
The Mental Status and Psychosocial History
Authors: DeMyer William E
Published: November 2023

Generally speaking, if the whole thing is a matter of mental disturbance, this is more easily recognized by the method of questioning than by any other. —Rufus of Ephesus, 1st century (reproduced in Brock, 1929, p 114) Definition of the mental status examination The mental status examination consists of a series of inquiries and observations that evaluate the patient’s mental state in regard to the following: Overall life adjustment Symptoms of mental illness Cognitive abilities: normal, retarded, or demented Emotionality Sensorium Many of the inquiries consist of test questions with specified, objective end points, such as knowing the day and date, whereas in the history per se the patient simply relates what has previously occurred or has previously been experienced. Nevertheless, the techniques for exploring the mental status are the same as those for eliciting the history.
A Short Discussion of Harm
Authors: Davis Dena S
Published: November 2023

Because Discussions Of Genetics and of reproductive technology often involve cases of children who are not yet conceived or born, ethical discussions in this area have to negotiate a pitfall that I will call the harm conundrum. Other writers have called it the problem of wrongful life1 or the wrongful-handicap problem.2 The essence of the problem is that often parents are criticized (or defended against criticism) for bringing into the world a child who is physically or mentally damaged in some way that seems very likely to cause that child a degree of suffering greater than that of normal children. But some writers argue that this criticism is misplaced because, counter to our intuitions, no one has actually been harmed, as the child herself could not have existed otherwise than in her suboptimal state. Thus, unless the child’s current existence is so terrible that she would have been better oR never having been born, she has not been harmed by being born in her damaged state.
Sex Selection
Authors: Davis Dena S
Published: November 2023

It was the monthly meeting of the Ethics Committee at Rubin Hospital for Women. Two dozen people spooned up their lunchtime yogurt and listened intently as the doctor outlined his problem and asked for guidance. An Indian couple now living permanently in America had been referred to him for routine amniocentesis because the wife, who was pregnant, was over thirty-’ve. Because fetal anomalies such as Down Syndrome are much more common with advancing maternal age, it is now standard practice to o6er, even to urge, that older pregnant women undergo genetic testing that can detect the most common fetal abnormalities in time for the women to decide whether or not she wants to continue the pregnancy. Although this couple had been interested in testing for fetal problems, they also expressed their interest in knowing the sex of the fetus and their intention of aborting the pregnancy if it was a girl. They already had one daughter, thought that two children was the right size for their family, and came from .
Introduction
Authors: Teukolsky Rachel
Published: November 2023

In Victorian Britain, critics and essayists turned with a new enthusiasm toward the subject of the visual arts. Art writing became tremendously popular as art spectatorship came to define taste and culture for a growing middle-class audience. This textual fascination in art accompanied other Victorian interests—in the body, in science, in vision, as well as in history, politics, and global conquest. Victorian writers responded to art with a myriad of textual forms: they published treatises on aesthetics, reviews of exhibitions at museums and galleries, volumes of art history, and lectures to amateur societies. John Ruskin conveys the Victorian passion for aesthetic spectatorship when he writes, famously, in Modern Painters III (1856), “The greatest thing a human soul ever does in this world is to see something, and tell what it saw in a plain way …To see clearly is poetry, prophecy and religion, all in one.”
Sublime Museum
Authors: Teukolsky Rachel
Published: November 2023

John Ruskin’s fierce demands for a truthful vision in art in the 1840s emerged from both his Evangelical beliefs and his investment in a scientific ethos. His calls for readers to conduct visual experiments in their gardens often sounded like a lone truth-teller beseeching an ignorant herd. This individualist strain in Ruskin’s early writings contrasts with a major development in art criticism in the 1850s, as some critics began to establish identities as new art professionals attached to evolving institutions such as the National Gallery and the British Museum. As art professionals began to create a collective identity by referencing other well-educated readers, they also asserted their expertise by demarcating a learned kind of looking unavailable to the ignorant amateur.
Conclusion
Authors: Teukolsky Rachel
Published: November 2023

If art writing was a luminous and influential body of literature in the nineteenth century, that prominence receded in the later twentieth century. Contemporary writing about visual arts, whether in the academy or in the press, is a professionalized kind of criticism defined in opposition to qualities we would deem “literary.” Few courses on post-war British or American literature would include art essays in their literary canon. Professional art writing takes a more objective tone, avoids poetic effusions, and speaks within the specialized world of its educated readers. The relative importance of art writing in culture has also changed directly in proportion to the role played by the visual arts in everyday life. Although the art world today in Britain and America is infinitely more accessible to viewers than it was in the nineteenth century, the visual arts have lost their central position as a topic necessary to assure middle-class respectability. While Victorian spectators needed a knowledge of art to cement their class status, the visual arts in the twentieth century are coded as the canons of a cultural elite, existing beyond the sphere of daily life.
Unlocking the Three Secrets of Life
Authors: Regis ED
Published: November 2023

Schrödinger had predicted in 1943 that no detailed information about “the functioning of the genetical mechanism” would emerge in the near future. As it happened, progress toward that end occurred in three distinct incremental stages, each of which nevertheless embodied a major discovery about the gene, which indeed gave up its secrets slowly. The first disclosure, announced to the world in 1944, was that genes were nucleic acids and not, as many biologists had thought, proteins. With that finding, scientists knew for the first time the composition of the basic entities that controlled the heredity and development of life on earth.
The Fiftieth-Anniversary Coronation and Dismissal
Authors: Regis ED
Published: November 2023

Schrödinger’ s Pioneering Little book had such a lasting impact among scientists that in 1993, fifty years after the original lecture series, a three-day scientific conference titled “What Is Life? The Next Fifty Years” was held at the original scene of the crime, Trinity College, Dublin. Such celestial bodies of the modern biological firmament as Stephen Jay Gould, John Maynard Smith, Manfred Eigen, Stuart Kauffman, and Leslie Orgel, among others, were on hand for the purpose of commemorating Schrödinger’ s seminal and prophetic achievements. But as would become clear over the following days, the scientists came both to praise Schrödinger and to bury him.
Assessment and Treatment Planning in Integrative Pediatric Practice
Authors: Culbert Timothy P , Maizes Victoria , Mendenhall, Tai , Becker David K
Published: November 2023

Fe primary purpose of an “integrative” assessment is to intimately understand the child or adolescent who is presenting for care, within a broad context of factors that are likely to have direct or indirect influence on the balance of health, wellness, and illness in their lives, whether this takes place in a primary care clinic or a consultative practice.
A Pediatric Perspective on Acupuncture
Authors: Wang Yuan-Chi Lin Shu-Ming
Published: November 2023

Acupuncture is a discipline of traditional Chinese medicine that has evolved over two millennia. It employs the technique of inserting and manipulating hair-thin needles into acupuncture points for therapeutic and preventive purposes. Acupuncture is widely practiced in the United States today and has become a visible component of the current healthcare system.
A Pediatric Perspective on Herbals and Supplements
Authors: Gardiner Paula , Dog Tieraona Low
Published: November 2023

Ask all your patients and their parents about herbal medicine use. (Provide examples of types of products, teas, foods, etc.) Advise parents and patients about the safety and effectiveness of the products they are using or are considering using.
A Pediatric Perspective on Homeopathy
Authors: Riley David , Oberbaum Menachem , Singer Shepherd Roee
Published: November 2023

Fe discipline of homeopathy identifies three key principles: law of Similars, individualization of therapy, and the minimum dose. Homeopathic medicines (single remedies or combination remedies) are prepared by a unique pharmaceutical production process involving serial dilutions alternating with vigorous shaking or succussion.
Microbes First
Authors: Sapp Jan
Published: November 2023

There were three proposals in the early 1860s for a third kingdom of life. They were set against the background of new explorations in microbial natural history and of a new conception of the organisms that emerged with the cell theory. Surveys of microscopic life expanded during the first half of the nineteenth century. Microscopic technology improved, allowing a great plethora of hitherto invisible organisms to be described and more details of their internal structure to be seen and compared. If Antony Leeuwenhoek was the “Columbus’ of this new world, then it was said that Christian Gottfried Ehrenberg (1795’1876) was its “Humboldt,’ for he “thoroughly investigated these hidden provinces to the outermost boundaries.’ Examining water, soil, sediment, and chalks, he described thousands of new species of infusoria, euglena, Paramecia, diatoms, and radiolarians, as well as many small fossils.
Symbiotic Complexity
Authors: Sapp Jan
Published: November 2023

Symbiosis as a means of evolutionary innovation had been discussed since the late nineteenth century. The dual nature of lichens as fungi and algae, nitrogenizing bacteria in the root nodules of legumes, fungi (mycorrhiza) in the roots of forest trees and orchids, algae living inside the bodies of protests, hydra, sea anemones, and the flat worm Convolute roscoffensis’all these showed how intimate physiological relationships could be established between distantly related organisms. Symbiosis often entailed the emergence of new structures and sometimes, as in the case of the lichen, to the evolution of whole new organisms.
Out of Eden
Authors: Sapp Jan
Published: November 2023

There was no direct phylogenetic evidence to support the view that the archaebacteria were actually older than other bacteria, the eubacteria, but the conjecture that the archaebacteria were ancient persisted as that grouping grew to include the extreme halophiles and thermoacidophiles. Their unique lipid membranes, odd walls lacking peptidoglycan, and the unique transcription enzymes were all compatible with the concept that the archaebacterial lineage diverged deeply in the tree of life before peptidoglycan of the eubacteria had evolved. John Bullock and Thomas Tornabene informed Woes that the archaebacterial lipids were more similar to the hydrocarbon in ancient sediments than were those of any other organisms.
Big Tree
Authors: Sapp Jan
Published: November 2023

In the summer of 1979, Woes, Fox, Stackebrandt, and Kindler were focused on “Big Tree,’ a universal phylogenetic tree of life. Kandler fixed on mapping the diverse wall types onto the 16S rRNA phylogenies that Wise’s laboratory shared with him. “Hopefully, George sent you what you need in terms of SAB’s [the similarity coefficient SAB; see chapter 11],’ Woes wrote him in September. “Our ’Big Tree’ mss. is near completion; the figures are at the artist’s.’ That paper integrated the past decade of empirical and conceptual work on 16S rRNA phylogenies into an outline of the foundational lineages of life on Earth. Several matters had piled up. To date, 170 species of bacteria had been cataloged by the 16S rRNA method; the archaebacterial group and its defining characteristics had grown, an outline of the relationships among its members had been discerned, and many of the published taxonomic groupings of eubacteria based on morphology and physiology were reclassified in terms of ribosomal RNA phylogenies. Yet several critical methodological issues remained unresolved.
Three Domains
Authors: Sapp Jan
Published: November 2023

There was great confusion over kingdoms in the 1980s. Woes and Fox had referred to Archaebacteria, Eubacteria, and Eukaryote informally as “kingdoms’ later they were sometimes called “primary kingdoms,’ or just “kingdoms.’ Some referred to the Prokaryote as a super kingdom; others referred to it as a kingdom. James Lake had put forth Oocyte and Phagocyte kingdoms, as well as Prokaryote and Karyotin super kingdoms. Lynn Margulies continued to champion the five-kingdom model of the 1960s, in which bacteria were placed in the kingdom Moneta, and eukaryote was not recognized as a taxon.
Entangled Roots and Braided Lives
Authors: Sapp Jan
Published: November 2023

Microbial evolutionary biology crossed the twenty-first century in a tumultuous state of competing ideas over the three-domains concept and its ramifications for the structure of microbial evolutionary theory. The Achaea, Bacteria, and Encarta trifurcation was widely taught in textbooks as representing fundamental phylogenetic lineages. Berge’s Manual of Systematic Bacteriology was based on the phylogenetic framework deduced from 16S RNA data, which by 2003 was the largest data set in the world for a gene or gene product. Still, there was no agreement regarding the relationships among the three domains. Their roots were discovered to be intertwined with many shared genes, and it was not clear which was the best way to disentangle them.
Public And Private Responsibilities n The U.S. Health-Care System
Authors: Buchanan Allen
Published: November 2023

Some private health-care insurers report that they are experiencing conflicts between what they take to be their ethical obligations and the pressures of escalating competition and cost-containment strategies. Following are the questions they are asking among themselves:

Some provider–insurers are asking similar questions about the scope and limits of their ethical responsibilities.
Trust in Managed Care Organizations
Authors: Buchanan Allen
Published: November 2023

Two basic criticisms of managed care are that it erodes patient’s trust in physicians and subjects physicians to incentives and pressures that compromise the physician’s fiduciary obligation to the patient. In this article, I first distinguish between status trust and merit trust, and then argue (1) that the value of status trust in physicians is probably overrated and certainly under documented; (2) that erosion of status trust may not be detrimental if accompanied by an increase in well-founded merit trust; and (3) that under conditions of managed care the physician’s commitment to traditional medical ethics cannot serve as an adequate basis for merit trust. Next, drawing on an analogy between managed care organizations and polities, I argue that (4) the most appropriate basis for merit trust in managed care is a conception of organizational legitimacy that includes procedural justice, empowerment of constructive criticism within the organization, and organizational accommodation of the non instrumental commitment to patient’s well-being that is distinctive of medical professionalism. I then explore the conditions necessary for robust competition for merit trust among managed care organizations and indicate the kinds of public policies needed to facilitate such competition. Finally, I show how the account of organization-based merit trust can accommodate the special fiduciary obligation of medical professionals, without indulging in the delusion that it is the physician’s fiduciary obligation always to provide all care that is expected to be of any net benefit to the patient.
Responsibility For Global Health
Authors: Buchanan Allen , Decamp Matthew
Published: November 2023

There are several reasons for the current prominence of global health issues. Among the most important is the growing awareness that some risks to health are global in scope and can only be countered by global cooperation. In addition, human rights discourse and, more generally, the articulation of a coherent cosmopolitan ethical perspective that acknowledges the importance of all persons, regardless of where they live, provide a normative basis for taking global health seriously as a moral issue. In this chapter we begin the task of translating the vague commitment to doing something to improve global health into a coherent set of more determinate obligations. One chief conclusion of our inquiry is that the responsibilities of states regarding global health are both more determinate and more extensive than is usually assumed. We also argue, however, that institutional innovation will be needed to achieve a more comprehensive, fair distribution of concrete responsibilities regarding global health and to provide effective mechanisms for holding various state and non-state actors accountable for fulfilling them.
Nietzsche’s Self-Creation
Authors: Nagel Thomas
Published: November 2023

Most people take life as they find it, and try to make something of the possibilities that are offered by their personal and social circumstances, avoiding catastrophe or failure, pursuing happiness, and working to realize some acceptable private or public ambitions. A small minority have the leisure to devote themselves systematically to understanding life and the world: scientists, historians, and thinkers. Others, seeing that there is much that is wrong with the world, spend their lives trying to change it for the better, and not just for themselves. Still others, creative artists, try to add to the world wonders that do not yet exist. Friedrich Nietzsche’s conception of his own task, the task of the true philosopher, was closest to the last of these—not merely to understand the world or to change it, but to create something new. And the field of his creation was himself. To take oneself and one’s world as given, and move forward intellectually and practically from that starting point, was in his view a betrayal of the extraordinary freedom we have as reflective beings. Nietzsche recognized that, like all human beings, he had reached consciousness with a sense of himself and a system of values that was produced by a tangled human history, together with biological sources of which he was largely unaware.
Sandel and the Paradox of Liberalism
Authors: Nagel Thomas
Published: November 2023

The political system of the United States manages to contain, under conditions of peace if not civility, a remarkable range of moral, ideological, and religious conflicts. The conflicts are not so severe as those that led to the Civil War, but they are greater than those that divide most European countries—where public opinion occupies a narrower political range, and religion is not an important element. Because of its size and regional differences, and the historical shadow of slavery and the Civil War, the United States is radically divided over issues of war, taxes, welfare, race, religion, abortion, and sex.
MacKinnon on Sexual Domination
Authors: Nagel Thomas
Published: November 2023

Catharine MacKinnon, the author of Women’s Lives, Men’s Laws, is an emblematic figure in American life and law. For many years she and her late collaborator, Andrea Dworkin, were the standardbearers of antiliberal feminism, and as a lawyer, writer, and teacher, she has had an explosive impact. She comes from the Left, and her antiliberalism, like the antiliberalism of Marx, derides individual rights as an ideological mask for the protection of existing structures of domination. In Marx’s case, the targets were rights of private property and due process, instruments of class domination. In MacKinnon’s case, they are freedom of speech and the right to privacy, and the domination they uphold is sexual. Her career has been dedicated to attacking male dominance, not as a denial of individual rights to women, but as a deep systemic inequality that defines the difference between the sexes and the meaning of sex. And she has made U.S. antidiscrimination law her weapon: “In societies governed by the rule of law, law is typically a status quo instrument; it does not usually guarantee rights that society is predicated on denying. In this context equality law is unusual: social equality does not exist, yet a legal guarantee of equality does.”
Williams: The Value of Truth
Authors: Nagel Thomas
Published: November 2023

The virtuoso blend of analytic philosophy, classical scholarship, historical consciousness, and uninhibited curiosity marks Truth and Truthfulness unmistakably as a work by Bernard Williams. He responds to Rousseau and Diderot; Thucydides, Herodotus, and Homer; Nietzsche, Hume, Plato, and Kant; Rorty, Habermas, and Hayden White. He manages to be frequently entertaining, and never to show off. The book is about what Williams calls the “virtues” of truth—that is, the value we attach to certain relations or attitudes to the truth, notably accuracy and sincerity, and including the modern virtue of authenticity. The book is also, more indirectly, a response to skeptics about the reality or intelligibility of truth—the “deniers,” as he calls them—and he leans over backward to find something other than confusion in their position, or in its underlying motives. Recent skeptics about truth have laid themselves open to easy rebuttal by overgeneralizing their doubts into a denial that there is such a thing as truth, or that it matters. Nobody really believes this, says Williams, including the deniers themselves. There are plenty of plain everyday truths—that today is Wednesday, that plants need water, that Paris is the capital of France—and no possessor of language can seriously think otherwise.
Terri Schiavo and the Culture Wars: Ethics vs. Politics
Authors: Goodman Kenneth W
Published: November 2023

By the time Terri Schiavo died on March 31, 2005, at Hospice of the Florida Suncoast in Clearwater, the nation—indeed the world—had eavesdropped on a family conflict with no equal, had witnessed unprecedented legislative machinations in the state capital and in Washington, and had seen dozens of courts hear and rule on scores of motions and pleadings that addressed cornerstone issues in end-of-life care: What are the powers of guardians and other surrogates? How much evidence is needed before their requests or refusals are honored? What is the role of government in bedside medical decisions? How should “disability” be deined? Are artificial nutrition and hydration like or unlike other forms of treatment?
A Common Uniqueness: Medical Facts in the Schiavo Case
Authors: Cranford Ronald E
Published: November 2023

Every day in the United States, tubes that provide artificial nutrition and hydration (ANH) are withdrawn from patients in a permanent vegetative state (PVS). No one knows the exact number, but it is a common occurrence.
Disability Rights and Wrongs in the Terri Schiavo Case
Authors: Nelson Lawrence J
Published: November 2023

Although the struggle over the fate of Terri Schiavo was waged in Florida and federal courts and in the media primarily by her husband and her parents, many other individuals and organizations enthusiastically and loudly joined in as well, including proponents of a right to die, health care workers, religious fundamentalists, politicians, right-to-life proponents, opponents of euthanasia and assisted suicide, lawyers, bioethicists—and disability rights activists. On October 15, 2003, Ms. Schiavo’s gastrostomy tube was removed for the second time pursuant to a court order. On October 21, the Florida Legislature passed “Terri’s Law,” which authorized the governor to issue an executive order directing the reinsertion of the tube. Governor Jeb Bush signed the bill and issued the order. On that same day, Michael Schiavo, her husband, filed a lawsuit arguing that “Terri’s Law” was unconstitutional and seeking an injunction to stop reinsertion of the tube; but the tube was reinserted anyway, and the controversy continued.
Chaucer’s Shorter Poems: Social and Cultural Contexts
Authors: Minnis A J , Scattergood V J , Smith J J
Published: November 2023

Our first clear sighting of the historical Chaucer is in the late 1350s, when he appears as a retainer, probably a page, of Elizabeth de Burgh, Countess of Ulster and wife of Lionel, son of King Edward III. Lionel was involved in the English invasion of France in September 1359; at one point in this campaign Chaucer was captured, but soon ransomed. During the peace negotiations at Calais in October 1360, the prince paid him for carrying letters from there to England, which may mark the beginning of his career as international courier and diplomat. When he reappears from the mists of the period 1360–6, Chaucer may well be going about the royal family’s business: he is named as the recipient of a safe conduct through Navarre. In 1366 his father, a prosperous London wine merchant, died. And by 12 September of the same year he had married a certain ‘Philippa’, usually identified as Philippa de Roet, whose family (or at least father) had come to England from Hainault with Edward’s Queen Philippa.
The Book of the Duchess
Authors: Minnis A J , Scattergood V J , Smith J J
Published: November 2023

Blanche of Lancaster died on 12 September 1368, perhaps of the plague. Two major monuments were constructed to preserve her memory. One was a poem by Geoffrey Chaucer, this being (as far as we know) his first substantial composition; he was probably in his mid-twenties at the time of Blanche’s death. The other was the work of her husband, John of Gaunt, the third surviving son of King Edward III. In 1374 he commissioned from master mason Henry Yevele a splendid alabaster tomb, surmounted by sculptures of the duchess and himself. Perpetual masses were to be said for her soul at an adjoining altar, and a memorial service held on 12 September of each year. Gaunt’s will contained the directive, ‘My body to be buried . . . beside my most dear late wife Blanche, who is there interred’. And that was done. However, the tomb of Gaunt and Blanche, which was located in the north arcade of the choir of old St Paul’s cathedral church in London, perished in the Great Fire. Chaucer’s poem has survived. Is it a record, however idealized, of a genuine love-affair, or an elaborate piece of princepleasing which plays fast and loose with the facts, assuming that the poet knew them? Marty critics have felt obliged to speculate on the nature of the royal relationship, since on it hangs—or at least they have made to hang—their views on the negotiations between artifice and life, conventional discourses and emotional integrity, which are made by the Book of the Duchess.
The House of Fame
Authors: Minnis A J , Scattergood V J , Smith J J
Published: November 2023

In the Inferno such reticence is short-lived. Dante presents himself as travelling farther than Virgil in paradise and in poetry. When Virgil can serve as his guide no longer, the now glorified Beatrice takes over, she in turn giving way to St Bernard of Clairvaux, the great authority on Christian love. The implication that the Christian Comedy transcends the pagan Aeneid is obvious. Dante’s reference to St Paul recalls 2 Corinthians 12: 2—4, where Paul describes how he was elevated ‘to the third heaven’, ‘whether in the body, or out of the body, I know not: God knoweth’. ‘Caught up into paradise’, he ‘heard secret words which it is not granted to man to utter’.
The Parliament of Fowls
Authors: Minnis A J , Scattergood V J , Smith J J
Published: November 2023

Here Gerard Manley Hopkins celebrates what he called ‘inscape’ —the distinctive pattern and design which is the unique property of each and every creature, yet which links it to God, inasmuch as ‘the fire that breaks from thee’ is ‘a billion/ Times told lovelier, more dangerous’ (as he puts it in ‘The Windhover: To Christ our Lord’). Hopkins’s formulation of his interest in individuality and personality owed much to the theory of ‘thisness’ (or haeccitas) as held by the medieval schoolman John Duns Scotus, the notion that there is an individuating difference, or final perfection, which makes every created thing ‘this’ and not ‘that’.
The Short Poems (by V. J. Scattergood)
Authors: Minnis A J , Scattergood V J , Smith J J
Published: November 2023

But to take these statements with absolute literalness may be ill-advised, because lists so similar as to suggest a well-known formula appear in the writings of Machaut, Froissart, and Deschamps, and Chaucer attributes a similar repertoire of poetry to the love-sick squire Aurelius in the Franklin’s Tale, where it is asserted that he made ‘manye layes, / Songes, compleintes, roundels, virelayes’ (V(F) 747—8). If these lists are genuine attempts at description, they are not very exact in relation to what has survived. The implication that Chaucer’s short poems are all about love ignores the fact that a number treat religious and moral subjects. And, on a formal level, there is no surviving virelai (unless parts of Anelida and Arcite, 211—380, can be counted as such). Most of all, however, scholars have been puzzled by the impression that Chaucer is said to have written ‘many’ short poems, whereas only twenty-two are now usually accepted as canonical.
Reparation and ‘The Sailor’s Mother’
Authors: Robinson Peter
Published: November 2023

Bernard Williams, Writing about regret and the desire to make amends, has observed that cases exist where

Poetry may arise from the many circumstances in which no appropriate action is possible, when the desire to make reparation which remains is expressed through the activity, less directed to the victims, of making poems. I think the ‘other action’ of writing a poem, since it is prompted by a sense of irreparability, of there being no ‘appropriate action’ of a direct kind, will have two interdependent aims: it will try to inhabit the circumstances of the irreparable, to describe its ‘painful consciousness that nothing can be done’; and it will attempt, through the attributes of poems themselves, to perform a ‘reparative action or substitute for it’. The precise interrelating of these two aims in particular poems will vary widely according to both the nature of the circumstances and the aesthetic dispositions of the poet. This chapter explores one such interrelation in a poem by William Wordsworth.
In Another’s Words: Hardy’s Poetry
Authors: Robinson Peter
Published: November 2023

In her short memoir, Some Recollections (a manuscript completed on 4 January 19u), Emma Lavinia Gifford, Thomas Hardy’s first wife, recalled the time of their courtship in the early 1870s: ‘We grew much interested in each other and I found him a perfectly new subject of study and delight, and he found a “mine” in me, he said’. Mrs Hardy had attempted to rival her husband as a writer, which may explain the curious air of people taking notes on each other in ‘a perfectly new subject of study and delight’, an air which runs on beyond the comma to inform the reciprocating ‘and he found a “mine” in me’, followed by the faintest note of possible recrimination in the halting, comma’d-off ‘he said’. Hardy introduced details of their courtship into A Pair of Blue Eyes (1873), as Mrs Hardy knew; he adopted phrases and incidents from Some Recollections when composing the poems that followed upon her death in the autumn of 1912. To account for the hold another’s words can have on the imagination of a writer conceiving and composing poems, I want to examine related qualities in Hardy’s work: regular and irregular rhythms and stanza forms; the unforeseen in human experience, and the predestined or fated; then, quoted or spoken words within inverted commas and the stanza forms they fit. James Joyce, referring to the final chapter of Ulysses in a letter to Frank Budgen of 28 February 1921, wrote: ‘The last word (human, all too human) is left to Penelope. This is the indispensable countersign to Bloom’s passport to eternity.’ An ‘indispensable countersign’ in Hardy’s ‘self-excelling’ poems is what I hope to depict.
Robert Lowell and ‘Moral Luck’
Authors: Robinson Peter
Published: November 2023

My daughter who was aged about five I think at the time happened to be listening to a radio programme and Anton Webern’s music came on and I said, ‘This is music you won’1t like, it’s difficult, for grown-ups’ and asked her what it’s like . . . then she said this amazing thing, ‘It’s like a lot of wild spiders crying but without tears’... I stole it from her.2
Robert Browning’s Grasp
Authors: Robinson Peter
Published: November 2023

Paying a compliment, she prefigures the terms of Browning’s ‘Essay on Shelley’ (1852), and shows how to apply to her future husband his distinction between subjective and objective poet. For Browning, as for the objective poet, ‘the world is not to be learned and thrown aside, but reverted to and relearned’(i. roo3); yet equally, Browning and the subjective poet are to intuit ‘Not what man sees, but what God sees-the Ideas of Plato, seeds of creation lying burningly on the Divine Hand-’ (i. roo2), and ‘it is towards these that he struggles’. Elizabeth’s effusion was a response to the praise in Browning’s letter of two days earlier, where he affirms that she was the truly subjective poet, the Shelleyan visionary, while he was merely and exclusively objective: ‘You speak out, you, I only make men & women speak-give you truth broken into prismatic hues, and fear the pure white light’. While each of the lovers-in-potential is writing to idealize and worship the poetry of the other, Elizabeth Barrett’s literary foresight and criticism seem, more than Browning’s: ‘shadows which futurity casts on the present’.