This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases' powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro-organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical-ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases’ powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro‐organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical‐ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

Since testing for HIV infection became possible in 1985, testing of pregnant women has been conducted primarily on a voluntary, ‘opt-in’ basis. Faden, Geller and Powers, Bayer, Wilfert, and McKenna, among others, have suggested that with the development of more reliable testing and more effective therapy to reduce maternal-fetal transmission, testing should become either routine with ‘opt-out’ provisions or mandatory. We ask, in the light of the new rapid tests for HIV, such as OraQuick, and the development of antiretroviral treatment (...) that can reduce maternal-fetal transmission rates to <2%, whether that time is now. Illustrating our argument with cases from the United States (US), Kenya, Peru, and an undocumented Mexican worker in the US, we show that when testing is accompanied by assured multi-drug therapy for the mother, the argument for opt-out or mandatory testing for HIV in pregnancy is strong, but that it is problematic where testing is accompanied by adverse events such as spousal abuse or by inadequate intrapartum or follow-up treatment. The difference is not a ‘double standard’, but reflects the presence of conflicts between the health interests of the mother and the fetus – conflicts that would be abrogated by the assurance of adequate, continuing multi-drug therapy. In light of these conflicts, where they still occur, careful processes of informed consent are appropriate, rather than opt-out or mandatory testing. (shrink)

In this view from 2007–2009, the ethical challenges facing a potential global effort to control infectious disease are explored; they provide sobering insight into the challenges of later decades. Despite the devastating pandemic of HIV/AIDS that erupted in the early 1980s, despite the failure to eradicate polio and the emergence of resistant forms of tuberculosis that came into focus in the 1990s, and despite newly emerging diseases like Severe Acute Respiratory Syndrome (SARS) in 2003 and the fearsome prospect of human-to-human (...) avian flu, it is nevertheless a time of some excitement over prospects for effective control of much of infectious disease. Funded by national and international governmental and nongovernmental organizations (NGOs), private foundations, and even popular entertainers, large-scale new efforts are under way to address global killers like AIDS, tuberculosis, and malaria, among others. This “marvelous momentum” can be seen as part of a continuing effort from the time of Jenner onward. Extrapolating from this, we explore the notion of a “comprehensive global effort for the eradication, elimination or control of infectious disease”, with particular attention to the ethical issues that arise. This is to “think big” about disease-control efforts that are now often done in piecemeal ways. This chapter identifies five tracks along which such efforts need to be pursued: (1) national and international organizations and the development of collective will; (2) epidemiological and health care infrastructure; (3) scientific development; (4) religious, social, and cultural considerations; (5) legal and social protections for individuals and groups. Each of these poses significant ethical issues which, we argue, should be viewed in a comprehensive way, to ensure that practice, research, and policy in each of these areas understands the person with communicable infectious disease as both victim and (potential) vector. (shrink)

MEDIEVAL LOGICS LAMBERT MARIE DE RIJK (ed.), Die mittelalterlichen Traktate De mod0 opponendiet respondendi, Einleitung und Ausgabe der einschlagigen Texte. (Beitrage zur Geschichte der Philosophie und Theologie des Mittelalters, Neue Folge Band 17.) Miinster: Aschendorff, 1980. 379 pp. No price stated. THE SEVENTEENTH CENTURY MARTA FATTORI, Lessico del Novum Organum di Francesco Bacone. Rome: Edizioni dell'Ateneo 1980. Two volumes, il + 543, 520 pp. Lire 65.000. VIVIAN SALMON, The study of language in 17th century England. (Amsterdam Studies in the Theory (...) and History of Linguistic Science, Series 111: Studies in theHistory of Linguistics, Volume 17.) Amsterdam: John Benjamins B.V., 1979.x + 218 pp. Dfl. 65. Theoria cum Praxi. Zum Verhaltnis von Theorie und Praxis im 17. und 18. Jahrhundert. (Akten des 111. Internationalen Leibnizkongress, Hannover, 12. bis 17.November 1977, Band 111: Logik, Erkenntnistheorie, Wissenschaftstheorie, Metaphysik, Theologie.) Wiesbaden: Franz Steiner Verlag, 1980. vii + 269 pp. DM 48. CLASSICAL AND NON-CLASSICAL LOGICS MICHAEL CLARK, The place of syllogistic in logical theory. Nottingham: University of Nottingham Press, 1980. ix + 151 pp. £3.00. A.F. PARKER-RHODES, The theory of indistinguishables. Dordrecht, Boston and London: D. Reidel Publishing Company, 1981. xvii + 216 pp. Dfl.90.00/$39.50. NICHOLAS RESCHER and ROBERT BRANDOM, The logic of inconsistency. Oxford:Basil Blackwell, 1980. x + 174 pp. f 11.50. MISCELLANEOUS J. ZELENY, The logic of Marx. Translated from the German by T. Carver. Oxford: Basil Blackwell, 1980. xcii + 247 pp. £12.50. FELIX KAUFMANN, The infinite in mathematics. Edited by Brian McGuinness. Introduction by E. Nagel. Translation from the German by Paul Foulkes. Dordrecht: Reidel, 1978. xvii + 235 pp. Dfl 85/$39.50 (cloth); Dfl 45/$19.95 (paper). PAMELA MCCORDUCK, Machines who think. San Francisco: W.H. Freeman and Company, 1979. xiv + 275 pp. $14.95. J. MITTELSTRASS (ed.), Enzyklopadie Philosophie und Wissenschaftstheorie Bd. 1 : A-G. Mannheim, Wien, Ziirich: Bibliographisches Institut, 1980. 835 pp. DM 128. (shrink)

This seminal collection on the ethical issues associated with infectious disease is the first book to correct bioethics’ glaring neglect of this subject. Timely in view of public concern about SARS, AIDS, avian flu, bioterrorism and antibiotic resistance. Brings together new and classic papers by prominent figures. Tackles the ethical issues associated with issues such as quarantine, vaccination policy, pandemic planning, biodefense, wildlife disease and health care in developing countries.

ABSTRACT In this article, we first document the virtually complete absence of infectious disease examples and concerns at the time bioethics emerged as a field. We then argue that this oversight was not benign by considering two central issues in the field, informed consent and distributive justice, and showing how they might have been framed differently had infectiousness been at the forefront of concern. The solution to this omission might be to apply standard approaches in liberal bioethics, such as autonomy (...) and the harm principle, to infectious examples. We argue that this is insufficient, however. Taking infectious disease into account requires understanding the patient as victim and as vector. Infectiousness reminds us that as autonomous agents we are both embodied and vulnerable in our relationships with others. We conclude by applying this reunderstanding of agency to the examples of informed consent and distributive justice in health care. (shrink)

ABSTRACT In this article, we first document the virtually complete absence of infectious disease examples and concerns at the time bioethics emerged as a field. We then argue that this oversight was not benign by considering two central issues in the field, informed consent and distributive justice, and showing how they might have been framed differently had infectiousness been at the forefront of concern. The solution to this omission might be to apply standard approaches in liberal bioethics, such as autonomy (...) and the harm principle, to infectious examples. We argue that this is insufficient, however. Taking infectious disease into account requires understanding the patient as victim and as vector. Infectiousness reminds us that as autonomous agents we are both embodied and vulnerable in our relationships with others. We conclude by applying this reunderstanding of agency to the examples of informed consent and distributive justice in health care. (shrink)

The prelims comprise: Seeing Infectious Disease as Central The Birth of Bioethics Amid the Decline of Infectious Disease The Shifting Concerns of Public Health Bioethics and Public Health: How the Twain Didn't Meet The Case of HIV Bridging the Gap: Seeing Bioethics in Terms of the Patient as Victim and Vector An Ordinary Example Summing Up: Autonomous Agency in the Context of Infectious Disease Notes.

TO DEFEND THE CONCEPT OF MIRACLES FROM ATTACKS SUCH AS THOSE RAISED BY NOWELL-SMITH, CERTAIN PHILOSOPHERS HAVE APPEALED TO ACTION THEORY AND ARGUED THAT THE THEIST’S EXPLANATION OF MIRACLES IS LIKE THE EXPLANATION OF AN ACTION AND NOT LIKE THE EXPLANATION OF A CAUSED EVENT. THIS ARTICLE SHOWS THAT NOWELL-SMITH’S OBJECTIONS CANNOT BE AVOIDED IN THIS WAY AND THAT BELIEF IN MIRACLES ONLY ACCENTS THE THEIST’S PROBLEM OF EXPLAINING GOD’S RELATION TO THE WORLD.

Previous research has yielded inconsistent findings concerning the relationship between envy and schadenfreude. Three studies examined whether the distinction between benign and malicious envy can resolve this inconsistency. We found that malicious envy is related to schadenfreude, while benign envy is not. This result held both in the Netherlands where benign and malicious envy are indicated by separate words (Study 1: Sample A, N = 139; Sample B, N = 150), and in the USA where a single word is used (...) to denote both types (Study 2, N = 180; Study 3, N = 349). Moreover, the effect of malicious envy on schadenfreude was independent of other antecedents of schadenfreude (such as feelings of inferiority, disliking the target person, anger, and perceived deservedness). These findings improve our understanding of the antecedents of schadenfreude and help reconcile seemingly contradictory findings on the relationship between envy and schadenfreude. (shrink)

In the behavioral literature on human movement, a distinction is made between the learning of parameters and the learning of new movement forms or topologies. Whereas the target articles by Thach, Smith, and Houk et al. provide evidence for cerebellar involvement in parametrization learning and adaptation, the evidence in favor of its involvement in the generation of new movement patterns is less straightforward. A case is made for focusing more attention on the latter issue in the future. This would (...) directly help to bridge the gap between current neurophysiological approaches to the role of the cerebellum and the behavioral expressions of human motor learning, [HOUK et al.; SMITH; THACH]. (shrink)

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

DNA is an important agent not only in chemistry and biology but also in technology and modern culture. A number of books approach the double helix from different angles. These perspectives include (1) the science of DNA and genetics; (2) genetic engineering; (3) the ethics of manipulating genetic material; and (4) DNA in culture and religion. Various views of DNAprovide insights into human nature beyond its molecular composition.

Launched in 1920 by C K Ogden and others as the successor to the Cambridge Magazine , Psyche occupied a unique place for over 30 years as a journal of general and linguistic psychology. Committed from the outset to keeping readers abreast of developments in the burgeoning fields of experimental, theoretical, and applied psychology, Psyche provided not only systematic reporting in these domains but set itself the task of stimulating research of high quality by the critical thrust of its editorial (...) stance. In addition to full-length articles, Psyche featured lively correspondence and discussion, a regular chronicle of research in the US and on the continent, a comprehensive survey of current literature, and regular reports from the meetings and congresses of associations and societies. I A Richards, E J Dingwall and Whately Smith were among those who added their regular contributions to editorials and features by C K Ogden. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Concepts, Judgments, and Unity in Kant's Metaphysical Deduction of the Relational Categories CHARLES NUSSBAUM 1. INTRODUCTION TO ANY ATTENTIVEREADERof the section of the Critique of Pure Reason' known as the "Metaphysical Deduction of the Categories" (A67/B92-A83/B to9), one paragraph in that section stands out particularly by virtue of its special importance for Kant's developing argument: The same function Which gives unity to the various representations in ajudgment also (...) gives unity to the mere synthesis of various representations in an intuition; and this unity, in its most general expression, we entitle the pure concept of the understanding. The same understanding, through the same operations by which in concepts, by means of analytical unity, it produced the logical form of a judgment, also introduces a transcendental content into its representations, by means of the synthetic unity of the manifold of intuition in general.... (CPR A79/B loS) The importance of this paragraph is, however, more than equaled by its difficulties, which center on the question of how the function which operates by means of analytical unity can be the same as one that operates by means of the synthetic unity of the manifold of intuition in general. Put shortly, the problem is this. If the functions are really the same, then how do we distinguish at all between analytic and synthetic operations? But if they are different, then how can these forms of judgment serve as a clue for the discovery of the categories? ' Immanuel Kant, Critiqueof Pure Reason, trans. Norman KempSmith (London: Macmillan and Co., Ltd., 1963).Hereafter CPR. [89] 9~ JOURNAL OF THE HISTORY OF PHILOSOPHY 28:1 JANUARY 1990 The results of this dilemma which can be observed in the literature are not surprising: commentators tend to grasp one horn or the other. They either emphasize the difference between analysis and synthesis, and reject or dilute the claims as to sameness of function; or they take seriously Kant's argument concerning sameness of functions, and try to minimize the difference between analysis and synthesis. The major twentieth-century representant of the former approach is Kemp Smith," and of the latter, Paton. 3 This latter approach has found a formidable contemporary champion in the person of Henry Allison. By Allison's own admission,4 however, his position on this controversial topic was suggested (in part) by arguments first put forward over fifty years ago by Klaus Reich in a most remarkable book entitled Die Volls~ndigkeit der Kantischen Urteilstafel, 5 a book, by the way, also greatly admired by Paton. 6 In the first section of this paper I will try to show that Reich's arguments are rather more subtle than Allison apparently takes them to be, and that Reich is one commentator who attempts to go between the horns of the dilemma described above, and who essays an interpretation of our crucial paragraph that unifies its seemingly divergent tendencies. In the second section of the paper I will introduce some interpretive elements of my own. 2. Let us begin by reacquainting ourselves with Kant's notion of analytical unity, one aspect of this debate which is not particularly controversial and is largely agreed upon by all parties. For Kant, analytical unity is the sort of unity achieved by all general concepts (conceptus communes) insofar as they abstract from all differences that subsist between the objects under them, or the lower concepts subordinated to them. 7 A general concept unifies these objects or concepts by means of a common mark or set of marks. Thus Kant's example at CPR A69/B94 of the unification of bodies under the concepts 'body' and 'divisible' is a perfectly representative instance of unification via analytical unity, as the function upon which such concepts "rest." Let us note that the " Norman KempSmith,A CommentarytoKant's "Cr/t~rueofPureReason"(NewYork:HumanitiesPress, 196~). 3 H.J. Paton, Kant's MetaphysicofExperience, 2 vols.(London:George Allenand Unwin,Ltd., 1936). 4 Henry Allison,Kant's TranscendentalIdealum (NewHaven:YaleUniversityPress, 1983), 144 n. 3o. Hereafter KTI. 5 KlausReich,Die Vollst~ndigkeitderKantischenUrteilstafel,3rd. ed. (Hamburg: Meiner, 1986). Hereafter VKU. 6 Paton, Kant's Metaphysic, 1:302. Kant, we should note, does not makethis important logicaldistinctionbetweensubordination... (shrink)

Current views of the control of complex, purposeful movements acknowledge that organizational processes must reconcile multiple concerns. The central priority is of course accomplishing the actor's goal. But in specifying the manner in which this occurs, the action plan must accommodate such factors as the interaction of mechanical forces associated with the motion of a multilinked system (classical mechanics) and, in many cases, intrinsic bias toward preferred movement patterns, characterized by so‐called “coordination dynamics.” The most familiar example of the latter (...) is the symmetry constraint, where spatial trajectories and/or temporal landmarks (e.g., reversal points) of concurrentlymoving body segments (limbs, digits, etc.) exhibit mutual attraction. The natural coordination tendencies that emerge through these constraints can facilitate or hinder motor control, depending on the degree of congruency with the desired movement pattern. Motor control theorists have long recognized the role of classical mechanics in theories of movement organization, but an appreciation of the importance of intrinsic interlimb bias has been gained only recently.Although detailed descriptions of temporal coordination dynamics have been provided, systematic attempts to identify additional salient dimensions of interlimb constraint have been lacking. We develop and implement here a novel method for examining this problem by exploiting two robust principles of psychomotor behavior, the symmetry constraint and the Two‐Thirds Power Law. Empirical evidence is provided that the relative spatial patterns of concurrently moving limbs are naturally constrained in much the same manner as previously identified temporal constraints and, further, that apparent velocity interference is an indirect, secondary consequence of primary spatial assimilation. The theoretical implications of spatial interference are elaborated with respect to movement organization and motor learning. The need to carefully consider the appropriate dimensions with which to characterize coordination dynamics is also discussed. (shrink)

"....an admirably clear account of Heidegger's relation to the philosophical tradition, and especially of his criticism of Cartesianism." -- Richard Rorty, University of Virginia.

This volume brings together for the first time some of the most helpful and insightful essays on the four most influential and discussed philosophers in the history of existentialism: Kierkegaard, Nietzsche, Heidegger, and Sartre.

Although the application of the emulation model to the control of simple positioning movements is relatively straightforward, extending the scheme to actions requiring multisegmental, interlimb coordination complicates matters a bit. Special consideration of the demands in this case, both on sensory processing and on the process model (two key elements of the Kalman filter), are discussed.

As originally planned this volume was meant to cover a somewhat wider scope than, in fact, it has turned out to do. When, in rg68, I initially conceived of preparing it, it was proposed to deal with several aspects of early modern scepticism, in addition to the fortuna of the Academica, and to publish various loosely related pieces under the title of 'Studies in the History of Early Modern Scepticism. ' Thereby, I foresaw that I would exhaust my knowledge of (...) the subject and would then be able to turn my attention to other matters. In initiating my research on this topic, however, I soon found that there remained a much greater bulk of material to study than could possibly be dealt with between the covers of the single modest volume which I envisioned. My proposed section on Cicero's Academica was to cover between 50 and 75 pages in the original plan. It soon became apparent, however, especially after Joannes Rosa's hitherto unstudied commentary on Cicero's work was uncovered, that this material would have to be treated at a much greater length than I had foreseen. The present volume is the result of this expanded investigation. The monograph which has come from this alteration in plans has, I think, the virtues of continuity and cohesive ness and one hopes that these advantages offset the benefits of a broader scope which were sacrificed. (shrink)

The culture of authenticity -- The enchanted garden -- The modern worldview -- Romanticism and the ideal of authenticity -- The heart of darkness -- De-centering the subject -- Story-shaped selves -- Authenticity in context.

Martin Heidegger is now widely recognized as one of the greatest philosophers of the twentieth century. He transformed mainstream philosophy by defining its central task as asking the 'question of being'. His thought has contributed to the turn to hermeneutics and to postmodernism and poststructuralism. Moreover, the disclosure of his deep involvement in Nazism has provoked much debate about the relation of philosophy to politics. This edition brings to the fore other works, as well as alternative approaches to scholarship. The (...) essays cover topics such as Heidegger's conception of phenomenology, his relation to Kant and Husserl, his account of truth, and his stand on the realism/anti-realism debate. This edition includes a new preface by the editor, revised versions of several essays from the first edition, and an exhaustive bibliography, providing guidance for both newcomers to Heidegger's work and established scholars. (shrink)

The origins of this book go back to I956 when it was suggested to me that a study on the philosophy of Gianfrancesco Pico della Mirandola would furnish an important addition to our knowledge of the philoso phy of the Italian Renaissance. It was not, however, until I960 that I could devote a significant portion of my time to a realization of this goal. My work was essentially completed in 1963, at which time it was presented in its original form (...) as a doctoral dissertation in the Phi losophy Department of Columbia University. Since then I have made many minor improvements and several chapters have been extensively reworked. This study represents the first attempt in fifty years to give a detailed account of even a portion of Gianfrancesco Pico's life and thought. The most comprehensive previous study, Gertrude Bramlette Richards, "Gianfrancesco Pico della lv1irandola" (Cornell University Dissertation, I 9 I 5), which I have found very useful in preparing my own book, is largely based on secondary literature and is mistaken in a number of details. Furthermore, Miss Richards' treatment of Gian francesco Pico as a thinker is very sketchy and is not an exhaustive study of his own writings. It is hoped that my present study, built in part on her extensive bibliographical indications, brings forth a certain amount of new information which will be of value for further research. (shrink)

This perceptive study of John Case, teacher of philosophy at Oxford from the mid-1560s until his death in 1600 and author of expositions of Aristotle which became standard textbooks of the time, focuses on his intellectual and cultural milieu and reveals.

Martin Heidegger is now widely recognised alongside Wittgenstein as one of the greatest philosophers of the twentieth century. He redefined the central task of philosophy as the investigation of the nature of being, and has exerted a profound impact on literary theory, theology, psychotherapy, political theory, aesthetics, environmental studies, as well as mainstream philosophy. His thought has contributed to the recent turn to hermeneutics in philosophy and the social sciences, and to current post-modern and post-structuralist developments. The disclosing of his (...) deep involvement in the ideology of Nazism has provoked much debate about the relation of philosophy to politics. This volume contains both overviews of Heidegger's life and works and analysis of his most important work, Being and Time. In addition there are discussions of Heidegger's thought in relation to mysticism, traditional theology, ecology, psychotherapy and the philosophy of language. The volume also contains the first in-depth study of what has been called Heidegger's second greatest work, the Beitrage zur Philosophie. (shrink)

IN his recent book on Heidegger's concept of authenticity, Eclipse of the Self, Michael Zimmerman points out Heidegger's life-long attempt to link the theoretical-ontological questions of traditional philosophy with the personal-existential issues of everyday life. The aim of grounding the "question of Being" in a deeper, more authentic way of being human is most strikingly evident in Being and Time. There the seemingly most abstract of all metaphysical questions--What is the meaning of Being?--is posed in terms of the most intensely (...) personal question facing any individual--What is the meaning of human existence? To answer the former question appropriately, Heidegger claims, we must transform our approach to the latter. And this in turn requires a radical alteration in the quality of our lives. Despite Heidegger's insistence that his ontological findings have no evaluative import, the exhortative tone of the account of authenticity is unmistakable. He quotes with full approval Count Yorck's description of his own philosophy: "The practical aim of our standpoint is pedagogical in the broadest sense of the word". Its goal is "to make possible the cultivation of individuality". Emerging out of an age that perceived itself as a time of profound crisis, a period shaken by intellectual currents of relativism, scientific materialism, Darwinism, and the complete secularization of life, Being and Time attempts to combat the "groundlessness" of the contemporary world by uncovering enduring values and meanings within the framework of "worldliness" and human finitude. The "question of Being" is no exercise in arcane speculation; its aim is to restore a sense of the gravity and responsibility of existence by recovering a more profound grasp of what it is to be. (shrink)