This volume explores the ethics of making or expanding families through adoption or technologically assisted reproduction. For many people, these methods are separate and distinct: they can choose either adoption or assisted reproduction. But for others, these options blend together. For example, in some jurisdictions, the path of assisted reproduction for same-sex couples is complicated by the need for the partner who is not genetically related to the resulting child to adopt this child if she wants to become the child's legal parent. The essays in this volume critically examine moral choices to pursue adoption, assisted reproduction, or both, and highlight the social norms that can distort decision-making. Among these norms are those that favour people having biologically related children ('bionormativity') or that privilege a traditional understanding of family as a heterosexual unit with one or more children where both parents are the genetic, biological, legal, and social parents of these children. As a whole, the book looks at how adoption and assisted reproduction are morally distinct from one another, but also emphasizes how the two are morally similar. Choosing one, the other, or both of these approaches to family-making can be complex in some respects, but ought to be simple in others, provided that one's main goal is to become a parent.

Women most fully experience the consequences of human reproductive technologies. Men who convene to evaluate such technologies discuss "them": the women who must accept, avoid, or even resist these technologies; the women who consume technologies they did not devise; the women who are the objects of policies made by men. So often the input of women is neither sought nor listened to. The privileged insights and perspectives that women bring to the consideration of technologies in human reproduction are the subject of these volumes, which constitute the revised and edited record of a Workshop on "Ethical Issues in Human Reproduction Technology: Analysis by Women" (EIRTAW), held in June, 1979, at Hampshire College in Amherst, Massachusetts. Some 80 members of the workshop, 90 percent of them women (from 24 states), represented diverse occupations and personal histories, different races and classes, varied political commitments. They included doctors, nurses, and scientists, lay midwives, consumer advocates, historians, and sociologists, lawyers, policy analysts, and ethicists. Each session, however, made plain that ethics is an everyday concern for women in general, as well as an academic profession for some.

This book offers a vision of politics that govern the womb; from antiquity ('be fertile and replenish the earth'), through the ages (hysterectomy, to extirpate women's 'hysteria'), up to the present time (abortion wars; assisted reproduction), and into the future (reprogenetics; the artificial womb). It explores how the womb has served humanity, either tacitly or explicitly, through the ages and examines how women have accepted and still perceive the rules created by men as natural - including the new anti-abortion laws in the USA - because 'that is the way things are.' The book also explores how the emerging of assisted reproduction technologies and novel genetic tools (reprogenetics) will pose additional challenges to womb bearers, as all women will be made to reproduce with IVF. What is more, the advent of the artificial womb is in sight; the gender and social implications of this development would be enormous. Certainly not just another organ, the womb has been and remains a powerful tool that cannot be left to the decisions of half of the population. This book engages a wide audience, including women and men, professionals and laypersons who are interested in gender, politics, legislation, women's health, and ethics.

Bridging memoir with key concepts in narratology, philosophy and history of medicine, and disability studies, this book identifies and names the phenomenon of metagnosis: the experience of learning in adulthood of a longstanding condition. It can occur when the condition has remained undetected (e.g. colorblindness) and/or when the diagnostic categories themselves have shifted (e.g. ADHD). More broadly, it can occur with unexpected revelations bearing upon selfhood, such as surprising genetic test results. Though this phenomenon has received relatively scant attention, learning of an unknown condition is often a significant and bewildering revelation, one that subverts narrative expectations and customary categories. How do we understand these revelations? In addressing this topic Danielle Spencer approaches narrative medicine as a robust research methodology comprising interdisciplinarity, narrative attentiveness, and the creation of writerly texts. Beginning with Spencer's own experience, the book explores the issues raised by metagnosis, from communicability to narrative intelligibility to different ways of seeing. Next, it traces the distinctive metagnostic narrative arc through the stages of recognition, subversion, and renegotiation, discussing this trajectory in light of a range of metagnostic experiences-from Blade Runner to real-world mid-life diagnoses. Finally, it situates metagnosis in relation to genetic revelations and the broader discourses concerning identity. Spencer proposes that better understanding metagnosis will not simply aid those directly affected, but will serve as a bellwether for how we will all navigate advancing biomedical and genomic knowledge, and how we may fruitfully interrogate the very notion of identity.

"The Advances in Bioethics" series is devoted to publishing collections of original papers and multi-authored volumes that advance the field of bioethics either by exploring new areas, or by taking new approaches to traditional areas. Although the series is published in English, its scope is international, and manuscripts are welcome from authors throughout the world. Divided into three sections this volume covers: Human Rights, Public Safety, and Public Policy; Practitioner Responsibilities During Times of Epidemics; Global Dimensions of Epidemics - each chapter in the book goes in depth to discuss the issues surrounding the topic in question and combines a theoretical thought process with practical application.

This collection of essays represents the work produced in the course of a three-year project funded by the Commission of the European Communities under the Biomed I programme, on the ethics of genetic screening, entitled 'Genetic screening: ethical and philosophical perspectives, with special reference to multifactorial diseases'. The short title of the project was Euroscreen, thereafter known as Euroscreen I, in the light of the fact that a second project on genetic screening was subsequently funded. The project was multinational and multidisciplinary, and had as its objectives to examine the nature and extent of genetic screening programmes in different European countries; to analyse the social policy response to these developments in different countries; and to explore the applicability of normative ethical frameworks to the issues. The project was led by a core group who had oversight of the project and members of which have acted as editors for this volume. Darren Shickle edited the first section; Henk ten Have the second; Ruth Chadwick and Urban Wiesing the third and final part. The volume opens with an overview of genetic screening and the principles available for addressing developments in the field, with special reference to the Wilson and Jungner principles on screening. The first of the three major sections thereafter includes papers on the state of the art in different countries, together with some analysis of social context and policy.

Millions of children suffer from diseases and illnesses that do not have adequate treatment, and many other children are harmed by medicines intended to help them. In order to protect and help these children, society must conduct pediatric research to identify safer and more effective medical treatments. This research requires exposing some children to risks for the benefit of others. Yet, critics and courts have argued that it is unethical to expose children to research risks for the benefit of others, and this practice seems to violate our obligation to protect children from harm and exploitation. In this way, clinical research with children presents us with what appears to be an irresolvable dilemma: either we can protect pediatric subjects from exploitation, or we can protect pediatric patients from dangerous medicines, but not both.
The Ethics of Pediatric Research is the first work to systematically evaluate this dilemma, and David Wendler offers an original justification for pediatric research based on an in-depth analysis of when it is in our interests to help others. It will be of interest primarily to scholars in pediatric ethics and clinical research ethics.

This volume contains the proceedings of the 10th International Symposium on Circumcision, Genital Integrity, and Human Rights. Authors are international experts in their fields, and the book contains the most up-to-date information on the issue of genital cutting of infants and children from medical, legal, bioethical, and human rights perspectives.

Unfit for the Future argues that the future of our species depends on our urgently finding ways to bring about radical enhancement of the moral aspects of our own human nature. We have rewritten our own moral agenda by the drastic changes we have made to the conditions of life on earth. Advances in technology enable us to exercise an influence that extends all over the world and far into the future. But our moral psychology lags behind and leaves us ill equipped to deal with the challenges we now face. We need to change human moral motivation so that we pay more heed not merely to the global community, but to the interests of future generations. It is unlikely that traditional methods such as moral education or social reform alone can bring this about swiftly enough to avert looming disaster, which would undermine the conditions for worthwhile life on earth forever. Persson and Savulescu maintain that it is likely that we need to explore the use of new technologies of biomedicine to change the bases of human moral motivation. They argue that there are in principle no philosophical or moral objections to such moral bioenhancement. Unfit for the Future? challenges us to rethink our attitudes to our own human nature, before it is too late.

Should editing the human genome be allowed? What are the ethical implications of social restrictions during a pandemic? Is it ethical to use animals in clinical research? Is prioritizing COVID-19 treatment increasing deaths from other causes? Bioethics is a dynamic field of inquiry that draws on interdisciplinary expertise and methodology to address normative issues in healthcare, medicine, biomedical research, biotechnology, public health, and the environment. This Is Bioethics is an ideal introductory textbook for students new to the field, exploring the fundamental questions, concepts, and issues within this rapidly evolving area of study. Assuming no prior knowledge of the subject, this accessible volume helps students consider both traditional and cutting-edge questions, develop informed and defensible answers, and evaluate the strengths and weaknesses of a diverse range of ethical positions in medicine. The authors avoid complex technical terms and jargon in favor of an easy-to-follow, informal writing style with engaging chapters designed to stimulate student interest and encourage class discussion. The book also features a deep dive into the realm of global public health ethics, including the response to the COVID-19 pandemic. It considers topics like triage decision-making, the proportionality of society's response to COVID-19, whether doctors have a professional obligation to treat COVID-19 patients, and whether vaccines for this virus should be mandatory. A timely addition to the acclaimed This Is Philosophy series, This Is Bioethics is the ideal primary textbook for undergraduate bioethics and practical ethics courses, and is a must-have reference for students in philosophy, biology, biochemistry, and medicine.

For over thirty years, David F. Kelly has worked with medical practitioners, students, families, and the sick and dying to confront the difficult and often painful issues that concern medical treatment at the end of life. In this short and practical book, Kelly shares his vast experience, providing a rich resource for thinking about life's most painful decisions. Kelly outlines eight major issues regarding end-of-life care as seen through the lens of the Catholic medical ethics tradition. He looks at the distinction between ordinary and extraordinary means; the difference between killing and allowing to die; criteria of patient competence; what to do in the case of incompetent patients; the meaning and use of advance directives; the morality of hydration and nutrition; physician-assisted suicide and euthanasia; and, medical futility. Kelly's analysis is sprinkled with significant legal decisions and, throughout, elaborations on how the Catholic medical ethics tradition - as well as teachings of bishops and popes - understands each issue. He provides a helpful glossary to supplement his introduction to the terminology used by philosophical health care ethics. Included in Kelly's discussion is his lucid description of why the Catholic tradition supports the discontinuation of medical care in the Terry Schiavo case. He also explores John Paul II's controversial papal allocution concerning hydration and nutrition for unconscious patients, arguing that the Catholic tradition does not require feeding the permanently unconscious. "Medical Care at the End of Life" addresses the major issues that inform this last stage of caregiving. It offers a critical guide to understanding the medical ethics and relevant legal cases needed for clear thinking when individuals are faced with those crucial decisions.

The idea for an anthology on personhood grew out of two things, viz., the work I did with Martin Benjamin during the Summer of 1982 at Michigan State University on the question, What is a person?, and the amount of time, effort, and expense required for serious research on the topic itself. The former experience taught me the importance of, among other things, attempting to get clear about what we are to mean by 'person, ' while the latter experience suggested a possible course of action whereby getting clear might be made more manage able simply by having relatively convenient access to some of the most insightful and stimulating writings on the topic. The problems of personhood addressed in this book are central to issues in ethics ranging from the treatment or termination of infants with birth defects to the question whether there can be rational suicide. But before questions on such issues as the morality of abortion, genetic engineering, infanticide, and so on, can be settled, the prob lems of personhood must be clarified and analyzed. Hence What Is a Person? has as its primary theme the examination of various proposed conditions of personhood."

Books do not come about by accident. This is especially the case when a volume grows out of a conference for which the participants wrote the original contributions in different languages. This volume descends from a conference held at the Zentrumjiir interdiszipliniire Forschung, University of Bielefeld, Germany, October 4 through 6, 1990, under the title "Technische Eingriffe in die menschliche Reproduktion: Per- spektiven eines moralischen Konsenses". Many with great generosity helped to ensure that the conference was a success and that the papers presented grew into a book. We want in particular to acknowledge our deep gratitude to the Zentrumjiir interdiszipliniire Forschung for spon- soring this important conference, and to its director, Peter Weingart, for his important guidance and support. Our thanks are also due to all of the staff ofthe Zentrum. It is they who made the conference successful. We are also grateful to Prof. Hilmar Stolte, head of the Institut jiir System- und Technologieanalysen in Bad Oeynhausen, Germany, for making available additional financial support for the conference. Our thanks are also owed to the participants who inspired us to transform a collection of papers into a completed volume. The general trans- formation of the original papers required translation. Here we must acknowledge the labors of Sarah L. Kirkby, who rendered many parts of the volume into English. Finally, we want to recognize the invaluable support given by the ecumenical teamwork of Kurt W.

The 14 chapters in Ethics at the End of Life: New Issues and Arguments, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters-written by a team of experts-survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section.

Transplantation is a medically successful and cost-effective way to treat people whose organs have failed-but not enough organs are available to meet demand. Ethics and the Acquisition of Organs is concerned with the major ethical problems raised by policies for acquiring organs. The main topics are the rights of the dead, the role of the family, opt in and opt out systems, the conscription of organs, living organ donation from adults and children, directed donation and priority for donors, and the sale of organs. In this ground-breaking work, T. M. Wilkinson uses concepts from moral and political theory such as autonomy, rights, posthumous interests, justice, and well-being, in a context informed by the clinical, legal, and policy aspects of transplantation. The result is a rigorous philosophical exploration of real problems and options. He argues that the ethics of acquiring organs for transplantation is not only of great intellectual interest, but also of practical importance. As such, this book will be of profit not only to students and academics who work in applied ethics and bioethics, but also to the lawyers, policy-makers, clinicians, and lobby groups interested in transplantation.

The spectacular development of medical knowledge over the last two centuries has brought intrusive advances in the capabilities of medical technology. These advances have been remarkable over the last century, but especially over the last few decades, culminating in such high technology interventions as heart transplants and renal dialysis. These increases in medical powers have attracted societal interest in acquiring more such knowledge. They have also spawned concerns regarding the use of human subjects in research and regarding the byproducts of basic research as in the recent recombinant DNA debate. As a consequence of the development of new biomedical knowledge, physicians and biomedical scientists have been placed in positions of new power and responsibility. The emergence of this group of powerful and knowledgeable experts has occasioned debates regarding the accountability of physicians and biomedical scientists. But beyond that, the very investment of resources in the acquisition of new knowledge has been questioned. Societies must decide whether finite resources would not be better invested at this juncture, or in general, in the alleviation of the problems of hunger or in raising general health standards through interventions which are less dependent on the intensive use of high technology. To put issues in this fashion touches on philosophical notions concerning the claims of distributive justice and the ownership of biomedical knowledge.

Long before it cured disease, medicine aimed to relieve suffering- but despite that precedence, the relief of suffering often takes a back seat in today's biomedical research and treatment. Modern bioethics, too, has been slow to come to terms with suffering. Attention to ethical quandaries has sometimes displaced attention to the experience of patients. This book seeks to place suffering at the center of bioethical thinking once again. Among the questions its contributors explore are: What is the meaning of suffering? How does it relate to pain? If there can be pain without suffering, can there be suffering without pain? Does suffering require advanced cognitive abilities? Can animals suffer? Many believe that we have strong obligations to relieve or minimize suffering; what are the limits of these obligations? Does the relief of suffering justify the termination of a patient's life, as proponents of euthanasia maintain? What is the bearing of suffering on the cherished bioethical principle of autonomy? Can suffering impair a patient's ability to make reasoned choices? To what extent must the encounter with suffering be an important component of medical education? Do religious traditions ever move from efforts to explain and relieve suffering to positions that justify and promote it? The aim of this book is to undertake a new foray into this "foreign territory" of suffering. With a foreword by the distinguished bioethicist Daniel Callahan, its twenty-two chapters, authored by leading scholars in science and bioethics, are organized so as to examine suffering in its biological, psychological, clinical, religious, and ethical dimensions.

Advances in medical treatment now enable physicians to prolong life to a previously unknown extent, however in many instances these new techniques mean not the saving of life but prolonging the act of dying. In the eyes of many, medical technology has run out of control and contributes to unnecessary suffering. Hence the demand has arisen that patients should be entitled to choose death when pain and physical and mental deterioration have destroyed the possibility of a dignified and meaningful life and that their doctors should help them to realize this endeavor.
At the present time there are seven jurisdictions in the world that, with various restrictions, have legalized the practice of assisted death -- physician-assisted suicide and/or voluntary euthanasia - to wit, the Netherlands, Belgium, Luxembourg, Switzerland in Europe and the states of Oregon, Washington and Montana in the United States. Four of these regimes - in the Netherlands, Belgium, Switzerland and the state of Oregon -- have been functioning for many years, and we have for them a substantial body of data as well as much observational research. This book is based upon this material.
The literature dealing with the moral, legal and social aspects of assisted death is voluminous, but there is a paucity of writing that provides a detailed account of the way these four regimes are actually working. Many partisans, on both sides of the issue, cite existing data selectively or, at times, willfully distort the empirical evidence in order to strengthen their case. Based on the documentary record and interviews with officials and scholars, this book seeks to give the specialist as well as the general interested reader a reliable picture of the way assisted death functions and to draw relevant lessons. While accurate factual information cannot settle a moral debate, it nevertheless is a precondition of any well-founded argument.
'The author speaks authoritatively about the issues he addresses. I think this book does make an important contribution to the field. It will be of interest to students and scholars of PAS as a source of information and reference. I definitely recommend publication.' Stuart Youngner, Department of Bioethics, Case Western Reserve University School of Medicine
'The information collected here makes an important contribution to the literature on PAS because it collects a broad array of relevant information into a single volume. It is interesting and enlightening. This will make the book a valuable resource for anyone interested in the subject and an especially useful resource for academics who study or teach about the issues.' Rosamond Rhodes, Director, Bioethics Education, Mt Sinai School of Medicine

Medicine is a complex social institution which includes biomedical research, clinical practice, and the administration and organization of health care delivery. As such, it is amenable to analysis from a number of disciplines and directions. The present volume is composed of revised papers on the theme of "Responsibility in Health Care" presented at the Eleventh Trans Disciplinary Symposium on Philosophy and Medicine, which was held in Springfield, illinois on March 16-18, 1981. The collective focus of these essays is the clinical practice of medicine and the themes and issues related to questions of responsibility in that setting. Responsibility has three related dimensions which make it a suitable theme for an inquiry into clinical medicine: (a) an external dimension in legal and political analysis in which the State imposes penalties on individuals and groups and in which officials and governments are held accountable for policies; (b) an internal dimension in moral and ethical analysis in which individuals take into account the consequences of their actions and the criteria which bear upon their choices; and (c) a comprehensive dimension in social and cultural analysis in which values are ordered in the structure of a civilization ( 8], p. 5). The title "Responsibility in Health Care" thus signifies a broad inquiry not only into the ethics of individual character and actions, but the moral foundations of the cultural, legal, political, and social context of health care generally."

This volume brings together a range of linguistic, sociological, and professional views on communication in surgical practice. It aims to provide an insight into the complexity of communication in surgery, covering the variety of communicative activities required in everyday surgical work.The selection of authors from a variety of interactive sociolinguistic disciplines in collaboration with clinicians explores a broad range of topics and the methodologies currently used to understand communication in surgical practice.The intended audience for this book includes surgeons, medical educators, communication researchers, linguists, sociologists, and others with an interest in surgical and medical communication.

The potential of modern medicine in a pluralistic world leads to the potential for moral conflict. The most prevalent bioethical theories often either overestimate or underestimate the amount of shared moral belief that can be used to address those conflicts. This work presents a means for taking seriously the pluralism in the modern world while recognizing the likelihood of moral "acquaintance" between persons with differing views. It criticizes moral theories that overstate the extent of the problem of pluralism as well as those that imply too much agreement between reasonable moral persons, yet it locates a means for the resolution of many moral conflicts in moral acquaintanceship. Drawing from the work of H. Tristram Engelhardt, Jr., casuists and principle-based theorists, and Erich Loewy and Kevin W. Wildes's initial development of the concept of moral acquaintanceship, Moral Acquaintances and Moral Decisions is philosophically indepth work with direct applications for decisionmaking in real medical settings. A work in moral theory as well as a source of real world guidance, clinically oriented bioethics professionals as well as students of bioethical theory should find the theory of moral acquaintanceship provided here important to their work.

Going back at least to the writings of John Stuart Mill and Jean-Jacques Rousseau, people have argued for and against maintaining a state of nature. Is there an inherent virtue in leaving alone a naturally occurring condition, or does the human species thrive when we find ways to improve our circumstances? This volume probes whether "nature" and "the natural" are capable of guiding moral deliberations in policy making.

Drawing on philosophy, religion, and political science, this book examines three questions central to debates over the idea of "nature" in human action. Conceptually, it asks what the term means, how it should be considered, and if it is, even in part, a social construct. From a moral perspective, the contributors question if being "natural" is itself of value or if its worth is only as a means to advance other morally acceptable ends. Politically, essays discuss whether appeals to nature can and should affect public policy and, if so, whether they are moral trump cards or should instead be fitted alongside or weighed against other concerns.

Achieving consensus on these questions has proven elusive and seems unattainable. This should not, however, be an obstacle to moving the debate forward. By bringing together disparate approaches to addressing these concepts, "The Ideal of Nature" suggests the possibility of intermediate positions that move beyond the usual full-throated defense and blanket dismissal found in much of the debate. Scholars of bioethics, environmental philosophy, religious studies, sociology, public policy, and political theory will find much merit in this book's lively discussion.

Since its inception as an international principle to protect the welfare of patients and volunteers taking part in medical research, informed consent has become increasingly important within healthcare. Despite its ubiquitous status, there are a number of scholars who are beginning to question whether consent is adequate for contemporary biomedical research. The Limits of Consent considers a number of criticisms that have been levelled at the prominence given to autonomy, a central tenet underpinning the rationale for informed consent in Western bioethics. It raises questions about how quickly and easily this principle has been adopted, and how appropriate it is for those actively engaged in research. In the context of genetic research, for example, the individual's overriding right of autonomy to give consent to research could have huge implications for other members of their families.
The Limits of Consent questions the assumption that informed consent protects or facilitates individual autonomy, and discusses empirical studies which suggest that gaining a truly informed consent can be difficult to achieve in practice. With the expectation of treatment and guidance from the physician, how much is the process of consent governed by social norms and expectations? The Limits of Consent focuses upon three principal areas within biomedical research: clinical trials, genetic research, and research with those who may have impaired capacity to consent. It is a truly multi-disciplinary book, incorporating perspectives from medicine, law, philosophy and sociology.
The Limits of Consent is a fascinating exploration of the inadequacies of consent, and will appeal to those in the fields of bioethics, socio-legal studies, sociology, and health law. Policy makers, research ethics committee members, and those healthcare professionals with an interest in medical ethics, will also find the book of interest.

In the last two decades, more than ever before dentists must determine how to properly maintain their focus on ethics and professionalism in the face of powerful commercial pressures. While there is encouragement for ethical conduct within the dental profession, there is still relatively little assistance available to dentists and dental students for judging what conduct is ethically best in concrete situations. For many years, Dental Ethics at Chairside has served as an invaluable resource for tens of thousands of dentists and dentistry students, and this third edition of the gold standard in the field is thoroughly revised and updated. In addition to exploring ongoing and critical issues such as the patient-professional relationship, patients with compromised capacity, confidentiality, justice and the inadequacies of society's health care systems, and dentistry as a business, the third edition addresses emerging ethical issues related to conflicts of interest, dental professionalism, advertising and social media, the serious indebtedness of graduating dental students, bad outcomes and bad work, the explosion of aesthetic dentistry, acquiring new skills and new technology, the impact of the market on the professional-patient relationship, and many others. The book includes fourteen realistic cases and commentary about dilemmas in dentistry, as well as online resources for further research and study.

The editors of the Philosophy and Medicine series recognize with grat itude the foresight, understanding, hard labor, and patience of Prof. Kazumasa Hoshino. It is his perseverance that has made this volume a reality. It was his faith in ideas that brought together a cluster of scholars in Tokyo on September 2-4, 1994, at Sophia University for a U. S. -J apan Bioethics Congress. With the support of the Foundation for Advance ment of International Science, the Japan Foundation Center for Global Partnership, the Foundation of Thanatology, the Japanese Center for Quality of Life Studies, and Sophia University, scholars from Canada, Germany, Japan, and the United States were able to explore the differ ences and similarities in their approaches to bioethics and health care policy. That conference first produced a volume through Shibunkaku Publishers of Kyoto that appeared in 1995 in J apanese: The Dignity of Death, edited by Kazumasa Hoshino. Selections from those materials have been reworked for an English audience and now appear, along with new essays, in this volume. The field of comparative bioethics is only in its infancy. We are deeply grateful to Prof. Kazumasa Hoshino, one of the fathers of J apanese bioethics, for having made this volume possible. H. Tristram Engelhardt, Jr. Stuart F. Spicker Vll ACKNOWLEDGEMENTS This volume's editors and Kluwer Academic Publishers wish to thank Shibunkaku Press, Kyoto, Japan, for permission to publish, without charge, essays derived from the U. S."