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The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms. A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.

This concerned me, but didn’t feel I was in the position to sound some kind of alarm back then. There was a team of about eight of us, and only one other person brought up the kinds of questions I had. Anyone who raised doubts ran the risk of being called a transphobe. 

I certainly saw this at the center. One of my jobs was to do intake for new patients and their families. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school. 

There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are. 

The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.

To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription. 

When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable. Our patients were told about some side effects, including sterility. But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor.

Many encounters with patients emphasized to me how little these young people understood the profound impacts changing gender would have on their bodies and minds. But the center downplayed the negative consequences, and emphasized the need for transition. As the center’s website said, “Left untreated, gender dysphoria has any number of consequences, from self-harm to suicide. But when you take away the gender dysphoria by allowing a child to be who he or she is, we’re noticing that goes away. The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.” 

Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).

Here’s an example. On Friday, May 1, 2020, a colleague emailed me about a 15-year-old male patient: “Oh dear. I am concerned that [the patient] does not understand what Bicalutamide does.” I responded: “I don’t think that we start anything honestly right now.”

Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects, and this patient experienced one of them: liver toxicity. He was sent to another unit of the hospital for evaluation and immediately taken off the drug. Afterward, his mother sent an electronic message to the Transgender Center saying that we were lucky her family was not the type to sue.

How little patients understood what they were getting into was illustrated by a call we received at the center in 2020 from a 17-year-old biological female patient who was on testosterone. She said she was bleeding from the vagina. In less than an hour she had soaked through an extra heavy pad, her jeans, and a towel she had wrapped around her waist. The nurse at the center told her to go to the emergency room right away.

when there was a dispute between the parents, it seemed the center always took the side of the affirming parent.

Other girls were disturbed by the effects of testosterone on their clitoris, which enlarges and grows into what looks like a microphallus, or a tiny penis. I counseled one patient whose enlarged clitoris now extended below her vulva, and it chafed and rubbed painfully in her jeans. I advised her to get the kind of compression undergarments worn by biological men who dress to pass as female. At the end of the call I thought to myself, “Wow, we hurt this kid.”

There are rare conditions in which babies are born with atypical genitalia—cases that call for sophisticated care and compassion. But clinics like the one where I worked are creating a whole cohort of kids with atypical genitals—and most of these teens haven’t even had sex yet. They had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist.

Being put on powerful doses of testosterone or estrogen—enough to try to trick your body into mimicking the opposite sex—-affects the rest of the body. I doubt that any parent who's ever consented to give their kid testosterone (a lifelong treatment) knows that they’re also possibly signing their kid up for blood pressure medication, cholesterol medication, and perhaps sleep apnea and diabetes. 

Besides teenage girls, another new group was referred to us: young people from the inpatient psychiatric unit, or the emergency department, of St. Louis Children’s Hospital. The mental health of these kids was deeply concerning—there were diagnoses like schizophrenia, PTSD, bipolar disorder, and more. Often they were already on a fistful of pharmaceuticals.

no matter how much suffering or pain a child had endured, or how little treatment and love they had received, our doctors viewed gender transition—even with all the expense and hardship it entailed—as the solution.

Another disturbing aspect of the center was its lack of regard for the rights of parents—and the extent to which doctors saw themselves as more informed decision-makers over the fate of these children.

We found out later this girl had had intercourse, and because testosterone thins the vaginal tissues, her vaginal canal had ripped open. She had to be sedated and given surgery to repair the damage. She wasn’t the only vaginal laceration case we heard about.

During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility. 

I left the clinic in November of last year because I could no longer participate in what was happening there. By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to “do no harm.” Instead, we are permanently harming the vulnerable patients in our care.

Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.

Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling.

For almost four years, I worked at The Washington University School of Medicine Division of Infectious Diseases with teens and young adults who were HIV positive. Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a transman, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt. 

The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus. 

All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children's Hospital, which had been established a year earlier. 

As a 15-year-old, I was condemned to long-term solitary confinement in the Florida prison system, which ultimately lasted for 18 consecutive years

From age 15 to 33.

For 18 years I didn’t have a window in my room to distract myself from the intensity of my confinement

I wasn’t permitted to talk to my fellow prisoners or even to myself. I didn’t have healthy, nutritious food; I was given just enough to not die

These circumstances made me think about how I ended up in solitary confinement.

United Nations standards on the treatment of prisoners prohibits solitary confinement for more than 15 days, declaring it “cruel, inhuman or degrading.”

For this I was arrested and charged as an adult with armed robbery and attempted murder.

My court-appointed lawyer advised me to plead guilty, telling me that the maximum sentence would be 15 years. So I did. But my sentence wasn’t 15 years — it was life imprisonment without the possibility of parole.

But a year and a half later, at age 15, I was put back into solitary confinement after being written up for a few minor infractions.

Florida has different levels of solitary confinement; I spent the majority of that time in one of the most restrictive

I was finally released from prison in 2016 thanks to my lawyer, Bryan Stevenson

Researchers have long concluded that solitary confinement causes post-traumatic stress disorder and impairs prisoners’ ability to adjust to society long after they leave their cell.

In the summer of 1990, shortly after finishing seventh grade, I was directed by a few older kids to commit a robbery. During the botched attempt, I shot a woman. She suffered serious injuries to her jaw and mouth but survived. It was reckless and foolish on my part, the act of a 13-year-old in crisis, and I’m simply grateful no one died.

More aggressive change is needed in state prison systems

In 2016, the Obama administration banned juvenile solitary confinement in federal prisons, and a handful of states have advanced similar reforms for both children and adults.

Yet the practice, even for minors, is still common in the United States, and efforts to end it have been spotty

Because solitary confinement is hidden from public view and the broader prison population, egregious abuses are left unchecked

I watched a corrections officer spray a blind prisoner in the face with chemicals simply because he was standing by the door of his cell as a female nurse walked by. The prisoner later told me that to justify the spraying, the officer claimed the prisoner masturbated in front of the nurse.

I also witnessed the human consequences of the harshness of solitary firsthand: Some people would resort to cutting their stomachs open with a razor and sticking a plastic spork inside their intestines just so they could spend a week in the comfort of a hospital room with a television

On occasion, I purposely overdosed on Tylenol so that I could spend a night in the hospital. For even one night, it was worth the pain.

Another time, I was told I’d be switching dorms, and I politely asked to remain where I was because a guard in the new area had been overly aggressive with me. In response, four or five officers handcuffed me, picked me up by my feet and shoulders, and marched with me to my new dorm — using my head to ram the four steel doors on the way there.

The punishments were wholly disproportionate to the infractions. Before I knew it, months in solitary bled into years, years into almost two decades.

As a child, I survived these conditions by conjuring up stories of what I’d do when I was finally released. My mind was the only place I found freedom from my reality

the only place I could play basketball with my brother or video games with my friends, and eat my mother’s warm cherry pie on the porch.

No child should have to use their imagination this way — to survive.

It is difficult to know the exact number of children in solitary confinement today. The Liman Center at Yale Law School estimated that 61,000 Americans (adults and children) were in solitary confinement in the fall of 2017

No matter the count, I witnessed too many people lose their minds while isolated. They’d involuntarily cross a line and simply never return to sanity. Perhaps they didn’t want to. Staying in their mind was the better, safer, more humane option.

Solitary confinement is cruel and unusual punishment, something prohibited by the Eighth Amendment, yet prisons continue to practice it.

When it comes to children, elimination is the only moral option. And if ending solitary confinement for adults isn’t politically viable, public officials should at least limit the length of confinement to 15 days or fewer, in compliance with the U.N. standards

As I try to reintegrate into society, small things often awaken painful memories from solitary. Sometimes relationships feel constraining. It’s difficult to maintain the attention span required for a rigid 9-to-5 job. At first, crossing the street and seeing cars and bikes racing toward me felt terrifying.

I will face PTSD and challenges big and small for the rest of my life because of what I was subjected to.

And some things I never will — most of all, that this country can treat human beings, especially children, as cruelly as I was treated.

Sadly, solitary confinement for juveniles is still permissible in many states. But we have the power to change that — to ensure that the harrowing injustice I suffered as a young boy never happens to another child in America.

The country will also need to open more vaccination sites, some of which should be open 24/7 to ensure people who get off work at odd hours have easy access to the vaccine.“This is a wartime sort of response,” Fagbuyi said. “You’re going to pull all the stops and not leave any stone unturned.”

“Enjoy the opportunity, but also be cautious and look at what’s going on around you,” Fagbuyi said.

So, when will we get to a point where it won’t be so complicated for the general public to score a vaccine appointment? Fagbuyi predicts sometime in June.

Adalja predicts that by the Fourth of July, vulnerable people will be vaccinated in all states and there will no longer be concerns about reaching hospital capacity.

“We’re going to be trying to convince people to come get vaccinated,” Adalja said.

We often hear doctors say we want 70% of the population to be immune to COVID-19, whether through vaccination, natural infection or preexisting immunity, to achieve herd immunity. Each dose pricked in someone’s arm makes it harder for the virus to spread.

“What I think is more important than herd immunity is making sure vulnerable populations are vaccinated so that COVID loses the ability to cause severe illness, hospitalization and death,” Adalja said.

Even if the doctors couldn’t pin down what was going on with me, I was so alarmed by my symptoms and the doctors’ gravest guesses that I felt anxious about whether or not I would have a future.

What was certain is that I was shrinking. Rapidly, uncontrollably.

My clothes hung loose at the waist and sloughed off my shoulders as if they belonged to a stranger, so I bought a stranger’s dress. Kate Spade, $348 retail.

I found it for $50 at an online designer consignment store while on hold with the hospital; a nurse was checking on the results of my bone marrow biopsy.

Online shopping was the sort of thing one might do if she were on hold with her cable company, not awaiting a possible blood cancer diagnosis.

I filled my cart with a cobalt dress, a blush silk blouse, a slinky skirt.

On paper, the doctors said, it looked like it could be lymphoma. The symptoms were classic: fever, night sweats, weight loss.

A biopsy of my enlarged lymph node showed it to be benign.

Two weeks earlier, a doctor had taken a surgical drill to my hip and hollowed out my bones with a syringe fit for a large horse. “Painful” was a deficient descriptor.

“I just don’t know what else to do,” my doctor said.

I sat still while my insides turned over. A cold sweat crept across my face. I closed my eyes, shook my head and returned to my shopping cart. I was not going to dwell.

No — I was going to shop. I was going to shop until I could think of nothing else. I punched in my credit card number and bought the Kate Spade.

Then I rushed to my closet, threw open the double doors and began rifling through Target impulse buys and ill-fitting hand-me-down

we’ll have to keep looking

I couldn’t breathe. I couldn’t do illness anymore. I could only do this.

I spun around in it, watching the hem rise and fall. Something about it made me feel less like a haggard patient and more like the kind of woman who went to cocktail parties dripping with perfume and family money.

Over the next few months, I made it my mission to build a new wardrobe from scratch. The process demanded every moment of my free time, every spare thought

We both knew it was impractical. The clothes were expensive and high maintenance, most of them over-the-top fancy for my modest life in nonprofit communications.

But they felt vital. I told myself I was overdue for some frivolity, that I deserved to treat myself.

For my next doctor’s appointment, I picked out a Valentino pencil skirt that fit snugly against my new, withered body.

I hurled the clothes into boxes and garbage bags. They smelled like the hospital, all burned coffee and antiseptic. I didn’t want them. I didn’t even want to look at them. I wanted silk. I wanted velvet.

“Can I see you again in six weeks? We can repeat blood work then and come up with a timeline for scans. Does that sound like an OK plan?”

“Just that I live here,” I said, gesturing at my body. “I have to live here.”

That night I ran my fingers through my hair, and a clump of blond strands fell loose into my palm. “It’s just stress,” I told my cat. I brushed my hands together, letting my hair fall into the trash, and returned to my shopping list.

Each one had lived a life before me. Now I held onto them in the dim light of my bedroom like tangible hope.

We’re forced to find hope in what we used to mock: God, the afterlife, miracles, hemp oil. Healing, by any means. Healing, against all odds.

After every appointment, after every failed attempt to name my illness, I would prop myself in bed, choose new dresses and think of all the places I would wear them.

The clothes promised me something the doctors, as they continue to search for a diagnosis, still can’t: an uncomplicated future. And I promised a future to the clothes.

This was their life after life. And they deserved that, didn’t they?

She and others emphasized the apparent lack of severe health repercussions from reinfection — and the lack of evidence that reinfection is common.

Nearly 4 percent of people who had a previous infection were reinfected, an almost identical rate to those with no history of infection.

“Basically, it’s saying vaccination actually needs to be better than natural immunity. But vaccination is better than natural immunity.”

The study backs up recent laboratory data from South African researchers analyzing blood plasma from recovered patients. Nearly half of the plasma samples had no detectable ability to block the variant from infecting cells in a laboratory dish

The good news is that vaccine trials from Johnson & Johnson and Novavax show that vaccines can work — even against the B.1.351 variant, and particularly in preventing severe illness.

Novavax did not provide a breakdown of mild, moderate and severe cases, but severe cases of covid-19 were rare in the trial, suggesting that reinfection is unlikely to send people to the hospital.

“It is not surprising to see reinfection in individuals who are convalescent. And it would not be surprising to see infection in people who are vaccinated, especially a few months out from vaccine,”

“The key is not whether people get reinfected, it’s whether they get sick enough to be hospitalized.

“If the data holds true, it means we will need to walk the public back on the idea of how close we are to the finish line for ending this pandemic.”

Projections created by data scientist Youyang Gu — whose pandemic models have been cited by the Centers for Disease Control and Prevention — suggest that about 65 percent of America’s population will reach immunity by June 1. But built into that 65 percent is roughly 20 percent having immunity from past infections only.

In a separate study, scientists at Rockefeller University in New York took blood plasma from people who had been vaccinated and found that vaccine-generated antibodies were largely able to block mutations found on the B.1.351 variant.

I think the fact that we … now have data from two vaccines indicating that we can prevent serious disease, even against the new variant, is hopeful,”

A future concern needing close monitoring is whether the reformulation of vaccines to keep up with the evolving virus could drive the virus to continue evolving.

There is also a concern that subpar immunity could allow new resistant variants to emerge. That possibility, Nussenzweig said, is one reason that people should get both doses of a vaccine, on time.

Rationality is the collection of theories, beliefs, principles, and facts that the human subject uses to judge the world, and a person’s rationality is, to a large extent, the product of that person’s education and moral formation.

To the extent that a person accepts what is handed down from the moral and intellectual traditions of her or his community in learning to judge truth and falsity, good and evil, that person’s rationality is “tradition-constituted.” Tradition-constituted rationality provides the schemata by which we interpret, understand, and judge the world we live in

The apparent problem of relativism in MacIntyre’s theory of rationality is much like the problem of relativism in the philosophy of science. Scientific claims develop within larger theoretical frameworks, so that the apparent truth of a scientific claim depends on one’s judgment of the larger framework. The resolution of the problem of relativism therefore appears to hang on the possibility of judging frameworks or rationalities, or judging between frameworks or rationalities from a position that does not presuppose the truth of the framework or rationality, but no such theoretical standpoint is humanly possible.

MacIntyre finds that the world itself provides the criterion for the testing of rationalities, and he finds that there is no criterion except the world itself that can stand as the measure of the truth of any philosophical theory.

MacIntyre’s philosophy is indebted to the philosophy of science, which recognizes the historicism of scientific enquiry even as it seeks a truthful understanding of the world. MacIntyre’s philosophy does not offer a priori certainty about any theory or principle; it examines the ways in which reflection upon experience supports, challenges, or falsifies theories that have appeared to be the best theories so far to the people who have accepted them so far. MacIntyre’s ideal enquirers remain Hamlets, not Emmas.

history shows us that individuals, communities, and even whole nations may commit themselves militantly over long periods of their histories to doctrines that their ideological adversaries find irrational. This qualified relativism of appearances has troublesome implications for anyone who believes that philosophical enquiry can easily provide certain knowledge of the world

According to MacIntyre, theories govern the ways that we interpret the world and no theory is ever more than “the best standards so far” (3RV, p. 65). Our theories always remain open to improvement, and when our theories change, the appearances of our world—the apparent truths of claims judged within those theoretical frameworks—change with them.

From the subjective standpoint of the human enquirer, MacIntyre finds that theories, concepts, and facts all have histories, and they are all liable to change—for better or for worse.

MacIntyre holds that the rationality of individuals is not only tradition-constituted, it is also tradition constitutive, as individuals make their own contributions to their own rationality, and to the rationalities of their communities. Rationality is not fixed, within either the history of a community or the life of a person

The modern account of first principles justifies an approach to philosophy that rejects tradition. The modern liberal individualist approach is anti-traditional. It denies that our understanding is tradition-constituted and it denies that different cultures may differ in their standards of rationality and justice:

Modernity does not see tradition as the key that unlocks moral and political understanding, but as a superfluous accumulation of opinions that tend to prejudice moral and political reasoning.

Although modernity rejects tradition as a method of moral and political enquiry, MacIntyre finds that it nevertheless bears all the characteristics of a moral and political tradition.

If historical narratives are only projections of the interests of historians, then it is difficult to see how this historical narrative can claim to be truthful

For these post-modern theorists, “if the Enlightenment conceptions of truth and rationality cannot be sustained,” either relativism or perspectivism “is the only possible alternative” (p. 353). MacIntyre rejects both challenges by developing his theory of tradition-constituted and tradition-constitutive rationality on pp. 354-369

How, then, is one to settle challenges between two traditions? It depends on whether the adherents of either take the challenges of the other tradition seriously. It depends on whether the adherents of either tradition, on seeing a failure in their own tradition are willing to consider an answer offered by their rival (p. 355)

how a person with no traditional affiliation is to deal with the conflicting claims of rival traditions: “The initial answer is: that will depend upon who you are and how you understand yourself. This is not the kind of answer which we have been educated to expect in philosophy”

MacIntyre focuses the critique of modernity on the question of rational justification. Modern epistemology stands or falls on the possibility of Cartesian epistemological first principles. MacIntyre’s history exposes that notion of first principle as a fiction, and at the same time demonstrates that rational enquiry advances (or declines) only through tradition

MacIntyre cites Foucault’s 1966 book, Les Mots et les choses (The Order of Things, 1970) as an example of the self-subverting character of Genealogical enquiry

Foucault’s book reduces history to a procession of “incommensurable ordered schemes of classification and representation” none of which has any greater claim to truth than any other, yet this book “is itself organized as a scheme of classification and representation.”

From MacIntyre’s perspective, there is no question of deciding whether or not to work within a tradition; everyone who struggles with practical, moral, and political questions simply does. “There is no standing ground, no place for enquiry . . . apart from that which is provided by some particular tradition or other”

Three Rival Versions of Moral Enquiry (1990). The central idea of the Gifford Lectures is that philosophers make progress by addressing the shortcomings of traditional narratives about the world, shortcomings that become visible either through the failure of traditional narratives to make sense of experience, or through the introduction of contradictory narratives that prove impossible to dismiss

MacIntyre compares three traditions exemplified by three literary works published near the end of Adam Gifford’s life (1820–1887)

The Ninth Edition of the Encyclopaedia Britannica (1875–1889) represents the modern tradition of trying to understand the world objectively without the influence of tradition.

The Genealogy of Morals (1887), by Friedrich Nietzsche embodies the post-modern tradition of interpreting all traditions as arbitrary impositions of power.

The encyclical letter Aeterni Patris (1879) of Pope Leo XIII exemplifies the approach of acknowledging one’s predecessors within one’s own tradition of enquiry and working to advance or improve that tradition in the pursuit of objective truth. 

Of the three versions of moral enquiry treated in 3RV, only tradition, exemplified in 3RV by the Aristotelian, Thomistic tradition, understands itself as a tradition that looks backward to predecessors in order to understand present questions and move forward

Encyclopaedia obscures the role of tradition by presenting the most current conclusions and convictions of a tradition as if they had no history, and as if they represented the final discovery of unalterable truth

Encyclopaedists focus on the present and ignore the past.

Genealogists, on the other hand, focus on the past in order to undermine the claims of the present.

In short, Genealogy denies the teleology of human enquiry by denying (1) that historical enquiry has been fruitful, (2) that the enquiring person has a real identity, and (3) that enquiry has a real goal. MacIntyre finds this mode of enquiry incoherent.

Genealogy is self-deceiving insofar as it ignores the traditional and teleological character of its enquiry.

Genealogical moral enquiry must make similar exceptions to its treatments of the unity of the enquiring subject and the teleology of moral enquiry; thus “it seems to be the case that the intelligibility of genealogy requires beliefs and allegiances of a kind precluded by the genealogical stance” (3RV, p. 54-55)

MacIntyre uses Thomism because it applies the traditional mode of enquiry in a self-conscious manner. Thomistic students learn the work of philosophical enquiry as apprentices in a craft (3RV, p. 61), and maintain the principles of the tradition in their work to extend the understanding of the tradition, even as they remain open to the criticism of those principles.

3RV uses Thomism as its example of tradition, but this use should not suggest that MacIntyre identifies “tradition” with Thomism or Thomism-as-a-name-for-the-Western-tradition. As noted above, WJWR distinguished four traditions of enquiry within the Western European world alone

MacIntyre’s emphasis on the temporality of rationality in traditional enquiry makes tradition incompatible with the epistemological projects of modern philosophy

Tradition is not merely conservative; it remains open to improvement,

Tradition differs from both encyclopaedia and genealogy in the way it understands the place of its theories in the history of human enquiry. The adherent of a tradition must understand that “the rationality of a craft is justified by its history so far,” thus it “is inseparable from the tradition through which it was achieved”

MacIntyre uses Thomas Aquinas to illustrate the revolutionary potential of traditional enquiry. Thomas was educated in Augustinian theology and Aristotelian philosophy, and through this education he began to see not only the contradictions between the two traditions, but also the strengths and weaknesses that each tradition revealed in the other. His education also helped him to discover a host of questions and problems that had to be answered and solved. Many of Thomas Aquinas’ responses to these concerns took the form of disputed questions. “Yet to each question the answer produced by Aquinas as a conclusion is no more than and, given Aquinas’s method, cannot but be no more than, the best answer reached so far. And hence derives the essential incompleteness”

argue that the virtues are essential to the practice of independent practical reason. The book is relentlessly practical; its arguments appeal only to experience and to purposes, and to the logic of practical reasoning.

Like other intelligent animals, human beings enter life vulnerable, weak, untrained, and unknowing, and face the likelihood of infirmity in sickness and in old age. Like other social animals, humans flourish in groups. We learn to regulate our passions, and to act effectively alone and in concert with others through an education provided within a community. MacIntyre’s position allows him to look to the animal world to find analogies to the role of social relationships in the moral formation of human beings

The task for the human child is to make “the transition from the infantile exercise of animal intelligence to the exercise of independent practical reasoning” (DRA, p. 87). For a child to make this transition is “to redirect and transform her or his desires, and subsequently to direct them consistently towards the goods of different stages of her or his life” (DRA, p. 87). The development of independent practical reason in the human agent requires the moral virtues in at least three ways.

DRA presents moral knowledge as a “knowing how,” rather than as a “knowing that.” Knowledge of moral rules is not sufficient for a moral life; prudence is required to enable the agent to apply the rules well.

“Knowing how to act virtuously always involves more than rule-following” (DRA, p. 93). The prudent person can judge what must be done in the absence of a rule and can also judge when general norms cannot be applied to particular cases.

Flourishing as an independent practical reasoner requires the virtues in a second way, simply because sometimes we need our friends to tell us who we really are. Independent practical reasoning also requires self-knowledge, but self-knowledge is impossible without the input of others whose judgment provides a reliable touchstone to test our beliefs about ourselves. Self-knowledge therefore requires the virtues that enable an agent to sustain formative relationships and to accept the criticism of trusted friends

Human flourishing requires the virtues in a third way, by making it possible to participate in social and political action. They enable us to “protect ourselves and others against neglect, defective sympathies, stupidity, acquisitiveness, and malice” (DRA, p. 98) by enabling us to form and sustain social relationships through which we may care for one another in our infirmities, and pursue common goods with and for the other members of our societies.

MacIntyre argues that it is impossible to find an external standpoint, because rational enquiry is an essentially social work (DRA, p. 156-7). Because it is social, shared rational enquiry requires moral commitment to, and practice of, the virtues to prevent the more complacent members of communities from closing off critical reflection upon “shared politically effective beliefs and concepts”

MacIntyre finds himself compelled to answer what may be called the question of moral provincialism: If one is to seek the truth about morality and justice, it seems necessary to “find a standpoint that is sufficiently external to the evaluative attitudes and practices that are to be put to the question.” If it is impossible for the agent to take such an external standpoint, if the agent’s commitments preclude radical criticism of the virtues of the community, does that leave the agent “a prisoner of shared prejudices” (DRA, p. 154)?

The book moves from MacIntyre’s assessment of human needs for the virtues to the political implications of that assessment. Social and political institutions that form and enable independent practical reasoning must “satisfy three conditions.” (1) They must enable their members to participate in shared deliberations about the communities’ actions. (2) They must establish norms of justice “consistent with exercise of” the virtue of justice. (3) They must enable the strong “to stand proxy” as advocates for the needs of the weak and the disabled.

The social and political institutions that MacIntyre recommends cannot be identified with the modern nation state or the modern nuclear family

The political structures necessary for human flourishing are essentially local

Yet local communities support human flourishing only when they actively support “the virtues of just generosity and shared deliberation”

MacIntyre rejects individualism and insists that we view human beings as members of communities who bear specific debts and responsibilities because of our social identities. The responsibilities one may inherit as a member of a community include debts to one’s forbearers that one can only repay to people in the present and future

The constructive argument of the second half of the book begins with traditional accounts of the excellences or virtues of practical reasoning and practical rationality rather than virtues of moral reasoning or morality. These traditional accounts define virtue as arête, as excellence

Practices are supported by institutions like chess clubs, hospitals, universities, industrial corporations, sports leagues, and political organizations.

Practices exist in tension with these institutions, since the institutions tend to be oriented to goods external to practices. Universities, hospitals, and scholarly societies may value prestige, profitability, or relations with political interest groups above excellence in the practices they are said to support.

Personal desires and institutional pressures to pursue external goods may threaten to derail practitioners’ pursuits of the goods internal to practices. MacIntyre defines virtue initially as the quality of character that enables an agent to overcome these temptations:

“A virtue is an acquired human quality the possession and exercise of which tends to enable us to achieve those goods which are internal to practices

Excellence as a human agent cannot be reduced to excellence in a particular practice (See AV, pp. 204–

The virtues therefore are to be understood as those dispositions which will not only sustain practices and enable us to achieve the goods internal to practices, but which will also sustain us in the relevant kind of quest for the good, by enabling us to overcome the harms, dangers, temptations, and distractions which we encounter, and which will furnish us with increasing self-knowledge and increasing knowledge of the good (AV, p. 219).

The excellent human agent has the moral qualities to seek what is good and best both in practices and in life as a whole.

The virtues find their point and purpose not only in sustaining those relationships necessary if the variety of goods internal to practices are to be achieved and not only in sustaining the form of an individual life in which that individual may seek out his or her good as the good of his or her whole life, but also in sustaining those traditions which provide both practices and individual lives with their necessary historical context (AV, p. 223)

Since “goods, and with them the only grounds for the authority of laws and virtues, can only be discovered by entering into those relationships which constitute communities whose central bond is a shared vision of and understanding of goods” (AV, p. 258), any hope for the transformation and renewal of society depends on the development and maintenance of such communities.

MacIntyre’s Aristotelian approach to ethics as a study of human action distinguishes him from post-Kantian moral philosophers who approach ethics as a means of determining the demands of objective, impersonal, universal morality

This modern approach may be described as moral epistemology. Modern moral philosophy pretends to free the individual to determine for her- or himself what she or he must do in a given situation, irrespective of her or his own desires; it pretends to give knowledge of universal moral laws

Aristotelian metaphysicians, particularly Thomists who define virtue in terms of the perfection of nature, rejected MacIntyre’s contention that an adequate Aristotelian account of virtue as excellence in practical reasoning and human action need not appeal to Aristotelian metaphysic

one group of critics rejects MacIntyre’s Aristotelianism because they hold that any Aristotelian account of the virtues must first account for the truth about virtue in terms of Aristotle’s philosophy of nature, which MacIntyre had dismissed in AV as “metaphysical biology”

Many of those who rejected MacIntyre’s turn to Aristotle define “virtue” primarily along moral lines, as obedience to law or adherence to some kind of natural norm. For these critics, “virtuous” appears synonymous with “morally correct;” their resistance to MacIntyre’s appeal to virtue stems from their difficulties either with what they take to be the shortcomings of MacIntyre’s account of moral correctness or with the notion of moral correctness altogether

MacIntyre continues to argue from the experience of practical reasoning to the demands of moral education.

Descartes and his successors, by contrast, along with certain “notable Thomists of the last hundred years” (p. 175), have proposed that philosophy begins from knowledge of some “set of necessarily true first principles which any truly rational person is able to evaluate as true” (p. 175). Thus for the moderns, philosophy is a technical rather than moral endeavor

MacIntyre distinguishes two related challenges to his position, the “relativist challenge” and the “perspectivist challenge.” These two challenges both acknowledge that the goals of the Enlightenment cannot be met and that, “the only available standards of rationality are those made available by and within traditions” (p. 252); they conclude that nothing can be known to be true or false

MacIntyre follows the progress of the Western tradition through “three distinct traditions:” from Homer and Aristotle to Thomas Aquinas, from Augustine to Thomas Aquinas and from Augustine through Calvin to Hume

Chapter 17 examines the modern liberal denial of tradition, and the ironic transformation of liberalism into the fourth tradition to be treated in the book.

MacIntyre credits John Stuart Mill and Thomas Aquinas as “two philosophers of the kind who by their writing send us beyond philosophy into immediate encounter with the ends of life

First, both were engaged by questions about the ends of life as questioning human beings and not just as philosophers. . . .

Secondly, both Mill and Aquinas understood their speaking and writing as contributing to an ongoing philosophical conversation. . . .

Thirdly, it matters that both the end of the conversation and the good of those who participate in it is truth and that the nature of truth, of good, of rational justification, and of meaning therefore have to be central topics of that conversation (Tasks, pp. 130-1).

Without these three characteristics, philosophy is first reduced to “the exercise of a set of analytic and argumentative skills. . . . Secondly, philosophy may thereby become a diversion from asking questions about the ends of life with any seriousness”

Neither Rosenzweig nor Lukács made philosophical progress because both failed to relate “their questions about the ends of life to the ends of their philosophical writing”

First, any adequate philosophical history or biography must determine whether the authors studied remain engaged with the questions that philosophy studies, or set the questions aside in favor of the answers. Second, any adequate philosophical history or biography must determine whether the authors studied insulated themselves from contact with conflicting worldviews or remained open to learning from every available philosophical approach. Third, any adequate philosophical history or biography must place the authors studied into a broader context that shows what traditions they come from and “whose projects” they are “carrying forward

MacIntyre’s recognition of the connection between an author’s pursuit of the ends of life and the same author’s work as a philosophical writer prompts him to finish the essay by demanding three things of philosophical historians and biographers

Philosophy is not just a study; it is a practice. Excellence in this practice demands that an author bring her or his struggles with the questions of the ends of philosophy into dialogue with historic and contemporary texts and authors in the hope of making progress in answering those questions

MacIntyre defends Thomistic realism as rational enquiry directed to the discovery of truth.

The three Thomistic essays in this book challenge those caricatures by presenting Thomism in a way that people outside of contemporary Thomistic scholarship may find surprisingly flexible and open

To be a moral agent, (1) one must understand one’s individual identity as transcending all the roles that one fills; (2) one must see oneself as a practically rational individual who can judge and reject unjust social standards; and (3) one must understand oneself as “as accountable to others in respect of the human virtues and not just in respect of [one’s] role-performances

J is guilty because he complacently accepted social structures that he should have questioned, structures that undermined his moral agency. This essay shows that MacIntyre’s ethics of human agency is not just a descriptive narrative about the manner of moral education; it is a standard laden account of the demands of moral agency.

MacIntyre considers “the case of J” (J, for jemand, the German word for “someone”), a train controller who learned, as a standard for his social role, to take no interest in what his trains carried, even during war time when they carried “munitions and . . . Jews on their way to extermination camps”

J had learned to do his work for the railroad according to one set of standards and to live other parts of his life according to other standards, so that this compliant participant in “the final solution” could contend, “You cannot charge me with moral failure” (E&P, p. 187).

The epistemological theories of Modern moral philosophy were supposed to provide rational justification for rules, policies, and practical determinations according to abstract universal standards, but MacIntyre has dismissed those theorie

Modern metaethics is supposed to enable its practitioners to step away from the conflicting demands of contending moral traditions and to judge those conflicts from a neutral position, but MacIntyre has rejected this project as well

In his ethical writings, MacIntyre seeks only to understand how to liberate the human agent from blindness and stupidity, to prepare the human agent to recognize what is good and best to do in the concrete circumstances of that agent’s own life, and to strengthen the agent to follow through on that judgment.

In his political writings, MacIntyre investigates the role of communities in the formation of effective rational agents, and the impact of political institutions on the lives of communities. This kind of ethics and politics is appropriately named the ethics of human agency.

The purpose of the modern moral philosophy of authors like Kant and Mill was to determine, rationally and universally, what kinds of behavior ought to be performed—not in terms of the agent’s desires or goals, but in terms of universal, rational duties. Those theories purported to let agents know what they ought to do by providing knowledge of duties and obligations, thus they could be described as theories of moral epistemology.

Contemporary virtue ethics purports to let agents know what qualities human beings ought to have, and the reasons that we ought to have them, not in terms of our fitness for human agency, but in the same universal, disinterested, non-teleological terms that it inherits from Kant and Mill.

For MacIntyre, moral knowledge remains a “knowing how” rather than a “knowing that;” MacIntyre seeks to identify those moral and intellectual excellences that make human beings more effective in our pursuit of the human good.

MacIntyre’s purpose in his ethics of human agency is to consider what it means to seek one’s good, what it takes to pursue one’s good, and what kind of a person one must become if one wants to pursue that good effectively as a human agent.

As a philosophy of human agency, MacIntyre’s work belongs to the traditions of Aristotle and Thomas Aquinas.

in keeping with the insight of Marx’s third thesis on Feuerbach, it maintained the common condition of theorists and people as peers in the pursuit of the good life.

He holds that the human good plays a role in our practical reasoning whether we recognize it or not, so that some people may do well without understanding why (E&P, p. 25). He also reads Aristotle as teaching that knowledge of the good can make us better agents

AV defines virtue in terms of the practical requirements for excellence in human agency, in an agent’s participation in practices (AV, ch. 14), in an agent’s whole life, and in an agent’s involvement in the life of her or his community

MacIntyre’s Aristotelian concept of “human action” opposes the notion of “human behavior” that prevailed among mid-twentieth-century determinist social scientists. Human actions, as MacIntyre understands them, are acts freely chosen by human agents in order to accomplish goals that those agents pursue

Human behavior, according to mid-twentieth-century determinist social scientists, is the outward activity of a subject, which is said to be caused entirely by environmental influences beyond the control of the subject.

Rejecting crude determinism in social science, and approaches to government and public policy rooted in determinism, MacIntyre sees the renewal of human agency and the liberation of the human agent as central goals for ethics and politics.

MacIntyre’s Aristotelian account of “human action” examines the habits that an agent must develop in order to judge and act most effectively in the pursuit of truly choice-worthy ends

MacIntyre seeks to understand what it takes for the human person to become the kind of agent who has the practical wisdom to recognize what is good and best to do and the moral freedom to act on her or his best judgment.

MacIntyre rejected the determinism of modern social science early in his career (“Determinism,” 1957), yet he recognizes that the ability to judge well and act freely is not simply given; excellence in judgment and action must be developed, and it is the task of moral philosophy to discover how these excellences or virtues of the human agent are established, maintained, and strengthened

MacIntyre’s Aristotelian philosophy investigates the conditions that support free and deliberate human action in order to propose a path to the liberation of the human agent through participation in the life of a political community that seeks its common goods through the shared deliberation and action of its members

As a classics major at Queen Mary College in the University of London (1945-1949), MacIntyre read the Greek texts of Plato and Aristotle, but his studies were not limited to the grammars of ancient languages. He also examined the ethical theories of Immanuel Kant and John Stuart Mill. He attended the lectures of analytic philosopher A. J. Ayer and of philosopher of science Karl Popper. He read Ludwig Wittgenstein’s Tractatus Logico Philosophicus, Jean-Paul Sartre’s L'existentialisme est un humanisme, and Marx’s Eighteenth Brumaire of Napoleon Bonaparte (What happened, pp. 17-18). MacIntyre met the sociologist Franz Steiner, who helped direct him toward approaching moralities substantively

Alasdair MacIntyre’s philosophy builds on an unusual foundation. His early life was shaped by two conflicting systems of values. One was “a Gaelic oral culture of farmers and fishermen, poets and storytellers.” The other was modernity, “The modern world was a culture of theories rather than stories” (MacIntyre Reader, p. 255). MacIntyre embraced both value systems

From Marxism, MacIntyre learned to see liberalism as a destructive ideology that undermines communities in the name of individual liberty and consequently undermines the moral formation of human agents

For MacIntyre, Marx’s way of seeing through the empty justifications of arbitrary choices to consider the real goals and consequences of political actions in economic and social terms would remain the principal insight of Marxism

After his retirement from teaching, MacIntyre has continued his work of promoting a renewal of human agency through an examination of the virtues demanded by practices, integrated human lives, and responsible engagement with community life. He is currently affiliated with the Centre for Contemporary Aristotelian Studies in Ethics and Politics (CASEP) at London Metropolitan University.

The second half of AV proposes a conception of practice and practical reasoning and the notion of excellence as a human agent as an alternative to modern moral philosophy

AV rejects the view of “modern liberal individualism” in which autonomous individuals use abstract moral principles to determine what they ought to do. The critique of modern normative ethics in the first half of AV rejects modern moral reasoning for its failure to justify its premises, and criticizes the frequent use of the rhetoric of objective morality and scientific necessity to manipulate people to accept arbitrary decisions

MacIntyre uses “modern liberal individualism” to name a much broader category that includes both liberals and conservatives in contemporary American political parlance, as well as some Marxists and anarchists (See ASIA, pp. 280-284). Conservatism, liberalism, Marxism, and anarchism all present the autonomous individual as the unit of civil society

The sources of modern liberal individualism—Hobbes, Locke, and Rousseau—assert that human life is solitary by nature and social by habituation and convention. MacIntyre’s Aristotelian tradition holds, on the contrary, that human life is social by nature.

MacIntyre identifies moral excellence with effective human agency, and seeks a political environment that will help to liberate human agents to recognize and seek their own goods, as components of the common goods of their communities, more effectively. For MacIntyre therefore, ethics and politics are bound together.

For MacIntyre ethics is not an application of principles to facts, but a study of moral action. Moral action, free human action, involves decisions to do things in pursuit of goals, and it involves the understanding of the implications of one’s actions for the whole variety of goals that human agents seek

In this sense, “To act morally is to know how to act” (SMJ, p. 56). “Morality is not a ‘knowing that’ but a ‘knowing how’”

If human action is a ‘knowing how,’ then ethics must also consider how one learns ‘how.’ Like other forms of ‘knowing how,’ MacIntyre finds that one learns how to act morally within a community whose language and shared standards shape our judgment

MacIntyre had concluded that ethics is not an abstract exercise in the assessment of facts; it is a study of free human action and of the conditions that enable rational human agency.

MacIntyre gives Marx credit for concluding in the third of the Theses on Feuerbach, that the only way to change society is to change ourselves, and that “The coincidence of the changing of human activity or self-changing can only be comprehended and rationally understood as revolutionary practice”

MacIntyre distinguishes “religion which is an opiate for the people from religion which is not” (MI, p. 83). He condemns forms of religion that justify social inequities and encourage passivity. He argues that authentic Christian teaching criticizes social structures and encourages action

Where “moral philosophy textbooks” discuss the kinds of maxims that should guide “promise-keeping, truth-telling, and the like,” moral maxims do not guide real agents in real life at all. “They do not guide us because we do not need to be guided. We know what to do” (ASIA, p. 106). Sometimes we do this without any maxims at all, or even against all the maxims we know. MacIntyre Illustrates his point with Huckleberry Finn’s decision to help Jim, Miss Watson’s escaped slave, to make his way to freedom

MacIntyre develops the ideas that morality emerges from history, and that morality organizes the common life of a community

The book concludes that the concepts of morality are neither timeless nor ahistorical, and that understanding the historical development of ethical concepts can liberate us “from any false absolutist claims” (SHE, p. 269). Yet this conclusion need not imply that morality is essentially arbitrary or that one could achieve freedom by liberating oneself from the morality of one’s society.

From this “Aristotelian point of view,” “modern morality” begins to go awry when moral norms are separated from the pursuit of human goods and moral behavior is treated as an end in itself. This separation characterizes Christian divine command ethics since the fourteenth century and has remained essential to secularized modern morality since the eighteenth century

From MacIntyre’s “Aristotelian point of view,” the autonomy granted to the human agent by modern moral philosophy breaks down natural human communities and isolates the individual from the kinds of formative relationships that are necessary to shape the agent into an independent practical reasoner.

the 1977 essay “Epistemological Crises, Dramatic Narrative, and the Philosophy of Science” (Hereafter EC). This essay, MacIntyre reports, “marks a major turning-point in my thought in the 1970s” (The Tasks of Philosophy, p. vii) EC may be described fairly as MacIntyre’s discourse on method

First, Philosophy makes progress through the resolution of problems. These problems arise when the theories, histories, doctrines and other narratives that help us to organize our experience of the world fail us, leaving us in “epistemological crises.” Epistemological crises are the aftermath of events that undermine the ways that we interpret our world

it presents three general points on the method for philosophy.

To live in an epistemological crisis is to be aware that one does not know what one thought one knew about some particular subject and to be anxious to recover certainty about that subject.

To resolve an epistemological crisis it is not enough to impose some new way of interpreting our experience, we also need to understand why we were wrong before: “When an epistemological crisis is resolved, it is by the construction of a new narrative which enables the agent to understand both how he or she could intelligibly have held his or her original beliefs and how he or she could have been so drastically misled by them

MacIntyre notes, “Philosophers have customarily been Emmas and not Hamlets” (p. 6); that is, philosophers have treated their conclusions as accomplished truths, rather than as “more adequate narratives” (p. 7) that remain open to further improvement.

To illustrate his position on the open-endedness of enquiry, MacIntyre compares the title characters of Shakespeare’s Hamlet and Jane Austen’s Emma. When Emma finds that she is deeply misled in her beliefs about the other characters in her story, Mr. Knightly helps her to learn the truth and the story comes to a happy ending (p. 6). Hamlet, by contrast, finds no pat answers to his questions; rival interpretations remain throughout the play, so that directors who would stage the play have to impose their own interpretations on the script

Another approach to education is the method of Descartes, who begins by rejecting everything that is not clearly and distinctly true as unreliable and false in order to rebuild his understanding of the world on a foundation of undeniable truth.

Descartes presents himself as willfully rejecting everything he had believed, and ignores his obvious debts to the Scholastic tradition, even as he argues his case in French and Latin. For MacIntyre, seeking epistemological certainty through universal doubt as a precondition for enquiry is a mistake: “it is an invitation not to philosophy but to mental breakdown, or rather to philosophy as a means of mental breakdown.

MacIntyre contrasts Descartes’ descent into mythical isolation with Galileo, who was able to make progress in astronomy and physics by struggling with the apparently insoluble questions of late medieval astronomy and physics, and radically reinterpreting the issues that constituted those questions

To make progress in philosophy one must sort through the narratives that inform one’s understanding, struggle with the questions that those narratives raise, and on occasion, reject, replace, or reinterpret portions of those narratives and propose those changes to the rest of one’s community for assessment. Human enquiry is always situated within the history and life of a community.

The third point of EC is that we can learn about progress in philosophy from the philosophy of science

Kuhn’s “paradigm shifts,” however, are unlike MacIntyre’s resolutions of epistemological crises in two ways.

First they are not rational responses to specific problems. Kuhn compares paradigm shifts to religious conversions (pp. 150, 151, 158), stressing that they are not guided by rational norms and he claims that the “mopping up” phase of a paradigm shift is a matter of convention in the training of new scientists and attrition among the holdouts of the previous paradigm

Second, the new paradigm is treated as a closed system of belief that regulates a new period of “normal science”; Kuhn’s revolutionary scientists are Emmas, not Hamlets

MacIntyre proposes elements of Imre Lakatos’ philosophy of science as correctives to Kuhn’s. While Lakatos has his own shortcomings, his general account of the methodologies of scientific research programs recognizes the role of reason in the transitions between theories and between research programs (Lakatos’ analog to Kuhn’s paradigms or disciplinary matrices). Lakatos presents science as an open ended enquiry, in which every theory may eventually be replaced by more adequate theories. For Lakatos, unlike Kuhn, rational scientific progress occurs when a new theory can account both for the apparent promise and for the actual failure of the theory it replaces.

The third conclusion of MacIntyre’s essay is that decisions to support some theories over others may be justified rationally to the extent that those theories allow us to understand our experience and our history, including the history of the failures of inadequate theories

For Aristotle, moral philosophy is a study of practical reasoning, and the excellences or virtues that Aristotle recommends in the Nicomachean Ethics are the intellectual and moral excellences that make a moral agent effective as an independent practical reasoner.

MacIntyre also finds that the contending parties have little interest in the rational justification of the principles they use. The language of moral philosophy has become a kind of moral rhetoric to be used to manipulate others in defense of the arbitrary choices of its users

examining the current condition of secular moral and political discourse. MacIntyre finds contending parties defending their decisions by appealing to abstract moral principles, but he finds their appeals eclectic, inconsistent, and incoherent.

The secular moral philosophers of the eighteenth and nineteenth centuries shared strong and extensive agreements about the content of morality (AV, p. 51) and believed that their moral philosophy could justify the demands of their morality rationally, free from religious authority.

MacIntyre traces the lineage of the culture of emotivism to the secularized Protestant cultures of northern Europe

Modern moral philosophy had thus set for itself an incoherent goal. It was to vindicate both the moral autonomy of the individual and the objectivity, necessity, and categorical character of the rules of morality

MacIntyre turns to an apparent alternative, the pragmatic expertise of professional managers. Managers are expected to appeal to the facts to make their decisions on the objective basis of effectiveness, and their authority to do this is based on their knowledge of the social sciences

An examination of the social sciences reveals, however, that many of the facts to which managers appeal depend on sociological theories that lack scientific status. Thus, the predictions and demands of bureaucratic managers are no less liable to ideological manipulation than the determinations of modern moral philosophers.

Modern moral philosophy separates moral reasoning about duties and obligations from practical reasoning about ends and practical deliberation about the means to one’s ends, and in doing so it separates morality from practice.

Many Europeans also lost the practical justifications for their moral norms as they approached modernity; for these Europeans, claiming that certain practices are “immoral,” and invoking Kant’s categorical imperative or Mill’s principle of utility to explain why those practices are immoral, seems no more adequate than the Polynesian appeal to taboo.

MacIntyre sifts these definitions and then gives his own definition of virtue, as excellence in human agency, in terms of practices, whole human lives, and traditions in chapters 14 and 15 of AV.

In the most often quoted sentence of AV, MacIntyre defines a practice as (1) a complex social activity that (2) enables participants to gain goods internal to the practice. (3) Participants achieve excellence in practices by gaining the internal goods. When participants achieve excellence, (4) the social understandings of excellence in the practice, of the goods of the practice, and of the possibility of achieving excellence in the practice “are systematically extended”

Practices, like chess, medicine, architecture, mechanical engineering, football, or politics, offer their practitioners a variety of goods both internal and external to these practices. The goods internal to practices include forms of understanding or physical abilities that can be acquired only by pursuing excellence in the associated practice

Goods external to practices include wealth, fame, prestige, and power; there are many ways to gain these external goods. They can be earned or purchased, either honestly or through deception; thus the pursuit of these external goods may conflict with the pursuit of the goods internal to practices.

An intelligent child is given the opportunity to win candy by learning to play chess. As long as the child plays chess only to win candy, he has every reason to cheat if by doing so he can win more candy. If the child begins to desire and pursue the goods internal to chess, however, cheating becomes irrational, because it is impossible to gain the goods internal to chess or any other practice except through an honest pursuit of excellence. Goods external to practices may nevertheless remain tempting to the practitioner.

Since MacIntyre finds social identity necessary for the individual, MacIntyre’s definition of the excellence or virtue of the human agent needs a social dimension:

These responsibilities also include debts incurred by the unjust actions of ones’ predecessors.

The enslavement and oppression of black Americans, the subjugation of Ireland, and the genocide of the Jews in Europe remained quite relevant to the responsibilities of citizens of the United States, England, and Germany in 1981, as they still do today.

Thus an American who said “I never owned any slaves,” “the Englishman who says ‘I never did any wrong to Ireland,’” or “the young German who believes that being born after 1945 means that what Nazis did to Jews has no moral relevance to his relationship to his Jewish contemporaries” all exhibit a kind of intellectual and moral failure.

“I am born with a past, and to cut myself off from that past in the individualist mode, is to deform my present relationships” (p. 221).  For MacIntyre, there is no moral identity for the abstract individual; “The self has to find its moral identity in and through its membership in communities” (p. 221).

Blacks and Hispanics are nearly five times more likely to be hospitalized with COVID-19 than whites are, and death rates among African Americans are more than double those of whites.

it’s hard to escape the conclusion that the majority of America has concluded that these groups—the poor, the minority, the imprisoned, and the elderly—are the “acceptable” losses. Were the situation reversed and the white, middle aged, and middle/upper classes the primary victims of the pandemic—one of the features of the 1918 influenza—COVID-19 would be a true national emergency and there would be far less complaining about disrupted schools, work, and social life brought about by social distancing requirements and economic shutdowns.

Mary Trump (the president’s niece who also happens to have a Ph.D. in psychology) paints a portrait of Fred Trump Sr. as a sociopath, utterly uninterested in entering into the moral, emotional, and psychological world of his family or its members. In keeping with Peale’s teaching, he would no more hear about his wife’s or children’s problems than he would accept a failed business deal

Fred would just say, “Everything’s great, right Toots?” refusing to acknowledge, much less accommodate, her illness. 

Fred Jr. was then further abused, repeatedly denied authority, second-guessed at every turn, and blamed for every problem, setback, and failure in a perverse tag-team between Fred Sr. and Donald. The abuse fed his alcoholism, which, in the family’s Peale-informed understanding, was not a disease requiring treatment but the result of Fred Jr.’s negative thinking

Peale wanted people to be hopeful, kind, and optimistic, and to become “people persons.” The Trump family heard the positive thinking, personal empowerment parts, which integrated easily with its win-at-all-cost ideology, but they, or at least Donald, missed the bits about seeking counsel from others and living a life of dependence upon God.

Fred Jr.’s deepening alcoholism only elicited increasing abuse from his father and brother seemingly under the theory that if they were hard enough on him he would turn around. Even in his final crisis, afflicted by fatal, alcohol-induced cardiac problems, no member of the family went with him to the hospital (Donald Trump went to a movie instead). Dying, it appears, is the result of late-stage negative thought.

The consistent element in each of these has been to deny negative realities and keep moving. The casinos, the airline, the football league, Trump Vodka, Trump Steaks, Trump University . . . all bear the same markings of hyper optimism and overpromise/underdeliver salesmanship

Trump’s just doing what he’s always done: conquering the challenge by blinding himself to it, just the way Reverend Peale taught him and his father insisted upon. 

My AEI colleague, Brad Wilcox, documented that men who identified as “evangelical” but infrequently attend church were more likely to engage in domestic violence than evangelicals who regularly attended church, mainline Protestants and those who never attend church. Wilcox believes this results from a kind of doctrinal cherry-picking—big on authority, sovereignty, and power but closed to other-directed teachings like altruism and self-sacrifice. Weak attachment to religious faith tends to put some of the worst behaviors on steroids.  

These are the problem-solving strategies that Donald Trump brought to his marriages, six corporate bankruptcies, presidential campaign, and now, what increasingly appears to be a failed presidency.

“prosperity gospel” (a belief popularized by televangelists that God intends Christians to be healthy and wealthy)

The purpose of these psychological and spiritual practices is to free individuals from self-doubt and feelings of inferiority and help them to become the people God truly intends them to be: happy, wealthy, popular, and professionally successful.

Now we have Trump COVID-19 and it’s following the same pattern. The virus is “very well under control” and “going to fade away.”

On Tuesday, the Russian leader paid a visit to the main Moscow hospital for monitoring suspected coronavirus patients, donning protective gear to visit the hospital in the city's suburb of Kommunarka. It was the kind of costume play we're used to seeing from the Kremlin, and reminiscent of one of his earliest moves as Russia's acting president: flying to the war-torn republic of Chechnya in 2000 in the co-pilot's seat of an Su-27 fighter jet.

Multiple health care workers on Thursday debunked a statement from a White House adviser that the media is overstating the need for personal protective equipment in hospitals amid the novel coronavirus pandemic.

But there is a shortage of lab technicians able to analyze coronavirus tests, Illinois Gov. J.B. Pritzker said, adding that even if he were able to obtain more machines for testing analysis, they wouldn't have enough people to operate them.

"This is going to be the disaster that defines our generation," said Collin Arnold

It wasn’t the manual labor. That’s a different kind of hardship. This was the worst kind of bitterness.

ou will have no future in this place. You will not have a good job. Everyone looks down on you.”That burden, that burden on your spirit, is very heavy.

Even before the Cultural Revolution, there were divisions in our class over family background.

After the Cultural Revolution broke out, they were also the ones who formed the first Red Guard group.

One night these rebels – Red Guards – burst into the apartment, turning everything inside out

At Tsinghua High School I also saw students and teachers who were beaten up, or had their hair shaved off.

But the hospital said they didn’t treat this kind of cow demon and snake spirit,

They said that because of my family background I could never love socialism and the Communist Party.

Struggle sessions, when people were accused of political crimes, publicly humiliated and subject to verbal and physical abuse by a crowd, were a frequent occurrence during the Cultural Revolution

People who didn’t experience the Cultural Revolution only know that a large number of officials were persecuted,

They treat one-sidedly extolling the achievements of the past as a “positive energy” to be exalted, and they treat exposing and reflecting on the mistakes of history as a “negative energy” to be beaten down.

As a result we end up with the most bizarre health-insurance system imaginable: One ever better designed to avoid sick people.

America’s giant health insurers are now busily consolidating into ever-larger behemoths.

In reality, they’re becoming huge to get more bargaining leverage over everyone they do business with — hospitals, doctors, employers, the government and consumers. That way they make even bigger profits.

researchers found, for example, that after Aetna merged with Prudential HealthCare in 1999, premiums rose 7 percent higher than had the merger not occurred.

The real choice in the future is either a hugely expensive for-profit oligopoly with the market power to charge high prices even to healthy people and stop insuring sick people.

Or else a government-run single payer system — such as is in place in almost every other advanced economy — dedicated to lower premiums and better care for everyone.

individualism, the desire to control one’s own life, has many variants. Tocqueville viewed it as selfishness and suspected it, while Emerson and Whitman viewed it as the moment-by-moment expression of one’s unique self and loved it.

individualism as the making of choices so as to maximize one’s preferences. This differed from “selfish individualism” in that the preferences were not specified: they could be altruistic as well as selfish. It differed from “expressive individualism” in having general algorithms by which choices were made. These made it rational.

it was born in 1951 as “rational choice theory.” Rational choice theory’s mathematical account of individual choice, originally formulated in terms of voting behavior, made it a point-for-point antidote to the collectivist dialectics of Marxism

Functionaries at RAND quickly expanded the theory from a tool of social analysis into a set of universal doctrines that we may call “rational choice philosophy.” Governmental seminars and fellowships spread it to universities across the country, aided by the fact that any alternative to it would by definition be collectivist.

rational choice philosophy moved smoothly on the backs of their pupils into the “real world” of business and governme

Today, governments and businesses across the globe simply assume that social reality  is merely a set of individuals freely making rational choices.

At home, anti-regulation policies are crafted to appeal to the view that government must in no way interfere with Americans’ freedom of choice.

But the real significance of rational choice philosophy lay in ethics. Rational choice theory, being a branch of economics, does not question people’s preferences; it simply studies how they seek to maximize them. Rational choice philosophy seems to maintain this ethical neutrality (see Hans Reichenbach’s 1951 “The Rise of Scientific Philosophy,” an unwitting masterpiece of the genre); but it does not.

Whatever my preferences are, I have a better chance of realizing them if I possess wealth and power. Rational choice philosophy thus promulgates a clear and compelling moral imperative: increase your wealth and power!

Today, institutions which help individuals do that (corporations, lobbyists) are flourishing; the others (public hospitals, schools) are basically left to rot. Business and law schools prosper; philosophy departments are threatened with closure.

Hegel, for one, had denied all three of its central claims in his “Encyclopedia of the Philosophical Sciences” over a century before. In that work, as elsewhere in his writings, nature is not neatly causal, but shot through with randomness. Because of this chaos, we cannot know the significance of what we have done until our community tells us; and ethical life correspondingly consists, not in pursuing wealth and power, but in integrating ourselves into the right kinds of community.

By 1953, W. V. O. Quine was exposing the flaws in rational choice epistemology. John Rawls, somewhat later, took on its sham ethical neutrality, arguing that rationality in choice includes moral constraints. The neat causality of rational choice ontology, always at odds with quantum physics, was further jumbled by the environmental crisis, exposed by Rachel Carson’s 1962 book “The Silent Spring,” which revealed that the causal effects of human actions were much more complex, and so less predicable, than previously thought.

In recent years, many of the industry’s elite have pledged financial support to schools, hospitals, police stations and homeless shelters, all while many of the industry’s companies have avoided paying taxes that would fund those same vital public institutions.

Any philanthropy seems legitimate when it aligns with your own goals.

We did indeed give them this mandate through our politics: loose campaign finance laws and lower tax rates. Through policies that have reinforced exceptional wealth disparities, we have allowed them not just to govern themselves, but us as well.

To many of Gawker’s critics, Mr. Thiel is a hero on a charitable crusade for justice. It would be safe to say that this is how his fellow Silicon Valley philanthropists would also define their giving. They are under a presumptive mandate to improve society according to their own values, purely because they have made a lot of money while most everyone else has not. The Gospel of Wealth dictates that this is not only their ability, but their responsibility.