Big Thinkers on Mental Health

Sponsored by the Mental Health Channel


You’re Wired for Anxiety. And You’re Wired to Handle It.

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


In our first video in the series, Dr. Anne Marie Albano, director of Columbia University Clinic for Anxiety and Related Disorders, traces the biological and evolutionary origins of anxiety, the unique features of anxiety in the 21st century, and the powerful research and tech-driven treatments that have emerged in recent decades.

You've Heard of OCD, but Do You Really Understand It?

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


In the second video in the series, Dr. Helen Blair Simpson, director of the Center for Obsessive-Compulsive and Related Disorders at Columbia University, paints a vivid portrait of the many different versions of OCD. Even though it's a well-known anxiety disorder, OCD is also one of the most misunderstood, so it's important to educate ourselves on what our peers who suffer from it are going through. Dr. Simpson runs through variations of OCD, offers some extreme examples from her patients, and details what we've learned from brain scans of OCD sufferers.

The Suicide Rate is Going Up. Here’s What We Can Do to Stop It.

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


In the third video in the series, Dr. Christine Moutier of the American Foundation for Suicide Prevention suggests several of the ways society can combat the rising suicide trend. Did you know white, middle-aged men are most at risk? What would it be like if mentally ill people got the treatment they needed before taking their lives? How would things be different if our opinions on suicidal tendencies changed overnight?

The Kids Are Not All Right: College Mental Health Needs an Intervention

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


In the fourth video in the series, Dr. Victor Schwartz of The Jed Foundation runs through some staggering stats about mental health in college. University students are, in general, a very stressed-out demographic. Factor in things like alcohol abuse, homesickness, and elevated risk for sexual assault, and you've got quite the cocktail for mental health issues. Does the typical college student, asks Schwartz, really understand the sort of care options available to her? One of the major challenges of college mental health care is encouraging students to step forward when they are depressed or suffering from anxiety. It's in everyone's best interest for mental health to be a big priority. The trick is to remove the stigma from the process.

When It Comes to Eating Disorders, "You Have the Bullet, The Culture Shoots the Gun"

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


There aren't many people on this planet who know more about eating disorders than psychologist Dr. Judith Brisman, founder of the Eating Disorder Resource Center. In this video, she offers a crash course in understanding the difference between someone who eats disorderly and someone with an eating disorder. We also learn that, deep down, people with anorexia use eating (or not eating) as a coping mechanism.

Finally, Brisman runs through some typical traits of those with anorexia: perfectionism, genetic disposition, and susceptibility to the pressures of society. Most of all, anorexia offers the illusion of control. When you're unable to control other parts of your life, losing weight by not eating seems like a major accomplishment because it was a (dangerous) decision made of your own volition.

It’s a Small, Small World: PTSD as Self-Imprisonment.

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


Dr. Rachel Yehuda is one of the foremost researchers in the country studying neurobiology with regard to PTSD. In this video interview, Dr. Yehuda relays common symptoms and struggles associated with the debilitating disorder. Where does one's brain go when traumatic flashbacks emerge? How do you fight these uncomfortable situations? Dr. Yehuda delves into these and other questions.

Black Mental Health Isn't the Same as White Mental Health

Big Think and the Mental Health Channel are proud to present Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


You can't have a frank discussion about mental health within the African-American community without confronting issues related to social trauma. Uncomfortable (and sometimes dangerous) encounters with a distrusted police force. Drugs and crime infesting a neighborhood. The institutional scars of slavery and segregation. These are all issues our contemporary black population must deal with each and every day.

Dr. Michael Lindsey of NYU's Silver School of Social Work sees signs of debilitating trauma throughout black America. He points to two key reasons for this. First, mental illness is unfairly stigmatized in these communities, just as it is throughout American culture. Second, cultural definitions of strength and courage are dictated by efforts to work against institutional ills such as discrimination. How one reacts to these ills, coupled with the community's response to said reaction, adds a lot of tension other Americans don't necessarily have to deal with.

Finally, Lindsey speaks to the value placed on authenticity, a major reason why many sufferers in the black community internalize their strife rather than share it with the outside world.

Bipolar Disorder Is Like Having Two Serious Illnesses at Once

Big Think and the Mental Health Channel are proud to present Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


This week, psychiatrist Nicole Foubister delves into the world of bipolar disorder. Most people are casually familiar with bipolar disorder, although few understand the colossal strain it can have on the lives of sufferers and their loved ones. It's vital for people diagnosed as bipolar to open themselves up to treatment and for people close to them to be aware of the illness' ramifications. What's most important is to understand that no one chooses to be bipolar; you must learn to be calm and patient with people who suffer from it. It's not their fault that they lack mental wellness and their behavior during manic episodes is not reflective of who they really are.

Media Sell the Mentally Ill as Violent Criminals. Truth Is, They’re Not.

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


In this video, Columbia University forensic psychiatrist Michael Stone dispels common myths about the intersection of violent acts and mental health disorders. He addresses the question of whether people with schizophrenia are more likely to commit violent crimes and how much danger they present to society at large. The answer? Not as much as you'd imagine, given the sensationalism of mainstream media coverage.

How Not to Be a Slave to Your Brain: Mindfulness for Mental Health

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


One of the classic definitions of mindfulness is that it helps us avoid clinging to what is pleasant and condemning what is unpleasant. In this video, psychiatrist Mark Epstein relays information about the practice of mindful meditation and its many mental health benefits.

Why Are Our Funniest People Also the Saddest?

Comedians are more likely to have mental health issues than the rest of us. Is it in their nature? Or their environment? And what can they do to help the rest of us improve our own mental health? Dr. Ildiko Tabori, America's foremost therapist for comedians, explains.

Is There A Psychopath Next Door? They’re More Common Than You Think

Every day you're likely to meet a psychopath. Dr. James Fallon of UC Irvine explains what a psychopath is, how they work, and what they want from you -- and he ought to know (but you'll have to watch to find out why).

6 Things You Need To Get Right About Depression

Depression is very common, affecting one in five people — if not you, then a friend or family member. This makes a basic knowledge of the disorder vital for everyone. Dr. Patricia Deldin of the University of Michigan Depression Center debunks misperceptions to encourage a better understanding.

How Childhood Trauma Can Make You A Sick Adult

The Adverse Childhood Study found that survivors of childhood trauma are up to 5,000 percent more likely to attempt suicide, have eating disorders, or become IV drug users. Dr. Vincent Felitti, the study's founder, details this remarkable and powerful connection.

For LGBT People, Discrimination Still Brings Mental Health Challenges.

It wasn’t until 1973 that the American Psychiatric Association voted to remove homosexuality as a mental disorder. The recency of that decision still affects the LGBT community today. It opens the door to discrimination. Discrimination contributes to higher rates of depression, substance abuse, and suicide. Dr. James Dilley of the Alliance Health Project discusses its effects, and the impact that a continued shift toward acceptance can have.

The First Things To Do When You Or Someone You Love Is In Crisis

What should you do when a mental health crisis strikes? Dr. Ken Duckworth of the National Alliance on Mental Illness reveals how understanding the patterns of one's illness and creating an action plan can help individuals and families manage – and even prevent – a crisis.

Mostly, We Respond to Tragedies in Ways That Don’t Really Help

What’s the best way to help after a natural disaster or school shooting? Mass tragedies can take many forms, but in all cases, extreme needs follow. Dr. Will Marling of the National Organization for Victim Assistance shares insight on how to provide support.

Hearing Voices and Paranoid Delusions: Inside a Schizophrenic Brain

Now and then, we've all thought we heard someone calling our name, or noticed a strange coincidence. But for people with schizophrenia, these can take on a much more nefarious quality. Dr. Vikaas Sohal walks us through what it feels like to be inside a schizophrenic brain.

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  • There is a great disconnect between the sciences and the humanities.
  • Solutions to most of our real-world problems need both ways of knowing.
  • Moving beyond the two-culture divide is an essential step to ensure our project of civilization.

For the past five years, I ran the Institute for Cross-Disciplinary Engagement at Dartmouth, an initiative sponsored by the John Templeton Foundation. Our mission has been to find ways to bring scientists and humanists together, often in public venues or — after Covid-19 — online, to discuss questions that transcend the narrow confines of a single discipline.

It turns out that these questions are at the very center of the much needed and urgent conversation about our collective future. While the complexity of the problems we face asks for a multi-cultural integration of different ways of knowing, the tools at hand are scarce and mostly ineffective. We need to rethink and learn how to collaborate productively across disciplinary cultures.

The danger of hyper-specialization

The explosive expansion of knowledge that started in the mid 1800s led to hyper-specialization inside and outside academia. Even within a single discipline, say philosophy or physics, professionals often don't understand one another. As I wrote here before, "This fragmentation of knowledge inside and outside of academia is the hallmark of our times, an amplification of the clash of the Two Cultures that physicist and novelist C.P. Snow admonished his Cambridge colleagues in 1959." The loss is palpable, intellectually and socially. Knowledge is not adept to reductionism. Sure, a specialist will make progress in her chosen field, but the tunnel vision of hyper-specialization creates a loss of context: you do the work not knowing how it fits into the bigger picture or, more alarmingly, how it may impact society.

Many of the existential risks we face today — AI and its impact on the workforce, the dangerous loss of privacy due to data mining and sharing, the threat of cyberwarfare, the threat of biowarfare, the threat of global warming, the threat of nuclear terrorism, the threat to our humanity by the development of genetic engineering — are consequences of the growing ease of access to cutting-edge technologies and the irreversible dependence we all have on our gadgets. Technological innovation is seductive: we want to have the latest "smart" phone, 5k TV, and VR goggles because they are objects of desire and social placement.

Are we ready for the genetic revolution?

When the time comes, and experts believe it is coming sooner than we expect or are prepared for, genetic meddling with the human genome may drive social inequality to an unprecedented level with not just differences in wealth distribution but in what kind of being you become and who retains power. This is the kind of nightmare that Nobel Prize-winning geneticist Jennifer Doudna talked about in a recent Big Think video.

CRISPR 101: Curing Sickle Cell, Growing Organs, Mosquito Makeovers | Jennifer Doudna | Big Think www.youtube.com

At the heart of these advances is the dual-use nature of science, its light and shadow selves. Most technological developments are perceived and sold as spectacular advances that will either alleviate human suffering or bring increasing levels of comfort and accessibility to a growing number of people. Curing diseases is what motivated Doudna and other scientists involved with CRISPR research. But with that also came the potential for altering the genetic makeup of humanity in ways that, again, can be used for good or evil purposes.

This is not a sci-fi movie plot. The main difference between biohacking and nuclear hacking is one of scale. Nuclear technologies require industrial-level infrastructure, which is very costly and demanding. This is why nuclear research and its technological implementation have been mostly relegated to governments. Biohacking can be done in someone's backyard garage with equipment that is not very costly. The Netflix documentary series Unnatural Selection brings this point home in terrifying ways. The essential problem is this: once the genie is out of the bottle, it is virtually impossible to enforce any kind of control. The genie will not be pushed back in.

Cross-disciplinary cooperation is needed to save civilization

What, then, can be done? Such technological challenges go beyond the reach of a single discipline. CRISPR, for example, may be an invention within genetics, but its impact is vast, asking for oversight and ethical safeguards that are far from our current reality. The same with global warming, rampant environmental destruction, and growing levels of air pollution/greenhouse gas emissions that are fast emerging as we crawl into a post-pandemic era. Instead of learning the lessons from our 18 months of seclusion — that we are fragile to nature's powers, that we are co-dependent and globally linked in irreversible ways, that our individual choices affect many more than ourselves — we seem to be bent on decompressing our accumulated urges with impunity.

The experience from our experiment with the Institute for Cross-Disciplinary Engagement has taught us a few lessons that we hope can be extrapolated to the rest of society: (1) that there is huge public interest in this kind of cross-disciplinary conversation between the sciences and the humanities; (2) that there is growing consensus in academia that this conversation is needed and urgent, as similar institutes emerge in other schools; (3) that in order for an open cross-disciplinary exchange to be successful, a common language needs to be established with people talking to each other and not past each other; (4) that university and high school curricula should strive to create more courses where this sort of cross-disciplinary exchange is the norm and not the exception; (5) that this conversation needs to be taken to all sectors of society and not kept within isolated silos of intellectualism.

Moving beyond the two-culture divide is not simply an interesting intellectual exercise; it is, as humanity wrestles with its own indecisions and uncertainties, an essential step to ensure our project of civilization.

  • A new paper confirms Stephen Hawking's black hole area theorem.
  • The researchers used gravitational wave data to prove the theorem.
  • The data came from Caltech and MIT's Advanced Laser Interferometer Gravitational-Wave Observatory.

The late Stephen Hawking's black hole area theorem is correct, a new study shows. Scientists used gravitational waves to prove the famous British physicist's idea, which may lead to uncovering more underlying laws of the universe.

The theorem, elaborated by Hawking in 1971, uses Einstein's theory of general relativity as a springboard to conclude that it is not possible for the surface area of a black hole to become smaller over time. The theorem parallels the second law of thermodynamics that says the entropy (disorder) of a closed system can't decrease over time. Since the entropy of a black hole is proportional to its surface area, both must continue to increase.

As a black hole gobbles up more matter, its mass and surface area grow. But as it grows, it also spins faster, which decreases its surface area. Hawking's theorem maintains that the increase in surface area that comes from the added mass would always be larger than the decrease in surface area because of the added spin.

Will Farr, one of the co-authors of the study that was published in Physical Review Letters, said their finding demonstrates that "black hole areas are something fundamental and important." His colleague Maximiliano Isi agreed in an interview with Live Science: "Black holes have an entropy, and it's proportional to their area. It's not just a funny coincidence, it's a deep fact about the world that they reveal."

The research team based their conclusions on the data from the gravitational waves spotted by Caltech and MIT's Advanced Laser Interferometer Gravitational-Wave Observatory (LIGO) in 2015.

What are gravitational waves?

Gravitational waves are "ripples" in spacetime, predicted by Albert Einstein in 1916, that are created by very violent processes happening in space. Einstein showed that very massive, accelerating space objects like neutron stars or black holes that orbit each other could cause disturbances in spacetime. Like the ripples produced by tossing a rock into a lake, they would bring about "waves" of spacetime that would spread in all directions.

As LIGO shared, "These cosmic ripples would travel at the speed of light, carrying with them information about their origins, as well as clues to the nature of gravity itself."

The gravitational waves discovered by LIGO's 3,000-kilometer-long laser beam, which can detect the smallest distortions in spacetime, were generated 1.3 billion years ago by two giant black holes that were quickly spiraling toward each other.

What Stephen Hawking would have discovered if he lived longer | NASA's Michelle Thaller | Big Think www.youtube.com

Confirming Hawking's black hole area theorem

The researchers separated the signal into two parts, depending on whether it was from before or after the black holes merged. This allowed them to figure out the mass and spin of the original black holes as well as the mass and spin of the merged black hole. With this information, they calculated the surface areas of the black holes before and after the merger.

"As they spin around each other faster and faster, the gravitational waves increase in amplitude more and more until they eventually plunge into each other — making this big burst of waves," Isi elaborated. "What you're left with is a new black hole that's in this excited state, which you can then study by analyzing how it's vibrating. It's like if you ping a bell, the specific pitches and durations it rings with will tell you the structure of that bell, and also what it's made out of."

The surface area of the resulting black holes was larger than the combined area of the original black holes. This conformed to Hawking's area law.


    • Hackers' motivations range from altruistic to nihilistic.
    • Altruistic hackers expose injustices, while nihilistic ones make society more dangerous.
    • The line between ethical and unethical hacking is not always clear.

    The following is an excerpt from Coding Democracy by Maureen Webb, which is publishing in paperback on July 21. Reprinted with Permission from The MIT PRESS. Copyright 2020.

    As people begin to hack more concertedly at the structures of the status quo, the reactions of those who benefit from things as they are will become more fierce and more punitive, at least until the "hackers" succeed in shifting the relevant power relationships. We know this from the history of social movements. At the dawning of the digital age, farmers who hack tractors will be ruthlessly punished.

    Somewhere on the continuum of altruism and transgression is the kind of hacking that might lead the world toward more accountable government and informed citizenries.

    Of course, it must be acknowledged that hackers are engaged in a whole range of acts, from the altruistic to the plainly nihilistic and dangerous. On the altruistic side of the continuum, they are creating free software (GNU/Linux and other software under GPL licenses), Creative Commons (Creative Commons licensing), and Open Access (designing digital interfaces to make public records and publicly funded research accessible). They are hacking surveillance and monopoly power (creating privacy tools, alternative services, cooperative platforms, and a new decentralized internet) and electoral politics and decision making (Cinque Stelle, En Comú, Ethelo, Liquid Democracy, and PartidoX). They have engaged in stunts to expose the technical flaws in voting, communications, and security systems widely used by, or imposed on, the public (by playing chess with Germany's election voting machines, hacking the German Bildschirmtext system, and stealing ministers' biometric identifiers). They have punished shady contractors like HackingTeam, HBGary, and Stratfor, spilling their corporate dealings and personal information across the internet. They have exposed the corruption of oligarchs, politicians, and hegemons (through the Panama Papers, WikiLeaks, and Xnet).

    More notoriously, they have coordinated distributed denial of service (DDoS) attacks to retaliate against corporate and government conduct (such as the Anonymous DDoS that protested PayPal's boycott of WikiLeaks; the ingenious use of the Internet of Things to DDoS Amazon; and the shutdown of US and Canadian government IT systems). They have hacked into databases (Manning and Snowden), leaked state secrets (Manning, Snowden, and WikiLeaks), and, in doing so, betrayed their own governments (Manning betrayed US war secrets, and Snowden betrayed US security secrets). They have interfered with elections (such as the hack and leak of the Democratic National Committee in the middle of the 2016 US election) and sown disinformation (the Russian hacking of US social media). They have interfered with property rights in order to assert user ownership, self-determination, and free software's four freedoms (farmers have hacked DRM code to repair their tractors, and Geohot unlocked the iPhone and hacked the Samsung phone to allow users administrator-level access to their devices) and to assert open access to publicly funded research. They have created black markets to evade state justice systems (such as Silk Road on the dark web) and cryptocurrencies that could undermine state-regulated monetary systems. They have meddled in geopolitics as free agents (Anonymous and the Arab Spring, and Julian Assange and his conduct with the Trump campaign). They have mucked around in and could potentially impair or shut down critical infrastructure. (The notorious "WANK worm" attack on NASA is an early, notorious, example, but hackers could potentially target banking systems, stock exchanges, electrical grids, telecommunications systems, air traffic control, chemical plants, nuclear plants, and even military "doomsday machines.")

    It is impossible to calculate where these acts nudge us as a species. Some uses of hacking — such as the malicious, nihilistic hacking that harms critical infrastructure and threatens lives, and the hacking in cyberwarfare that injures the critical interests of other countries and undermines their democratic processes — are abhorrent and cannot be defended. The unfolding digital era looks very grim when one considers the threat this kind of hacking poses to peace and democracy combined with the dystopian direction states and corporations are going with digital tech.

    But somewhere on the continuum of altruism and transgression is the kind of hacking that might lead the world toward more accountable government and informed citizenries, less corrupt and unfair economic systems, wiser public uses of digital tech, more self-determination for the ordinary user, fairer commercial contracts, better conditions for innovation and creativity, more decentralized and robust infrastructure systems, and an abolition of doomsday machines. In short, some hacking might move us toward a digital world in which there are more rather than fewer democratic, humanist outcomes.

    It is not clear where the line between "good" and "bad" hacking should be drawn or how to regulate it wisely in every instance. Citizens should inform themselves and begin to consider this line-drawing seriously, however, since we will be grappling intensely with it for the next century or more. My personal view is that digital tech should not be used for everything. I think we should go back to simpler ways of running electrical grids and elections, for example. Systems are more resilient when they are not wholly digital and when they are smaller, more local, and modular. Consumers should have analogue options for things like fridges and cars, and design priorities for household goods should be durability and clean energy use, not interconnectedness.

    In setting legal standards, prohibiting something and enforcing the prohibition are two different things. Sometimes a desired social norm can be struck by prohibiting a thing and not enforcing it strenuously. And the law can also recognize the constructive role that civil disobedience plays in the evolution of social norms, through prosecutorial discretion and judicial discretion in sentencing.

    Wau Holland told the young hackers at the Paradiso that the Chaos Computer Club was "not just a bunch of techno freaks: we've been thinking about the social consequences of technology from the very beginning." Societies themselves, however, are generally just beginning to grapple with the social consequences of digital technology and with how to characterize the various acts performed by hackers, morally and legally. Each act raises a set of complex questions. Societies' responses will be part of the dialectic that determines where we end up. Should these various hacker acts be treated as incidents of public service, free speech, free association, legitimate protest, civil disobedience, and harmless pranksterism? Or should they be treated as trespass, tortious interference, intellectual property infringement, theft, fraud, conspiracy, extortion, espionage, terrorism, and treason? I invite you to think about this as you consider how hacking has been treated by societies to date.

    A financial shot in the arm could be just what is needed for Americans unsure about vaccination.


    On May 12, 2021, the Republican governor of Ohio, Mike DeWine, announced five US$1 million lottery prizes for those who are vaccinated. Meanwhile, in West Virginia, younger citizens are being enticed to get the shot with $100 savings bonds, and a state university in North Carolina is offering students who get vaccinated a chance to win the cost of housing. Many companies are paying vaccinated employees more money through bonuses or extra paid time off.

    The push to get as many people vaccinated as possible is laudable and may well work. But leading behavioral scientists are worried that paying people to vaccinate could backfire if it makes people more skeptical of the shots. And ethicists have argued that it would be wrong, citing concerns over fairness and equity.

    As a behavioral scientist and ethicist, I draw on an extensive body of research to help answer these questions. It suggests that incentives might work to save lives and, if properly structured, need not trample individual rights or be a huge expense for the government.

    In the United States, incentives and disincentives are already used in health care. The U.S. system of privatized health insurance exposes patients to substantial deductibles and copays, not only to cover costs but to cut down on what could be deemed as wasteful health care – the thinking being that putting a cost to an emergency room visit, for example, might deter those who aren't really in need of that level of care.

    In practice, this means patients are encouraged to decline both emergency and more routine care, since both are exposed to costs.

    Paying for health behaviors

    In the case of COVID-19, the vaccines are already free to consumers, which has undoubtedly encouraged people to be immunized. Studies have shown that reducing out-of-pocket costs can improve adherence to life-sustaining drugs, whether to prevent heart attacks or to manage diabetes.

    A payment to take a drug goes one step further than simply reducing costs. And if properly designed, such incentives can change health behaviors.

    Payments and cash prizes have been shown effective in encouraging blood donations, adherence to blood thinner drugs, blood glucose monitoring, physical activity and smoking cessation.

    And for vaccination in particular, payments have been successful for human papillomavirus (HPV) in England; hepatitis B in the United States and the United Kingdom; and tetanus toxoid in Nigeria. The effects can be substantial: For example, for one group in the HPV study, the vaccination rate more than doubled with an incentive.

    For COVID-19, there are no field studies to date, but several survey experiments, including one my group conducted with 1,000 Americans, find that incentives are likely to work. In our case, the incentive of a tax break was enough to encourage those hesitant about vaccinations to say they would take the shot.

    Coercion concerns

    Even if incentives will save lives by increasing vaccinations, there are still other ethical considerations. A key concern is protecting the autonomous choices of people to decide what they put into their own bodies. This may be especially important for the COVID-19 vaccines, which – although authorized as likely safe and effective – are not yet fully approved by the Food and Drug Administration.

    But already people are often paid to participate in clinical trials for drugs that have not yet been approved by the FDA. Ethicists have worried that such payments may be “coercive" if the money is so attractive as to override a person's free choices or make them worse off overall.

    One can quibble about whether the term “coercion" applies to offers of payment. But even if offers were coercive, payments may still be reasonable to save lives in a pandemic if they succeed in greater levels of immunization.

    During the smallpox epidemic nearly 100 years ago, the U.S. Supreme Court upheld the power of states to mandate vaccines. Compared with mandating vaccination, the incentives to encourage vaccines seem innocuous.

    Exploitation and paternalism

    Yet some still worry. Bioethicists Emily Largent and Franklin Miller wrote in a recent paper that a payment might “unfairly" exploit “those U.S. residents who have lost jobs … or slipped into poverty during the pandemic," which could leave them feeling as if they have “no choice but to be vaccinated for cash." Others have noted that vaccine hesitancy is higher in nonwhite communities, where incomes tend to be lower, as is trust in the medical establishment.

    Ethicists and policymakers should indeed focus on the poorest members of our community and seek to minimize racial disparities in both health outcomes and wealth. But there is no evidence that offering money is actually detrimental to such populations. Receiving money is a good thing. To suggest that we have to protect adults by denying them offers of money may come across as paternalism.

    Some ethicists also argue that the money is better spent elsewhere to increase participation. States could spend the money making sure vaccines are convenient to everyone, for example, by bringing them to community events and churches. Money could also support various efforts to fight misinformation and communicate the importance of getting the shot.

    The cost of incentives

    Financial incentives could be expensive as a policy solution. As in Ohio, lottery drawings are one way to cap the overall cost of incentives while giving millions of people an additional reason to get their shot.

    The tax code could also allow for a no-cost incentive for vaccination. Tax deductions and credits are often designed to encourage behaviors, such as savings or home ownership. Some states now have big budget surpluses and are considering tax relief measures. If a state announced now that such payments would be conditional on being vaccinated, then each person declining the shot would save the government money.

    Ultimately, a well-designed vaccination incentive can help save lives and need not keep the ethicists up at night.The Conversation

    Christopher Robertson, Professor of Law, Boston University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    • It appears that Earth has a geologic "pulse," with clusters of major events occurring every 27.5 million years.
    • Working with the most accurate dating methods available, the authors of the study constructed a new history of the last 260 million years.
    • Exactly why these cycles occur remains unknown, but there are some interesting theories.

    Our hearts beat at a resting rate of 60 to 100 beats per minute. Lots of other things pulse, too. The colors we see and the pitches we hear, for example, are due to the different wave frequencies ("pulses") of light and sound waves.

    Now, a study in the journal Geoscience Frontiers finds that Earth itself has a pulse, with one "beat" every 27.5 million years. That's the rate at which major geological events have been occurring as far back as geologists can tell.

    A planetary calendar has 10 dates in red

    Credit: Jagoush / Adobe Stock

    According to lead author and geologist Michael Rampino of New York University's Department of Biology, "Many geologists believe that geological events are random over time. But our study provides statistical evidence for a common cycle, suggesting that these geologic events are correlated and not random."

    The new study is not the first time that there's been a suggestion of a planetary geologic cycle, but it's only with recent refinements in radioisotopic dating techniques that there's evidence supporting the theory. The authors of the study collected the latest, best dating for 89 known geologic events over the last 260 million years:

    • 29 sea level fluctuations
    • 12 marine extinctions
    • 9 land-based extinctions
    • 10 periods of low ocean oxygenation
    • 13 gigantic flood basalt volcanic eruptions
    • 8 changes in the rate of seafloor spread
    • 8 times there were global pulsations in interplate magmatism

    The dates provided the scientists a new timetable of Earth's geologic history.

    Tick, tick, boom

    Credit: New York University

    Putting all the events together, the scientists performed a series of statistical analyses that revealed that events tend to cluster around 10 different dates, with peak activity occurring every 27.5 million years. Between the ten busy periods, the number of events dropped sharply, approaching zero.

    Perhaps the most fascinating question that remains unanswered for now is exactly why this is happening. The authors of the study suggest two possibilities:

    "The correlations and cyclicity seen in the geologic episodes may be entirely a function of global internal Earth dynamics affecting global tectonics and climate, but similar cycles in the Earth's orbit in the Solar System and in the Galaxy might be pacing these events. Whatever the origins of these cyclical episodes, their occurrences support the case for a largely periodic, coordinated, and intermittently catastrophic geologic record, which is quite different from the views held by most geologists."

    Assuming the researchers' calculations are at least roughly correct — the authors note that different statistical formulas may result in further refinement of their conclusions — there's no need to worry that we're about to be thumped by another planetary heartbeat. The last occurred some seven million years ago, meaning the next won't happen for about another 20 million years.