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Contents
Preface xxi
1 Catalysts for Change 1

1.1 Introduction 2
1.2 Milestones in Computing 5
1.2.1 Aids to Manual Calculating 6
1.2.2 Mechanical Calculators 6
1.2.3 Cash Register 8
1.2.4 Punched-Card Tabulation 9
1.2.5 Precursors of Commercial Computers 11
1.2.6 First Commercial Computers 13
1.2.7 Programming Languages and Time-Sharing 14
1.2.8 Transistor and Integrated Circuit 16
1.2.9 IBM System/360 16
1.2.10 Microprocessor 17
1.2.11 Personal Computer 19
1.3 Milestones in Networking 21
1.3.1 Electricity and Electromagnetism 22
1.3.2 Telegraph 23
1.3.3 Telephone 23
1.3.4 Typewriter and Teletype 25
1.3.5 Radio 26
1.3.6 Television 26
1.3.7 Remote Computing 27
1.3.8 ARPANET 28
1.3.9 Email 28
1.3.10 Internet 30
1.3.11 NSFNET 30
1.3.12 Broadband 30
1.3.13 Wireless Networks 31
viii Contents
1.4 Milestones in Information Storage and Retrieval 31

1.4.1 Greek Alphabet 31
1.4.2 Codex and Paper 32
1.4.3 Gutenberg’s Printing Press 32
1.4.4 Newspapers 33
1.4.5 Hypertext 33
1.4.6 Graphical User Interface 34
1.4.7 Single-Computer Hypertext Systems 35
1.4.8 Networked Hypertext: World Wide Web 36
1.4.9 Search Engines 36
1.5 Information Technology Issues 37
Summary 39
Further Reading and Viewing 40
Review Questions 41
Discussion Questions 41
In-Class Exercises 42
References 43
An Interview with Dalton Conley 47
2 Introduction to Ethics 49
2.1 Introduction 49
2.1.1 Defining Terms 50
2.1.2 Four Scenarios 52
2.1.3 Overview of Ethical Theories 55
2.2 Subjective Relativism 56
2.2.1 The Case for Subjective Relativism 56
2.2.2 The Case against Subjective Relativism 57
2.3 Cultural Relativism 58
2.3.1 The Case for Cultural Relativism 58
2.3.2 The Case against Cultural Relativism 59
2.4 Divine Command Theory 61
2.4.1 The Case for the Divine Command Theory 62
2.4.2 The Case against the Divine Command Theory 63
2.5 Ethical Egoism 64
2.5.1 The Case for Ethical Egoism 65
2.5.2 The Case against Ethical Egoism 65
2.6 Kantianism 67
2.6.1 Good Will and the Categorical Imperative 67
2.6.2 Evaluating a Scenario Using Kantianism 70
Contents ix
2.6.3 The Case for Kantianism 70

2.6.4 The Case against Kantianism 71
2.7 Act Utilitarianism 72

2.7.1 Principle of Utility 72
2.7.2 Evaluating a Scenario Using Act Utilitarianism 74
2.7.3 The Case for Act Utilitarianism 75
2.7.4 The Case against Act Utilitarianism 76
2.8 Rule Utilitarianism 77

2.8.1 Basis of Rule Utilitarianism 78
2.8.2 Evaluating a Scenario Using Rule Utilitarianism 78
2.8.3 The Case for Rule Utilitarianism 79
2.8.4 The Case against Utilitarianism in General 80
2.9 Social Contract Theory 81

2.9.1 The Social Contract 81
2.9.2 Rawls’s Theory of Justice 83
2.9.3 Evaluating a Scenario Using Social Contract Theory 85
2.9.4 The Case for Social Contract Theory 86
2.9.5 The Case against Social Contract Theory 87
2.10 Virtue Ethics 88

2.10.1 Virtues and Vices 88
2.10.2 Making a Decision Using Virtue Ethics 91
2.10.3 The Case for Virtue Ethics 92
2.10.4 The Case against Virtue Ethics 93
2.11 Comparing Workable Ethical Theories 94
2.12 Morality of Breaking the Law 94

2.12.1 Social Contract Theory Perspective 96
2.12.2 Kantian Perspective 96
2.12.3 Rule Utilitarian Perspective 97
2.12.4 Act Utilitarian Perspective 97
2.12.5 Conclusion 98
Summary 98
Review Questions 99
References 103
An Interview with James Moor 105
x Contents
3 Networked Communications 109

3.1 Introduction 109
3.2 Spam 111
3.2.1 The Spam Epidemic 111
3.2.2 Need for Social-Technical Solutions 113
3.2.3 Case Study: Ann the Acme Accountant 113
3.3 Internet Interactions 116

3.3.1 The World Wide Web 116
3.3.2 Mobile Apps 116
3.3.3 How We Use the Internet 117
3.4 Text Messaging 119

3.4.1 Transforming Lives in Developing Countries 119
3.4.2 Twitter 120
3.4.3 Business Promotion 120
3.4.4 Political Activism 120
3.5 Censorship 121

3.5.1 Direct Censorship 121
3.5.2 Self-Censorship 122
3.5.3 Challenges Posed by the Internet 122
3.5.4 Government Filtering and Surveillance of Internet Content 123
3.5.5 Ethical Perspectives on Censorship 124
3.6 Freedom of Expression 126

3.6.1 History 126
3.6.2 Freedom of Expression Not an Absolute Right 127
3.6.3 FCC v. Pacifica Foundation 128
3.6.4 Case Study: Kate’s Blog 129
3.7 Children and Inappropriate Content 131

3.7.1 Web Filters 131
3.7.2 Child Internet Protection Act 132
3.7.3 Ethical Evaluations of CIPA 132
3.7.4 Sexting 134
3.8 Breaking Trust 135

3.8.1 Identity Theft 135
3.8.2 Fake Reviews 137
3.8.3 Online Predators 137
3.8.4 Ethical Evaluations of Police Sting Operations 138
3.8.5 False Information 140
3.8.6 Cyberbullying 141
3.8.7 Revenge Porn 142
Contents xi
3.9 Internet Addiction 143

3.9.1 Is Internet Addiction Real? 143
3.9.2 Contributing Factors to Addiction 145
3.9.3 Ethical Evaluation of Internet Addiction 145
Summary 146
Review Questions 148
References 152
An Interview with Michael Liebhold 159
4 Intellectual Property 161

4.2 Intellectual Property Rights 162
4.2.1 Property Rights 163
4.2.2 Extending the Argument to Intellectual Property 165
4.2.3 Benefits of Intellectual Property Protection 167
4.2.4 Limits to Intellectual Property Protection 167
4.3 Protecting Intellectual Property 169
4.3.1 Trade Secrets 169
4.3.2 Trademarks and Service Marks 170
4.3.3 Patents 171
4.3.4 Copyrights 172
4.3.5 Case Study: The Database Guru 175
4.4 Fair Use 179
4.4.1 Sony v. Universal City Studios 181
4.4.2 Audio Home Recording Act of 1992 182
4.4.3 RIAA v. Diamond Multimedia 183
4.4.4 Kelly v. Arriba Soft 183
4.4.5 Authors Guild v. Google 184
4.4.6 Mashups 185
4.5 Digital Media 186
4.5.1 Digital Rights Management 186
4.5.2 Digital Millennium Copyright Act 187
4.5.3 Secure Digital Music Initiative 187
4.5.4 Sony BMG Music Entertainment Rootkit 188
4.5.5 Criticisms of Digital Rights Management 188
4.5.6 Online Music Stores Drop Digital Rights Management 189
4.5.7 Microsoft Xbox One 189
xii Contents
4.6 Peer-to-Peer Networks and Cyberlockers 190

4.6.1 RIAA Lawsuits against Napster, Grokster, and Kazaa 190
4.6.2 MGM v. Grokster 192
4.6.3 BitTorrent 193
4.6.4 Legal Action against the Pirate Bay 194
4.6.5 PRO-IP Act 195
4.6.6 Megaupload Shutdown 195
4.6.7 Legal Online Access to Entertainment 196
4.7 Protections for Software 197
4.7.1 Software Copyrights 197
4.7.2 Violations of Software Copyrights 197
4.7.3 Safe Software Development 198
4.7.4 Software Patents 199
4.8 Legitimacy of Intellectual Property Protection for Software 201
4.8.1 Rights-Based Analysis 202
4.8.2 Utilitarian Analysis 203
4.8.3 Conclusion 204
4.9 Open-Source Software 204
4.9.1 Consequences of Proprietary Software 205
4.9.2 “Open Source” Definition 206
4.9.3 Beneficial Consequences of Open-Source Software 206
4.9.4 Examples of Open-Source Software 207
4.9.5 The GNU Project and Linux 207
4.9.6 Impact of Open-Source Software 209
4.10 Creative Commons 209
Summary 212
References 216
An Interview with June Besek 223
5 Information Privacy 227

5.2 Perspectives on Privacy 229
5.2.1 Defining Privacy 229
5.2.2 Harms and Benefits of Privacy 230
5.2.3 Is There a Natural Right to Privacy? 232
5.2.4 Privacy and Trust 236
5.2.5 Case Study: The New Parents 237
Contents xiii
5.3 Information Disclosures 239

5.3.1 Facebook Tags 240
5.3.2 Enhanced 911 Services 241
5.3.3 Rewards or Loyalty Programs 241
5.3.4 Body Scanners 242
5.3.5 RFID Tags 243
5.3.6 Implanted Chips 244
5.3.7 Mobile Apps 244
5.3.8 OnStar 244
5.3.9 Automobile “Black Boxes” 245
5.3.10 Medical Records 245
5.3.11 Digital Video Recorders 246
5.3.12 Cookies and Flash Cookies 246
5.4 Data Mining 246
5.4.1 Data Mining Defined 246
5.4.2 Opt-In versus Opt-Out Policies 247
5.4.3 Examples of Data Mining 249
5.4.4 Social Network Analysis 252
5.4.5 Release of “Anonymized” Datasets 252
5.5 Examples of Consumer Backlash 254
5.5.1 Marketplace: Households 254
5.5.2 Facebook Beacon 254
5.5.3 Malls Track Shoppers’ Cell Phones 255
5.5.4 iPhone Apps Uploading Address Books 255
5.5.5 Instagram’s Proposed Change to Terms of Service 256
Summary 256
References 261
An Interview with Michael Zimmer 267
6 Privacy and the Government 271

6.2 US Legislation Restricting Information Collection 273
6.2.1 Employee Polygraph Protection Act 273
6.2.2 Children’s Online Privacy Protection Act 273
6.2.3 Genetic Information Nondiscrimination Act 273
6.3 Information Collection by the Government 274
6.3.1 Census Records 274
xiv Contents
6.3.2 Internal Revenue Service Records 275

6.3.3 FBI National Crime Information Center 2000 275
6.3.4 OneDOJ Database 277
6.3.5 Closed-Circuit Television Cameras 278
6.3.6 License Plate Scanners 279
6.3.7 Police Drones 279
6.4 Covert Government Surveillance 280

6.4.1 Wiretaps and Bugs 281
6.4.2 Operation Shamrock 283
6.4.3 Carnivore Surveillance System 284
6.4.4 Covert Activities after 9/11 284
6.5 US Legislation Authorizing Wiretapping 285

6.5.1 Title III 286
6.5.2 Foreign Intelligence Surveillance Act 286
6.5.3 Electronic Communications Privacy Act 286
6.5.4 Stored Communications Act 287
6.5.5 Communications Assistance for Law Enforcement Act 287
6.6 USA PATRIOT Act 288

6.6.1 Provisions of the Patriot Act 288
6.6.2 National Security Letters 289
6.6.3 Responses to the Patriot Act 290
6.6.4 Successes and Failures 291
6.6.5 Long-Standing NSA Access to Telephone Records 292
6.7 Regulation of Public and Private Databases 293

6.7.1 Code of Fair Information Practices 293
6.7.2 Privacy Act of 1974 295
6.7.3 Fair Credit Reporting Act 296
6.7.4 Fair and Accurate Credit Transactions Act 296
6.7.5 Financial Services Modernization Act 296
6.8 Data Mining by the Government 297

6.8.1 Internal Revenue Service Audits 297
6.8.2 Syndromic Surveillance Systems 297
6.8.3 Telecommunications Records Database 297
6.8.4 Predictive Policing 298
6.8.5 Potential Harms of Profiling 298
6.9 National Identification Card 299

6.9.1 History and Role of the Social Security Number 299
6.9.2 Debate over a National ID Card 300
6.9.3 The REAL ID Act 302
6.10 Information Dissemination 303

6.10.1 Family Education Rights and Privacy Act 303
Contents xv
6.10.2 Video Privacy Protection Act 303

6.10.3 Health Insurance Portability and Accountability Act 303
6.10.4 Freedom of Information Act 304
6.10.5 Tollbooth Records Used in Court 304
6.11 Invasion 305
6.11.1 Telemarketing 305
6.11.2 Loud Television Commercials 306
6.11.3 Requiring Identification for Pseudoephedrine Purchases 306
6.11.4 Advanced Imaging Technology Scanners 306
Summary 307
References 312
An Interview with Jerry Berman 317
7 Computer and Network Security 321

7.2 Hacking 322
7.2.1 Hackers, Past and Present 322
7.2.2 Penalties for Hacking 324
7.2.3 Selected Hacking Incidents 324
7.2.4 Case Study: Firesheep 325
7.3 Malware 328
7.3.1 Viruses 328
7.3.2 The Internet Worm 330
7.3.3 Sasser 335
7.3.4 Instant Messaging Worms 335
7.3.5 Conficker 335
7.3.6 Cross-Site Scripting 336
7.3.7 Drive-By Downloads 336
7.3.8 Trojan Horses and Backdoor Trojans 336
7.3.9 Rootkits 336
7.3.10 Spyware and Adware 337
7.3.11 Bots and Botnets 337
7.3.12 Defensive Measures 337
7.4 Cyber Crime and Cyber Attacks 338
7.4.1 Phishing and Spear Phishing 338
7.4.2 SQL Injection 339
xvi Contents
7.4.3 Denial-of-Service and Distributed Denial-of-Service Attacks 339

7.4.4 Cyber Crime 339
7.4.5 Politically Motivated Cyber Attacks 341
7.5 Online Voting 346
7.5.1 Motivation for Online Voting 346
7.5.2 Proposals 346
7.5.3 Ethical Evaluation 347
Summary 350
References 354
An Interview with Matt Bishop 361
8 Computer Reliability 365

8.2 Data Entry or Data Retrieval Errors 366
8.2.1 Disenfranchised Voters 366
8.2.2 False Arrests 366
8.2.3 Utilitarian Analysis: Accuracy of NCIC Records 367
8.3 Software and Billing Errors 368
8.3.1 Errors Leading to System Malfunctions 368
8.3.2 Errors Leading to System Failures 369
8.3.3 Analysis: E-retailer Posts Wrong Price, Refuses to Deliver 371
8.4 Notable Software System Failures 372
8.4.1 Patriot Missile 372
8.4.2 Ariane 5 373
8.4.3 AT&T Long-Distance Network 374
8.4.4 Robot Missions to Mars 375
8.4.5 Denver International Airport 376
8.4.6 Tokyo Stock Exchange 377
8.4.7 Direct-Recording Electronic Voting Machines 378
8.5 Therac-25 381
8.5.1 Genesis of the Therac-25 382
8.5.2 Chronology of Accidents and AECL Responses 382
8.5.3 Software Errors 385
8.5.4 Postmortem 387
8.5.5 Moral Responsibility of the Therac-25 Team 388
8.5.6 Postscript 389
Contents xvii
8.6 Computer Simulations 389

8.6.1 Uses of Simulation 389
8.6.2 Validating Simulations 390
8.7 Software Engineering 392

8.7.1 Specification 393
8.7.2 Development 393
8.7.3 Validation 394
8.7.4 Evolution 395
8.7.5 Improvement in Software Quality 395
8.7.6 Gender Bias 396
8.8 Software Warranties and Vendor Liability 397

8.8.1 Shrink-Wrap Warranties 397
8.8.2 Are Software Warranties Enforceable? 398
8.8.3 Should Software Be Considered a Product? 400
8.8.4 Case Study: Incredible Bulk 401
Summary 401
References 407
An Interview with Avi Rubin 411
9 Professional Ethics 413

9.2 How Well Developed Are the Computing Professions? 415
9.2.1 Characteristics of a Fully Developed Profession 415
9.2.2 Case Study: Certified Public Accountants 416
9.2.3 How Do Computer-Related Careers Stack Up? 417
9.3 Software Engineering Code of Ethics 419

9.4 Analysis of the Code 427
9.4.1 Preamble 427
9.4.2 Alternative List of Fundamental Principles 428
9.5 Case Studies 429

9.5.1 Software Recommendation 430
9.5.2 Child Pornography 431
9.5.3 Antiworm 432
9.5.4 Consulting Opportunity 434
xviii Contents
9.6 Whistle-Blowing 436

9.6.1 Morton Thiokol/NASA 437
9.6.2 Hughes Aircraft 438
9.6.3 US Legislation Related to Whistle-Blowing 440
9.6.4 Morality of Whistle-Blowing 441
Summary 444
References 450
An Interview with Paul Axtell 453
10 Work and Wealth 457

10.2 Automation and Employment 458
10.2.1 Automation and Job Destruction 458
10.2.2 Automation and Job Creation 461
10.2.3 Effects of Increase in Productivity 462
10.2.4 Case Study: The Canceled Vacation 463
10.2.5 Rise of the Robots? 465
10.3 Workplace Changes 469
10.3.1 Organizational Changes 469
10.3.2 Telework 471
10.3.3 The Gig Economy 473
10.3.4 Monitoring 474
10.3.5 Multinational Teams 475
10.4 Globalization 475
10.4.1 Arguments for Globalization 476
10.4.2 Arguments against Globalization 477
10.4.3 Dot-Com Bust Increases IT Sector Unemployment 478
10.4.4 Foreign Workers in the American IT Industry 478
10.4.5 Foreign Competition 479
10.5 The Digital Divide 479
10.5.1 Global Divide 480
10.5.2 Social Divide 481
10.5.3 Models of Technological Diffusion 482
10.5.4 Critiques of the Digital Divide 483
10.5.5 Massive Open Online Courses 484
10.5.6 Net Neutrality 485
Contents xix
10.6 The “Winner-Take-All” Society 486

10.6.1 Harmful Effects of Winner-Take-All 487
10.6.2 Reducing Winner-Take-All Effects 489
Summary 490
References 495
An Interview with Martin Ford 499
Appendix A: Plagiarism 503

Consequences of Plagiarism 503
Types of Plagiarism 503
Guidelines for Citing Sources 504
How to Avoid Plagiarism 504
Misuse of Sources 504
Additional Information 505
References 505
Index 507
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Preface
Computers and high-speed communication networks are transforming our world.

These technologies have brought us many benefits, but they have also raised many social
and ethical concerns. My view is that we ought to approach every new technology in a
thoughtful manner, considering not just its short-term benefits, but also how its long-
term use will affect our lives. A thoughtful response to information technology requires
a basic understanding of its history, an awareness of current information-technology-
related issues, and a familiarity with ethics. I have written Ethics for the Information Age
with these ends in mind.
Ethics for the Information Age is suitable for college students at all levels. The only
prerequisite is some experience using computers and the Internet. The book is appro-
priate for a stand-alone “computers and society” or “computer ethics” course offered by
a computer science, business, or philosophy department. It can also be used as a supple-
mental textbook in a technical course that devotes some time to social and ethical issues
related to computing.
As students discuss controversial issues related to information technology, they have
the opportunity to learn from one other and improve their critical thinking skills. The
provocative questions raised at the end of every chapter, together with dozens of in-class
exercises, provide many opportunities for students to express their viewpoints. My hope
is that they will get better at evaluating complex issues and defending their conclusions
with facts, sound values, and rational arguments.
WHAT’S NEW IN THE SEVENTH EDITION

The most significant change in the seventh edition is the reorganization of Chapter 4,
Intellectual Property. The “new, improved” chapter is organized around six important
themes:
.
Intellectual property is different from tangible property. Trying to apply Locke’s
theory of property rights to intellectual property is problematic.
.
Intellectual property is protected by trade secrets, trademarks, service marks, pat-
ents, and copyrights.
.
Governments have attempted to find the proper balance between the interests of
creators of intellectual property, who wish to maintain control over their creations,
and the interests of the public, which wants to be able to use these creations. The
concept of “fair use” is an example of such a compromise.
xxii Preface
.
The digital representation of intellectual property enables perfect copies to be made.
Free copies are widely available, thanks to high-speed Internet connections. To-
gether, these two technological developments have made possible an unprecedented
amount of illegal copying, forcing companies selling these products to make “doing
the right thing”—obtaining a legal copy—as easy as “doing the wrong thing”—
obtaining a pirated copy [Christopher Kauffman, private communication].
.
The concepts of copyright and patent have been extended to computer software,
but issuing software patents has been problematic. The arguments for granting
intellectual property protection to software are not strong.
.
Some believe that the current system of intellectual property protection actually
inhibits creativity. The open-source movement advocates the distribution of source
code to programs. Creative Commons has developed licenses that make it easier
for artists, musicians, and writers to use the Internet as a vehicle for stimulating
creativity and enhancing collaboration.
The seventh edition also adds new coverage of many important recent develop-
ments. Among them are
.
employers accessing social media to learn more about job candidates
.
the growth of the “gig economy”
.
the “right to be forgotten” and the European Union court order requiring Google
to suppress certain search results
.
revenge porn
.
fake online reviews and efforts to filter them out
.
the debate over whether mashups are a violation of copyright law
.
breaches of privacy caused by corporations releasing large data sets that were not
correctly anonymized
.
the “smartphone patent wars”
.
the Open Internet Order released by the Federal Communications Commission to
preserve net neutrality
.
responses by China and South Korea to the Internet addiction of many of its youth
.
the use of darknets by criminals, political dissidents, and others
.
recent US Supreme Court rulings that seem to indicate that software, as a class, is
worthy of patent protection
.
passage of the USA Freedom Act to reform the Patriot Act in light of Edward
Snowden’s revelations
.
the emerging power of data brokers
.
the trend away from using direct-recording electronic voting machines in the
United States
The seventh edition contains many other improvements. It introduces two new
ethical case studies: one in Chapter 4 and the other in Chapter 10. Dozens of new review
questions require the reader to apply and analyze material appearing in the chapters,
Preface xxiii
replacing more simplistic review questions. Finally, I have updated a significant number
of facts and figures throughout the book.
ORGANIZATION OF THE BOOK

The book is divided into 10 chapters. Chapter 1 has three objectives: to get the reader
thinking about the process of technological change; to present a brief history of com-
puting, networking, and information storage and retrieval; and to provide examples of
moral problems brought about by the introduction of information technology.
Chapter 2 is an introduction to ethics. It presents nine different theories of ethical
decision making, weighing the pros and cons of each one. Five of these theories—
Kantianism, act utilitarianism, rule utilitarianism, social contract theory, and virtue
ethics—are deemed the most appropriate “tools” for analyzing moral problems in the
remaining chapters.
Chapters 3–10 discuss a wide variety of issues related to the introduction of infor-
mation technology into society. I think of these chapters as forming concentric rings
around a particular computer user.
Chapter 3 is the innermost ring, dealing with what can happen when people com-
municate over the Internet using the Web, email, and Twitter. Issues such as the increase
in spam, easy access to pornography, cyberbullying, and Internet addiction raise impor-
tant questions related to quality of life, free speech, and censorship.
The next ring, Chapter 4, deals with the creation and exchange of intellectual prop-
erty. It discusses intellectual property rights; legal safeguards for intellectual property;
the definition of fair use; the impact of digital media, peer-to-peer networks, and cyber-
lockers; the legitimacy of intellectual property protection for software; and the rise of
the open-source movement.
Chapter 5 focuses on information privacy. What is privacy exactly? Is there a natural
right to privacy? How do others learn so much about us? The chapter examines the
electronic trail that people leave behind when they use a cell phone, make credit card
purchases, open a bank account, go to a physician, or apply for a loan, and it explains
how mining data to predict consumer behavior has become an important industry.
Chapter 6 focuses on privacy and the US government. Using Daniel Solove’s taxon-
omy of privacy as our organizing principle, we look at how the government has steered
between the competing interests of personal privacy and public safety. We consider US
legislation to restrict information collection and government surveillance; government
regulation of private databases and abuses of large government databases; legislation to
reduce the dissemination of information and legislation that has had the opposite effect;
and finally government actions to prevent the invasion of privacy as well as invasive gov-
ernment actions. Along the way, we discuss the implications of the USA PATRIOT Act
and the debate over the REAL ID Act to establish a de facto national identification card.
Chapter 7 focuses on the vulnerabilities of networked computers. A case study
focuses on the release of the Firesheep extension to the Firefox Web browser. A section
on malware discusses rootkits, spyware, cross-site scripting, and drive-by downloads.
We discuss common Internet-based attacks—phishing, spear phishing, SQL injection,
denial-of-service attacks, and distributed denial-of-service attacks—and how they are
xxiv Preface
used for cyber crime, cyber espionage, and cyber attacks. We conclude with a discussion
of the risks associated with online voting.
Computerized system failures have led to lost business, the destruction of property,
human suffering, and even death. Chapter 8 describes some notable software system
failures, including the story of the Therac-25 radiation therapy system. It also discusses
the reliability of computer simulations, the emergence of software engineering as a
distinct discipline, and the validity of software warranties.
Chapter 9 is particularly relevant for those readers who plan to take jobs in the
computer industry. The chapter presents a professional code related to computing, the
Software Engineering Code of Ethics and Professional Practice, followed by an analysis
of the code. Several case studies illustrate how to use the code to evaluate moral problems
related to the use of computers. The chapter concludes with an ethical evaluation of
whistle-blowing, an extreme example of organizational dissent.
Chapter 10 raises a wide variety of issues related to how information technology
has impacted work and wealth. Topics include workplace monitoring, telecommuting,
and globalization. Does automation increase unemployment? Is there a “digital divide”
separating society into “haves” and “have nots”? Is information technology widening the
gap between rich and poor? These are just a few of the important questions the chapter
addresses.
NOTE TO INSTRUCTORS
In December 2013, a joint task force of the Association for Computing Machinery
and the IEEE Computer Society released the final draft of Computer Science Curricula
2013 (www.acm.org/education/CS2013-final-report.pdf). The report recommends that
every undergraduate computer science degree program incorporate instruction related
to Social Issues and Professional Practice through “a combination of one required course
along with short modules in other courses” (Computer Science Curricula 2013, p. 193).
Ethics for the Information Age covers nearly all of the core and elective material described
in the report, with the notable exception of Professional Communications. Table 1 shows
Name Chapter(s)
SP/Social Context 3, 10
SP/Analytical Tools 2
SP/Professional Ethics 9
SP/Intellectual Property 4
SP/Privacy and Civil Liberties 5, 6
SP/Sustainability 8, 10
SP/History 1
SP/Economies of Computing 10
SP/Security Policies, Laws, and Computer Crimes 7
Table 1 Mapping between the conceptual areas of Social and Professional Issues in
Computer Science Curricula 2013 and the chapters of this book.
Preface xxv
the mapping between the other conceptual areas within Social Issues and Professional
Practice and the chapters of this book.
The organization of the book makes it easy to adapt to your particular needs. If
your syllabus does not include the history of information technology, you can skip the
middle three sections of Chapter 1 and still expose your students to examples motivating
the formal study of ethics in Chapter 2. After Chapter 2, you may cover the remaining
chapters in any order you choose, because Chapters 3–10 do not depend on one other.
Many departments choose to incorporate discussions of social and ethical issues
throughout the undergraduate curriculum. The independence of Chapters 3–10 makes
it convenient to use Ethics for the Information Age as a supplementary textbook. You can
simply assign readings from the chapters most closely related to the course topic.
SUPPLEMENTS
The following supplements are available to qualified instructors on Pearson’s Instructor
Resource Center. Please contact your local Pearson sales representative or visit www
.pearsonhighered.com/educator to access this material.
.
An instructor’s manual provides tips for teaching a course in computer ethics. It
also contains answers to all of the review questions.
.
A test bank contains more than 300 multiple-choice, fill-in-the-blank, and essay
questions that you can use for quizzes, midterms, and final examinations.
.
A set of PowerPoint lecture slides outlines the material covered in every chapter.
FEEDBACK
Ethics for the Information Age cites hundreds of sources and includes dozens of ethical
analyses. Despite my best efforts and those of many reviewers, the book is bound to
contain errors. I appreciate getting comments (both positive and negative), corrections,
and suggestions from readers. Please send them to quinnm@seattleu.edu or Michael J.
Quinn, Seattle University, College of Science and Engineering, 901 12th Avenue, Seattle,
WA 98122.
ACKNOWLEDGMENTS
I appreciate the continuing support of a great publications team, beginning with editor
Matt Goldstein, and including Carole Snyder, Scott Disanno, Kristy Alaura, Joyce Wells,
Paul Anagnostopoulos, Jacqui Scarlott, Jennifer McClain, Richard Camp, Laurel Muller,
and Ted Laux. I thank them and everyone else who helped produce this edition.
A superb group of reviewers provided me with many helpful suggestions regard-
ing new material to incorporate into the seventh edition. My thanks to Richard Egan,
New Jersey Institute of Technology; Fred Geldon, George Mason University; D.C. Grant,
Columbia Basin College; Musconda Kapatamoyo, Southern Illinois University, Ed-
wardsville; Christopher Kauggman, George Mason University; James Markulic, New
Jersey Institute of Technology; Linda O’Hara, Oregon State University; Dorothy Sunio,
Leeward Community College; and Todd Will, New Jersey Institute of Technology.
xxvi Preface
I am grateful to professors Paulette Kidder and Gregory Silverman of Seattle Uni-

versity, who reviewed the new case studies and provided me with helpful suggestions on
how to improve them.
I thank all who participated in the creation of the first six editions or provided
useful suggestions for the seventh edition: Paul Anagnostopoulos, Valerie Anctil, Beth
Anderson, Bob Baddeley, George Beekman, Brian Breck, Maria Carl, Sherry Clark,
Thomas Dietterich, Roger Eastman, Beverly Fusfield, Robert Greene, Peter Harris, Su-
san Hartman, Michael Hirsch, Michael Johnson, Paulette Kidder, Marilyn Lloyd, Pat
McCutcheon, Beth Paquin, Konrad Puczynski, Brandon Quinn, Courtney Quinn, Stu-
art Quinn, Victoria Quinn, Charley Renn, Gregory Silverman, Lindsey Triebel, Charles
Volzka, Shauna Weaver, and Todd Will.
Reviewers of previous editions include Ramprasad Bala, University of Massachu-
setts at Dartmouth; Phillip Barry, University of Minnesota; Bo Brinkman, Miami
University; Diane Cassidy, University of North Carolina at Charlotte; Madhavi M.
Chakrabarty, New Jersey Institute of Technology; John Clark, University of Colorado
at Denver; Timothy Colburn, University of Minnesota Duluth; Lorrie Faith Cranor,
Carnegie Mellon University; Lee D. Cornell, Minnesota State University, Mankato;
Donna Maria D’Ambrosio, University of South Florida; Dawit Demissie, The Sage
Colleges; J.C. Diaz, University of Tulsa; Richard W. Egan, New Jersey Institute of Tech-
nology; Fred Geldon, George Mason University; David Goodall, State University of New
York at Albany; Richard E. Gordon, University of Delaware; Mike Gourley, Univer-
sity of Central Oklahoma; Robert Greene, University of Wisconsin-Eau Claire; Fritz H.
Grupe, University of Nevada, Reno; Ric Heishman, George Mason University; Gurdeep
Hura, University of Maryland Eastern Shore; Evelyn Lulis, DePaul University; Tamara
A. Maddox, George Mason University; Aparna Mahadev, Worcester State University;
Eric Manley, Drake University; Richard D. Manning, Nova Southeastern University;
John G. Messerly, University of Texas at Austin; Joe Oldham, Centre College; Mimi
Opkins, California State University, Long Beach; Daniel Palmer, Kent State University;
Holly Patterson-McNeill, Lewis-Clark State College; Colin Potts, Georgia Tech; Jason
Rogers, George Mason University; Medha S. Sarkar, Middle Tennessee State University;
Michael Scanlan, Oregon State University; Robert Sloan, University of Illinois at Chi-
cago; Matthew Stockton, Portland Community College; Leon Tabak, Cornell College;
Renée Turban, Arizona State University; Scott Vitz, Indiana University–Purdue Uni-
versity Fort Wayne; David Womack, University of Texas at San Antonio; John Wright,
Juniata College; and Matthew Zullo, Wake Technical Community College.
Finally, I am indebted to my wife, Victoria, for her support and encouragement. You
are a wonderful helpmate. Thanks for everything.
Michael J. Quinn
Seattle, Washington
We never know how high we are
Till we are called to rise;
And then, if we are true to plan,
Our statures touch the skies.
The heroism we recite
Would be a daily thing,
Did not ourselves the cubits warp
For fear to be a king.
—–Emily Dickinson, Aspiration
I dedicate this book to my children Shauna, Brandon, and Courtney.
Know that my love goes with you, wherever your aspirations may lead you.
This page intentionally left blank
C H A P T E R
1 Catalysts for
Change
A tourist came in from Orbitville,

parked in the air, and said:
The creatures of this star
are made of metal and glass.
Through the transparent parts
you can see their guts.
Their feet are round and roll
on diagrams of long
measuring tapes, dark
with white lines.
They have four eyes.
The two in back are red.
Sometimes you can see a five-eyed
one, with a red eye turning
on the top of his head.
He must be special—–
the others respect him
and go slow
when he passes, winding
among them from behind.
They all hiss as they glide,
like inches, down the marked
tapes. Those soft shapes,
shadowy inside
the hard bodies—–are they
their guts or their brains?
—–May Swenson, “Southbound on the Freeway”1
1. Copyright © 1963 by the Literary Estate of May Swenson. Reprinted by permission.

2 Chapter 1 Catalysts for Change
Figure 1.1 Low-cost computers and high-speed communication networks make possible
the products of the Information Age, such as the Apple iPhone 6. It functions as a phone,
email client, Web browser, camera, video recorder, digital compass, and more. (Richard
Sharrocks/Alamy)
1.1 Introduction
Most of us take technological change for granted. In the past two decades
alone, we have witnessed the emergence of exciting new technologies, including smart-
phones, digital photography, automobile navigation systems, and Internet-based music
and video streaming. There is good reason to say we are living in the Information Age.
Never before have so many people had such easy access to information. The two prin-
cipal catalysts for the Information Age have been low-cost computers and high-speed
communication networks (Figure 1.1). Even in a society accustomed to change, the rate
at which computers and communication networks have transformed our lives is breath-
taking.
In 1950 there were no more than a handful of electronic digital computers in the
world. Today we are surrounded by devices containing embedded computers. We rely
upon microprocessors to control our heating and cooling systems, microwaves, smart-
phones, elevators, and a multitude of other devices we use every day. Thanks to micro-
1.1 Introduction 3
processors, our automobiles get better gas mileage and produce less pollution. On the
other hand, the days of the do-it-yourself tune-up are gone. It takes a mechanic with
computerized diagnostic equipment to work on a modern engine.
In 1990 few people other than college professors used email. Today more than a
billion people around the world have email accounts. Email messages are routed in-
stantaneously for very low cost, which can be both a blessing and a curse. Business
communications have never been so efficient, but it’s not unusual to hear businesspeople
complain that they can never get caught up with their email.
The World Wide Web was still being designed in 1990; today it contains more than a
trillion pages and makes possible extraordinarily valuable information retrieval systems.
Even grade school children are expected to gather information from the Web when
writing their reports. However, many parents worry that their Web-surfing children may
be exposed to pornographic images or other inappropriate material.
May Swenson has vividly described our ambivalent feelings toward technology.
In her poem “Southbound on the Freeway,” an alien hovers above an expressway and
watches the cars move along [1]. The alien notes “soft shapes” inside the automobiles
and wonders, “are they their guts or their brains?” It’s fair to ask: Do we drive technology,
or does technology drive us?
Our relationship with technology is complicated. We create technology and choose
to adopt it. However, once we have adopted a technological device, it can transform us
and how we relate to other people and our environment.
Some of the transformations are physical. The neural pathways and synapses in our
brains demonstrate neuroplasticity: literally changing with our experiences. One well-
known brain study focused on London taxi drivers. In order to get a license, aspiring
London taxi drivers must spend two to four years memorizing the complicated road
network of 25,000 streets within 10 kilometers of the Charing Cross train station, as
well as the locations of thousands of tourist destinations. The hippocampus is the region
of the brain responsible for long-term memory and spatial navigation. Neuroscientists
at University College London found that the brains of London taxi drivers have larger-
than-average hippocampi and that the hippocampi of aspiring taxi drivers grow as they
learn the road network [2].
Stronger longer-term memory and spatial navigation skills are great outcomes of
mental exercise, but sometimes the physical effects of our mental exertions are more
insidious. For example, studies with macaque monkeys suggest that when we satisfy
our hunger for quick access to information through our use of Web browsers, Twitter,
and texting, neurons inside our brains release dopamine, producing a desire to seek out
additional information, causing further releases of dopamine, and so on, which may
explain why we find it difficult to break away from these activities [3, 4].
Adopting a technology can change our perceptions, too. More than 90 percent of
cell phone users report that having a cell phone makes them feel safer, but once people
get used to carrying a cell phone, losing the phone may make them feel more vulnerable
than they ever did before they began carrying one. A Rutgers University professor asked
his students to go without their cell phones for 48 hours. Some students couldn’t do it.
A female student reported to the student newspaper, “I felt like I was going to get raped
if I didn’t have my cell phone in my hand.” Some parents purchase cell phones for their
Figure 1.2 The Amish carefully evaluate new technologies, choosing those that enhance
family and community solidarity. (AP photo/The Indianapolis Star and News, Mike Fender)
children so that a child may call a family member in an emergency. However, parents
who provide a cell phone “lifeline” may be implicitly communicating to their children
the idea that people in trouble cannot expect help from strangers [5].
The Amish understand that the adoption of a new technology can affect the way
people relate to each other (Figure 1.2). Amish bishops meet twice a year to discuss mat-
ters of importance to the church, including whether any new technologies should be
allowed. Their discussion about a new technology is driven by the question, “Does it
bring us together, or draw us apart?” You can visit an “Old Order” Amish home and
find a gas barbecue on the front porch but no telephone inside, because they believe gas
barbecues bring people together while telephones interfere with face-to-face conversa-
tions [6].
New technologies are adopted to solve problems, but they often create problems,
too. The automobile has given people the ability to travel where they want, when they
want. On the other hand, millions of people spend an hour or more each day stuck in
traffic commuting between home and work. Refrigerators make it possible for us to keep
food fresh for long periods of time. We save time because we don’t have to go grocery
shopping every day. Unfortunately, Freon leaking from refrigerators has contributed to
the depletion of the ozone layer that protects us from harmful ultraviolet rays. New
communication technologies have made it possible for us to get access to news and
entertainment from around the world. However, the same technologies have enabled
major software companies to move thousands of jobs to India, China, and Vietnam,
putting downward pressure on the salaries of computer programmers in the United
States [7].
1.2 Milestones in Computing 5
We may not be able to prevent a new technology from being invented, but we
do have control over whether to adopt it. Nuclear power is a case in point. Nuclear
power plants create electricity without producing carbon dioxide emissions, but they
also produce radioactive waste products that must be safely stored for 100,000 years.
Although nuclear power technology is available, no new nuclear power plants were built
in the United States for more than 25 years after the accident at Three Mile Island in
1979 [8].
Finally, we can influence the rate at which new technologies are developed. Some
societies, such as the United States, have a history of nurturing and exploiting new
inventions. Congress has passed intellectual property laws that allow people to make
money from their creative work, and the federal income tax structure allows individuals
to accumulate great wealth.
Most of us appreciate the many beneficial changes that technology has brought into
our lives. In health care alone, computed tomography (CT) and magnetic resonance
imaging (MRI) scanners have greatly improved our ability to diagnose major illnesses;
new vaccines and pharmaceuticals have eradicated some deadly diseases and brought
others under control; and pacemakers, hearing aids, and artificial joints have improved
the physical well-being of millions.
To sum up, societies develop new technologies to solve problems or make life better,
but the use of new technologies changes social conditions and may create new problems.
That doesn’t mean we should never adopt a new technology, but it does give us a
good reason why we should be making informed decisions, weighing the benefits and
potential harms associated with the use of new devices.To that end, this book will help
you gain a better understanding of contemporary ethical issues related to the use of
information technology.
This chapter sets the stage for the remainder of the book. Electronic digital com-
puters and high-performance communication networks are central to contemporary
information technology. While the impact of these inventions has been dramatic in the
past few decades, their roots go back hundreds of years. Section 1.2 tells the story of the
development of computers, showing how they evolved from simple manual calculation
aids to complex microprocessors. In Section 1.3 we describe two centuries of progress
in networking technology, starting with the semaphore telegraph and culminating in
the creation of an email system connecting over a billion users. Section 1.4 shows how
information storage and retrieval evolved from the creation of the Greek alphabet to
Google. Finally, Section 1.5 discusses some of the moral issues that have arisen from the
deployment of information technology.
1.2 Milestones in Computing

Calculating devices have supported the development of commercial enterprises, gov-
ernments, science, and weapons. As you will see in this section, the introduction of new
technologies has often had a social impact.
1.2.1 Aids to Manual Calculating

Adding and subtracting are as old as commerce and taxes. Fingers and toes are handy
calculation aids, but to manipulate numbers above 20, people need more than their
own digits. The tablet, the abacus, and mathematical tables are three important aids to
manual calculating [9].
Simply having a tablet to write down the numbers being manipulated is a great
help. In ancient times, erasable clay and wax tablets served this purpose. By the late
Middle Ages, Europeans often used erasable slates. Paper tablets became common in
the nineteenth century, and they are still popular today.
An abacus is a computing aid in which a person performs arithmetic operations
by sliding counters along rods, wires, or lines. The first abacus was probably devel-
oped in the Middle East more than 2,000 years ago. In a Chinese, Japanese, or Russian
abacus, counters move along rods or wires held in a rectangular frame. Beginning in
medieval Europe, merchants performed their calculations by sliding wooden or metal
counters along lines drawn in a wooden counting board (Figure 1.3). Eventually, the
word “counter” came to mean not only the disk being manipulated but also the place in
a store where transactions take place [9].
Mathematical tables have been another important aid to manual computing for
about 2,000 years. A great breakthrough occurred in the early seventeenth century, when
John Napier and Johannes Kepler published tables of logarithms. These tables were
tremendous time savers to anyone doing complicated math because they allowed them
to multiply two numbers by simply adding their logarithms. Many other useful tables
were created as well. For example, businesspeople consulted tables to compute interest
and convert between currencies. Today people who compute their income taxes “by
hand” make use of tax tables to determine how much they owe.
Even with tablets, abacuses, and mathematical tables, manual calculating is slow, te-
dious, and error-prone. To make matters worse, mathematical tables prepared centuries
ago usually contained errors. That’s because somebody had to compute each table entry
and somebody had to typeset each entry, and errors could occur in either of these steps.
Advances in science, engineering, and business in the post-Renaissance period moti-
vated European inventors to create new devices to make calculations faster and more
reliable and to automate the printing of mathematical tables.
1.2.2 Mechanical Calculators

Blaise Pascal had a weak physique but a powerful mind. When he got tired of summing
by hand long columns of numbers given him by his father, a French tax collector,
he constructed a mechanical calculator to speed the chore. Pascal’s calculator, built
in 1640, was capable of adding whole numbers containing up to six digits. Inspired
by Pascal’s invention, the German Gottfried Leibniz constructed a more sophisticated
calculator that could add, subtract, multiply, and divide whole numbers. The hand-
cranked machine, which he called the Step Reckoner, performed multiplications and
divisions through repeated additions and subtractions, respectively. The calculators of
Pascal and Leibniz were not reliable, however, and did not enjoy commercial success.
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operator then takes hold of the patient's hand and the other
electrode is passed over the muscles of the neck, back, trunk, and
extremities.
When the patient is in bed, as in the regular rest treatment, this

method has to be modified, and then the best treatment is by direct
muscular faradization. Two sponge electrodes are employed. The
sponges are moistened, so that the current may pass through the
skin and reach the muscles. Both electrodes are taken in one hand,
the handle of one, pointing backward, being between the first and
second fingers, while the handle of the other is between the third and
fourth fingers. In this way the distance between the points of
application can be readily altered. The current is then applied to the
muscles everywhere, beginning with those of the feet. Muscles
should be relaxed before passing the current through them. The
whole body can be gone over in this way in the course of half an
hour.
The hydropathic treatment of hysteria is one that has much in it to be

commended. Jolly approves the systematic external application of
cold water; Chambers advocates the daily morning use of shower-
baths, holding that the bracing up of the mind to the shock of a cold
shower-bath is a capital exercise for the weak will-power of the
hysterical individual, and some admirable results have been reported
by Charcot in inveterate neurasthenics and hysterics.
Hydrotherapeutic treatment, continued perseveringly for a long time,
says Rosenthal, “diminishes the extreme impressionability of
hysterical patients, strengthens them, and increases their power of
resistance to irritating influences, stimulates the organic functions,
combats the anæmia, calms the abnormal irritability of the peripheral
nervous system, and by diminishing the morbid increase of reflex
power relieves the violence of the spasmodic symptoms. Even
chronic forms which are combined with severe paroxysms of
convulsions are susceptible of recovery under this plan of treatment.”
The hydrotherapeutic treatment may be contrasted with the

treatment by seclusion, rest, massage, and electricity. Undoubtedly,
one class of hysterical patients is greatly benefited by the latter
method systematically carried out; these have already been
described. In other cases, however, this method of treatment is
useless; in some of them it has a tendency to prolong or aggravate
the hysterical disorder, while in the same cases a well-managed
hydrotherapeutic treatment will answer admirably. This is applicable
in hysterical patients who eat and drink well, who, as a rule, preserve
a good appearance, but whose mind and muscles are equally flabby
and out of tone, and need to be stirred up both physically and
mentally.
Dujardin-Beaumetz recommends prolonged warm baths of from one

to two hours' duration, and believes that the therapeutic virtues of
these baths are augmented by infusions of valerian.
In order to obtain satisfactory results from hydrotherapy, as well as

from massage, electricity, etc., it is best to remove patients from their
family surroundings. Good sanitariums near our large American
cities where hydrotherapy and other special methods of treatment
can be carried out are sadly needed. Hydrotherapeutic treatment is
much more efficacious when conducted at a well-regulated
institution, for several reasons. Measures troublesome in themselves
are here carried out as a matter of daily routine. Numerous patients
permit of the employment of competent attendants. The change is
often of great benefit. The close personal supervision which
hysterical patients are likely to have in a hydrotherapeutic
establishment is also to be taken into consideration. Better modes of
living, proper forms of exercise, regulated diet, etc. also enter; but
still, a fair share of the good which results can be attributed to the
water treatment.
While, however, it is better to remove hysterical patients, for

hydrotherapeutic as well as for other treatment, from their family
surroundings, and to place them in some well-regulated
establishment, it is not by any means impossible to carry out such
treatment in private practice, particularly in a house supplied with a
bath-room. Many of our hydrotherapeutic institutions are in the
hands of charlatans or of individuals who are not practically well
fitted for their work. Not infrequently, however, good results are
obtained even under these circumstances. Much more can be done
in this direction with modest buildings and appliances than is
generally supposed. It is not necessary to have numerous
apartments: three or four rooms in a well-appointed house, if the
arrangements for carrying out the hydrotherapeutic treatment are of
a proper kind, will suffice for a large amount of good work. In almost
any house provided with bath-rooms with hot and cold water some
useful hydrotherapy may be attempted. The spinal douche or pour
can be used by placing the patient in a sitz- or ordinary hip-bath and
pouring the water from a spout or hose held at a certain height, the
distance being regulated according to the patient's condition. Again,
the patient sitting in a tub, water can be poured upon her, beginning
at first with a high temperature and gradually lowering it. The
shower-bath may also be used. An extemporaneous shower-bath
can be provided by an ordinary watering-pot. Whole, three-quarters,
or half baths at different temperatures can be given. One method of
carrying out the wet pack is very simple. A comforter is spread upon
the bed; next to this is placed a woollen blanket, and over the
blanket a wet linen sheet, upon which the patient rests, with the head
on a low pillow. The wet sheet, blanket, and comforter are then
wrapped closely about the patient, bottles of hot water being placed
at the feet. The cold drip-sheet method is another easily used. It
consists in placing about the patient, while sitting up or standing, a
sheet wet with cold water, and then vigorously rubbing her through
the sheet.
Baths to the head may be used in some cases; cool head-baths are
most frequently applied. One method of using these baths is to have
the patient lie in such a position that the head projects a little beyond
the edge of the bed and over a basin or receptacle of some kind.
Water of a suitable temperature is then poured gently or squeezed
out of a sponge over the head. For some forms of insomnia or some
of the disorders of sleep in hysteria this treatment is a valuable
auxiliary to other measures.
For the hysterical spine cold compresses may be used along the
spine. On the other hand, hot fomentations may be found of benefit
in some cases. Where hydrotherapeutic measures are employed
attention should be paid to the condition of the circulation,
particularly in the extremities. If the feet or hands are cold, hot
applications or frictions should be used.
For certain of the vaso-motor disorders of hysteria, such as cold or

hot feet, flushings, etc., local hydrotherapeusis will be of service. In
hysterical contractures local stimulation by the douche method or by
the steam bath may be tried. For the excitable rectum cold enemata
in small quantities, so as not to be expelled, will be found to be very
efficacious. For spasmodic attacks, whether purposive or involuntary,
the use of the wet pack or the plunge-bath will sometimes be found
of good service. In neuralgias and other painful local disorders of
hysteria, frictions, fomentations, Turkish or Russian baths, and the
wet pack are often very beneficial.
When hysteria is complicated, as it very often is, with disorders of

the liver and stomach, hydrotherapeutic measures will be of added
efficacy. When it is associated with genito-urinary disorders, even
though the latter are not regarded as the cause of the former, special
beneficial effects, both local and general, can be obtained from
hydrotherapeutic measures. Locally, sitz-baths, hip-baths, douche-
baths, hot and cold injections, and foot-baths may act as revulsives,
astringents, or local tonics, while at the same time they are
measures which tend to strengthen the system as a whole.
Sea-bathing is often of the greatest value, although it is sometimes

difficult to induce hysterical patients, who are willing enough to go to
the seashore, to resort to surf-bathing. Few measures are better
calculated to bring up the tone of the nervous system of an hysterical
or neurasthenic patient than well-directed sea-bathing. Where sea-
bathing cannot be employed sea-water may be used indoors. Sea-
water establishments, where baths at various temperatures may be
had, are now to be found at all the best seaside resorts. In a few
cases the internal use of large quantities of either hot or cold water,
or of the ferruginous mineral waters, may be associated with the
external treatment.
The climatic treatment of hysteria has received little or no attention;

undoubtedly, much could be said in this connection. In a great
country like ours a climate suited to the requirements of almost every
form of disease can be had. The climate of those regions, either of
the seaboard or inland, particularly well suited to cases of lung
trouble, will often be useless, and sometimes harmful, to neurotic
patients. For a certain class of hysterical patients a sojourn at the
seashore, if not too protracted, will prove of great value. On the
whole, for most hysterical patients of the neurasthenic type the best
plan is to go first to the seashore for a few weeks, and then resort to
an inland hilly or mountainous country, but not at too great an
elevation. I have known the climate of some of the high altitudes of
Colorado to be of positive injury by depressing the nervous system.
Resorts like Capon Springs in West Virginia, out of the reach of
steam and worry, with prevailing south-west winds, are desirable
places.
The treatment of hysteria by the method of metallotherapy is worthy

of some consideration. It is a method by no means new. It was
known and practised by the ancients with rings and amulets.
Popularized at the beginning of the present century by certain
travelling charlatans, it was later, for a time, wholly ignored. In recent
years it has been received with considerable attention. One Burq for
many years practised metallotherapy in Paris disregarded or scouted
by the profession, but claiming many remarkable cures. Finally,
Charcot was induced to give him an opportunity of demonstrating the
truth or falsity of his claims at Salpêtrière.124 Cases of grave hysteria
were submitted to the treatment, and in certain instances with
striking results.
124 Lancet, Jan. 19, 1878.
After having determined by a series of experiments the particular

metal to which the patient is sensitive, bits of metal may be applied
to the surface of the body in various places; this constitutes external
metallotherapy. Or the metal, in the form of powder (as reduced iron)
or an oxide or some other salt, may be administered; this is internal
metallotherapy. That certain definite effects may be produced by the
application of metals to the surface of the body is unquestionable.
Some of the results which have followed their employment are the
removal of anæsthesia and analgesia, relief of hysterical paralysis,
improvement in the circulation, removal of achromatopsia, relief of
contracture.
Many investigations in Germany, England, France, and this country

have demonstrated that the same or similar effects can be produced
by the application of other non-metallic substances, such as discs of
wood, minerals, mustard plasters, etc. Hammond, among others,
has shown this. How the results are obtained is still a matter of
dispute. On the one hand, it is claimed, principally by the French
observers, that the cures are due to the metals themselves, either by
virtue of some intrinsic power or through some electrical currents
generated by their application. On the other hand, it is asserted,
particularly by the English observers, that the phenomena are best
explained on the doctrine of the influence of the mind on the body; in
other words, by the principle of expectant attention. Some at least of
the effects are to be explained on the latter hypothesis, but it is likely
that the monotonous impressions made upon the peripheral sense-
organs by different substances applied locally may act reflexly on the
brain.
Seguin125 reports a case of convulsion and hemianæsthesia in an

adult male cured by metallotherapy; the metal used was gold. Two
ordinary twenty-dollar gold pieces were placed in the patient's
hands, and afterward on his forearm, cheek, and tongue. Nothing
else was suggested or done to him; sensibility returned, and the
staggering and other symptoms disappeared. The patient left the
hospital claiming to be perfectly well. The same author reports
several other successful cases of metallotherapy, all of them
reactions to gold. One was a girl sixteen years old with analgesia.
125 Arch. of Medicine, New York, 1882.
Not a few cases are now on record of the cure of hysterical
contracture and other forms of local hysterical disorders by the
application of a magnet. Charcot and Vigouroux cured one case of
hysterical contracture of the left arm by repeated applications of the
magnet to the right or healthy arm. Debove by prolonged application
of magnets relieved hemianæsthesia and hemiplegias—not only the
hysterical varieties, but also, it is said, when dependent upon such
conditions as alcoholism, plumbism, and even cerebral lesions.
Maggiorani of Rome studied the physiological action of the magnet
and laid down the first rules for its therapeutic use. In the case of
powerful magnets we have more room for believing that an actual,
tangible force is at work in producing the results than in the case of
simple metals.
The question has been sometimes asked whether hypnotism can be

used with success in the treatment of hysteria. Richer reports a few
cures of hysteria through this agency. Braid has put on record
between sixty and seventy cases which he claims to have cured by
the same means. This list undoubtedly includes some hysterical
cases—of paralysis, anæsthesia, aphonia, blindness and deafness,
spinal irritation, etc. Both on theoretical grounds and from
experience, however, I believe that the practice of hypnotization may
be productive of harm in some cases of hysteria, and should be
resorted to only in rare cases of mental or motor excitement.
By some, special measures during the hysterical fit are regarded as

unnecessary. Jolly, for instance, says that we must merely take care
that the patients do not sustain injury in consequence of their
convulsive movements, and that respiration is not impeded by their
clothing. Rothrock126 reports several cases of hysterical paroxysms
relieved by the application of either snow or ice to the neck. The
applications were made by stroking up and down either side of the
neck along the line of the sterno-cleido-mastoid muscles. He
believed that the most probable explanation of the results obtained
was the shock received from the cold substance, but that
supplemental to this there may have been supplied through the
pneumogastric nerve a besoin de respirer. This measure and the use
of the cold spinal douche are both to be recommended.
126 Philada. Med. Times, 1872-73, iii. 67.
Emetics are sometimes valuable. Miles127 reports several cases of

severe hysterical seizure in which tobacco was promptly efficient in
controlling the affection. He used the vinum tabaci in doses of one
drachm every half hour or hour until the system was relaxed and
nausea induced, the effects usually being produced after taking
three or four doses. Fifteen grains of sulphate of zinc may be used in
adult cases. James Allen for a case of hysterical coma successfully
used a hypodermic injection of one-tenth of a grain of apomorphia.
Recently, at the Philadelphia Hospital this remedy has been
successfully employed in two cases, one of hysterical coma and the
other of hysterical mania. Inhalations of nitrite of amyl are often of
surprising efficiency. This and other measures referred to under
HYSTERO-EPILEPSY are also applicable in the treatment of any form of
hysterical spasm.
127 Clinical Med. Reporter, 1871, iv. 25-27.
For hysterical convulsions occurring during pregnancy an enema of

asafœtida, camphor, the yolk of an egg, and water, such as has
been recommended by Braun of Vienna, will often be found promptly
efficacious.
Fagge128 mentions a procedure which he had often seen adopted by

Stocker—namely, pressure upon the arteries and other structures on
each side of the neck.
128 British Medical Journal, March 27, 1880.
For hysterical paralysis faradism and galvanism hold the chief place.
Metallic-brush electricity should be used in the treatment of
anæsthesia.
Whenever, in local hysteria, particularly of the paralytic, ataxic, or
spasmodic form, it is possible to coax or compel an organ or part to
perform its usual function long unperformed or improperly performed,
treatment should be largely directed to this end. Thus, as Mitchell
has shown, in some cases of aphonia, especially in those in which
loss of voice is due to the disassociation of the various organs
needed in phonation, by teaching the patient to speak with a very full
chest an involuntary success in driving air through the larynx may
sometimes be secured. Once compel a patient by firm but gentle
means to swallow, and œsophageal paralysis begins to vanish.
Mitchell makes some interesting remarks upon the treatment of the

peculiar disorders of sleep, which he describes and to which I have
referred. When the symptoms are directly traceable to tobacco, he
believes that strychnia and alcohol are the most available remedies,
but gives a warning against the too liberal use of the latter. A
treatment which was suggested to him by a clever woman who
suffered from these peculiar attacks consists in keeping in mind the
need of breaking the attack by motion and by an effort of the will. As
soon as the attack threatens the patient should resolutely turn over,
sit up, or jump out of bed, and move about, or in some such way
overcome the impending disorder. Drugs are of little direct use.
Small doses of chloral or morphia used until the habit is broken may
answer, but general improvement in health, proper exercise, good
food, and natural sleep are much more efficient.
Fagge says that he has seen more benefit in hysterical contracture

from straightening the affected joints under chloroform, and placing
the limb upon a splint, than from any other plan of treatment.
Hammond129 (at a meeting of the New York Neurological Society,
Nov. 6, 1876) reports a case of supposed hysterical contracture in
the form of wry neck, in which he divided one sterno-cleido-mastoid
muscle; immediately the corresponding muscle of the other side
became affected; he cut this; then contraction of other muscles took
place, which he kept on cutting. The case was given up, and got well
spontaneously about two years later. Huchard130 entirely relieved an
hysterical contracture of the forearm by the application of an elastic
bandage.
129 Philadelphia Medical Times, vol. vii., Nov. 25, 1876.
130 Revue de Thérapeutique, quoted in Med. Times, vol. xiii., June 16, 1883.
A lady with violent hysterical cough was chloroformed by Risel of

Messeberg131 for fourteen days at every access of the cough, and
another for eight days. In both the symptoms were conquered. Nitrite
of amyl is useful in similar cases.
131 Allg. Med. Centralzeitung, Oct. 9, 1878.
Graily Hewitt132 reports a case of hysterical vomiting of ten months'

duration, caused by displacement of the uterus, and cured by
reposition of that organ. The same authority, in a paper read to the
London Congress, advanced the opinion that the exciting cause of
attacks of hysteria and hystero-epilepsy was a distortion of the
uterus produced by a flexion of the organ upon itself, either forward
or backward. He believed the attacks were the result of reflex
irritation. He recited eighteen cases, all of which were relieved.
Flechsig133 favors the gynæcological treatment of hysteria, including
castration or oöphorectomy. He reports three cases with good
results. His article favors the idea that any morbid condition of the
genital organs present ought to be remedied before treating the
hysterical symptoms. Zeuner,134 on the other hand, refers to a
number of cases in which gynæcological treatment gave either
entirely negative results or was productive of positive injury to
hysterical patients. He quotes Perreti,135 physician to an asylum for
the insane, who gives the details of a number of cases in which
gynæcological examinations or treatment were directly productive of
injury. He mentions a case of a female patient who had delusions
and hallucinations of a sexual type in which the physician was the
central figure. He reports cases in which proper constitutional
treatment, without gynæcological interferences, led to a full recovery.
Playfair, also quoted by Zeuner, states that he has often known the
condition of hysterical patients to be aggravated by injudicious
gynæcological interference. Oöphorectomy will be more fully
discussed under HYSTERO-EPILEPSY.
132 Med. Press and Circ., June 2, 1880.
133 Neurol., 7 Abt., 1885, Nos. 19, 20.
134 Journ. American Med. Ass., Chicago, 1883, i. 523-525.
135 Berliner klinische Wochenschrift, No. 10.
HYSTERO-EPILEPSY.
BY CHARLES K. MILLS, M.D.
DEFINITION.—Hystero-epilepsy is a form of grave hysteria

characterized by involuntary seizures in which the phenomena of
hysteria and epilepsy are commingled, and by the presence in
unusual number and severity, between the paroxysms, of symptoms
of profound and extensive nervous disturbance, such as paralysis,
contracture, hemianæsthesia, hyperæsthesia, and peculiar psychical
disorders.
SYNONYMS.—Hystero-epilepsy has long been known under various
names, as Epileptiform hysteria, by Loyer-Villermay and Tissot; as
Hysteria with mixed attacks, by Briquet; as Hysteria major or Grave
hysteria, by Charcot. The term hystero-epilepsy has been used with
various significations, and often without due consideration, and for
these reasons some authorities advise that it should not be used at
all. Gowers,1 for instance, refers to epileptic hysteria, hysterical
epilepsy, and hystero-epilepsy as hybrid terms which tend rather to
hinder than to advance the study of the nature of these convulsive
attacks and their relations to other forms of hysteria. He holds that it
is a clear advantage to discard them as far as possible, and
suggests the use of the term hysteroid, as proposed by W. W.
Roberts, or that of co-ordinate convulsions, as describing accurately
the character of the attack. These suggested terms do not strike me
as improvements upon those which he wishes the profession to
avoid. The word hysteroid, while good enough in its way, is certainly
objectionable on the ground of indefiniteness. Co-ordinate is
proposed, because the convulsive movements are of a quasi-
purposive appearance; that is, they are so grouped as to resemble
phenomena which may be controlled by the will. This meaning of co-
ordinate, however, as applied to the disorder in question, would not
be easily grasped by the average physician. When it is impossible to
name a disease from the standpoint of its pathological anatomy, the
next best plan is to use a clinical term which in a plain common-
sense manner gives a fair idea of the main phenomena of the
affection. Hystero-epilepsy, if it means anything, means simply a
disorder in which the phenomena of both hysteria and epilepsy are
to some degree exhibited. Certainly, this is what is seen in the cases
known as hystero-epileptic. In forming the compound the hysterical
element is, very properly, expressed first, the disease being a
hysteria with epileptic or epileptoid manifestations, rather than an
epilepsy with hysterical or hysteroid manifestations. A study of the
definition of hystero-epilepsy which has been given will show that it
is intended to restrict the application of the term in the present article
to cases with involuntary or non-purposive attacks, the voluntary or
purposive having been considered in the last article.
1 Epilepsy and other Chronic Convulsive Diseases: their Causes, Symptoms, and
Treatment, by W. R. Gowers, M.D., F. R. C. P., etc., London, 1881.
HISTORY.—The greatest impulse to the study of hystero-epilepsy in

recent years has been given by the brilliant labors of Charcot and his
pupils and assistants in his famous service at La Salpêtrière. In his
lectures on diseases of the nervous system2 (edited by Bourneville),
and in various publications in Le Progrès médical and other journals,
Charcot has reinvestigated hysteria major with great thoroughness,
and has thrown new light upon many points before in obscurity. He
deserves immense credit also for the work which he has stimulated
others to do. Bourneville, well known as the editor of some of
Charcot's most valuable works, has published, alone or with others,
several valuable monographs upon hysteria and epilepsy.3 The most
valuable work on hystero-epilepsy, however, because the most
elaborate and comprehensive, is the treatise of Richer.4 Richer was
for a time interne in the Salpêtrière Hospital, and with Regnard
pursued his investigations under the superintendence and direction
of Charcot. His book is a volume of more than seven hundred pages,
containing a vast amount of information and profusely illustrated, in
large part by original sketches by the author. Charcot himself has
written for it a commendatory preface.
2 Leçons sur les Maladies du Système nerveux. A portion of these lectures have been
translated by G. Sigerson, M.D., and published by the New Sydenham Society of
London, and reprinted in 1878 and 1879 in Medical News.
3 Bourneville, Recherches clinique et therapeutique sur l'Épilepsie et l'Hystérie, 1876;

Bourneville et Voulet, De la Contracture hystérique-permanente, 1872; Bourneville et
Regnard, Iconographie photographique de la Salpêtrière. I have made special use of
the second volume of the last of these works.
4 Études cliniques sur l'Hystero-épilepsie, ou Grande Hystérie, par le Dr. Paul Richer,
Paris, 1881.
No article on hystero-epilepsy can be written without frequent use of

this work of Richer, and also of the numerous contributions of
Charcot. To them we are indebted for new ways of looking at this
disease, as well as for an almost inexhaustible array of facts and
illustrations of the diverse phases of this disorder.
While the curious, grotesque, or outrageous manifestations now

known as hystero-epileptic have been discussed with more or less
minuteness by authors from the time of Sydenham to the present,
usually, and more especially in all countries but France, these
manifestations have been studied as isolated phenomena. Charcot
and Richer, however, present a comprehensive view of hysteria as a
disease of a certain typical form, but often manifesting itself in an
imperfect or irregular manner. This regular type is characterized
particularly by a frequently- or infrequently-recurring grave attack,
which is divided into distinct periods, and these periods into phases.
This regular type of grave hysteria once understood, a place of

advantage is gained from which to study the disease in its imperfect,
irregular, and abortive forms. Whatever its pathology may be, such
striking symptoms as loss of consciousness with spasm,
hallucinations, and illusions show at least temporary disturbance of
the integrity of the cerebrum.
Hystero-epilepsy of imperfectly developed or irregular type is a not

uncommon affection in this country, but the disease in its regular
type is comparatively rare.
VARIETIES.—Hysteria and epilepsy, so far as seizures are concerned,

may show themselves in two ways in the same patient; but I believe
that it is best that the term hystero-epilepsy should be restricted in its
application, as Charcot, Bourneville, and Richer have advised, to the
disorder in which hysterical and epileptic symptoms are commingled
in the same attack—what is spoken of by the French as hystero-
epilepsy with combined crises. The other method of combination is in
the affection known as hystero-epilepsy with separate crises, in
which the same patient is the victim of two distinct diseases, hysteria
and epilepsy, the symptoms of which appear independently of each
other.
The fact that hysteria is at times associated with true epilepsy is
often overlooked. A patient who is known to have had pure hysterical
seizures of the grave type has also a genuine paroxysm of epilepsy,
and thus the medical attendant is deceived. I will dismiss the
consideration of hystero-epilepsy with separate crises with a few
paragraphs at this place, devoting the rest of the article to the
disorder with combined crises.
The coexistence of hysteria and epilepsy, with distinct manifestations

of the two neuroses, has been most thoroughly considered by
D'Olier.5 Beau in 1836, and Esquirol in 1838, first showed this
coexistence. Landouzy in 1846 first made use of the name hystero-
epilepsy with separate crises.
5 Memoir which obtained the Esquirol prize in 1881, by M. D'Olier, interne of the
hospitals of Paris, on “Hystero-Epilepsy with Distinct Crises, considered in the Two
Sexes, and particularly in Man,” translated and abstracted by E. M. Nelson, M.D., in
the Alienist and Neurologist, April, 1882.
In France the distinct existence of hysteria and epilepsy in the same

individual is not, according to D'Olier, a very exceptional fact. Beau
has reported it 20 times in 276 cases. The different modes of
coexistence have been summed up by Charcot as follows: “1,
Hysteria supervening in a subject already epileptic; 2, epilepsy
supervening in a subject previously hysterical; 3, convulsive hysteria
coexisting with epileptic vertigo; 4, epilepsy developing upon non-
convulsive hysteria (contracture, anæsthesia).”
The following case, now in the Philadelphia Hospital, illustrates the

first of these modes of combination: S——, aged thirty-nine, female,
a Swede, came to this country in 1869. She said that her mother had
fits of some kind. The patient had her first fit when she was four
years old. Her menses did not come on until she was nineteen. With
the appearance of her periods she had fainting-spells off and on for
two years, and in these spells she would fall to the ground. After two
years she improved somewhat, but still would have an occasional
seizure like petit mal. Four years ago she had a severe fit, in which
she bit her tongue. This was a paroxysm of true epilepsy. It was
witnessed by the chief nurse in the hospital, a competent observer.
Since then she has had attacks of some kind every month or oftener.
She rarely had a true epileptic seizure. Often, however, she had
hysterical and hystero-epileptic attacks. These paroxysms have
been witnessed by myself and by the resident physician and nurse.
Rarely they were epileptic, frequently they were hysterical. Mental
excitement will often induce an hysterical spasm.
PATHOLOGY.—Holding that hystero-epilepsy is a form of grave

hysteria, the remarks which have been made in the last article on the
probable nature of severe convulsive attacks will be applicable here.
In hystero-epilepsy with the typical grave attack we have the highest
expression of that disturbance of cerebro-spinal equilibrium which
constitutes the pathology of hysteria.
ETIOLOGY.—It will also be unnecessary to go at length into the

discussion of the predisposing and exciting causes of hystero-
epilepsy. In general, its predisposing causes are those of hysteria of
any form. Certain causes or conditions, however, predispose to
certain types or forms of hysteria. The Latin races are more inclined
to the hystero-epileptic form of hysteria than are the natives of more
temperate or colder climates. Bearing upon this point, I have already
quoted the letter of Guiteras with reference to hysteria and hystero-
epilepsy in Cuba and semi-tropical America. Forms of religion which
cultivate to an extreme degree the emotional or the sentimental side
of human nature tend to produce hystero-epilepsy.
With reference to sex it may be said that hystero-epilepsy prevails to

a greater extent among females than males, even proportionately to
a larger degree than some of the other marked phases of hysteria. It
does, however, occur in men and boys, although rarely. Richer
records, from the practice of Charcot, a case in a lad of twelve years.
Several cases have fallen under my own care.
Ten years since I saw a case of hystero-epilepsy, which in some

respects closely simulated tetanus, in a youth nineteen years old. He
was well until seventeen years of age, when he slightly wrenched his
back. Shortly afterward he felt some pain between the shoulders.
From that time, at irregular intervals, generally of a few days only, he
was subject to attacks of dull pain, which seemed to run up the spine
to the head. About two months after this injury he first had a
spasmodic attack. A spasm would come on while he was quietly
sitting or working. The body assumed the backward-arched position.
As his father described the case, there was always space enough
under his back for a baby to crawl through. Generally, he would have
more than one seizure on a given occasion. He would sometimes
have as many as six or seven in one hour. On coming to, he would
stare and mutter and work his mouth and lips, at the same time
pointing around with his hands and fingers in a wild way. Sometimes
he would sleep for several hours afterward if not disturbed, but his
sleep was not of a stertorous character. He said that he could feel
the attacks coming on; his body felt as if it was stretching, his head
going back. He thought he was not conscious during the whole of the
attacks, but between the spasms he could take medicine when
directed. When first examined he had decided tenderness on
pressure over the second, third, and fourth dorsal vertebræ.
Pressure in this region would sometimes bring on a convulsive
paroxysm. When first seen he had been for three months having
seizures every two or three weeks. He was under observation for
several months, during which time he was treated with faradization
to the spine, the hot spinal douche, tonics, and bromides, and made
a complete recovery.
W. Page McIntosh6 has reported several cases of hystero-epilepsy in

the male, one of which is doubly interesting because it was in a
negro. This patient was twenty-one years old, stout, and previously
in good health. He complained of intense pain in the stomach, and
soon passed into a violent convulsion. To show the importance of
diagnosis in these cases, it is interesting to note that the doctor first
thought of strychnia-poisoning, then of acute indigestion, next of
tetanus. Soon, however, he decided that he had a case of hysteria.
The patient had other convulsions on the day following the first
attack. The seizures were evidently hystero-epileptic or hysterical.
He was not unconscious, and believed that on a recent previous
evening he had been conjured by an old negress. The spell was to
work in three days, which it did. The doctor counter-spelled him with
a hypodermatic syringe, after which he promptly recovered.
McIntosh reports another case in a man forty years old and the
father of six children, who was laboring under strong mental
excitement because of the sufferings of a dangerously ill child. His
whole form was convulsed, and his body underwent a variety of
peculiar contortions. He had had similar attacks before, and had
subsequent recurrences.
6 Med. News, vol. xlviii., No. 1, Jan. 2, 1886, pp. 5-8.
The following case was observed in the Philadelphia Hospital: W. F.

——, aged twenty-eight years, married, has one child. His seizures
began seven years ago, when he had an attack while playing a
game of pool. At this time he had, according to his account, a
sudden feeling of giddiness or vertigo in which he fell over and had a
spasm, during which he thinks he was unconscious. After the seizure
he suffered from headache, but had no disposition to sleep.
From that time until the present he has been subject to these spells,
though the paroxysms are very irregular in frequency. Sometimes he
will have several attacks in a day; again, he will be free from them for
days, and perhaps for two or three weeks, but never for more than a
month at a time. They have come on him while walking in the street,
and on several occasions he has been taken to different hospitals.
He was admitted to the Philadelphia Hospital four times. On his first
admission he only remained over night; on his second and third he
remained for two or three weeks. On the last admission he remained
four weeks, and had spasms every day and night after admission.
He had, by actual count, from five to six hundred after he went in;
and in one evening, from seven P.M. to midnight, he had no less than
thirty-eight. These seizures, which were witnessed by myself and
two resident physicians, differed but little from each other, although
at times some were more violent than others. They began with a
forced inspiration; then the patient straightened himself out and
breathed in a stertorous or pseudo-stertorous manner. The pulse in
that stage became slow, and at times was as low as 48 per minute.
The temperature was normal or subnormal. The arched position was
sometimes taken, but the opisthotonos was not marked. The
paroxysm ceased by an apparent forced expiration, and the
breathing then became normal; the patient remained in a somewhat
dazed condition, which was only momentary. During the attack the
patient said that he was unconscious of his surroundings. In the
interval between the attacks he suffered from headache and from
pain over the region of the stomach. He also had tenderness on
pressure over the lumbar vertebræ. He never bit his tongue.
Age has some influence in the development of hystero-epilepsy. It is

of most common occurrence at the period of pubescence; it is rare in
old age, but occurs with comparative frequency in middle life; or,
rather, it should be said that middle-aged hystero-epileptics are not
uncommonly met with, individuals who have for many years been
subject to the attacks. In young children, girls or boys, it is certainly
rare.
With reference to the exciting causes of hystero-epilepsy, it will only

be necessary to say that of those which have already been
enumerated in the general discussion of the etiology of hysteria, a
few, such as domestic troubles, abnormal sexual excitement, and
painful menstruation, are likely to induce the paroxysm, but fright,
excitement, anxiety, sudden joy, and other psychical disturbances
are the most frequent of the exciting causes of the seizures. A threat
or a blow has been known to precipitate an attack. The use or abuse
of alcohol is sometimes an exciting cause. Reflex irritation, such as
that from intestinal worms, and digestive disorders sometimes
produces hystero-epileptic attacks in children.
SYMPTOMATOLOGY.—In considering the symptoms of hystero-epilepsy

the subject must be approached from several points of view. In the
first place, the disorder can be divided (1) into the regular or typical
grave attack; and (2) into the irregular attacks. These irregular
seizures can be greatly subdivided, but their discussion will be
confined to those types which have been most observed in this
country, although I do not think that any variety of hystero-epilepsy is
distinctively American; and this is what might be supposed from the
largeness of our country and the different nationalities of which it is
composed.
I have seen but few cases of hystero-epilepsy of the regular type.

One of these was first described at some length in the American
Journal of Medical Sciences for October, 1881. I will here give the
case, with illustrations, somewhat condensed from the accounts as
first published.7
7 For the opportunity of studying and treating this case I was under obligations to
Charles S. Turnbull and J. Solis Cohen, the patient having been for several months
under their care at the German Hospital of Philadelphia. Carefully prepared notes of
the case were furnished to me by H. S. Bissey and H. W. Norton, resident physicians
at the hospital. I was also under great obligations to my friend J. M. Taylor for a series
of sketches of the positions assumed by the patient at different stages of the attack.
R——, æt. 21, single, was first admitted to the German Hospital Nov.
13, 1879. Between her ninth and twelfth years she had had several
attacks of chorea. During childhood she was often troubled with
nightmare and unpleasant dreams; she often felt while asleep as if
she were held down by hands. She was frequently beaten about the
head and body. Her menses did not appear until she was nearly
eighteen. Before and at her first menstrual epoch she suffered
severe pain and cramp. During the first year of her menstruation,
while at Atlantic City, the flow appeared in the morning, and she went
in bathing the same afternoon. She stayed in the water two hours,
was thoroughly chilled, and the discharge stopped. Ever since that
time she had only menstruated one day at each period, and the flow
had been scanty and attended with pain. When about eighteen she
kept company with a man for five months, and after having put much
confidence in him learned that he had a wife and two children. This
episode caused her much worriment. She positively denied
seduction. She became much depressed. September 2, 1879, she
was seized in a street-car with a fainting fit. On coming to, she found
her left arm was affected with an unremitting tremor. Seven weeks
later she was admitted to the German Hospital. She had severe

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Ethics in Information Technology 6th Edition Reynolds

(eTextbook PDF) for Management Information Systems:

1 Catalysts for Change 1

1.4 Milestones in Information Storage and Retrieval 31

2.6.3 The Case for Kantianism 70

2.7 Act Utilitarianism 72

2.8 Rule Utilitarianism 77

2.9 Social Contract Theory 81

2.10 Virtue Ethics 88

2.11 Comparing Workable Ethical Theories 94

2.12 Morality of Breaking the Law 94

3 Networked Communications 109

3.3 Internet Interactions 116

3.4 Text Messaging 119

3.5 Censorship 121

3.6 Freedom of Expression 126

3.7 Children and Inappropriate Content 131

3.8 Breaking Trust 135

3.9 Internet Addiction 143

4 Intellectual Property 161

4.6 Peer-to-Peer Networks and Cyberlockers 190

5 Information Privacy 227

5.3 Information Disclosures 239

6 Privacy and the Government 271

6.3.2 Internal Revenue Service Records 275

6.4 Covert Government Surveillance 280

6.5 US Legislation Authorizing Wiretapping 285

6.6 USA PATRIOT Act 288

6.7 Regulation of Public and Private Databases 293

6.8 Data Mining by the Government 297

6.9 National Identification Card 299

6.10 Information Dissemination 303

6.10.2 Video Privacy Protection Act 303

7 Computer and Network Security 321

7.4.3 Denial-of-Service and Distributed Denial-of-Service Attacks 339

8 Computer Reliability 365

8.6 Computer Simulations 389

8.7 Software Engineering 392

8.8 Software Warranties and Vendor Liability 397

9 Professional Ethics 413

9.3 Software Engineering Code of Ethics 419

9.5 Case Studies 429

9.6 Whistle-Blowing 436

10 Work and Wealth 457

10.6 The “Winner-Take-All” Society 486

Appendix A: Plagiarism 503

Computers and high-speed communication networks are transforming our world.

WHAT’S NEW IN THE SEVENTH EDITION

ORGANIZATION OF THE BOOK

I am grateful to professors Paulette Kidder and Gregory Silverman of Seattle Uni-

I dedicate this book to my children Shauna, Brandon, and Courtney.

A tourist came in from Orbitville,

1. Copyright © 1963 by the Literary Estate of May Swenson. Reprinted by permission.

1.2 Milestones in Computing

1.2.1 Aids to Manual Calculating

1.2.2 Mechanical Calculators