The Morality of Managed Care Essay -- Health Care Medical Medicine Ess

The Morality of Managed Care "The preservation of health is a duty" according to Herbert Spencer, an English philosopher (Andrews, 1993). Managed care conglomerates provide health coverage for increasing numbers of Americans. Many critics question whether these businesses provide care dutifully. At the very least, the present managed care system requires health care providers and recipients to reexamine established principles underling physician-patient interaction. Although health maintenance organizations are commonly misunderstood, Americans hope these institutions will dampen runaway health care expenditures. Since HMO's are increasing in number, health care recipients need to examine how established, ethical principles in America are changing. These subtle alterations create conflicts between physicians, HMO's, and patients. Ultimately, patients are regarded as consumers, and understandably, quality care may be more difficult to obtain. Definition Of Managed Care Although numerous health care plans presently exist, managed care plans have dominated the marketplace since the early 1980's. Preferred provider organizations (PPO's) and health maintenance organizations (HMO's) are the most common, and they continue to grow in number. Since managed care has become commonplace, the differences between PPO's, HMO's and fee-for-service reimbursement arrangements must be critically evaluated. Without understanding their general organizational and payment structures, moral judgments pertaining to varying plans cannot be ascertained easily. PPO's contract with a limited number of physicians and hospitals who agree to care for patients on a discounted fee for service basis. On the other hand, HMO's amass insurers and providers... ...ew York Times, July 15, 1996, pp. A13. Kassirer, Jerome P. "Managed Care and the Morality of the Marketplace" The New England Journal of Medicine, July 6, 1995, pp. 50-52. King, Cheryl S. "Managed Care: Is It Moral." Advanced Practical Nursing, 1995, pp. 7-11. Larson, Erik. "The Soul of an HMO." Time, January 22, 1996, pp. 44-52. Light, Donald W. "The Practice and Ethics of Risk-rated Health Insurance." The Journal of the American Medical Association, 1992, pp. 2503-2508. Peliegrino, Edmund D. "Ethics." The Journal of the American Medical Association, June 1, 1994, pp. 1668-1670. Relman, Arnold S. "What Market Values Are Doing to Medicine." The Atlantic Monthly, March 1992, pp. 99-106. Shenkin, Budd N. "The Independent Practice Association in Theory and Practice." The Journal of the American Medical Association, June 28, 1995, pp. 1937-1942. The Morality of Managed Care Essay -- Health Care Medical Medicine Ess The Morality of Managed Care "The preservation of health is a duty" according to Herbert Spencer, an English philosopher (Andrews, 1993). Managed care conglomerates provide health coverage for increasing numbers of Americans. Many critics question whether these businesses provide care dutifully. At the very least, the present managed care system requires health care providers and recipients to reexamine established principles underling physician-patient interaction. Although health maintenance organizations are commonly misunderstood, Americans hope these institutions will dampen runaway health care expenditures. Since HMO's are increasing in number, health care recipients need to examine how established, ethical principles in America are changing. These subtle alterations create conflicts between physicians, HMO's, and patients. Ultimately, patients are regarded as consumers, and understandably, quality care may be more difficult to obtain. Definition Of Managed Care Although numerous health care plans presently exist, managed care plans have dominated the marketplace since the early 1980's. Preferred provider organizations (PPO's) and health maintenance organizations (HMO's) are the most common, and they continue to grow in number. Since managed care has become commonplace, the differences between PPO's, HMO's and fee-for-service reimbursement arrangements must be critically evaluated. Without understanding their general organizational and payment structures, moral judgments pertaining to varying plans cannot be ascertained easily. PPO's contract with a limited number of physicians and hospitals who agree to care for patients on a discounted fee for service basis. On the other hand, HMO's amass insurers and providers... ...ew York Times, July 15, 1996, pp. A13. Kassirer, Jerome P. "Managed Care and the Morality of the Marketplace" The New England Journal of Medicine, July 6, 1995, pp. 50-52. King, Cheryl S. "Managed Care: Is It Moral." Advanced Practical Nursing, 1995, pp. 7-11. Larson, Erik. "The Soul of an HMO." Time, January 22, 1996, pp. 44-52. Light, Donald W. "The Practice and Ethics of Risk-rated Health Insurance." The Journal of the American Medical Association, 1992, pp. 2503-2508. Peliegrino, Edmund D. "Ethics." The Journal of the American Medical Association, June 1, 1994, pp. 1668-1670. Relman, Arnold S. "What Market Values Are Doing to Medicine." The Atlantic Monthly, March 1992, pp. 99-106. Shenkin, Budd N. "The Independent Practice Association in Theory and Practice." The Journal of the American Medical Association, June 28, 1995, pp. 1937-1942.

Essay --

In the course of years of stock market study, two quite distinct schools of thought have arisen, two radically different methods of arriving at the answers to the trader’s problem of what and when. In the street jargon, one of these is commonly referred to as the fundamental analysis or statistical, and the other as the technical. The term technical in its application to the stock market has come to have a special meaning. It refers to the study of the action of the market itself as opposed to the study of goods in which the market deals. Technical analysis is the science of recording, usually in graphic form, the actual history of trading (price changes, volumes, and transactions, etc) in a certain stock or in â€Å"the averages† and then deducing from that pictured history the probable future trend. According to Park and Irwin (2007) recent studies indicate that technical trading strategies consistently produce economic profits in a range of speculative markets at lea st until the early 1990s. From a total of 95 recent studies, 56 studies find positive results regarding technical trading strategies, 20 studies obtained negative results, and 19 studies indicate mixed results. In pioneering work, Smidt (1965b) studies amateur traders in US commodity futures markets and finds that more than half of the respondents use charts exclusively or moderately in order to identify trends. Charts are working tools of the technical analyst, and they have been developed in a multitude of forms and styles to represent graphically almost anything that takes place in the market as well as to plot â€Å"index† derived thereform. From a more recent study, Billingsley and Chance (1996) found that about 60% of commodity trading advisors (CTAs) rely heavily or e... ...market quotation already contains in itself all that can be known about the future and in that sense has discounted future contingencies as much as is humanly possible.† There are also negative empirical findings in numerous pioneer and widely cited studies of technical analysis in the stock market, such as Fama and Blume (1966), Jensen and Benington (1970), and Van Horne and Parker (1967, 1968). Sullivan et al (1999, 2003) and Olson (2004) are among recent studies that have shown that technical trading rules do generate positive economic profits before the 1990s, but the profits are declining markedly or are disappearing altogether as time passes and globalization occurs. Such results may be explained by temporary market inefficiencies in periods before the 1990s. According to Park and Irwin, 2007, there are two possible explanations for the temporary inefficiencies Essay -- In the course of years of stock market study, two quite distinct schools of thought have arisen, two radically different methods of arriving at the answers to the trader’s problem of what and when. In the street jargon, one of these is commonly referred to as the fundamental analysis or statistical, and the other as the technical. The term technical in its application to the stock market has come to have a special meaning. It refers to the study of the action of the market itself as opposed to the study of goods in which the market deals. Technical analysis is the science of recording, usually in graphic form, the actual history of trading (price changes, volumes, and transactions, etc) in a certain stock or in â€Å"the averages† and then deducing from that pictured history the probable future trend. According to Park and Irwin (2007) recent studies indicate that technical trading strategies consistently produce economic profits in a range of speculative markets at lea st until the early 1990s. From a total of 95 recent studies, 56 studies find positive results regarding technical trading strategies, 20 studies obtained negative results, and 19 studies indicate mixed results. In pioneering work, Smidt (1965b) studies amateur traders in US commodity futures markets and finds that more than half of the respondents use charts exclusively or moderately in order to identify trends. Charts are working tools of the technical analyst, and they have been developed in a multitude of forms and styles to represent graphically almost anything that takes place in the market as well as to plot â€Å"index† derived thereform. From a more recent study, Billingsley and Chance (1996) found that about 60% of commodity trading advisors (CTAs) rely heavily or e... ...market quotation already contains in itself all that can be known about the future and in that sense has discounted future contingencies as much as is humanly possible.† There are also negative empirical findings in numerous pioneer and widely cited studies of technical analysis in the stock market, such as Fama and Blume (1966), Jensen and Benington (1970), and Van Horne and Parker (1967, 1968). Sullivan et al (1999, 2003) and Olson (2004) are among recent studies that have shown that technical trading rules do generate positive economic profits before the 1990s, but the profits are declining markedly or are disappearing altogether as time passes and globalization occurs. Such results may be explained by temporary market inefficiencies in periods before the 1990s. According to Park and Irwin, 2007, there are two possible explanations for the temporary inefficiencies

The Developments and Changes the Monster Undergoes in Frankenstein by M

The Developments and Changes the Monster Undergoes in Frankenstein by Mary Shelley Frankenstein is a classic novel by Mary Shelley, published in 1818. It recounts the life of Victor Frankenstein; Victor is a young, idealistic student of natural philosophy whose aim is to discover the elixir of life. He succeeds in his aim and consequently brings into existence a monstrous creation. However, he abandons his creation, which is then forced to discover the complicated ways in which society and the world works, in a very cruel but candid and unequivocal manner. The novel begins in the epistolary style, presenting the story in a series of letters. These letters are from Robert Walton, a British sailor who describes and communicates to his sister, though correspondence, his search for fame and glory by exploring the North Pole. More importantly, his letters also announce the discovery and rescue of a stranger, Victor Frankenstein. Consequently, Victor tells the story of his life to Robert Walton, who then includes it in his letters home to his sister. Therefore, Frankenstein is essentially an account of the life of Victor Frankenstein as related to him by a British sailor, Robert Walton, by whom he has been found on the ice floes of the Arctic Ocean. However, Frankenstein's story contains yet another narrative, that of the monster he has created. Furthermore, the monster includes within his narrative the story of the De Laceys, the family of exiles whom he unsuccessfully tries to make contact with. To synopsize, Frankenstein is one novel, but within it there are several narratives and consequently it contains several contrasting .. ...It may well be that Mary Shelley wanted her work to be a warning to all scientists. She was fascinated by the discoveries and scientific inventions that modern science produced. However, at the same time she was very aware of the potential dangers of scientific quest. In Victor Frankenstein's case, his obsessive thirst for knowledge and power developed into a self destructive passion. Through his research, he severs himself off from his family and friends, who are all finally destroyed by his creation. The innermost embedded narrative of the monster reveals to us that he is in an equally miserable and isolated situation. The monster is tragically fated to a life of rejection and isolation from humanity and ultimately we tend to sympathise with him and condemn Victor Frankenstein for his actions that resulted in this.

Pledge of Allegiance in School Essay

Pledge of Allegiance in School My choice of writing for the Rogerian essay is on the topic of the Pledge of Allegiance in School. â€Å"In a decision that stunned the nation, a federal appeals court in June ruled that reciting the Pledge of Allegiance in public schools is unconstitutional because the pledge contains the words â€Å"under God† â€Å" (Chmielewski). The banning of the Pledge of Allegiance is a very large controversial topic because one side believes that while the foundation of our country is religion, the other side believes that the reciting of the Pledge of Allegiance is an infringement on our First Amendment right. The Pledge of Allegiance began in 1892. It was a way of showing a sense of celebration for being an American. Since 1892 the â€Å"Pledge† has been changed four times, and in 1954 the words â€Å"under God† were added (Chmielewski). A cause of the Pledge of Allegiance being banned from school is mostly because of these two words â€Å"under God†. An Atheist by the name, Newdow, filed the claim against the pledge because he did not want his second grade daughter pressured into saying something that he does not believe (Chmielewski). I believe that this topic has quite a bit of historic meaning because it basis is on our historical beginning. I think that because the times of our country and have changed so much, in that, religion is not just based on Christianity for our country anymore, it does way on peoples mind. I would like to show in this essay that the Pledge of Allegiance is an important part, not just in our schools, but in our nation. My research on this is going to be a bit strenuous. There are so many articles about court proceedings and individual states that it might be difficult to find a common ground. Most of what I have read has just been the individual states versus the Supreme Court or, as in the case above, the Nine District Court. I have read articles from Massachusetts, California, Washington, and Nevada, to name a few. Most of the articles also are very one sided. Meaning that the author shows what the problem in question is and then turns the article to what they believe.

Broadway The American Musical Essay

At the start of the 20th century, the popular vaudeville shows that crossed the nation became the training ground and inspiration for the birth of the American musical. As the primary location for the professionalization of American performance art, understanding the complicated negotiation of gendered and racial identities on the Broadway stage provides important background to the development of an American identity in concert dance through the rest of the century. As you watch these videos notice how musicals come to represent American ideals such as abundance, opportunity, pluralism, optimism. 2.1 Give My Regards to Broadway: 2.1.1 Some of the images from the Follies look like the creation of a new Eden. It was said that in America the streets were paved with gold. Describe the ‘abundance’ found in Ziegfeld Follies and how this relates to an image of America. It reflects to how women being described pure like gold. In the show, all the women wear gold that describes valuable objects. Ziegfeld understands of how he could sell â€Å"sex† idea (by women) to the audience. 2.1.2 What were the Follies and how did they include the different ethnic minorities present in America. The include other cultures in the show by telling jokes to the audience. There were several culture mentioned in the jokes, such as Irish jokes, Italian jokes, and Jewish jokes. 2.1.3 A Follies ‘girl’ had to have a ‘regular profile’, and most were six feet tall. If a Follies girl is the ideal American girl, who is excluded from the image of ideal America? Mostly others race, such as Asian, Black, or any other race besides Causasion. 2.1.4 Many immigrants left the Old World because the social structures of the time kept them locked in a certain economic class. America held the promise of changing one’s station in life. It was the land of opportunity. How was the opportunity and variety found in Vaudeville representative of this idea of America? Vaudeville is the era when anyone can perfome anything featuring dancing, comedies, and singing that focus on individual performance. It represents the idea of America because it displays of mixed cultures in America. It defines a picture of culture variety in America, which unites America. 2.1.5 Describe the clip from Yankee Doodle Dandy. How is Cagney, playing Cohan, the ideal American? Look at who else is on stage, who is or is not allowed to be in this image of America?  Cagney represents a picture of American pictures, such as white man and high class image (nice suit). Based on the video, all of the people on stage are Causasion, which excludes other culture. 2.1.6 How does the musical ‘Mythologize’ America? 1.2.3=Lesson 1.Resource 2. Question 3 2 Mostly represent majority race (mostly represent Causasion), displays perfect picture of American girl (pure, pretty, perfect picture), and represents great music and dance. 2.1.7 How did Burt Williams both perpetuate and challenge stereotypes of black Americans? What does it mean for a black man to perform in black face? Burt William represents a picture of black Americans at that time by telling the audience jokes that related about black Americans. However, besides his jokes he also put other images like the pain being a black American indirectly by his jokes or by his song. Perform in black face was the only way for him to perform in enternainment industry. 2.1.8 Burt Williams claims that he would like to do both the ‘pathos’ (drama) and the fun, but he is known for comedy and if he did the pathos, he would no longer be Burt Williams. Is Burt Williams, then, an actual man, or just a character? Burt Williams at that times represents as a character only because he hides himself and only performs the arts by telling audience jokes. He understands  that his job is to entertain the audience. 2.1.9 Form/technique: Describe blackface performance through its origins, its popularity and performances by Burt Williams and Al Jolson.  Using blackface for black performers and white performers, mostly contains comedy, and stereotyping of black cultures (make fun of black Americans) 2.1.10 How did Fanny Brice break the expected image of the Ziegfeld girl? She breaks all the images of American standard of beauty such as being physically pretty. She represents a comedy story by using facial gestures and eyes movevents. 2.1.11 How did World War I change Broadway? It changed the characteristic of broadway, from blackface to Tin Pan Alley era where most of all the musicians and artists produce their idea in the one building and presents it after. 2.1.12 Show Boat was a marriage of what two traditions? European operetta and American musical comedy. 2.1.13 Why was Show Boat so influential? In terms of subject matter? In terms of who was included on stage? Show Boat represent producer’s idea of musics, which represents American music. 2.1.14 Based on what you have seen, how was Broadway ‘uniquely American’? It represented musical theme and comedy which was entertaining to audience. It also displayed of mixed cultural background to represent the arts on the stage, such as black American culture , Causasion culture (mostly European), and Jewish. 2.2 Syncopated City â€Å"In the ‘20s everyone had permission to visit each other’s land and see what they were doing.† 2.2.1 Alcohol was outlawed during Prohibition, but was not strictly enforced in NY. This meant that people of all social classes were breaking the law and thus normal rules about 1.2.3=Lesson 1.Resource 2.

Determining the Accounting for Receivables from Officers and Directors Essay

Philadelphia Communications Inc. (â€Å"Philly†) is a public company that completed an initial public offering (IPO) a few months ago. John Sigar is the current CEO and member of the board of directors. He is the only family member involved in the business and owns significant amount of the company’s stock. While, we were doing audit testing for accounts receivable we came across number of Notes Receivable from several Mr Sigar’s cousins. They have taken advances frequently but never failed to pay when they came due. The notes are secured by shares of Philly’s convertible preferred stock, which were purchased by the family members following IPO. The receivable support provided by the client doesn’t specify interest payment terms for these notes. During our preparation to test accounts receivable we reviewed the Financial Accounting Standards Board (FASB) Accounting Standards Codifications (ASC) and identified special presentation and disclosure requirements for these sorts of receivables. We also reviewed above described situation from International Financial Reporting Standards’ (IFRS) standpoint. When determining the accounting for receivables from officers and directors, special treatment of these cases must be accorded. The case for Philly refers to related parties transactions, which would require special disclosure in the financial reports. The receivables that is provided by Philadelphia Communications Inc. does not give specification concerning both the terms of payment and the interest payable on these notes. Testing for Accounts Receivable in Philly Case. According to Financial Accounting Standards Board (FASB) codifications, there are a number of codification references that are applicable to the Philly case. One applicable reference is FASB ASC 850-10-50-1 on related party transactions. The FASB code 850 discusses the disclosures that are required to be made concerning related parties. This reference provides the legal and applicable definition of what related party transaction entails. This reference also outlines the disclosure that is required to be made. One of the disclosures is the nature of the involved relationship. The description of the transaction including the dollar amounts, period of transaction, amounts due, and the due date must be disclosed. Disclosing transactions in financial statements that were eliminated while preparing consolidated financial statements is not mandatory. FASB ASC 850-10-50-2 is another codification reference that is applicable to this case. This reference discusses the notes and accounts receivables. This is the principal and direct reference that relates to the Philly case in question. The notes and accounts receivable mentioned under this codification reference are particular to the employees, officers or other entities that are affiliated to the company. For the case of Philly, notes are transacted between Philadelphia Communications Inc. CEO and the cousins. FASB ASC 850-10-50-2 requires notes or accounts receivable from related parties to be separately shown. Any effects that arise from a change in method of determining the terms of transaction from the previous period must be disclosed. It states that this transaction should not be included under notes and accounts receivable general heading. Philadelphia Communications Inc. October 19, 2013 Page 2 Another applicable reference is FASB ASC 850-10-15-2. This codification reference stresses on the requirement that the guidelines on disclosure for related parties is applicable to all entities. It does not matter if it is a private entity or public company like in this case. The financial reports must provide disclosure for the transactions. FASB ASC 850-10-50-5 discusses issue concerning disclosure of transactions that occur at an arm’s length base. This reference states that it cannot be presumed that related parties’ transaction are undertaken on an arm’s length basis. This is because the market conditions that competitive and free might not exist. This describes the relationship evident in the case of Philly’s transaction with the CEO’s cousins. Any form of representations concerning CEO’s cousins and Philadelphia Communications Inc. does not mean that, the transactions were executed on terms applicable at arm’s length. It can only be presumed so if and only if the representations of the transactions can be substantiated. The company management should supply more additional information concerning the notes and receivable concerning related parties for further clarifications. The management should provide the names of the parties issued with the notes that are secured by convertible preferred stock purchased by family members. This is per the requirement of FASB ASC 850-10-50-4. The management should also provide information concerning related parties transactions to help in comparison of financial results with the past. The payments terms and the interest accruing to such notes and receivables should be specified and provided by Philly. IFRSs Standpoint. The International Financial Reporting Standards (IFRS) also recognises related party transactions. This is given as per the explanation under IFRS International Accounting Standards (IAS) 24. It describes a related party as involving an entity that is heavily influenced by a person transacting with a close family member. The Member of the family transacting with the entity must have significant influence on the person by the one having ownership in the company. For this case, the cousins have significant influence on the CEO of the company thus establishing a related party relationship. IFRS IAS 24 requires the firm to make certain disclosures. It requires that the total amount involved, and the nature of the transaction be disclosed in the financial statements. The outstanding amounts should also be revealed stating the terms and all conditions relating securing and settling of the notes and receivables. The disclosures should also include information regarding the guarantees made. The IFRS also demands that any provision made for doubtful debts arising from this transaction should be disclosed. Conclusion The Philadelphia Communications Inc. in its operation, have related party transactions. These transactions involve the issuance of notes to close relatives of the CEO of the company. The Financial Accounting Standards Board (FASB) requires that activities must be disclosed. The Philadelphia Communications Inc. October 19, 2013 Page 3 FASB has well explained the information that the management should consider when presenting their financial statements. The management should also improve its operations and provide further data concerning the parties they are regularly trading. Adoption of the FASB and IFRSs will ensure that all financial statements are truly and fairly presented. References FASB. Related Party Disclosures. Retrieved from Accounting Standards Codification: https://asc. fasb. org IASB. Related party disclosures. Retrieved from IFRS: http://www. ifrs. org

Existentialism and Metamorphosis Essay

Existentialism is defined as a modern philosophical movement stressing the importance of one’s experience and accountability. Its focus is the make on the personal reflections that these make on the individual, who is seen as a free agent in a deterministic and seemingly meaningless universe. Its philosophy is meticulous that, in a nutshell, advocates a diverse arsenal of responses and solutions to the ‘existentialist attitude’; which, essentially, is what an individual feels when confronted by the absurdity of life. Throughout humanity, rumination and self-proclaimed ‘ultimate’ truths have assumed various forms: poetry, religion, and numerous other doctrines and textual works. In The Metamorphosis, Franz Kafka narrates the ramifications of a metamorphosis in which the subject and protagonist, a man named Gregor Samsa, is transformed into a bug. Despite the novella’s literary methods and influences, the most prominent being the way Kafka so nonchalantly describes such irregularity in his life, The Metamorphosis is also hailed as a prime textual work of existentialism, the previously mentioned philosophical movement. Both prior and subsequent to the transformation, Kafka portrays Gregor as a man who seems lost within himself, and lacking identity. The reminiscences of his past are neither nostalgic nor poignant: his human life is seen to revolve solely around trivial matters. His social life pays the price from this, his failure to assert a concrete and consistent existence. The extent of his lack of individuality is further exemplified by his reaction to the metamorphosis: finding himself â€Å"transformed in his bed into a gigantic insect† (K afka, 296), he prioritizes work over all else, even in his newly equated insect form. Furthermore, he panics because â€Å"the next train went at seven o’clock; to catch that he would need to hurry like mad and his samples weren’t even packed up† (297). Gregor’s identity crisis is a device for conveying Kafka’s belief of an impersonal society where individualism is drastically mitigated as a result of excessive materialism. Gregor, in the context of Fyodor Dostoyevsky’s Notes from Underground analogy, would be the ‘ant’ in the anthill— thus rendering his metamorphosis ironically. Another dominant theme prevalent throughout the novella is the absurd situation Gregor is confronted by. These nonsensical happenings (296-327) reflect the world as seen from the existentialist perspective: a world absent of a rational and comprehensive objective. Jean-Paul Sartre postulated that ‘every existing thing is born without reason, prolongs itself out of weakness, and dies by chance’. This meaninglessness is precisely what Gregor is victim to in the microcosm of society that Kafka generates: Gregor flounders about, beleaguered by absurdity and helplessness, presumably because he is unaware of Nietzsche and Kierkegaard’s somewhat consoling conclusions that one must devise meaning for one’s own existence ex nihilo. Once again, Kafka utilizes a combination of plot and character to convey his angst concerning an apparently pointless existence. Freedom— or rather the lack thereof— is another existentialist tenet that Kafka addresses. Gregor is depicted as someone constrained by self-imposed burdens, the most demanding being the role as the financial pillar of the family. Despite having the freedom to repudiate this role, Gregor instead pursues it with feverish ardor to the extent that it becomes his ‘sole desire’ (310). Yet his harangue regarding his career (297-298) reveals that this is not due to personal desire, but rather the belief that he must replace his father financially, regardless of preference. Gregor’s delusion regarding an absence of choice contradicts what Kafka perceives as the truth: that freedom is ubiquitous in spite of any ethical obligations we may be expected to adhere to, and that the individual defines his or herself via one’s decisions. A quasi-motto of existentialism coined by Sartre, ‘existence precedes essence’. In conclusion, Kafka employs the fictional literary elements he constructs to address the very non-fictional, existentialist aspects of society and life. Akin to Dostoyevsky’s Notes from Underground, it can be interpreted as both a rumination and tirade against impersonal communities, restriction of freedom, and the absurdity of life.