If love drugs become more widely available, who should use them? This chapter introduces Stella and Mario, a married couple with dependent children who are in a ‘gray’ relationship—that is, a relationship that is not violent, abusive, or otherwise clearly dysfunctional, but which has lost its romantic spirit, despite many earnest attempts to keep it alive. The couple are unhappy. They are considering a divorce. They worry about how this might affect the children. They do still care about each other and value what they have built together. But they’ve run out of places to look for a shared sense of joy. The chapter argues that this is a very common situation for long-term partners, and that love drugs may soon be a viable option for supporting couples’ mutual well-being within such relationships.

This chapter presents a concluding discussion on the PPEs’ activity and their impact, building on the proposed theoretical framework and the empirical comparative analysis of the four main case studies, alongside the other cases from the broad database. In order to examine the question of the PPEs’ impact, the chapter first analyzes which influence patterns were evident in the PPEs’ activity and which of these were most prevalent and effective. It then examines the impact of variables at three levels: variables related to the PPE, variables related to the initiative, and external variables. The next part analyzes other questions that arise from the research regarding various aspects of the PPE phenomenon: the personality profile of the PPEs, their social characteristics, the risk of misperception and misunderstandings in their activity, PPEs as a historical phenomenon, and the potential of the study’s proposed framework as a basis for future research.

Shafiuddean Choudry presents his boarding pass at Heathrow for his flight to San Francisco. A red light flickers on the screen with the words ‘Enhanced checks’. It’s one thing being judged by a human, but a whole other being chewed through an algorithm, stripped of agency and categorised as a potential threat. From the intrusive Snooper’s Charter collecting data on an unprecedented scale to proprietary ‘black-box’ algorithms from Big Tech, our digital footprint when interacting with technology shapes how we are defined. Through each ‘Alexa, can you …’ or aimless scroll through Instagram, we’re algorithmic kindling. Algorithms aren’t interested in who we are as individuals. Nuance is stripped away; the fat is cut and we’re reduced to ones and zeroes. A machine-readable record; parsed and filed. A lifetime of studying and working in technology has taught Choudry that algorithms aggregate; they simplify and reduce. If you’re not an if or a then, then you’re an else. The edge case defined within a defined set of parameters. In a world where intelligence is artificial and machines learn, it’s of vital importance to understand what these parameters are and how their architects think. Moreover, is it possible to resist? How do we Ctrl+Alt+Del this Orwellian reality? This chapter is an exploration of how our personal data is exploited under the glare of algorithms and systems, and equips us with the knowledge of how to mitigate from becoming a search result from the future.

Chapter 8 outlines the ways in which collective identities were catalogued and counted. The chapter makes the reciprocal move, to focus on the individuals lost in the statistics that grew out of the HIV and AIDS epidemic. Building lists of lesbian and gay men, and their icons, has been a way of occupying cultural space. At a series of vigils held in memorial and protest against the silence around AIDS, reading the names of the dead challenged those silences. For example, Sir Ian McKellen gave voice to the lives of those who had died of AIDS by reading their names aloud at a World AIDS Day vigil in 1994. But when these lists of icons produced a collective obituary of those affected by AIDS, it added another layer to the process. The numbers of losses started to define years and map connections; 1992 was officially ‘the worst of times’. Memorialisation turned numbers into names. In the memory boom of the 1980s, with a new understanding of the disruptive relationship between commemoration, trauma and popular memory, there was a new emphasis on the power of being counted, not as a number, but as a name.

Instead of trying to strengthen a relationship, what if the relationship needs to end? This chapter discusses existing drugs that may be capable of diminishing love, lust, attraction, or attachment to a current romantic partner. It also raises concerns about possible negative outcomes and points to the limits of what is likely to be possible. Given that drugs or medications used for other purposes may have anti-love side-effects, what would be the ethics of prescribing them off-label as a way of assisting with a difficult breakup or healing a broken heart? The chapter concludes by acknowledging the risk of ‘pathologizing’ love and romantic relationships by intervening in them with medical substances, and suggests a way to avoid this particular worry.

While some risks for disease like our genetic make-up cannot be modified, many risks are amenable to reduction. The major modifiable risk factors for the modern plagues are outlined: our body mass index and obesity; our levels of physical activity; and degrees of social isolation. While infections spread through a population owing to the transmission of a physical disease agent, research shows that modifiable risk factors like obesity spread via social networks. These modifiable risk factors all arise from modern ways of life. This term is preferred to ‘lifestyle’ which implies that way of life is a matter of individual choice. This chapter looks at the definition of obesity, its prevalence and its transmission through social networks. It considers historical change in the prevalence of physical activity and recommendations on optimal levels of such activity, the rise of social isolation, and the risks that arise from the current modern way of life.

Diagnosis of one of the modern plagues is simply the beginning of the accumulation of disabilities at the end of healthspan. Other long-term conditions – including more than one modern plague - tend to arise after the diagnosis of the first one. Individuals must endure successively increasing numbers of long-term conditions. Diabetes is associated with increased risk of heart disease and damage to nerves, kidneys, eyes and feet. Conversely, smoking, alcohol and pollution are among the risk factors for the modern plagues.

One of the most hyped possibilities for chemically strengthening love and attachment is the hormone oxytocin. This chapter surveys the evidence on oxytocin-enhanced relationships and identifies a number of gaps in the literature that would need to be filled before oxytocin could be used as a love drug. If stronger evidence comes out supporting real-world effectiveness of oxytocin in a relationship context, clear guidelines would need to be put in place to ensure that it was used responsibly and ethically. Building on this insight, the chapter concludes with an outline of key ethical constraints that should apply to any drug-assisted mode of couples therapy.