Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (...) (23%), consultation in individual cases (17.6%), and individual ethicists (8.8%), but also to other kinds of less formal ethics support (23.6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed. Although most respondents (81%) reported that they would find help useful in facing ethical difficulties, they reported having used the available services infrequently (14%). Physicians with greater confidence in their knowledge of ethics (P = 0.001), or who had had ethics courses in medical school (P = 0.006), were more likely to have used available services. Access to help in facing ethical difficulties among general physicians in the surveyed countries is provided by a mix of official ethics support services and other resources. Developing ethics support services may benefit from integration of informal services. Development of ethics education in medical school curricula could lead to improved physicians sensititity to ethical difficulties and greater use of ethics support services. Such support services may also need to be more proactive in making their help available. (shrink)

Background Decisions regarding Cardio-Pulmonary Resuscitation (CPR) and Do Not Attempt Resuscitation (DNAR) orders remain demanding, as does including patients in the process. Objectives To explore physicians’ justification for CPR/DNAR orders and decisions regarding patient inclusion, as well as their reports of how they initiated discussions with patients. Methods We administered a face-to-face survey to residents in charge of 206 patients including DNAR and CPR orders, with or without patient inclusion. Results Justifications were provided for 59% of DNAR orders and included (...) severe comorbidity, patients and families’ resuscitation preferences, patients’ age, or poor prognosis or quality of life. Reasons to include patients in CPR/DNAR decisions were provided in 96% and 84% of cases, and were based on respect for autonomy, clinical assessment of the situation as not too severe, and the view that such inclusion was required. Reasons for not including patients were offered in 84% of cases for CPR and in 70% for DNAR. They included absent decision-making capacity, a clinical situation viewed as good (CPR) or offering little hope of recovery (DNAR), barriers to communication, or concern that discussions could be emotionally difficult or superfluous. Decisions made earlier in the patient's management were infrequently viewed as requiring revision. Residents reported a variety of introductions to discussions with patients. Conclusions These results provide better understanding of reasons for CPR/DNAR decisions, reasons for patient inclusion or lack thereof, and ways in which such inclusion is initiated. They also point to potential side-effects of implementing CPR/DNAR recommendations without in-depth and practical training. This should be part of a regular audit and follow-up process for such recommendations. (shrink)

Résumé À première vue, les idées morales de l’abbé de Condillac (1714-1780) – et contrairement à celles de son frère Mably – ne doivent pas être comptées au rang de ses succès. Sans postérité apparente, elles ont surtout souffert d’un étonnant manque de notoriété dès le siècle des Lumières et ce jusqu’à nos jours. Aucun des grands commentateurs, contemporains ou plus anciens, de la pensée du philosophe ne s’y est arrêté avant que deux thèses de doctorat récentes ne viennent remettre (...) en cause cet état de fait. Leurs interprétations des idées morales de Condillac sont cependant assez divergentes. La première s’appuie principalement sur l’ Essai sur l’origine des connaissances humaines (1746) et conclut à une forme particulière de morale déontologique. Celle-ci s’appuierait sur la connaissance du principe de conservation de soi, limitatif de la volonté et créateur de devoirs, au travers du langage articulé des êtres humains. La seconde, s’appuyant sur le rôle des besoins et le « calcul des plaisirs et des peines », tente d’inscrire la morale condillacienne dans une optique plutôt utilitariste. Cet article s’inscrit clairement dans cette seconde perspective. Il s’attachera d’abord à présenter en quoi les principes de l’association humaine (de « l’état de nature » au « contrat ») et de la morale sont chez Condillac le résultat de la nécessité de « se conserver », cette dernière notion devant être entendu au sens large de la satisfaction de tous les besoins de l’homme social. Nous verrons ensuite comment Condillac propose un véritable « calcul moral » qui conduit les individus à agir vertueusement tout en n’ayant pour objet que leur intérêt propre. Enfin, la conclusion inscrira cette théorie morale au carrefour des conceptions de Jean-Jacques Burlamaqui et celles des utilitaristes français de la seconde moitié du xviii e siècle, les idées de Condillac constituant finalement un pas supplémentaire, par rapport au droit naturel, vers une morale conséquentialiste. (shrink)

The interventionist account of causation offers a criterion to distinguish causes from non-causes. It also aims at defining various desirable properties of causal relationships, such as specificity, proportionality and stability. Here we apply an information-theoretic approach to these properties. We show that the interventionist criterion of causation is formally equivalent to non-zero specificity, and that there are natural, information-theoretic ways to explicate the distinction between potential and actual causal influence. We explicate the idea that the description of causes should be (...) proportional to that of their effects. Then we draw a distinction between two ideas in the existing literature, the range of invariance of a causal relationship and its stability. The range of invariance is related to specificity and range of causal values. Stability concerns the effect of additional variables on the relationship between some focal pair of cause and effect variables. We show how to distinguish and measure the direct influence of background variables on the effect variable, and their influence on the relationship between the focal cause and the effect variable. Finally, we discuss the limitations of the information-theoretic approach, and offer prospects for complementary approaches. (shrink)

Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case (...) and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK.Results: Survey respondents ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision-making capacity , disagreement among caregivers and limitation of treatment at the end of life . The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct , someone capable of providing specific advice , help in weighing outcomes and clarification of the issues . Few of the types of help expected to be useful varied among countries.Conclusion: Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. (shrink)

En expliquant comment les forces de l’ordre se dotent d’uniformes spécifiques au cours du xixe siècle, il s’agit de comprendre la signification de cet objet. Au-delà de l’utilité pratique du costume, qui peut faire débat, policiers et gendarmes affichent une prestance militaire qui renforce leur prestige. Mais ils montrent aussi qu’ils travaillent en toute transparence, en assumant leurs actes et en se plaçant au service du public. Ils prouvent enfin leur valeur en engageant des dépenses vestimentaires qui deviennent un gage (...) de respectabilité. S’il constitue un enjeu symbolique fort, l’uniforme évolue dans le sens d’une plus grande simplicité fonctionnelle au cours du xixe siècle, s’adaptant dans une certaine mesure à la mode masculine. (shrink)

Le " troisième homme " de la primaire socialiste compte bien peser dans le sprint final à l'élection présidentielle. Il n'a pas fini de faire parler de lui... Mais à quoi peut bien encore servir la politique? Jamais la démocratie n'a été aussi solidement installée et, en même temps, jamais elle n'a été autant menacée par le vide, l'impuissance ou l'abus de pouvoir. Le politique a-t-il encore la main? Le rouleau-compresseur des marchés a-t-il eu raison de sa superbe? L'archaïsme des (...) institutions n'a-t-il pas réduit la démocratie française à un théâtre d'ombres? Les multiples filtres qui s'intercalent entre la sphère politique et le peuple ont-ils vidé le fait politique de son sens, laissant derrière lui des résignés et une société en forme de cocotte-minute? Et pourtant, si notre démocratie ne cesse de se dévorer elle-même, elle se régénère toujours. En effet, le politique est là, comme une braise sous les cendres, prêt à renaître, prêt à écrire encore quelques belles pages de l'histoire de France. C'est comme une étincelle à côté d'un baril de poudre, car il suffit de peu. Quand le voisin de classe de votre enfant est arrêté sans ménagement à la sortie de l'école, avec ses parents parce qu'ils sont sans-papier, voilà que vous vous mobilisez dans des comités de soutien, que vous faites le tour des élus, que vous interpellez le préfet et que vous organisez des manifs! Vous, parent d'élève tranquille qui n'avez jamais eu le moindre intérêt pour la cause des sans-papier! Là est le paradoxe du politique, à la fois décevant, incontournable et enthousiasmant quand la cause s'y prête. Alors, dans ce contexte, comment faire pour changer la vie? Comment débusquer le prêt-à penser politique? A qui s'adresse aujourd'hui la politique? Comment réenchanter ceux qui ne le sont plus? Où mener le combat politique qui est aussi un combat culturel? Quelles vieilles certitudes faut-il déboulonner? Qu'est-ce que l'on a encore à se dire dans notre société et comment la faire tenir ensemble? Toutes ces questions sont au coeur de cet antimanuel politique qui entend prendre à contrepied les stratèges cyniques, les barons inamovibles, les communicants qui pensent le politique comme une publicité, les ambitieux qui veulent la place à tous prix, les résignés qui méprisent tout... Et pourtant, la stratégie, la communication ou l'ambition sont nécessaires à tout projet politique. Arnaud Montebourg ne décerne ni les bons ni les mauvais points comme le maître d'école, mais prend une distance critique sur la politique, sublime et misérable, et sur le politique, omniprésent et invisible. (shrink)

The canonists’ determination of the sphere of sanction provides an insight into the foundations of ecclesiastical tolerance. There is indeed an ecclesiastical tolerance that leads the magisterium to limit the scope of penal normativity for theological and pastoral reasons. The distinction between sin and crime, well known to canonists, is justified less by recourse to decretals or decisions of councils than by a return to the discourses of the Church Fathers. The definition of the notion of crime in canon law (...) and beyond owes a debt to Augustine’s meditation on the Donatist quarrel: according to this approach, it is a question of tolerating the tares. (shrink)

In 1952, Heinrich Scholz published a question in The Journal of Symbolic Logic asking for a characterization of spectra, i.e., sets of natural numbers that are the cardinalities of finite models of first order sentences. Günter Asser in turn asked whether the complement of a spectrum is always a spectrum. These innocent questions turned out to be seminal for the development of finite model theory and descriptive complexity. In this paper we survey developments over the last 50-odd years pertaining to (...) the spectrum problem. Our presentation follows conceptual developments rather than the chronological order. Originally a number theoretic problem, it has been approached by means of recursion theory, resource bounded complexity theory, classification by complexity of the defining sentences, and finally by means of structural graph theory. Although Scholz' question was answered in various ways, Asser's question remains open. (shrink)

If European metropolises witnessed the development, throughout the 19th century, of various forms of concentrationary assistance and radical isolation through penal colonies, colonial space was the site of an even more explicit formulation and experimentation with the creation and the exclusion of of an undesirable human surplus, notably in South Asia, where the social system of castes could provide powerful ideological foundations for the colonial thinking on exclusion. This article seeks to illustrate this by examining the creation of the category (...) of « criminal tribes » in India, during the last third of the 19th century. (shrink)

In this paper, we apply the perspective of intra-organismal ecology by investigating a family of ecological models suitable to describe a gene therapy to a particular metabolic disorder, the adenosine deaminase deficiency (ADA-SCID). The gene therapy is modeled as the prospective ecological invasion of an organ (here, bone marrow) by genetically modified stem cells, which then operate niche construction in the cellular environment by releasing an enzyme they synthesize. We show that depending on the chosen order (a choice that cannot (...) be made on \textit{a priori} assumptions), different kinds of dynamics are expected, possibly leading to different therapeutic strategies. This drives us to discuss several features of the extension of ecology to intra-organismal ecology. (shrink)

We propose to represent the syntax and semantics of natural languages with labelled proof nets in the implicative fragment of intuitionistic linear logic. Resource-sensitivity of linear logic is used to express all dependencies between the syntactic constituents of a sentence in the form of a proof net. Phonological and semantic labelling of the proof net from its inputs to the unique output are used to produce the well-formed phonological form and the semantic representation of a sentence from entries of a (...) lexicon. In this way we obtain a linguistic model of great flexibility because labelling is not completely determined logically: it is used to introduce linguistic constraints which go beyond the underlying logic. (shrink)

Despite epistemological and ideological obstacles, the reasons of which are briefly recalled in this article, the relationship between law and religion in the medieval West has been extensively explored, notably through studies devoted to canon law, ecclesiastical procedures and legal qualifications. Yet the boundaries, contact zones and connections between these two “regimes of normativity” and “veridiction” have been left in the dark. This paper does not claim to encompass all the aspects of such a titanic investigation. Instead, it intends to (...) point out some of the problems that arise as soon as one approaches (as a historian) the relations that the Catholic Church – that established the Christian religion – has maintained with the law, and to indicate the paths currently explored in this direction. (shrink)

Ce volume réunit 10 articles en italien, à une exception française près, issus pour la plupart d’un colloque de 2015 et paraissant dans une série philosophique. Il y a fort peu de coquilles dans cet ouvrage soigné (68 : *ἱδιότητος, 226 : *Alres, 228 : *εἴληκεν, 244 : *Oppenraay, 267 : *aniumalium). Il se signale par son orientation pédagogique, conforme au cadre de la rencontre, qui était une journée de formation : la plupart des articles sont des synthèses, proposées par (...) des spécialistes qui... (shrink)

In this article, the authors, as researchers, are part of a clinical approach to psychoanalytic orientation in education sciences, questioning their research approach during an investigation on the expulsion from classrooms in secondary school in France. Trying to compare themselves to different types of collaborative research, they analyse the modalities of relationship they tried to implement during this research ‘with’ subjects, including teenagers students they have interviewed.

A causal approach to biological information is outlined. There are two aspects to this approach: information as determining a choice between alternative objects and information as determining the construction of a single object. The first aspect has been developed in earlier work to yield a quantitative measure of biological information that can be used to analyze biological networks. This article explores the prospects for a measure based on the second aspect and suggests some applications for such a measure. These two (...) aspects are not suggested to exhaust all the facets of biological information. (shrink)

Cet article documente la pratique du plan dans les relations entre hommes, à savoir ces rencontres rapides, à but sexuel principalement et en général non répétées. Le matériel mobilisé résulte de trente entretiens semi-directifs. Le plan correspond souvent à une dissociation marquée entre le courant sensuel et le courant tendre, au sens freudien, et présente donc un intérêt pour approfondir la compréhension de cette dualité. L’article observe les prises de contact virtuelles, les lieux des plans et la possibilité de penser, (...) ou de ne pas penser, le plan, d’en refouler le souvenir. Les affects éprouvés dans la rencontre de l’autre comme l’absence d’affect ( désaffectation ) sont alors analysés aux côtés de la question de la sociabilité et des impressions d’inquiétante étrangeté. (shrink)

We study the extension of dependence logic \ by a majority quantifier \ over finite structures. We show that the resulting logic is equi-expressive with the extension of second-order logic by second-order majority quantifiers of all arities. Our results imply that, from the point of view of descriptive complexity theory, \\) captures the complexity class counting hierarchy. We also obtain characterizations of the individual levels of the counting hierarchy by fragments of \\).

In this paper, we discuss the perspective of intra-organismal ecology by investigating a family of ecological models. We consider two types of models. First order models describe the population dynamics as being directly affected by ecological factors (here understood as nutrients, space, etc). They might be thought of as analogous to Aristotelian physics. Second order models describe the population dynamics as being indirectly affected, the ecological factors now affecting the derivative of the growth rate (that is, the population acceleration), possibly (...) through an impact on non-genetically inherited factors. Second order models might be thought of as analogous to Galilean physics. In the joint paper, we apply these ideas to a situation of gene therapy. (shrink)

In recent years, scholars have shown the fruitfulness of linking Peirce’s speculative rhetoric with the rhetorical tradition—which can be broadly construed as the art, time and again rediscovered and refined, of rendering discourses eloquent and persuasive. They have suggested many ways in which the historical development of rhetoric sheds light on the third branch of Peirce’s semiotic and further pointed out many contributions Peirce makes in turn to the field of rhetoric. However, with the notable exception of Colapietro, these authors (...) have focused almost exclusively on questions of method and discovery. They have... (shrink)

Saffran, Newport, and Aslin (1996a) found that human infants are sensitive to statistical regularities corresponding to lexical units when hearing an artificial spoken language. Two sorts of segmentation strategies have been proposed to account for this early word‐segmentation ability: bracketing strategies, in which infants are assumed to insert boundaries into continuous speech, and clustering strategies, in which infants are assumed to group certain speech sequences together into units (Swingley, 2005). In the present study, we test the predictions of two computational (...) models instantiating each of these strategies i.e., Serial Recurrent Networks: Elman, 1990; and Parser: Perruchet & Vinter, 1998 in an experiment where we compare the lexical and sublexical recognition performance of adults after hearing 2 or 10 min of an artificial spoken language. The results are consistent with Parser’s predictions and the clustering approach, showing that performance on words is better than performance on part‐words only after 10 min. This result suggests that word segmentation abilities are not merely due to stronger associations between sublexical units but to the emergence of stronger lexical representations during the development of speech perception processes. (shrink)

Social Catholic criticisms of Frédéric Bastiat’s thinking, notably Charles Périn’s, clarify the link between the labour theory of value and the demands for social justice. Claiming that Bastiat’s theory of value rests on a sophism, Périn rejects his view that competition is the solution to the social question. Contrary to Bastiat, indeed, he accepts the labor theory of value and apparently makes it a standard of justice: according to him, rents sanction an injustice. Social Catholics, particularly René de La Tour (...) du Pin, follow in his tracks, insisting that a specific course must be taken so as to set right the injustice of rents — the course of what will be called furtherly ‘social justice’.Les critiques portées par les catholiques sociaux à la doctrine de Frédéric Bastiat, notamment celles de Charles Périn, permettent de comprendre le lien qui unit la théorie de la valeur travail et l’exigence de justice sociale. Périn affirme que la théorie de la valeur de Bastiat repose sur un sophisme et repousse donc sa réponse à la question sociale, la concurrence. Il a adopté en effet, au contraire de Bastiat, la théorie de la valeur travail et l’a érigée, semble-t-il, en critère de justice : la rente consacre, à ses yeux, une injustice. A sa suite, les catholiques sociaux, exemplairement, René de La tour du Pin, affirmeront qu’il faut mener une action spécifique pour corriger l’injustice de la rente et l’appelleront justice sociale. (shrink)