Dans ce texte, je propose d’adapter la théorie de l’agentivité collective de List et Pettit de manière à considérer les nations comme des agents. Cet exercice pourrait ainsi conférer un argument supplémentaire aux théories des droits collectifs s’intéressant aux groupes nationaux puisque ces derniers pourront véritablement être reconnus comme des sujets de droits, capables d’autodétermination et de revendications morales. La théorie des droits collectifs de Seymour sera utilisée comme modèle à cet égard. Bien que le libéralisme politique dans lequel s’inscrit (...) Seymour refuse de se prononcer sur des problèmes métaphysiques, il est intéressant d’ouvrir la possibilité conceptuelle que des groupes nationaux soient des agents à part entière. Pour ce faire, il faudra déterminer comment un agent national peut prendre des décisions et comment il peut subir des actions, en plus d’étudier ce que cela pourrait impliquer pour la responsabilité collective des nations. (shrink)

Cet article explore les conséquences pour le libéralisme politique de considérer l’existence d’un pluralisme raisonnable au sujet des différentes conceptions du juste. Comment une conception publique de la justice peut se développer malgré un désaccord raisonnable et profond sur les termes mêmes de cette justice ? En comparant le libertarisme, la justice comme équité et l’égalitarisme strict, il sera montré que les concepts fondamentaux de ces conceptions du juste sont essentiellement contestés. En guise de solution, deux conditions seront suggérées afin (...) de faire en sorte que la conception publique de la justice en soit une de tolérance politique : premièrement, elle devra se baser sur une liste de droits minimaux reconnus par les différentes conceptions raisonnables du juste; et deuxièmement, si la conception publique de la justice a pour ambition de se développer au-delà du dénominateur commun, elle devra offrir des mesures compensatoires à ceux supportant des conceptions du juste plus restrictives. À certains égards, cette problématique et ces accommodements s’apparentent à ce qui est déjà proposé au sujet de multiculturalisme. (shrink)

La philosophie médiévale du langage présente deux séries d’affinités remarquables avec les approches contemporaines. L’une se situe du côté des sémantiques formelles et, plus généralement, des analyses logiques des conditions de vérité des énoncés. L’autre relève plutôt de la pragmatique, notamment des perspectives contextuelles sur les actes de langage. Les logiciens, grammairiens et théologiens du Moyen Âge étaient, de fait, pleinement conscients qu’ils avaient à leur disposition deux types d’approche des énoncés, selon qu’ils prenaient en compte les seules propriétés (...) sémantiques de leurs composants ou qu’ils intégraient des considérations extralinguistiques allant de l’intention des auteurs / locuteurs à leur statut, en passant par le contexte d’énonciation. Chacune de ces perspectives a bénéficié d’un certain nombre d’études récentes ; la question que je voudrais aborder est plutôt celle de leur frontière en logique, de son emplacement, ses déplacements, sa porosité éventuelle. La complexité des matériaux en jeu ne permettra pas de proposer plus que quelques points de repères, qui peuvent toutefois aider à évaluer l’hypothèse d’un « projet formel » en sémantique médiévale. (shrink)

La philosophie médiévale du langage présente deux séries d’affinités remarquables avec les approches contemporaines. L’une se situe du côté des sémantiques formelles et, plus généralement, des analyses logiques des conditions de vérité des énoncés. L’autre relève plutôt de la pragmatique, notamment des perspectives contextuelles sur les actes de langage. Les logiciens, grammairiens et théologiens du Moyen Âge étaient, de fait, pleinement conscients qu’ils avaient à leur disposition deux types d’approche des énoncés, selon qu’ils prenaient en compte les seules propriétés (...) sémantiques de leurs composants ou qu’ils intégraient des considérations extralinguistiques allant de l’intention des auteurs / locuteurs à leur statut, en passant par le contexte d’énonciation. Chacune de ces perspectives a bénéficié d’un certain nombre d’études récentes ; la question que je voudrais aborder est plutôt celle de leur frontière en logique, de son emplacement, ses déplacements, sa porosité éventuelle. La complexité des matériaux en jeu ne permettra pas de proposer plus que quelques points de repères, qui peuvent toutefois aider à évaluer l’hypothèse d’un « projet formel » en sémantique médiévale. (shrink)

Si la différence épistémologique est d’abord une différence linguistique – à l’image des sciences de la nature qui parlent la langue mathématique – alors les sciences sociales, qui s’établissent nécessairement dans la langue naturelle, doivent s’appuyer sur la différence d’une langue de concepts. Et, partant, se tourner à nouveau vers la philosophie qui en est la première pourvoyeuse. Comme, de son côté, la philosophie, sollicitée par une crise historique du capitalisme, tend de plus en plus à faire travailler ses (...) concepts sur les objets du monde social-historique, il se pourrait que la longue histoire des rapports houleux de la philosophie et des sciences sociales, jusqu’ici faite de séparation fracassante et d’exaspérations mutuelles, connaisse un changement d’époque, pour expérimenter une nouvelle alliance. (shrink)

Le rapport Sarr-Savoy sur la restitution du patrimoine africain a provoqué controverses et crispations. Quels peuvent être les critères de restitution des objets? Les modes d’acquisition, les usages dans le contexte culturel d’origine, les modalités de retour en Afrique? Il s’agit ici de faire un pas de côté par rapport au débat sur le devenir des musées détenteurs de collections coloniales, particulièrement euro centré. La restitution n’est pas seulement le déplacement physique d’un artefact d’un musée à un autre, elle (...) est un geste symbolique. Ainsi, dans les angles morts de la restitution formelle, cette Mineure recherche des formes alternatives de restitution de basse intensité, à partir desquels pourrait s’ouvrir de nouveaux horizons d’appropriation. (shrink)

De la fin du XVIIIe siècle à 1830, l’Amérique hispanique est entrée dans l’ère des révolutions atlantiques. Sur les côtes du Venezuela, dans les années 1790, les échos des révolutions de France, de Saint-Domingue et d’autres îles des Antilles ont contribué à la floraison de révoltes et de conspirations aux mots d’ordre nouveaux. Les demandes de liberté des esclaves et d’égalité des métis s’inscrivaient désormais dans un nouvel horizon d’attente révolutionnaire. Cependant, la monarchie hispanique était toujours capable de mobiliser des (...) troupes pour défendre l’ordre établi. À partir de 1806, le Vénézuélien Francisco de Miranda, ancien général de la Révolution française, tenta de coordonner, d’abord sans succès, les efforts des premiers indépendantistes. La première indépendance fut proclamée à Caracas en 1811 dans un contexte de dislocation de la monarchie hispanique, à la suite de l’invasion des troupes napoléoniennes et des conflits entre péninsulaires et hispano-américains. Les patriotes proclamèrent l’égalité civile en mettant fin aux catégories socio-raciales d’Ancien Régime, mais maintinrent l’esclavage. Ce n’est que progressivement qu’ils incorporèrent des esclaves aux armées en échange de la liberté. Malgré ces libérations par les armes, l’alliance avec Haïti et les tentatives de Simón Bolívar, l’indépendance ne coïncida pas avec l’abolition de l’esclavage, qui fut finalement proclamée au Venezuela en 1854. (shrink)

Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics in reflexive governance (...) operates as a systematic critical-thinking procedure that aims to define its value: What are the “right” criteria to justify how to govern “good” actions for a “better” future? The objective is to lay the foundations for a methodological framework in empirical bioethics, the rudiments of which have been applied to a case study to building reflexive governance in One Health. This ongoing critical thinking process involves “mapping, framing, and shaping” the dynamics of interests and perspectives that could jeopardize a “better” future. This paper proposes to hybridize methods to combine insights from collective deliberation and expert evaluation through a reflexive governance functioning as a community-based action-ethics methodology. The intention is to empower individuals and associations in a dialogue with society, which operation is carried out using a case study approach on data sharing systems. We based our reasoning on a feasibility study conducted in Québec, Canada (2018–2021), envisioning an antibiotic use surveillance program in animal health for 2023. Using the adaptive cycle and governance techniques and perspectives, we synthesize an alternative governance model rooted in the value of empowerment. The framework, depicted as a new “research and design (R&D)” practice, is linking operation and innovation by bridging the gap between Reflexive, Evaluative, and Deliberative reasonings and by intellectualizing the management of democratizing critical thinking locally (collective ethics) by recognizing its context (social ethics). Drawing on the literature in One Health and sustainable development studies, this article describes how a communitarian and pragmatic approach can broaden the vision of feasibility studies to ease collaboration through public-private-academic partnerships. The result is a process that “reassembles” the One Health paradigm under the perspective of global bioethics to create bridges between the person and the ecosystem through pragmatic ethics. (shrink)

. Computational chemistry grew in a new era of “desktop modeling,” which coincided with a growing demand for modeling software, especially from the pharmaceutical industry. Parameterization of models in computational chemistry is an arduous enterprise, and we argue that this activity leads, in this specific context, to tensions among scientists regarding the epistemic opacity transparency of parameterized methods and the software implementing them. We relate one flame war from the Computational Chemistry mailing List in order to assess in detail the (...) relationships between modeling methods, parameterization, software and the various forms of their enclosure or disclosure. Our claim is that parameterization issues are an important and often neglected source of epistemic opacity and that this opacity is entangled in methods and software alike. Models and software must be addressed together to understand the epistemological tensions at stake. (shrink)

The author attempts to encompass the self, or a self, that, while at some times appears to be his own, at other times not, thus encompassing and continually morphing. It is a mixture of poetry and prose.

resumo Trata-se aqui de mostrar como a filosofia de Bergson decorre da constatação da passagem do tempo enquanto fato primordial e originário; nessa medida, as suas obras podem ser consideradas como diferentes tentativas de esclarecer tal experiência da temporalidade que, filosoficamente considerada, consiste na intuição da duração. Para isso, examina-se a forma pela qual o tratamento dado a problemas filosóficos distintos e discutidos em cada um de suas obras efetiva-se como meditação sobre o fato primitivo e seu esclarecimento progressivo. Em (...) primeiro lugar, acompanhamos o percurso de dedução das principais características da duração, sucessão, conservação e ato, sublinhando algumas de suas conseqüências filosóficas. A seguir, examinamos a dimensão crítica da filosofia de Bergson pela análise do pensamento do instante, aquele que desfigura a experiência do tempo e origina a via equivocada da metafísica tradicional; nesse exame procuramos diferenciar tal pensamento da experiência da simultaneidade, que é constitutiva de nossa relação concreta com as coisas. palavras-chave duração, sucessão, simultaneidade, criação, experiência, instante. (shrink)

Trata-se aqui de mostrar como a filosofia de Bergson decorre da constatação da passagem do tempo enquanto fato primordial e originário; nessa medida, as suas obras podem ser consideradas como diferentes tentativas de esclarecer tal experiência da temporalidade que, filosoficamente considerada, consiste na intuição da duração. Para isso, examina-se a forma pela qual o tratamento dado a problemas filosóficos distintos e discutidos em cada um de suas obras efetiva-se como meditação sobre o fato primitivo e seu esclarecimento progressivo. Em primeiro (...) lugar, acompanhamos o percurso de dedução das principais características da duração, sucessão, conservação e ato, sublinhando algumas de suas conseqüências filosóficas. A seguir, examinamos a dimensão crítica da filosofia de Bergson pela análise do pensamento do instante, aquele que desfigura a experiência do tempo e origina a via equivocada da metafísica tradicional; nesse exame procuramos diferenciar tal pensamento da experiência da simultaneidade, que é constitutiva de nossa relação concreta com as coisas.Duração. Sucessão. Simultaneidade. Criação. Experiência. Instante. The bergsonian Conception of Time AbstractThe aim of this article is to show how Bergson´s philosophy derives from the understanding of the passing of time as an original and primordial fact. In this way, his works can be considered to be different attempts to explain this experience of temporality which, philosophically considered, consist of the intuition of duration. Thus, we examine the way in which the treatment given to distinct philosophical problems discussed in each of his works takes place as a meditation on the primitive fact and its progressive clarification. Firstly, we follow the course of deduction of the main characteristics of duration, succession, conservation and act, emphasizing some of his philosophical consequences. We then examine the critical dimension of Bergson´s philosophy through the analysis of the thought of the instant, which distorts the experience of time and gives rise to an equivocal way of traditional metaphysics; in this examination we shall seek to differentiate this idea from the experience of simultaneity that constitutes our concrete relationship with things.Duration. Succcession. Simultaneity. Creation. Experience. Instant. (shrink)

The personhood of the physician is a crucial element in accomplishing the goals of medicine. We review claims made on behalf of the humanities in guiding professional identity formation. We explore the dichotomy that has evolved, since the Renaissance, between the humanities and the natural sciences. The result of this evolution is an historic misconstrual, preoccupying educators and diverting them from the moral development of physicians. We propose a curricular framework based on the recovery of Aristotelian concepts that bridge identity (...) and activity. The humanities and the natural sciences, jointly and severally, can fulfill developmental, characterological and instrumental purposes. (shrink)

Background:Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses’ sources of distress is important when planning interventions to support them.Purpose:To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic.Design:Qualitative descriptive component within a larger mixed-methods study.Participants and research context:Participants were invited to write down their experiences of a critical incident, which distressed them when providing nursing care. Thematic analysis was used (...) to analyze the data.Ethical considerations:The study was approved by the ethics committee at the researchers’ university in eastern Canada.Results:A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families’ grief, (3) our safety, and (4) futility of care. Many nurses’ stories also focused on the organizational preparedness of their institutions and concerns over their own safety.Discussion:Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed.Conclusion:Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses’ well-being. (shrink)

The practice of medicine involves continual change, driven by a constant stream of developments in the understanding of biological structure and function relevant to human diseases, and the parallel improvements in pharmacologic and other technological interventions. This change is also driven by evolving social philosophies, ethical trends, and lifestyles. As products of society, doctors absorb contemporary values and norms. Indeed, it would appear that the ethical norms and standards of medical practice are flexible, and that the characteristics of medical practice (...) at any particular point in history may reflect the mores of the times rather than any enduring moral imperatives.However, a common perception .. (shrink)

Van Rensselaer Potter (1911-2001), le biologiste à l’origine du terme « bioéthique » dans les écrits nord-américains, considère que « real bioethics falls in the context of the ideals of […] Aldo Leopold », un forestier, philosophe et poète ayant marqué le XXe siècle. Associer Leopold à Potter a pour effet de placer la bioéthique dans la famille des éthiques de l’environnement, ce qui la différencie du sens conventionnel retenu en médecine et en recherche depuis le Rapport Belmont (1979), une (...) déclaration ayant propulsé l’institutionnalisation de la bioéthique en Amérique du Nord. Cependant, diviser la bioéthique entre le médical et l’environnemental est réducteur. Potter propose au contraire une bioéthique globale s’intéressant aux enjeux situés à leur interface, dont ceux concernant la terre, la vie sauvage, la surpopulation, la consommation, etc. Cet article vise à amorcer un nouveau chantier d’analyse de la pensée de Potter en s’appuyant sur l’héritage de Leopold en biologie. Une synthèse de cette vision potterienne est proposée de manière à considérer son œuvre comme un tout cohérent s’intégrant aux grands débats qui transcendent les XXe et XXIe siècles. Sa vision apparaît comme une sagesse collective et prospective sous la forme d’une science de la survie et d’un code de bioéthique. Dépassant l’éthique de l’environnement, son association avec Leopold offre un modèle de la complexité s’imposant comme cas indissociable du contexte qui l’englobe, en améliorant nos façons d’intervenir en pratique dans un monde en constante transformation, à titre de gouvernance adaptative et de sagesse de la responsabilité. (shrink)

Reflection has been proclaimed as a means to help physicians deal with medicine’s inherent complexity and remedy many of the shortcomings of medical education. Yet, there is little agreement on the nature of reflection nor on how it should be taught and practiced. Emerging neuroscientific concepts suggest that human thought processes are largely nonconscious, in part inaccessible to introspection. Our knowledge of the world is fraught with uncertainty, ignorance and indeterminacy, and influenced by emotion, biases and illusions, including the illusion (...) of not having illusions. Neuroscience also documents that lifelong learning processes may hone nonconscious cognition to high levels of sophistication, allowing rapid and precise perceptions, judgments and actions in complex situations. We argue that knowledge of mechanisms underlying human thought may be useful in designing educational programs to foster desired attributes such as curiosity, critical self-awareness and intuitive acumen in medical professionals. The juxtaposition of neuroscientific insights with ideas from Kant on reflective judgement, van Manen on tact, and Aristotle on phronésis, supports a concept of reflection that manifests as wise practice. We suggest that reflection in medical education should be an imperative for educators seeking to guide learners to manage the complexity and “messiness” of medical practice, and a role-modelling mode of medical practice characterized by self-correcting behaviors that culminate in good and right professional actions. An example illustrates reflective practice in the teaching and learning of physicianship. (shrink)

We argue that a fashionable interpretation of the theory of natural selection as a claim exclusively about populations is mistaken. The interpretation rests on adopting an analysis of fitness as a probabilistic propensity which cannot be substantiated, draws parallels with thermodynamics which are without foundations, and fails to do justice to the fundamental distinction between drift and selection. This distinction requires a notion of fitness as a pairwise comparison between individuals taken two at a time, and so vitiates the interpretation (...) of the theory as one about populations exclusively. (shrink)

An analysis of the physical implications of abstractness reveals the reality of three interconnected modes of existence: abstract, virtual and concrete, corresponding in physics to information, energy and matter. This triple-aspect monism clarifies the ontological status of subatomic quantum particles. It also provides a non-spooky solution to the weirdness of quantum physics and a new outlook for the mind-body problem. The ontological implications are profound for both physics and philosophy.

Although an invasive medical intervention, Deep Brain Stimulation (DBS) has been regarded as an efficient and safe treatment of Parkinson’s disease for the last 20 years. In terms of clinical ethics, it is worth asking whether the use of DBS may have unanticipated negative effects similar to those associated with other types of psychosurgery. Clinical studies of epileptic patients who have undergone an anterior temporal lobectomy have identified a range of side effects and complications in a number of domains: psychological, (...) behavioural, affective and social. In many cases, patients express difficulty adjusting from being chronically ill to their new status as ‘treated’ or ‘seizure free’. This postoperative response adjustment has been described in the literature on epilepsy as the ‘Burden of Normality’ (BoN) syndrome. Most of the discussion about DBS postoperative changes to self is focused on abnormal side effects caused by the intervention (ie, hypersexuality, hypomania, etc). By contrast, relatively little attention is paid to the idea that successfully ‘treated’ individuals might experience difficulties in adjusting to becoming ‘normal’. The purpose of this paper is (1) to articulate the postoperative DBS psychosocial adjustment process in terms of the BoN syndrome, (2) to address whether the BoN syndrome illustrates that DBS treatment poses a threat to the patient’s identity, and (3) to examine whether the current framework for rehabilitation after DBS procedures should be updated and take into account the BoN syndrome as a postoperative self-change response. (shrink)

Ecological fitness has been suggested to provide a unifying definition of fitness. However, a metric for this notion of fitness was in most cases unavailable except by proxy with differential reproductive success. In this article, I show how differential persistence of lineages can be used as a way to assess ecological fitness. This view is inspired by a better understanding of the evolution of some clonal plants, colonial organisms, and ecosystems. Differential persistence shows the limitation of an ensemblist noncausal understanding (...) of evolution. Causal explanations are necessary to understand the evolution by natural selection of these biological systems. †To contact the author write to: Department of Philosophy, University of Montreal, P.O. Box 6128, Station Centre‐Ville, Montreal, Quebec, H3C 3J7 Canada; e‐mail: [email protected]. (shrink)

One important concern regarding implantable Brain Computer Interfaces is the fear that the intervention will negatively change a patient’s sense of identity or agency. In particular, there is concern that the user will be psychologically worse-off following treatment despite postoperative functional improvements. Clinical observations from similar implantable brain technologies, such as deep brain stimulation, show a small but significant proportion of patients report feelings of strangeness or difficulty adjusting to a new concept of themselves characterized by a maladaptive je ne (...) sais quoi despite clear motor improvement. Despite the growing number of cases in the DBS literature, there is currently no accepted or standardized tool in neuroethics specifically designed to capture the phenomenological postoperative experience of patients implanted with DBS or BCI devices. Given potential risks of postoperative maladaptation, it is important for the field of neuroethics to develop a qualitative instrument that can serve as a shared method for capturing postoperative variations in patient experience of identity and agency. The goal of this article is to introduce an instrument we have developed for this purpose and call for further neuroethical efforts to assess the phenomenology of implantable brain device use. (shrink)

For Van Rensselaer Potter (1911–2001), Global Bio-Ethics is about building on the legacy of Aldo Leopold (1887–1948), one of the most notable forest managers of the twentieth century who brought to light the importance of pragmatism in the sciences and showed us a new way to proceed with environmental ethics. Following Richard Huxtable and Jonathan Ives's methodological 'Framework for Empirical Bioethics Research Projects' called 'Mapping, framing, shaping,' published in BMC Medicine Ethics (2019)), we propose operationalizing a framework for Global Bio-Ethics (...) by hybridizing approaches in empirical bioethics and ecosystem management. We explain this framework using the metaphor of forest management. This mixed approach is articulated through three phases: (1) mapping the “landscape” to build a working theory, (2) framing the “scene” to prepare the fieldwork, and (3) shaping bioethics “tools” to stimulate cooperation. Applying this methodology, an adaptive management cycle is outlined to help ensure that political processes are sustainable and socially acceptable, still based on strategic and ethical thinking, but also capable of reshaping failing policies. (shrink)

This paper studies welfare tradeoffs in two-sided, one-to-one matching markets. We begin by providing theoretical upper bounds on a utilitarian price of stability, and show that these bounds vary with the composition of participants’ ordinal preference lists. We then turn to simulation experiments to describe how changes in basic characteristics of agents’ preferences can increase or decrease the average price of stability as measured by both utilitarian and Rawlsian welfare criteria. Our results indicate that markets featuring moderate degrees of correlation (...) and positive intercorrelation in the preferences of participants exhibit the steepest tradeoffs between stability and utilitarian welfare and between stability and Rawlsian welfare. (shrink)

Following Wallace’s suggestion, Darwin framed his theory using Spencer’s expression “survival of the fittest”. Since then, fitness occupies a significant place in the conventional understanding of Darwinism, even though the explicit meaning of the term ‘fitness’ is rarely stated. In this paper I examine some of the different roles that fitness has played in the development of the theory. Whereas the meaning of fitness was originally understood in ecological terms, it took a statistical turn in terms of reproductive success throughout (...) the 20th Century. This has lead to the ever-increasing importance of sexually reproducing organisms and the populations they compose in evolutionary explanations. I will argue that, moving forward, evolutionary theory should look back at its ecological roots in order to be more inclusive in the type of systems it examines. Many biological systems can only be satisfactorily accounted for by offering a non-reproductive account of fitness. This argument will be made by examining biological systems with very small or transient population structures. I argue this has significant consequences for how we define Darwinism, increasing the significance of survival over that of reproduction. (shrink)

The idea that deep brain stimulation (DBS) induces changes to personality, identity, agency, authenticity, autonomy and self (PIAAAS) is so deeply entrenched within neuroethics discourses that it has become an unchallenged narrative. In this article, we critically assess evidence about putative effects of DBS on PIAAAS. We conducted a literature review of more than 1535 articles to investigate the prevalence of scientific evidence regarding these potential DBS-induced changes. While we observed an increase in the number of publications in theoretical neuroethics (...) that mention putative DBS-induced changes to patients’ postoperative PIAAAS, we found a critical lack of primary empirical studies corroborating these claims. Our findings strongly suggest that the theoretical neuroethics debate on putative effects of DBS relies on very limited empirical evidence and is, instead, reliant on unsubstantiated speculative assumptions probablyin lieuof robust evidence. As such, this may reflect the likelihood of a speculative neuroethics bubble that may need to be deflated. Nevertheless, despite the low number of first-hand primary studies and large number of marginal and single case reports, potential postoperative DBS changes experienced by patients remain a critical ethical concern. We recommend further empirical research in order to enhance theoretical neuroethics work in the area. In particular, we call for the development of better instruments capable of capturing potential postoperative variations of PIAAAS. (shrink)

Although being generally safe, the use of Deep Brain Stimulation has been associated with a significant number of patients experiencing postoperative psychological and neurological harm within experimental trials. A proportion of these postoperative severe adverse effects have lead to the decision to medically prescribe device deactivation or removal. However, there is little debate in the literature as to what is in the patient’s best interest when device removal has been prescribed; in particular, what should be the conceptual approach to ethically (...) guide the decision to remove or maintain implants. The purpose of this article is to examine the ethical issues raised when patients refuse brain device explantation despite medical prescription. In order to illustrate these issues, we report and discuss a clinical case involving a patient suffering from treatment resistant depression who experienced forms of postoperative self-estrangement, as well as suicidal attempts, but who resists giving consent to device explantation. (shrink)

This article evaluates the experience of an extraordinary mental change of novice female runners that is connected to long-distance running. Two female participants were interviewed regarding their life-changing experience associated with endurance exercise. Descriptions of the lived experience from women who train for marathons were gathered and a phenomenological analysis of the data was conducted which suggests that the women underwent a mental change that improved their self-confidence and enhanced relationships with their selves and others. The six constituents that emerged (...) were: Participants Perception of an Enhancing Outdoor Environment, Life-Style Changes Resulting in More Openness to Others and Self, Discoveries Concerning Self-Improvements, Sustaining a Desired Mental Disposition, Empowerment in Considering New Possibilities, and Support for Encountering Future Challenges. This article demonstrates how a mental change associated with long-distance running positively impacts participants’ personal and professional lives. (shrink)

In order to understand the lived experiences of physicians in clinical practice, we interviewed eleven expert, respected clinicians using a phenomenological interpretative methodology. We identified the essence of clinical practice as engagement. Engagement accounts for the daily routine of clinical work, as well as the necessity for the clinician to sometimes trespass common boundaries or limits. Personally engaged in the clinical situation, the clinician is able to create a space/time bubble within which the clinical encounter can unfold. Engagement provides an (...) account of clinical practice as a unitary lived experience. This stands in stark contrast to the prevailing notion, referred to as a dual discourse, that describes medicine as the addition of humanism to science. Drawing on Aristotle’s notion of phronesis and Sartre’s definition of the situation, we illustrate how this novel perspective entwines clinical practice, the person of the clinician, and the clinician’s situation. (shrink)

Building upon a non-standard understanding of evolutionary process focusing on variation and persistence, I will argue that communities and ecosystems can evolve by natural selection as emergent individuals. Evolutionary biology has relied ever increasingly on the modeling of population dynamics. Most have taken for granted that we all agree on what is a population. Recent work has reexamined this perceived consensus. I will argue that there are good reasons to restrict the term “population” to collections of monophyletically related replicators and (...) interactors, which explains why many existing models in population biology exclude by definition many genuine evolving biological individuals such as communities and ecosystems. By studying a case of community evolution (a symbiotic termite–fungus community), we will see that it is variation that is important to evolutionary processes, not populations. Variation within a population is only one of many types of variation that can lead to evolution by natural selection. The upshot of focusing on variation is that cases of community and ecosystem adaptive change become tractable in evolutionary terms. I will show that complex emergent individuals such as communities and ecosystems cannot be fully accommodated by conventional population/reproduction models but can be accommodated by variation/persistence models. (shrink)

The phenomenological effects of deep brain stimulation (DBS) on the self of the patient remains poorly understood and under described in the literature, despite growing evidence that a significant number of patients experience postoperative neuropsychiatric changes. To address this lack of phenomenological evidence, we conducted in-depth, semistructured interviews with 17 patients with Parkinson's disease who had undergone DBS. Exploring the subjective character specific to patients' experience of being implanted gives empirical and conceptual understanding of the potential phenomenon of DBS-induced self-estrangement. (...) Our study concluded that (1) the more patients preoperatively felt alienated by their illness, the more they experienced postoperative self-estrangement, and (2) the notion of self-estrangement seems to exist in association with certain common qualitative characters, namely, loss of control, which reflects a deteriorative estrangement, and distorted perception of capacities, which reveals a restorative estrangement. These findings indicate that subjective self-reports help us to understand some aspects of the potential phenomenon of DBS-induced self-estrangement. (shrink)

Phronesis is often described as a ‘practical wisdom’ adapted to the matters of everyday human life. Phronesis enables one to judge what is at stake in a situation and what means are required to bring about a good outcome. In medicine, phronesis tends to be called upon to deal with ethical issues and to offer a critique of clinical practice as a straightforward instrumental application of scientific knowledge. There is, however, a paucity of empirical studies of phronesis, including in medicine. (...) Using a hermeneutic and phenomenological approach, this inquiry explores how phronesis is manifest in the stories of clinical practice of eleven exemplary physicians. The findings highlight five overarching themes: ethos (or character) of the physician, clinical habitus revealed in physician know-how, encountering the patient with attentiveness, modes of reasoning amidst complexity, and embodied perceptions (such as intuitions or gut feeling). The findings open a discussion about the contingent nature of clinical situations, a hermeneutic mode of clinical thinking, tacit dimensions of being and doing in clinical practice, the centrality of caring relations with patients, and the elusive quality of some aspects of practice. This study deepens understandings of the nature of phronesis within clinical settings and proposes ‘Clinical phronesis’ as a descriptor for its appearance and role in the daily practice of (exemplary) physicians. (shrink)

This is an important new book about human motivation, about the reasons people have for their actions. What is distinctively new about it is its focus on how people see or understand their situations, options, and prospects. By taking account of people's understandings, Professor Schick is able to expand the current theory of decision and action. The author provides a perspective on the topic by outlining its history. He defends his new theory against criticism, considers its formal structure, and shows (...) at length how it resolves many currently debated problems: the problems of conflict and weakness of will, Allais' problem, Kahneman and Tversky's problems, Newcomb's problem, and others. The book will be of special interest to philosophers, psychologists, and economists. (shrink)

À la suite du printemps arabe, nombre de citoyens des démocraties occidentales se sont regroupés sur les places publiques pour afficher ouvertement leur indignation par rapport aux dérives du système démocratique affaibli par un pouvoir financier grandissant. Ce texte retrace le chemin qui a amené les auteurs à investir l’espace public. Pensée comme un espace inclusif où le citoyen peut se réapproprier son pouvoir par la discussion, l’écoute et l’autoéducation au vivre ensemble, l’occupation se définit d’abord par sa pratique. Ce (...) sont en effet des moyens alternatifs, et novateurs qui sont mobilisés pour faire face à la crise environnementale, politique, économique et sociale que le système économique capitaliste néolibéral exacerbe. De nombreux outils : réseau social international, réunions, bulletin heb­domadaire, actions, émissions de radios, créés durant l’occupation permettent aujour­d’hui au mouvement de se renouveler dans le but de redonner légitimité et force au réel pouvoir politique démocratique. (shrink)

La notion de compétence en milieu de travail est presque devenue un mot culte depuis le milieu des années 1990. Dans la foulée des réformes en éducation qui ont eu cours un peu partout en Occident, on a en effet mis de plus en plus l’accent sur la compétence plutôt que sur la connaissance et les savoirs dans les différents programmes scolaires, mais aussi dans les milieux de travail. À ce premier mouvement de réforme s’est ajoutée la transformation du monde (...) du travail qui oblige travailleurs... (shrink)