Background: Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing (...) the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making.Methods/DesignDyads (n = 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the end of the intervention and 6 months later to assess improvement in predictive accuracy and cost savings, if any. Copies of completed guides are made at the time of these assessments.DiscussionThis study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system.Trial RegistrationISRCTN89993391. (shrink)

This article summarily presents the explicitation interview with some examples of interviews. In the first part, referring to three excerpts from protocols, we consider some of the techniques used to guide a subject into an introspective posture. We show how these techniques create conditions conducive to access to pre-reflective knowledge, knowledge stemming from a moment of action experienced by the subject, of which the subject has no knowledge in the mode of reflective consciousness. Some of this knowledge is in fact (...) surprising both for the interviewer and for the interviewee. The experience or the expertise of the subject interviewed is invariably increased as a result. In the second part, we provide a brief insight into the fields of application of the explicitation interview, with reference to three case studies, which are presented in a vivid and detailed way . We conclude with a very brief panorama of the various known fields of application of the explicitation interview. (shrink)

The increase in women’s labor market participation emphasizes the importance of understanding maternal separation anxiety, that is, the unpleasant maternal emotional state, due to the actual or anticipated short-term separation from the child. Drawing on the insights of the attachment and psychoanalytic perspectives, the Maternal Separation Anxiety Scale was developed to overcome existing measurement gaps. However, prior research did not replicate its original three-factor structure in the contemporary context and in other cultural settings, using large samples composed of mothers of (...) preschool children. This study aimed to examine the factorial structure of the MSAS in a sample of 597 Portuguese mothers of children aged 5–84 months who completed the questionnaire. The exploratory factor analysis conducted in subsample 1 revealed a four-factor structure: Maternal Negative Feelings, Beliefs about Exclusive Maternal Care, Need of Proximity, and Perceptions of Separation Benefits for Children. Confirmatory factor analyses conducted in subsample 2 revealed that the original three-factor structure revealed a poor fit, whereas the four-factor solution revealed an acceptable fit. As in previous studies, our findings report deviations from the original three-factor structure of the MSAS. Three of the newly identified factors seem to reflect specific sub-dimensions that originally guided item development in the MSAS, namely, maternal negative feelings, maternal attitudes about the value of exclusive maternal care, and the need of proximity with the child. The last factor appears to represent a refinement of original items pertaining to perceptions about separation effects for children. (shrink)

What are individuals? How can they be identified? These are crucial questions for philosophers and scientists alike. Criteria of individuality seem to differ markedly between metaphysics and the empirical sciences - and this might well explain why no work has hitherto attempted to relate the contributions of metaphysics, physics and biology on this question. This timely volume brings together various strands of research into 'individuality', examining how different sciences handle the issue, and reflecting on how this scientific work relates to (...) metaphysical concerns. The collection makes a major contribution to clarifying and overcoming obstacles to the construction of a general conception of the individual adequate for both physics and biology, and perhaps even beyond. (shrink)

Nietzsche’s self-proclaimed ‘anti-political’(EH ‘wise’ 3; cf. TI 8.4) stance is often ignored.1 Commentators, that is, often interpret Nietzsche’s texts as responding to familiar issues within political philosophy, and as furnishing a novel position therein. This could indeed be the appropriate hermeneutic response. Dismissing one of Nietzsche’s proclamations is, on a variety of different grounds, hermeneutically reasonable. In this particular case, given all that Nietzsche has to say about sociality and the roles of public institutions in modern life, dismissal might even (...) seem compelling. Here, however, I wish to recuperate Nietzsche’s anti-political stance. That is, I shall argue that Nietzsche’s self-proclamation does in fact reflect his deep commitments, and thus compels a reassessment of the political interpretations of his thought. (shrink)

In this paper I argue that a basic problem in philosophical discussions of culture is what I call the “integration problem”: the need to provide an account of how distinctive considerations of culture can be integrated within practical deliberation in general. I then show how the failure to resolve this problem generates three paradoxes, which I call the “cosmopolitan paradox,” the “inclusion paradox,” and the “representation paradox.” I argue that these paradoxes arise from a common source, the attempt to separate (...) out determinations of worth from demands of recognition, and both from socially contested deliberative practices. I conclude by suggesting that resolving these paradoxes probably requires not a theoretical solution but the achievement of a fully inclusive, cosmopolitan culture. (shrink)

As James Caesar highlights in Reconstructing America, the word “globalization” seems sometimes to be synonymous with “Americanization” or “Americanism,” evoking negative images. Globalization may bring indigenous cultures to their death and cause national individualism to disappear into a shapeless muddle. On Americanism, Heidegger declared that it was “the future monstrosity of modern times.” This would be homogenization, the rubbing out of cultural specificity, life in one universe, one dimension. Extremists like Alexandre Kohève take it further still. It would be the (...) end of history. Third world nations, particularly the Caribbean countries, would be predesignated victims of such an order, without power in political or economic realms, only making the front page of newspapers during cataclysm and natural catastrophes like Hugo, George, and Mitch. The tiny island of Montserrat, never before known to the West, rose to international fame when its volcano La Soufrière began to erupt. Rwanda would be known for genocide, and the Congo for a civil war and the assassination of its leader. (shrink)

info:eu-repo/semantics/publishedVersion.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Will to Nothingness: An Essay on Nietzsche's by Bernard ReginsterRobert GuayBernard Reginster, The Will to Nothingness: An Essay on Nietzsche's On the Genealogy of Morality New York: Oxford University Press, 2022. viii + 202 pp. isbn: 978-0-19-886890-3. Cloth, $80.00.One might imagine making a rough division between two different modes of modern European philosophy. In one, the way that the world seems to proceed belies the actual ground (...) of things; the task of philosophy is to uncover the sources of our misunderstanding and identify the categories that account for genuinely real processes. The other mode of philosophy questions the determinacy and stability of the categories through which we make sense of the world. Here the task of philosophy is not to settle on the right categories or the actual ground, but to gain some purchase on our confusions and self-deceptions when we try to make sense of things. There may be some philosophers (Hegel and Wittgenstein, perhaps) who try to straddle the divide here. But in general the divide is great enough that if an interpreter mistakes one mode for the other it would be costly: no matter how circumspect the particular claims are, all the interpretive results will be misguided. Something like this, I want to claim, is the case with Bernard Reginster's The Will to Nothingness.There are many detailed discussions in Reginster's book. For the purpose of this review, however, I want to focus on the general critical argument, [End Page 104] in part because there is already at least one excellent review of the book (Mark Migotti's in Notre Dame Philosophical Reviews, June 1, 2022), and in part because I think it goes wrong at the level of its entire approach. On Reginster's account GM is composed of a series of "psychological studies" (3) of a version of Christian morality and its central aspects. These psychological studies treat moral judgments as symptoms of affective states, and in this way uncover the functional role that moralities play in the affective lives of agents. Moralities are "designed" (12), as it were, for emotional regulation. Christian morality, in particular, expresses the ressentiment of those beset by feelings of impotence and serves their will to power. Genealogical critique proceeds by uncovering the actual function of morality and then showing how well (or rather poorly) morality fulfills its proper function. Moral beliefs are supposed to enhance the agents' feeling of power, but instead work to sicken and enervate them, and indeed morality "incites" (46) such a pernicious functioning.While I am sympathetic to the idea that genealogy offers a functional assessment of morality, I think that Reginster has taken the wrong approach here. So now I want to draw a broad contrast between Reginster's approach and an alternative one, and then offer six sets of reasons for favoring the alternative approach.On Reginster's account, Nietzsche is interested in specifying and analyzing a precise conception of morality, with all of its attendant normative judgments, metaethical commitments, characteristic beliefs about moral psychology, and so on. These features were all, as constitutive of the morality in question, familiar to the believers in that morality. The purpose, then, of a historical account of origins is to give a unitary explanation for the adoption of the morality in terms of a single underlying affective condition and drive. Agents adopt moralities because, whether they realize it or not, holding moral beliefs facilitates a form of emotional self-regulation. To criticize these beliefs Nietzsche makes a sort of inverted teleological argument. He identifies the essential function of the beliefs and shows that they work against the fulfillment of their own function.Here, by contrast, is a different way of thinking about what Nietzsche is doing. He is not interested in explaining the moral beliefs of reflective, fully developed agents. Instead, he wants to explain how the semantic resources that contribute to morality could have become available at all. The puzzle, for Nietzsche, is how the basic terms of morality could ever even seem to make sense. So the historical account of genealogy is meant to suggest [End Page 105] social... (shrink)

The transference theory reduces causation to the transmission of physical conserved quantities, like energy or momenta. Although this theory aims at applying to all felds of physics, we claim that it fails to account for a quantum electrodynamic effect, viz. the Aharonov-Bohm effect. After having argued that the Aharonov-Bohm effect is a genuine counter-example for the transference theory, we offer a new physicalist approach of causation, ontic and modal, in which this effect is embedded.

In this study we examine college cheating behaviors of business students compared to non-business students, and investigate possible antecedents to cheating in an effort to better understand why and when students cheat. We specifically examine power values; we found that they were positively related to academic cheating in our sample, and that choice of major (business or non-business) partially mediated the relationship between power values and cheating. We also considered the extent to which students provide justifications for their cheating, and (...) found that business students were more likely to justify (rationalize) their cheating behaviors. Finally, we update the literature in terms of the ways students cheat. We assess newer forms of academic cheating, as increased accessibility to information via the Internet and smartphones may have changed the ways and ease with which students cheat – a particularly relevant topic currently, as many classes have moved online during the COVID-19 pandemic. In our study, cheating was especially prevalent when taking quizzes or tests or completing homework online. We found that only 10% of participants reported never engaging in any of the cheating behaviors we examined. (shrink)

The thesis of this paper is that consequentialism does not work as a comprehensive theory of right action. This paper does not offer a typical refutation, in that I do not claim that consequentialism is self-contradictory. One can with perfect consistency claim that the good is prior to the right and that the right consists in maximizing the good. What I claim, however, is that it is senseless to make such a claim. In particular, I attempt to show that the (...) notion of what course of action maximizes the good has no content within a consequentialist framework. Since the problem that I identify rests with maximization, this refutation does not cut across the act/rule distinction. If rule consequentialism holds that there are occasions on which one should follow a rule rather than violate the rule in an optimific way, then it is not maximizing and my arguments do not apply; if not, then it collapses into act consequentialism. I have nothing to say about nonmaximizing forms of consequentialism.1 This refutation does, however, cut across the direct/indirect distinction.2 It makes no difference whether we take consequentialism as offering a principle of decision, or a standard of right. Presumably the former would be parasitic upon the latter for its legitimacy. (shrink)

Comment aborder la souffrance conjugale dans la consultation de conseil conjugal et familial? Le couple qui pousse la porte du bureau d’une conseillère conjugale n’a pas d’a priori, il vient chercher une écoute, de l’aide. À travers quelques vignettes cliniques, l’auteur expose la spécificité de l’écoute et du soutien du conseiller conjugal.

Lors des entretiens pré- IVG chez les mineures dans le cadre du Centre de planification, la conseillère conjugale se pose la question de ce qu’il est nécessaire de connaître pour que cet entretien aide la jeune fille à vivre son interruption de grossesse et à affronter éventuellement ses parents. Comment poser des limites à cet entretien bien particulier? Que transmettre dans le dossier de la patiente et dans la synthèse avec les autres partenaires?

De nos expériences de conseillères conjugales et familiales, nous avons le sentiment d’un féminin difficile à représenter, comme si les jeunes femmes “zappaient” le féminin pour le maternel. À partir de situations auprès de groupes d’adolescentes et d’adultes, les deux auteures se sont attachées à saisir ce qui vient se dire du féminin chez les jeunes filles et leurs parents. Elles en discutent la spécificité de leurs places en tant que conseillères conjugales et familiales comme créatrices d’un espace de transmission.

In this paper, we show that it is not a conceptual truth about laws of nature that they are immutable (though we are happy to leave it as an open empirical question whether they do actually change once in a while). In order to do so, we survey three popular accounts of lawhood—(Armstrong-style) necessitarianism, (Bird-style) dispositionalism and (Lewis-style) ‘best system analysis’—and expose the extent, as well as the philosophical cost, of the amendments that should be enforced in order to leave (...) room for the possibility of changing laws. (shrink)

The accounts of social freedom offered by G. W. F. Hegel and Axel Honneth identify the normative demands on social institutions and explain how individual freedom is realized through rational participation in such institutions. While both offer normative reconstructions of the market economy, public sphere and family, they both derive the norms of educational institutions from education’s role in preparing people for participation in other institutions. We argue that this represents a significant defect in their accounts of social freedom because (...) they both fail to account for the distinctive aims and norms of education. Only educational institutions bring individuals into a both shared and autonomous standpoint necessary for participation in social life. We thus argue both that Hegel’s and Honneth’s accounts are empirically inadequate and that they neglect the normative demands on schools to contribute to individual moral and intellectual development. (shrink)

Bien que le thème de la révolution soit marginal dans l’œuvre de Gustav Chpet, il nous permet d’éclairer certains aspects importants de sa vie et de sa pensée. Le rapport de Chpet à la révolution a évolué entre ses années de jeunesse et l’année 1922, où il écrit sa préface à l’Aperçu du développement de la philosophie russe. Dans ce texte, ce qu’il entend par « révolution » ne correspond pas non plus aux événements historiques qu’il vient de traverser. Il (...) y définit la révolution en l’opposant au projet de l’intelligentsia et en la plaçant du côté de la vraie vie. Il la pense comme une perspective permettant d’allier le développement de la culture et l’épanouissement de la personne humaine. En nous référant à ses écrits, nous montrerons que, pour lui, il ne s’agissait pas d’une utopie mais, au contraire, des conditions de résistance à toute forme d’autoritarisme intellectuel. C’est cela qui, s’enracinant dans l’idée fondamentale de son œuvre, lui permit aussi d’accomplir au mieux sa tâche de philosophe. (shrink)

Christians, Allison, Benoît-Guay, Nicolas.

Formées au conseil conjugal et familial dans une approche psychanalytique, deux conseillères conjugales et familiales montrent comment cette formation colore leur accompagnement à la vie affective, relationnelle et sexuelle et à son « éducation », prévue par la loi en milieu scolaire et en milieu spécialisé. Elles partagent ce qui les a guidées pour construire des projets spécifiques, au-delà de la simple prévention/information, allant souvent jusqu’à la mise en place de groupes de parole dédiés à l’ evars. Elles décrivent leurs (...) expériences aussi bien avec les jeunes et les usagers qu’avec les professionnels, les familles, les structures. (shrink)

Natural modalities are often analysed from an abstract point of view where they are associated with putative laws of nature. However, the way possibilities are represented in physics is more complex. Lagrangian mechanics, for instance, involves two different layers of modalities: kinematical and dynamical possibilities. This paper examines the status of these two layers, both in the classical and quantum case. The quantum case is particularly problematic: we identify four possible interpretive options. The upshot is that a close inspection of (...) the way possibilities are represented in physics could lead to new ways of thinking about natural modalities. (shrink)