Volume 19, Issue 5, May 2019, Page 31-33.

Det er muligens ikke lenger et spørsmål om, men når mennesker med Downs syndrom ikke lenger finnes blant oss. Moderne medisinsk teknologi brukt i masseundersøkelser av gravide, tilsier at det nesten ikke behøver å bli født mennesker med Downs syndrom i fremtiden. I den politiske debatten i flere av de nordiske landene er dette kontroversielt. Det handler om et samfunn der det er plass til alle, hevdes det. På samme tid tas moderne genteknologi i bruk for bl.a. å forhindre at (...) mennesker disponert for Huntingtons sykdom eller arvelig brystkreft blir født. Om noen generasjoner kan slike sykdommer være utryddet. Dette påkaller imidlertid ikke henvisninger til «sortering» og «seleksjon». I denne artikkelen undersøkes de viktigste forutsetningene for hvorfor fosterdiagnostikk på noen indikasjoner vekker etisk debatt, mens det ikke skjer i andre tilfeller. Det argumenteres for at den medisinske forståelsen av alvorlighetsgrad ved en sykdom/funksjonshemming ikke gir oss nøkkelen til å forstå den etiske bekymringen rundt seleksjon. Identitets- og anerkjennelsesproblematikk, hevdes det, er kjernen i kontroversene rundt fosterdiagnostikk i Norden. Derfor står det noe vesentlig på spill i fosterdiagnostikkdebatten. Men bare for noen grupper. (shrink)

Advances in neonatology have led to improved survival for periviable infants. Immaturity still carries a high risk of short- and long-term harms, and uncertainty turns provision of life support int...

Dette nummeret av Etikk i praksis er i utgangspunktet ikke et temanummer. Profesjonsetiske utfordringer synes likevel å utgjøre et gjennomgangstema i de fleste av artiklene som utgis i dette nummeret. Det er en påminnelse om at en aldri blir ferdig med etiske problemstillinger innenfor et fagfelt, siden fagfeltene og profesjonelle oppgaver samt forventninger til profesjonen forandres hele tiden.

I dette nummeret av Etikk i praksis ønsker vi å fokusere på et betent problemområde, nemlig etikken rundt teknologisk fravalg og tilvalg av fremtidige syke og funksjonshemmede barn. Det handler om abort, medisinsk teknologi og valg av barn. Det kan synes som om vi står overfor nye muligheter for fravalg og tilvalg som ikke bare setter en ny debatt, men som samtidig krever en tilbakevending og nyåpning av tidligere gjennomdiskuterte spørsmål og tema. Debattene rundt «valg av barn» berører dype, eksistensielle (...) dimensjoner ved menneskelivet. I tillegg berører det store samfunnsmessige temaer som inklusjon og menneskeverd, selvbestemmelse, abort, eugenikk og samfunnets forståelse av funksjonshemming. (shrink)

Idrettens etiske spørsmål oppleves særdeles engasjerende for svært mange mennesker. Enten man er topp- eller breddeidrettsutøver, TV-titter, foreldre til idrettsaktive barn eller man har en idrettsbarndom bak seg – hvilket til sammen utgjør en stor del av befolkningen – så oppleves idrettens etiske utfordringer så å si på kroppen. Juks og urettferdighet i idretten setter følelsene i kok.

Norway’s liberal abortion law allows for abortion on social indications, yet access to screening for fetal abnormalities is restricted. Norwegian regulation of, and public discourse about prenatal screening and diagnosis has been exceptional. In this study, we wanted to investigate whether the exceptional regulation is mirrored in public attitudes. An electronic questionnaire with 11 propositions about prenatal screening and diagnosis was completed by 1617 Norwegian adults (response rate 8.5%). A majority of respondents supports increased access to prenatal screening with ultrasound (...) (60%) and/or full genome sequencing of fetal DNA (55%) available for all pregnant women. Significant minorities indicate, however, that a public offer of prenatal screening for all pregnant women would signal that people with Down syndrome are unwanted (46%) or could be criticized for contributing to a ‘sorting society’ (48%). Results indicate deeper ambivalences and a cultural sensitivity to the ethical challenges of prenatal screening and subsequent abortions. The specific diagnosis of Down syndrome and the fear of becoming a ‘sorting society’ which sorts human life due to diagnoses, appear to play prominent roles in citizen deliberations. The low response rate means that a non-response bias cannot be excluded, yet reasons why results are still likely to be of value are discussed. (shrink)

A rapidly growing proportion of health research uses ‘secondary data’: data used for purposes other than those for which it was originally collected. Do researchers using secondary data have an obligation to disclose individual research findings to participants? While the importance of this question has been duly recognised in the context of primary research, it remains largely unexamined in the context of research using secondary data. In this paper, we critically examine the arguments for a moral obligation to disclose individual (...) research findings in the context of primary research, to determine if they can be applied to secondary research. We conclude that they cannot. We then propose that the nature of the relationship between researchers and participants is what gives rise to particular moral obligations, including the obligation to disclose individual results. We argue that the relationship between researchers and participants in secondary research does not generate an obligation to disclose. However, we also argue that the biobanks or data archives which collect and provide access to secondary data may have such an obligation, depending on the nature of the relationship they establish with participants. (shrink)

Da dette tidsskriftet ble etablert for seks år siden, var det ut fra tanken om at det finnes noen felles problemstillinger innen etikk og politikk som får en spesiell karakter i nordiske land. Den velferdsmodellen vi har utviklet innenfor rammene av et deltakende demokrati, gir vilkår for debatten som vi ikke deler fullt ut med de fleste andre demokrati i verden. Mange av de artiklene vi har trykket i disse årene, har vist betydningen av denne nordiske konteksten. Det gjelder også (...) noen av bidragene i dette nummeret. (shrink)

Rosamond Rhodes and John Harris have both recently argued that we all have a general moral duty to participate in medical research. However, neither Rhodes' nor Harris' arguments in support of this obligation stand up to scrutiny, and severe and convincing criticism has been levelled against their case. Still, to refute their arguments is not to refute the conclusion. There seems to be some truth in the view that when people are asked to take part in medical research, their choice (...) is not completely morally neutral. In this article, we argue that the proper question to ask is when, rather than if, a certain moral duty to volunteer for medical research can be appealed to. To answer this question, we need a denser description of relevant research projects and their context rather than just describing medical research in general. Drawing on our study of participants in the Norwegian HUNT biobank, we use the normative implications of the Norwegian concept «dugnad» as an analogy to discuss the requirement of providing neutral information to potential biobank participants in order to promote their free and informed decision as to whether or not to take part. We suggest that normative recruitment is not just a question of principles and ethics. It is also a question of research design and the creation of the common good in the community where the research takes place. (shrink)

Great hope has been placed on biobank research as a strategy to improve diagnostics, therapeutics and prevention. It seems to be a common opinion that these goals cannot be reached without the participation of commercial actors. However, commercial use of biobanks is considered morally problematic and the commercialisation of human biological materials is regulated internationally by policy documents, conventions and laws. For instance, the Council of Europe recommends that: “Biological materials should not, as such, give rise to financial gain”. Similarly, (...) Norwegian legislation reads: “Commercial exploitation of research participants, human biological material and personal health data in general is prohibited”. Both articles represent kinds of common moral intuitions. A problem, however, is that legislative documents are too vague and provide room for ample speculation. Through the use of focus group interviews with Norwegian biobank donors, we have tried to identify lay intuitions and morals regarding the commercial use of biobanks. Our findings indicate that the act of donation and the subsequent uses of the samples belong to two different spheres. While concerns around dignity and commodification were present in the first, injustice and unfairness were our informants’ major moral concerns in the latter. Although some opposition towards commercial actors was voiced, these intuitions show that it is possible to render commercial use of biobanks ethically acceptable based on frameworks and regulations which hinder commodification of the human body and promote communal benefit sharing. (shrink)

Den dominerende oppfatningen i den politiske og moralfilosofiske tenkningen de siste tiår har vært at religion ikke bør spille noen avgjørende politisk rolle i det moderne sekulariserte demokrati. Religion tilhører privatsfæren, og politiske avgjørelser må fattes på et felles grunnlag, uavhengig av livssyn. De mest sentrale tenkerne i vår tids politiske filosofi, John Rawls og Jürgen Habermas, har begge i tidlige arbeider gitt uttrykk for at dette er en oppfatning som vil få en allmenn, global tilslutning, for de ser modernisering (...) og sekularisering som to sider av samme sak. Det er nærmest to uunngåelige fenomen ettersom globalisering og modernisering vil føre til svekkelse av tradisjonelle kulturer og utbredelse av individualisme og demokratiske idealer. Bakgrunnen for dette temanummeret er at en rekke erfaringer fra de siste tiår har ledet til en gjenåpning av spørsmålet om religionens plass i sekulariserte samfunn. (shrink)

Velkommen til Etikk i praksis – Nordic Journal of Applied Ethics. Gjennom dette tidsskriftet ønsker vi å bidra til bedre kontakt mellom forskere innenfor anvendt etikk i Norden. Det finnes et økende antall forskere som arbeider med anvendte etiske problemstillinger, og anvendt etikk har blitt et tverrfaglig forskningsfelt i alle nordiske land. Etikk i praksis har som mål å gjøre den anvendte etikken i Norden sterkere og synligere.

Mat er så mangt, som David Kaplan påpeker i innledningen til The Philosophy of Food, blant annet næring, natur, kultur, et sosialt gode, åndelighet, begjærsgjenstand og estetisk objekt. Ikke minst er det et politisk tema på så mange måter. Derfor inviterte vi til et temanummer om matens etikk, for det er lite som berører våre liv så sterkt og fundamentalt som mat. Det er et område som til alle tider har hatt tydelige etiske regler, både hva man kan og ikke (...) kan spise, men også hvordan man skal behandle mat. I Første Mosebok står det: «Med svette i ansiktet skal du spise ditt brød». Vi gjør oss fortjent til å spise gjennom vårt arbeid. Til det er det også knyttet sterke tradisjoner rundt det å dele mat, takke for den, behandle den med respekt og ikke la noe gå til spille. Dette er tradisjoner som står stadig svakere ettersom vår kontakt med opphavet til mat i jordbruk, jakt og fiske blir svekket. Vi står ikke lenger i et direkte og intimt forhold til maten i vår del av verden, og det får betydning for matens etikk. (shrink)

Moderne samfunn synes mer sårbare enn vi synes å like og ta inn over oss. Flere tenkere som Ulrich Beck og Anthony Giddens har påpekt sammenhengen mellom teknologi, kompleksitet og risiko som et særtrekk ved det moderne samfunnet. De teknologier som bidrar til vår velstand og trygghet, er samtidig opphav til nye former for risiko. Vi utsettes dermed for risikoformer som er skapt av en utvikling vi alle har medansvar for, og som ingen enkeltpersoner eller grupper alene kan bære ansvaret (...) for. Det førmoderne livet var farefullt, og samfunnet ble utsatt for alvorlige kriser, men det var en type krise man i mindre grad kunne kalle menneskeskapt og som vi derfor ikke behøvde å laste oss selv og andre for. Noen av de mest alvorlige av vår tids kriser, derimot, er knyttet til våre egne, kollektive handlinger, og det stiller oss overfor spesifikt moderne etiske og politiske utfordringer. (shrink)

Dette nummeret av Etikk i praksis fokuserer på et av de største, om ikke det største, satsningsområdet vi har sett innenfor forskningsverdenen. Det handler om nanoteknologi, et felt som forventes å få betydelige positive samfunnsmessige konsekvenser i form av industriutvikling og forbedrede produkter for befolkningen. Nanoteknologien er et omfattende og uoversiktlig fagfelt, der det viktigste felles kjennetegnet er at en opererer med strukturer som er 100 nanometer eller mindre. Materialer i denne størrelsesorden har endrete egenskaper som innebærer en rekke nye (...) anvendelsesmuligheter innen medisin, elektronikk, fysikk og energiproduksjon. Artiklene i temadelen omhandler utfordringer og muligheter for utvikling av en etikk-komponent innenfor dette satsningsområdet. Når vi ser på hvor tidlig vi er i utvikling av nanoetikk som fagfelt, kan man spørre om det er for tidlig å ha et temanummer i et nordisk tidsskrift. Tross alt trenger en tid for å kunne si noe forskningsmessig interessant om et fagområde. Samtidig er det første internasjonale tidsskriftet for nanoetikk over ett år gammelt, og de nordiske land er generelt langt framme i teknologiutvikling, så det skulle være god grunn til å presentere feltet. I tillegg er de senere års studier av teknologiutvikling som en etisk og samfunnsmessig størrelse i økende grad opptatt av å være i forkant av utviklingen, og da er det rimelig å formidle tidlige resultat av denne oppstrømsforskningen. (shrink)

An increasing number of European research projects return, or plan to return, individual genomic research results (IRR) to participants. While data access is a data subject’s right under the General Data Protection Regulation (GDPR), and many legal and ethical guidelines allow or require participants to receive personal data generated in research, the practice of returning results is not straightforward and raises several practical and ethical issues. Existing guidelines focusing on return of IRR are mostly project-specific, only discuss which results to (...) return, or were developed outside Europe. To address this gap, we analysed existing normative documents identified online using inductive content analysis. We used this analysis to develop a checklist of steps to assist European researchers considering whether to return IRR to participants. We then sought feedback on the checklist from an interdisciplinary panel of European experts (clinicians, clinical researchers, population-based researchers, biobank managers, ethicists, lawyers and policy makers) to refine the checklist. The checklist outlines seven major components researchers should consider when determining whether, and how, to return results to adult research participants: 1) Decide which results to return; 2) Develop a plan for return of results; 3) Obtain participant informed consent; 4) Collect and analyse data; 5) Confirm results; 6) Disclose research results; 7) Follow-up and monitor. Our checklist provides a clear outline of the steps European researchers can follow to develop ethical and sustainable result return pathways within their own research projects. Further legal analysis is required to ensure this checklist complies with relevant domestic laws. (shrink)

Few sports-related events have generated as much controversy as the steroid crisis in baseball. Both ardent fans and casual observers wonder why professional baseball players would choose to use such substances when their use was viewed as outside the bounds of fair play. This article attempts to answer that question by applying concepts from the area of organizational culture. Understanding the culture of baseball and the ways leaders embedded and strengthened that culture adds insight into the decisions by athletes to (...) engage in steroid use. In general, such use was consistent with the already-existing culture. In addition, key decisions and events likely created the conditions in which steroid use was more likely. (shrink)

The first book that presents key original texts from the modern German philosophical tradition to English-language students and scholars of German, with introductions, commentaries, and annotations that make them accessible.

BackgroundThe state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-fertilisation between the academic (...) fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities.DiscussionTwo questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, ‘When is the worst time to die?’ A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die.ConclusionsDeprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global Burden of Disease. Finally, we suggest that the Time-Relative Interest Account may serve as an alternative to the discounting and age weighting previously applied in the Global Burden of Disease. (shrink)

The aim of this article is to study the relationship between Epicureanism and pandemic priority-setting and to explore whether Epicurus's philosophy is compliant with the later developed utilitarianism. We find this aim interesting because Epicurus had a different way of valuing death than our modern society does: Epicureanism holds that death—understood as the incident of death—cannot be bad (or good) for those who die (self-regarding effects). However, this account is still consistent with the view that a particular death can be (...) bad for everyone else but those who die, such as family, friends, and society (other-regarding effects). During the pandemic, the focus has been on the number of deaths more than on the suffering and reduced well-being of those infected and the rest of society. However, since the pandemic requires prioritization, it is, on a utilitarian account, important to consider priorities that do the most good overall. In this article, we approach the harm of death from an Epicurean point of view, seeking to flesh out potential implications for pandemic priority-setting, and healthcare in general, using a case study of COVID-19 priority-setting. We also explore whether this would conflict with utilitarianism. We conclude that an Epicurean pandemic priority-setting approach would be different but, surprisingly, not radically different from many of the actual priority-setting decisions we saw under the COVID-19 pandemic. (shrink)

In the Global Burden of Disease study, disease burden is measured as disability-adjusted life years (DALYs). The paramount assumption of the DALY is that it makes sense to aggregate years lived with disability (YLDs) and years of life lost (YLLs). However, this is not smooth sailing. Whereas morbidity (YLD) is something thathappens toan individual, loss of life itself (YLL) occurs when that individual’s life has ended. YLLs quantify something that involves no experience and does not take place among living individuals. (...) This casts doubt on whether the YLL is an individual burden at all. If not, then YLDs and YLLs are incommensurable. There are at least three responses to this problem, only one of which is tenable: a counterfactual account of harm. Taking this strategy necessitates a re-examination of how we count YLLs, particularly at the beginning of life. (shrink)

In recent years, it has become commonplace among the Global Burden of Disease study authors to regard the disability-adjusted life year primarily as a descriptive health metric. During the first phase of the GBD, it was widely acknowledged that the DALY had built-in evaluative assumptions. However, from the publication of the 2010 GBD and onwards, two central evaluative practices—time discounting and age-weighting—have been omitted from the DALY model. After this substantial revision, the emerging view now appears to be that the (...) DALY is primarily a descriptive measure. Our aim in this article is to argue that the DALY, despite changes, remains largely evaluative. Our analysis focuses on the understanding of the DALY by comparing the DALY as a measure of disease burden in the two most significant phases of GBD publications, from their beginning to the most recent releases. We identify numerous assumptions underlying the DALY and group them as descriptive or evaluative. We conclude that while the DALY model arguably has become more descriptive, it remains, by necessity, largely evaluative. (shrink)

PurposeSocial media has increased as a marketing channel, and Facebook is the biggest social media company globally. Facebook contains both positive and negative information about companies; therefore, it is important for companies to manage their Facebook page to best serve their own interests. Although most users are familiar with business and marketing activities on Facebook, they use it primarily for fun and personal purposes. The most effective methods for companies to use Facebook have not been clear. The personal nature of (...) Facebook presents unique challenges for companies by raising ethical and social responsibility issues that are important to users. The purpose of this paper is to discover how companies can optimize their use of Facebook as a marketing channel.Design/methodology/approachA survey was conducted. The respondents were 158 users of Facebook in Sweden; complete answers were provided by all respondents. In a series of specific questions and comments, the respondents were asked to describe an optimal marketing solution on Facebook for companies. They rated different functions, which were illustrated with pictures, to help in the cognitive process and to avoid misunderstandings.FindingsMost users who have an opinion on the issue accept marketing on Facebook, but only in the right amount. There are basically two groups: those who think that companies have no place on Facebook and those who want companies to be active on Facebook. The latter group emphasizes the importance of meaningful posts without unsolicited sales messages, and would prefer to search for the companies themselves rather than being bombarded by company messages. By far, status updates and pictures/images were found to be the most important functions to respondents.Research limitations/implicationsThe sample consisted of only Swedish users. Another limitation was that, since many Facebook users do not normally think about the implications of being exposed to marketing on Facebook, they have difficulty taking a position on many issues related to the service.Practical implicationsThe results give companies a clear idea of how to effectively use Facebook in their marketing efforts.Originality/valueA large number of companies are currently asking themselves, “How can we use Facebook in an optimal way?” The results in this study answer this question and lead directly to saving time and resources for these companies. (shrink)

Telling the story of three overlooked revolutionary thinkers, Liberty in Their Names explores the lives and works of Olympe de Gouges, Sophie de Grouchy and Manon Roland. All three were thinking and writing about political philosophy, especially equality and social justice, before the French Revolution. As they became engaged in its efforts, their political writing became more urgent. At a time when women could neither vote nor speak at the Assembly, they became influential through their writings. Yet instead of Gouges, (...) Grouchy and Roland, we speak of Voltaire, Rousseau and Diderot. -/- Sandrine Bergès examines the lives and writings of these trailblazing women philosophers, and their impact on philosophical thought during the French Revolution. Featuring pictures, a timeline and a bibliography of their works, this book offers exciting new insights into the history of political philosophy and of the French Revolution. (shrink)

This paper investigates conceptions of explanation, teleology, and analogy in the works of Immanuel Kant (1724-1804) and Georges Cuvier (1769-1832). Richards (2000, 2002) and Zammito (2006, 2012, 2018) have argued that Kant’s philosophy provided an obstacle for the project of establishing biology as a proper science around 1800. By contrast, Russell (1916), Outram (1986), and Huneman (2006, 2008) have argued, similar to suggestions from Lenoir (1989), that Kant’s philosophy influenced the influential naturalist Georges Cuvier. In this article, I wish to (...) expand on and further the work of Russell, Outram, and Huneman by adopting a novel perspective on Cuvier and considering (a) the similar conceptions of proper science and explanation of Kant and Cuvier, and (b) the similar conceptions of the role of teleology and analogy in the works of Kant and Cuvier. The similarities between Kant and Cuvier show, contrary to the interpretation of Richards and Zammito, that some of Kant’s philosophical ideas, whether they derived from him or not, were fruitfully applied by some life scientists who wished to transform life sciences into proper sciences around 1800. However, I also show that Cuvier, in contrast to Kant, had a workable strategy for transforming the life sciences into proper sciences, and that he departed from Kant’s philosophy of science in crucial respects. (shrink)

The welfare of the child is the prevailing principle and concern regarding access to assisted reproduction in Western countries today, and there is a wish to avoid harm to future children. New research fields have developed in order to provide scientific evidence on the welfare of children living with different “types” of parents. Assisted reproductive technologies (ART) seems to be heading in a responsible direction where the care and concern for future children is vital. However, the claim of this article (...) is that the principle of the welfare of the child confuses the ethical framing of ART. Several philosophers in the past have argued that potential people must be regarded as outside the moral domain, and therefore cannot be harmed or benefitted. This message has not reached the policymakers, probably because the welfare of the child principle seems to fit so elegantly with common sense. In this article a different ethical framing of ART is proposed. The author argues that “futile care” and not “the welfare of the child” should be the guiding principle for eventually rejecting access to ART. The desired goal of ART treatment should be understood to be the production of functional families. Assisted reproduction is primarily about us, actual people in an actual society, and how potential children may affect us. (shrink)

There are inherent difficulties in a subject like chemistry particularly the notion of a chemical reaction. In this paper the difficulties are discussed from a teaching and learning perspective and from a history of chemistry perspective. Three teaching/learning studies of the incompleteness of the iron thiocyanate reaction in chemical equilibrium are reviewed and it is shown that a recent historical study of the iron thiocyanate reaction has the potential to challenge the interpretation of the incompleteness of the reaction. This establishes (...) a controversial context where students can be introduced to epistemic thinking, that is, how to interrogate chemistry data and form a conclusion which resonates with what we know about the nature of science. A curriculum suggestion for pre-service chemistry teachers is provided. (shrink)

Death is something we mourn or fear as the worst thing that could happen―whether the deaths of close ones, the deaths of strangers in reported accidents or tragedies, or our own. And yet, being dead is something that no one can experience and live to describe. This simple truth raises a host of difficult philosophical questions about the negativity surrounding our sense of death, and how and for whom exactly it is harmful. The question of whether death is bad has (...) occupied philosophers for centuries, and the debate emerging in philosophical literature is referred to as the "badness of death." Are deaths primarily negative for the survivors, or does death also affect the deceased? What are the differences between death in fetal life, just after birth, or in adolescence? In order to properly evaluate deaths in global health, we must find answers to these questions. -/- In this volume, leading philosophers, medical doctors, and economists discuss different views on how to evaluate death and its relevance for health policy. This includes theories about the harm of death and its connections to population-level bioethics. For example, one of the standard views in global health is that newborn deaths are among the worst types of death, yet stillbirths are neglected. This raises difficult questions about why birth is so significant, and several of the book's authors challenge this standard view. -/- This is the first volume to connect philosophical discussions on the harm of death with discussions on population health, adjusting the ways in which death is evaluated. Changing these evaluations has consequences for how we prioritize different health programs that affect individuals at different ages, as well as how we understand inequality in health. (shrink)

Dr André Berge : médecin et psychanalyste, est directeur médical du Centre psycho-pédagogique Claude Bernard. Les données traditionnelles, toutes les valeurs, tous les principes sont discutés et sans cesse remis en cause. Et pourtant, personne ne saurait échapper à la nécessité d’adopter dans l’existence une ligne de conduite — c’est-à-dire une morale — sous peine de sombrer dans l’incohérence. Mais l’homme, s’il a besoin d’une morale, n’en est pas moins enclin à l’utiliser pour s’écraser lui-même et tend parfois à (...) transformer cet instrument en une arme qu’il lui arrive de retourner contre sa propre personne. C’est cela qu’il s’agit d’empêcher. Ce que veut établir cet ouvrage, ce sont les bases d’une morale psychologique tendant à remédier au désarroi des esprits et à contribuer à l’avènement d’un nouvel humanisme. (shrink)

Historical case studies of scientific concepts are a useful medium for showing how scientific ideas originate and how they change over time. They are thus a useful tool for conveying knowledge about the nature of science. This paper focuses on the concepts of heat and temperature and discusses some issues related to choosing the content for a historical case study which incorporates not only nature of science perspectives but understandings related to what we know about the teaching and learning of (...) these concepts. The case study is designed for first-year university chemistry students as an introduction to their study of thermodynamics. The paper includes a general chemistry textbook analysis of the heat and temperature concepts and a discussion of the caloric theory of heat, thermometry, and a brief survey of how the energy concept transformed our understanding of heat and temperature. (shrink)

Adopting the methods of Ethnomethodology and Conversation Analysis, this article aims to add to our knowledge of the dynamics and resistance in professional-client encounters. It does this by examining the argumentative function of second-hand assessments in the setting of vocational rehabilitation. In the situated negotiation of appropriate work-targeted initiatives, the practice of reporting second-hand assessments functions either as ‘opposing’ the professional’s investigations, or, when used in initiating turns, as ‘promoting’ the client’s case. Regarding the first, second-hand assessments provide opportunities to (...) oppose and redirect the institutional agenda. That is, the issue introduced by the professional is fended off more or less openly through second-hand accounts, which provide a presumptive better grasp on the matter at hand. (shrink)

Schopenhauer, "le vieux prophete", disait Nietzsche. Paru en 1819 dans l'obscurite la plus totale, son ouvrage majeur, Le Monde comme Volonte et comme representation, lui a valu d'atteindre en 1900 a une celebrite posthume telle qu'aucun penseur n'en a jamais connue - influence que son extension meme a fini par occulter aujourd'hui. Car Schopenhauer a fait cristalliser la crise des croyances qui marque la fin du XIXe siecle, dessinant pour l'avenir la physionomie de l'homme moderne. Un homme qui sous un (...) ciel vide eprouve dans le ressentiment la condition qu'il s'est lui-meme assignee : un intellect regi secretement par des pulsions irrationnelles, une concurrence vitale qui l'isole de ses semblables et de la nature, une sexualite dominatrice mais sans joie, une irresponsabilite aveugle vis-a-vis de son propre comportement comme de l'histoire collective, bref l'enracinement de son existence entiere dans une inconscience fondamentale. Nietzsche et Freud n'ont pas ete les seuls heritiers de Schopenhauer qui a remodele ce territoire invisible sur lequel la litterature edifie son discours. Aussi est-il present, on l'ignore generalement, dans la genealogie de tant de grands ecrivains - de Tolstoi, Strindberg, Maupassant, Conrad, Proust, Pirandello, jusqu'a Kafka, Thomas Mann, Celine, Beckett, Bernhard. Ce sont les voies de ce renouvellement inventif qui sont ici tracees. (shrink)

The overarching aim of this article is to scrutinize how severity can work as a qualifier for the moral impetus of malady. While there is agreement that malady is of negative value, there is disagreement about precisely how this is so. Nevertheless, alleviating disease, injury, and associated suffering is almost universally considered good. Furthermore, the strength of a diseased person’s moral claims for our attention and efforts will inevitably vary. This article starts by reflecting on what kind of moral impetus (...) malady incites. We then analyze how severity may qualify this impetus. We do so by discussing the relationship between severity and need, well-being and disvalue, death, urgency, rule of rescue, and distributive justice. We then summarize our thoughts about severity as a moral qualifier. We conclude that severity is, and should continue to be seen, as a morally significant concept that deserves continued attention in the future. (shrink)

The legalization of physician-assisted suicide (PAS) in various U.S. states draws into question the interpretation of the cardinal virtues of medicine, including beneficence, non-maleficence, auton...

Le projet de réforme de la Chancellerie du 13 mars 2017 consacre pour l’essentiel les solutions dégagées depuis plusieurs décennies par la jurisprudence en matière de réparation des dommages résultant d’une atteinte à un bien corporel dont la finalité est de trouver un juste équilibre entre le droit de la victime à obtenir la réparation intégrale de ses préjudices et la nécessité de ne pas sacrifier les intérêts du responsable.

La présente contribution analyse le rôle du principe de précaution lorsque des médicaments ou des vaccins exposent les patients à un risque d’atteintes corporelles. S’il était pleinement consacré en droit de la responsabilité civile, le principe de précaution permettrait de faire peser sur les laboratoires pharmaceutiques, non seulement la charge des dommages que les médicaments ou les vaccins causent, mais encore celle des risques graves et irréversibles, même scientifiquement incertains, auxquels ils exposent les patients, ce qui peut sembler injuste. L’examen (...) du droit positif montre cependant que le principe de précaution a d’ores et déjà contribué à assouplir les conditions de la responsabilité civile en matière de médicaments et de vaccins. (shrink)