The analysis of identity in cases of memory loss, particularly in Alzheimer’s disease, sheds light on relevant philosophical and practical concerns, such as decision-making processes, autonomy, and the improvement of interaction with patients. Literature on psychological continuity recognizes identity when there are no disruptions in memory, which is certainly not the case in Alzheimer´s disease. Narrative identity, particularly in its relational and non-relational versions, delivers tools which are not exempt from difficulties. Either the caregivers’ narrative or the patient’s narrative is (...) dismissed. Furthermore, if there is a contradiction of narratives in relational theories, we are advised to either find the best narrative or seek agreement. However, one option rejects one narrative, while the other is unattainable in practice for the case in question. Hence, we propose drawing from ironism (Rorty, 1989), which suggests duality of dialogues when dealing with problems. This will be used to defend that the narratives of both, a person with Alzheimer and those close to them, are valid when constituting identity of the former. In this case, we will articulate and defend relational ironism, which allows us to embrace inconsistent narratives without seeking agreements. According to this, personal identity in this case is in constant tension between the narratives of those who suffer Alzheimer’s disease and the narratives of those close to them. We close illustrating possible benefits for how best to interact with patients. (shrink)

Is the mammalian embryo/fetus a part of the organism that gestates it? According to the containment view, the fetus is not a part of, but merely contained within or surrounded by, the gestating organism. According to the parthood view, the fetus is a part of the gestating organism. This paper proceeds in two stages. First, I argue that the containment view is the received view; that it is generally assumed without good reason; and that it needs substantial support if it (...) is to be taken seriously. Second, I argue that the parthood view derives considerable support from a range of biological and physiological considerations. I tentatively conclude in favour of the parthood view, and end by identifying some of the interesting questions it raises. (shrink)

A 2017 Nature report was widely touted as hailing the arrival of the artificial womb. But the scientists involved claim their technology is merely an improvement in neonatal care. This raises an under-considered question: what differentiates neonatal incubation from artificial womb technology? Considering the nature of gestation—or metaphysics of pregnancy—(a) identifies more profound differences between fetuses and neonates/babies than their location (in or outside the maternal body) alone: fetuses and neonates have different physiological and physical characteristics; (b) characterizes birth as (...) a physiological, mereological and topological transformation as well as a (morally relevant) change of location; and (c) delivers a clear distinction between neonatal incubation and ectogestation: the former supports neonatal physiology; the latter preserves fetal physiology. This allows a detailed conceptual classification of ectogenetive and ectogestative technologies according to which the 2017 system is not just improved neonatal incubation, but genuine ectogestation. But it is not an artificial womb, which is a term that is better put to rest. The analysis reveals that any ethical discussion involving ectogestation must always involve considerations of possible risks to the mother as well as her autonomy and rights. It also adds a third and potentially important dimension to debates in reproductive ethics: the physiological transition from fetus/gestateling to baby/neonate. (shrink)

This article presents the critique of cybernetics as central to the history of one of the twentieth century’s most infamous avant-garde movements: the Situationist International (SI). Bringing together and analysing a series of seemingly marginal events in the build-up to May ’68, this article shows how the SI’s portrait of cybernetics as an emerging form of social power and control foreshadows later developments in French radical thought. This little-noted trajectory in the situationist movement also highlights the ways in which aesthetics, (...) theory, and politics are inextricably tied together in the events of May ’68. (shrink)

The literature on health and diseases is usually presented as an opposition between naturalism and normativism. This article argues that such a picture is too simplistic: there is not one opposition between naturalism and normativism, but many. I distinguish four different domains where naturalist and normativist claims can be contrasted: (1) ordinary usage, (2) conceptually clean versions of “health” and “disease,” (3) the operationalization of dysfunction, and (4) the justification for that operationalization. In the process I present new arguments in (...) response to Schwartz (2007) and Hausman (2012) and expose a link between the arguments made by Schwartz (2007) and Kingma (2010). Distinguishing naturalist claims at these four domains will allow us to make progress by (1) providing more nuanced, intermediate positions about a possible role for values in health and disease; and (2) assisting in the addressing of relativistic worries about the value-ladenness of health and disease. (shrink)

Mammalian synthetic biology holds the promise of providing novel therapeutic strategies, and the first success stories are beginning to be reported. Here we focus on the latest generation of mammalian transgene control devices, highlight state‐of‐the‐art synthetic gene network design, and cover prototype therapeutic circuits. These will have an impact on future gene‐ and cell‐based therapies and help bring drug discovery into a new era. The inventory of biological parts that are essential for life on this planet is becoming increasingly complete. (...) The postgenomic era has provided encyclopedic information on gene‐function correlations and systems biology is now delivering comprehensive details on the dynamics of biochemical reaction networks in living organisms. The time has come to reassemble these catalogued items and design new biological devices and systems with novel and useful functionality in a rational and systematic manner. This is the premise of synthetic biology, a constructive systems biology discipline likely to become the life science revolution of the 21st century. (shrink)

Le rôle majeur que jouent les sciences et les techniques dans les sociétés modernes et les mutations profondes qu’elles connaissent exigent de nouveaux moyens d’analyse. On ne peut désormais comprendre l’activité scientifique qu’en replaçant ses logiques propres dans leur contexte social. Il s’agit de saisir la pratique actuelle des sciences, en révisant les notions constitutives de leur histoire et de leur philosophie, comme l’expérimentation ou la preuve ; de penser les sciences en société, lorsqu’elles quittent le laboratoire et qu’elles interviennent (...) dans les grandes questions économiques, politiques et sociétales (OGM, nucléaire, etc.) ; de faire le point sur le statut des études récentes sur les sciences ( Science Studies ), en montrant ce qu’elles ont apporté de décisif, mais aussi ce qu’elles ignorent. Des laboratoires européens du XIXe siècle à la Silicon Valley aujourd’hui, c’est en s’appuyant sur de nombreux exemples historiques que ces études sont menées. Les savoirs scientifiques, mais aussi managériaux et économiques, participent à la mise en place de la société néolibérale, faisant surgir des questions cruciales comme celle de la possibilité d’une participation démocratique aux choix scientifiques et techniques, ou celle du sens de la notion de développement durable. C’est pourquoi la visée finale de ce livre est essentiellement politique. (shrink)

Christopher Boorse's Bio Statistical Theory (BST) defines health as the absence of disease, and disease as the adverse departure from normal species functioning. This paper presents a two-pronged problem for this account. First I demonstrate that, in order to accurately account for dynamic physiological functions, Boorse's account of normal function needs to be modified to index functions against situations. I then demonstrate that if functions are indexed against situations, the BST can no longer account for diseases that result from specific (...) environmental factors. The BST is impaled on either horn of this dilemma and therefore must be dismissed. (shrink)

What is the metaphysical relationship between the fetus/embryo and the pregnant organism? In this paper I apply a substance metaphysics view developed by Barry Smith and Berit Brogaard to argue, on the basis of topological connectedness, that fetuses/embryos are Lady-Parts: part of the maternal organism up until birth. This leaves two options. Either mammalian organisms begin at birth, or we revise our conception of organisms such that mammalian organisms can be part of other mammals. The first option has some advantages: (...) it is numerically neat; aligns with an intuitive picture of organisms as physically distinct individuals; and ties ‘coming into existence’ to a suitably recognisable and important event: birth. But it denies that the fetus survives birth, or that human organisms existed prior to their birth. The second option allows us to recognise that human organisms exist prior to and survive their birth, but at a cost: it leaves the question of when an organism comes into existence unanswered, and demands potentially far-reaching conceptual revision across a range of domains. (shrink)

When did we begin to exist? Barry Smith and Berit Brogaard argue that a new human organism comes into existence neither earlier nor later than the moment of gastrulation: 16 days after conception. Several critics have responded that the onset of the organism must happen earlier; closer to conception. This article makes a radically different claim: if we accept Smith and Brogaard’s ontological commitments, then human organisms start, on average, roughly nine months after conception. The main point of contention is (...) whether the fetus is or is not part of the maternal organism. Smith and Brogaard argue that it is not; I demonstrate that it is. This claim in combination with Smith and Brogaard’s own criteria commits to the view that human organisms begin, precisely, at birth. (shrink)

Mammals are usually considered unproblematic as biological individuals. This article contends the opposite. Once we consider pregnancy, criteria for biological individuality are not easily applicab...

This chapter examines naturalistic accounts of mental disorder: accounts that define disorder as biological dysfunction. There are three such accounts: an eliminativist account ; a forward-looking or goal-contribution account and a backward-looking or evolutionary account. I argue first, and contra Szasz, that biological functions can be attributed at a mental level. But our mental architecture might simultaneously support many different ways of attributing function claims, which might undermine a strong naturalism about mental disorder. Second, I argue that Boorse's forward-looking account (...) of disorder as dysfunction is not value-free. Third, I argue that Wakefield's backward-looking account does not accurately map onto our disorder judgments or medical purposes. I conclude that whilst Boorse's forward-looking account of disorder as dysfunction tracks medical usage better than Wakefield's evolutionary account, a truly value-free account of mental disorder cannot be sustained. (shrink)

In, I argued that Boorse's biostatistical theory of health is unable to accommodate diseases that are the normal result of harmful environments. Hausman disagrees: if the BST compares normal dispositional function against the whole population or reference class, rather than against organisms in similar circumstances as I proposed, then my challenge can be avoided. In this paper, I argue that Hausman's response fails: his proposal cannot accommodate a series of common physiological processes, such as sleep and those involved in reproduction. (...) In the course of this argument, I also offer a detailed discussion of the concept of functional efficiency, and reveal a link between the problem of environments and that of reference classes. 1 Introduction2 Kingma on Boorse3 Hausman on Kingma4 Response to Hausman5 Three Possible Replies5.1 Reference classes5.2 Temporary pathologies5.3 Adequacy of function6 Concluding Discussion. (shrink)

This paper critically analyses ‘the paradox of autonomy and consent in maternity care’. It argues that maternity care has certain features that increase the need for explicit attention to, and respect for, both autonomy and rigorous informed consent processes. And, moreover, that the resulting need is considerably greater than in almost all other areas of medicine. These features are as follows: (1) maternity care involves particularly socially sensitive body parts that are regularly implicated in consent‐centred procedures, as well as in (...) unconsented interventions, in ordinary, non‐medical life; and (2) much of maternity care (especially intervening in childbirth) is medically unique, in that it harms one patient (the mother) not primarily for the promotion of her own health but for the benefit of another (the baby). The apt comparison, within medicine, is therefore with non‐therapeutic research and transplantation medicine—both of which have elevated consent requirements characterized by very rigorous consent processes. At the same time—and this delivers the titular paradox—the importance of autonomy and consent in maternity care is at particular risk of being denied or disregarded. Jointly, these considerations make a very strong case for change: attention to and respect for autonomy and consent should be (1) core values; (2) key points of practical attention in the years ahead; and (3) central quality indicators in maternity care. (shrink)

Ectogestation—that is, ‘artificial’ or extramammalian pregnancy—may soon be within technological reach. This confronts us with questions about the correct moral and legal attitude towards the subjects of this technology, which are called ‘gestatelings’. Colgrove argues that gestatelings are a kind of newborn, and consequently should have the same moral and legal protections as newborns. This paper responds that both claims are unsupported by his arguments, which equivocate on two understandings of the term ‘newborn’. Questions about the appropriate moral and legal (...) status of gestatelings are therefore left unanswered, but in the course of attempting to answer them, we are well advised to continue using the term gestateling. (shrink)

L’époque carolingienne est qualifiée de renaissance car il y eut alors une forte volonté de retourner aux textes antiques. Dans le présent article, après avoir précisé les conditions matérielles qui ont commandé la copie des écrits patristiques puis leur circulation dans le monde carolingien, on tente de mettre en lumière la fréquentation des Pères par les différents auteurs carolingiens. Mais, et c’est là le cœur de la question, les œuvres des Pères ne sont-elles pas employées par les clercs du ix (...) e siècle comme autant d’arguments dans les différentes polémiques qui les mettent aux prises? C’est ce qui justifierait leur copie. (shrink)

Whether it is morally permissible to compel women to undergo a caesarean section is a topic of longstanding debate. Despite plenty of arguments against the moral permissibility of a forced caesarean section, the question keeps cropping up. This paper seeks to scrutinise a particular moral argument in favour of compulsion: the appeal to parental obligation. We present what we take to be a distillation of the basic form of this argument. We then argue that, in the absence of an exhaustive (...) theory of parental obligation, the question of whether a labouring woman is morally obliged to undergo emergency surgery—and especially the further question of it is morally permissible for third parties to compel this—cannot be answered via ready-made theory. We propose that the most viable option for settling both questions is by analogy. We follow earlier writers in presenting an analogous case—that of fathers being compelled to undergo non-consensual invasive surgery to save their children—but expand the analogy by considering objections that appeal to the ownership of the fetus. We offer two lines of response: the parthood view of pregnancy and chimaera dad. We argue that it is clear in the analogous case that compulsion cannot be justified. We also offer this analogy as a useful tool for assessing whether mothers have a moral duty to undergo caesarean sections, both in general and in particular cases, even if such a duty is insufficient to warrant compulsion. (shrink)

Dominique Lecourt argues that a counter-revolution in French intellectual life has seen the period of the master thinkers of the 1960s succeeded by an era of ...

Synthetic biology promises to eliminate the distinction between biology and engineering by delivering a philosophically interesting new kind of entity: a biological organism that is wholly designed and constructed by humans. The possibility of such organisms raises interesting questions in three domains: the analysis of (1) biological functions, (2) engineering functions, and (3) health and disease. This paper identifies and systematically answers these questions. This does not only establish how we should think about functions and health and disease in synthetic (...) biological organisms, but it also reveals insights that are of broader relevance: (1) aetiological accounts of biological function need to omit or reinterpret reference to natural selection. This results in complete continuity between aetiological analyses of function in engineering and philosophy; (2) considering synthetic biology prompts interesting further questions about heritability, ancestry, and biological individuals; and (3) accounts of disease as biological dysfunction do not straightforwardly map onto our intuitive health and disease judgments regarding non‐human animals. In response to the latter point I examine three possible avenues, and tentatively defend one on behalf of the ‘disease as dysfunction’ theorist. (shrink)

L'influence de la philosophie sur le cinéma peut être observée sous trois éclairages : la manière dont le cinéma représente le philosophe ; les tentatives pour adapter à l'écran les textes philosophiques ; la capacité enfin du cinéma à philosopher. Cinéma et philosophie en dresse un bilan à la fois historique et critique et témoigne d'une phase nouvelle de la théorie du cinéma. Dominique Château synthétise ici les contributions de Bergson, Benjamin, Eisenstein, Epstein, Bazin, Merleau-Ponty, Mitry, Cavell, Deleuze, Schefer (...) entre autres et s'arrête sur les propositions de philosophie du cinéma qui considèrent ce médium comme un phénomène historique lié à la modernité, un domaine d'expression spécifique ou encore un objet d'expérience où la philosophie autant que le cinéma sont mis à l'épreuve. Les grandes tendances de la philosophie moderne (phénoménologie, philosophie analytique, déconstruction, Gender Studies...) sont ici présentées sous l'angle de leur apport à la théorie du cinéma. Le livre s'achève enfin sur l'examen d'un projet d'une véritable esthétique du cinéma. (shrink)

Nursing migration: global treasure hunt or disaster‐in‐the‐making?International nurse migration — moving from one country to another in the search of employment — is the focus of this article. The majority of member states of the World Health Organization report a shortage, maldistribution and misutilisation of nurses. International recruitment has been seen as a solution. The negative effects of international migration on the ‘supplier’ countries may be recognised today but are not effectively addressed.Nurse migration is motivated by the search for professional (...) development, better quality of life and personal safety. Pay and learning opportunities continue to be the most frequently reported incentives for nurse migration, especially by nurses from less‐developed countries. Career opportunities were considered key incentives for nurses emigrating from high‐income countries. Language was reported to be a significant barrier. The positive global economic/social/professional development resulting from international migration needs to be weighed against a substantial ‘brain and skills drain’ experienced by supplier countries. The vulnerable status of migrant nurses is also of concern in certain cases. The focus on short‐term solutions as opposed to resolving the problem of a worldwide shortage of nurses causes great concern. Recent initiatives attempt to curb or channel international recruitment. The delicate balance between recognising the right of individual nurses to migrate and a collective concern for the health of a nation’s population must be achieved. (shrink)

Deux innovations caractérisent la philosophie de Berkeley : il met la perception au centre de sa théorie de l'être (esse est percipi out percipere) et il lie étroitement vision et langage, en affirmant que les idées de la vue constituent un " langage universel de l'Auteur de la nature ". Ces deux innovations continuent à nourrir la philosophie contemporaine, en particulier certains aspects de la philosophie analytique. C'est pourquoi, il est essentiel d'examiner à nouveaux frais les questions concernant l'hétérogénéité des (...) champs sensoriels, la nature de la suggestion, le rôle de l'imagination et celui de l'idée médiate dans la construction de l'objet. Le présent ouvrage vise donc à éclairer le tournant philosophique et sémantique instauré par Berkeley dans l'étude de la perception et de la vision. Une comparaison avec Locke met en valeur la spécificité des thèses du philosophe irlandais. Un examen précis des textes concernés permet de réévaluer la place et le rôle des thèses sur la vision dans l'économie générale de l'œuvre. Textes de Margaret Atherton, Bertil Belfrage, Geneviève Brykman, Richard Glauser, Philippe Hamou, Jean-Michel Vienne. (shrink)

Larzac, Plogoff, Creys-Malville, mais aussi Faucheurs volontaires ou Notre-Dame-des-Landes... Ces noms résonnent à nos oreilles comme autant de jalons de luttes citoyennes et politiques autour des grands enjeux de l'écologie depuis plus de 40 ans en France. Les 150 affiches réunies dans cet ouvrage nous racontent à leur façon ces engagements, de façon joyeuse, agressive, ou simplement informatives. C'est en 1974, lorsque René Dumont se présente avec panache à l'élection présidentielle française, que l'écologie politique entre dans la vie quotidienne de (...) chacun. Il apparaît alors que le diagnostic écologique appelle une réforme de la société en général. Mouvements, courants de pensée, philosophie, style de vie, les enjeux qu'elle défend sont multiples et pluriels. Progrès, croissance, nucléaire, mais aussi citoyenneté, pollution... De ce foisonnement complexe émergent des luttes locales, environnementales, nationales, européennes... Près de 150 affiches et de documents accompagnent dans ce livre le propos de l'auteur. Joyeuses, agressives, ou simplement informatives, elles montrent les enjeux de ces combats, entre utopie, détermination, et nouvelles donnes. Cette promenade dans le temps, par le texte et l'image, restitue le lyrisme ou le désenchantement d'une époque qui oscille entre espérance et désillusion. Elles donnent le ton des revendications écologiques, environnementales, sur la pertinence de la partition traditionnelle droite/gauche pour les enjeux écologiques ou simplement humains qui ponctuent notre société depuis quarante ans. (shrink)

Demander une assistance médicale à la procréation, recourir à l'avortement pour des raisons diverses, contrôler après coup une conduite sexuelle à risque par une pilule du lendemain, et bientôt peut-être exiger d'être euthanasié : depuis que l'État s'est engagé dans un processus de dépénalisation de ces pratiques médicales, on peut aujourd'hui faire beaucoup de choses de son propre corps quand il s'agit du début ou de la fin de vie. Cette liberté s'exerce néanmoins à une condition, toujours la même : (...) se présenter devant un médecin. Et que vous demande ce médecin? Presque rien, semble-t-il. Il vous demande de vous asseoir et de parler de votre état, de votre demande. Bref, de ce qui vous amène là. C'est ce " presque rien " dont il est question dans cet ouvrage. Un " presque rien " qui révèle, en réalité, un nouveau système de surveillance dans lequel le médecin prodigue informations et conseils à un sujet jugé désormais capable de prendre seul des décisions souveraines en matière de vie et de mort. Un face-à-face où apparaît le malaise de ceux qui assument la délicate mission de recueillir l'expression du désir ou de la détresse. À partir d'une longue enquête dans le secret des cabinets médicaux, l'auteur explique comment la régulation juridique a laissé place à des formes de pouvoir beaucoup plus sophistiquées, un dispositif souple de gouvernement des conduites qui laisse toute sa place à l'autocontrôle et à l'intériorisation par les individus des normes sociales. Elle montre ainsi comment, du cabinet du praticien jusqu'au Comité consultatif national d'éthique, c'est une nouvelle administration du vivant qui se met en place. (shrink)

De Bie et al. (2023) propose an organizing framework for different stages of human gestational development from conception to the viable premature. They also identify ethical considerations and con...

On the 13th June 2014, the Centre for the Humanities and Health (CHH) at King’s College London hosted a one-day workshop on ‘Parentalism and Trust.’ This workshop was the sixth in a series of workshops whose aim is to provide a new model for high-quality open interdisciplinary engagement between medical professionals and philosophers. The term ‘Parentalism’ rather than paternalism is chosen and used throughout because of some of the derisory and unfortunate gender connotations associated with paternalism (and/or its counterpart ‘maternalism’). (...) Medical Parentalism is the position that unwanted interference with a patient’s choices and actions in order to protect and promote her best interests is morally justified. Whilst there are many problems with its justification and implementation, the workshop addressed how such interference depends on a trusting relationship between the doctor and patient, and the extent to which parentalist interferences might undermine this trust. (shrink)

On 27 September 2013, the Centre for the Humanities and Health (CHH) at King's College London hosted a 1-day workshop on ‘Medical knowledge, Medical Duties’. This workshop was the fifth in a series of five workshops whose aim is to provide a new model for high-quality, open interdisciplinary engagement between medical professionals and philosophers. This report identifies the key points of discussion raised throughout the day and the methodology employed.

Histoire de ce traité, de sa diffusion et de son influence et étude littéraire et doctrinale. L'étude doctrinale de la triade " puissance, sagesse, bonté " telle qu'elle est formulée dans le traité, sa comparaison avec les " Theologiae " d'Abélard, invitent à réinterpréter le débat trinitaire au XIIe siècle, Hugues de Saint-Victor devant être tenu pour l'auteur de la triade.

In democratic political systems, political equality is often defined as an equality of opportunity for influence. But inequalities in resources and status affect the capacity of disadvantaged citizens to achieve an effective political equality. One common thread running through recent democratic innovations is the belief that appropriate institutional devices and procedures can alleviate the impact of background inequalities on the presence and voice of the disadvantaged within those designs. My objective is to achieve a clearer understanding of the conception of (...) political equality that informs a specific subset of these designs: deliberative mini-publics. I focus firstly on the methods of participant selection advocated to secure equal presence. According to what principle is participation distributed? If it is according to the ‘equal probability’ principle, rather than ‘equal opportunity’, what difference does this make in terms of political equality? Secondly, achieving equality of voice is usually conceived in terms of equalising opportunities for influence among participants. How is this objective understood and what does this say about the underlying conception of political equality? (shrink)