Health equity is a global concern. Although health equity extends far beyond the equitable distribution of healthcare, equitable access to healthcare is essential to the achievement of health equity. In Canada, Indigenous Peoples experience inequities in health and healthcare access. Cultural safety and trauma‐ and violence‐informed care have been proposed as models of care to improve healthcare access, yet practitioners lack guidance on how to implement these models. In this paper, we build upon an existing framework of equity‐oriented care for (...) primary healthcare settings by proposing strategies to guide nurses in operationalizing cultural safety and trauma‐ and violence‐informed care into nursing practice at the individual level. This component is one strategy to redress inequitable access to care among Indigenous Peoples in Canada. We conceptualize barriers to accessing healthcare as intrapersonal, interpersonal, and structural. We then define three domains for nursing action: practicing reflexivity, prioritizing relationships, and considering the context. We have applied this expanded framework within the context of Indigenous Peoples in Canada as a way of illustrating specific concepts and focusing our argument; however, this framework is relevant to other groups experiencing marginalizing conditions and inequitable access to healthcare, and thus is applicable to many areas of nursing practice. (shrink)

Inequities in access to oncology care among Indigenous peoples in Canada are well documented. Access to oncology care is mediated by a range of factors; however, emerging evidence suggests that healthcare providers, including nurses, play a significant role in shaping healthcare access. The purpose of this study was to critically examine access to oncology care among Indigenous peoples in Canada from the perspective of oncology nurses. Guided by postcolonial theoretical perspectives, interpretive descriptive and critical discourse analysis methodologies informed study design (...) and data analysis. Oncology nurses were recruited from across Canada to complete an online survey (n = 78). Nurses identified a range of barriers experienced by Indigenous peoples when accessing oncology care, yet located these barriers primarily at the individual and systems levels. Nurses perceived themselves as mediators of access to oncology care; however, their efforts to facilitate access to care were constrained by the dominance of biomedicine within healthcare. Nurses' constructions of access to oncology care highlight the embedded narrative of individualism within nursing practice and the relative invisibility of racism as a determinant of equitable access to care among Indigenous peoples. This suggests a need for oncology nurses to better understand and incorporate structural determinants of health perspectives. (shrink)

Like most goods‐producing sectors in the West, modern health‐care systems have been profoundly changed by globalization and the neoliberal policies that attend it. Since the 1970s, the role of the welfare state has been considerably reduced; funding and management of health systems have been subjected to wave upon wave of reorganization and assimilated to the private sector. At the same time, neoliberal policy has imposed the notion of patient empowerment, thus turning patients into consumers of health. The literature on nursing (...) has accordingly reported on the significant repercussions on all aspects of the profession, from delivery of care and treatment, through training for new nurses, to legislated policy reforms regarding the role and responsibilities of modern nurses. In light of these developments, this paper analyses and theorizes about the way the injection of neoliberal policy is linked to and affects the practice of nursing. Drawing on a number of Nietzschean arguments, we begin with an exploration of the complex effects of neoliberalism, bureaucratization, and technocratization on the health system and the practice of nursing. Our main theoretical point here is that neoliberal policy engenders and promotes a neoliberal tide, which results in the conversion of the values that drive modern nursing practice. We then examine this tide in the light of Nietzsche's concepts. Starting with an analysis based on the ontology of the will to power, we show that nurses are dominated by neoliberal values embedded in technocratic and bureaucratic ideologies. Finally, we argue that the application of neoliberal policy constitutes a form of domestication from which one might potentially be freed through the Nietzschean concept of transvaluation of values. This transvaluation, as its freeing from some of the neoliberal tide, may be accomplished in accordance with a hierarchy of specific life‐affirming values for nursing culture and practice. (shrink)

Discussions about real knowledge contained in grand theories and models seem to remain an active quest in the academic sphere. The most fervent of these defendants is Rosemarie Parse with her Humanbecoming School of Thought (1981, 1998). This article first highlights the similarities between Parse's theory and Blumer's symbolic interactionism (1969). This comparison will act as a counterargument to Parse's assertions that her theory is original ‘nursing’ material. Standing on the contemporary philosophy of science, the very possibility for discovering specific (...) nursing knowledge will be questioned. Second, Parse's scientific assumptions will be thoroughly addressed and contrasted with Blumer's more moderate view of knowledge. It will lead to recognize that the valorization of the social nature of existence and reality does not necessarily induce requirements and methods such as those proposed by Parse. According to Blumer's point of view, her perspective may not even be desirable. Recommendations will be raised about the necessity for a distanced relationship to knowledge, being the key to the pursuit of its improvement, not its circular contemplation. (shrink)

Lavoie and Talwar examine the phenomenon of prosocial lie telling: lying with the intention to benefit others. They investigate how well children aged 4 to 11 are able to conceal information about a surprise gift from their parents based on these children’s responses to their parents’ questions. Lavoie and Talwar conclude that, as children’s theory of mind abilities and working memory improve, their ability to conceal information from others also develops.

This article seeks to shed light on the beliefs that influence nurses’ intention of respecting or not respecting an advance directive document, namely a living will or a durable power of attorney. Nurses’ beliefs were measured using a 44-statement questionnaire. The sample was made up of 306 nurses working either in a long-term care centre or in a hospital centre offering general and specialized care in the province of Québec. The results indicate that nurses have a strong intention of complying (...) with advance directives written by patients. The analysis also shows that four variables determine the strength of this intention: respect for autonomy; the location of the workplace; justice; and the dimension of relationships and emotions. Although these documents favour the expression of patients’ wishes, nurses should be aware that they do not systematically guarantee respect of a patient’s autonomy, nor do they replace a relationship based on trust between patients and health care professionals. (shrink)

Hermeneutics has become a major topic of debate throughout the scholarly community. What has been called the "interpretive turn" has led to interesting new approaches in both the human and social sciences, and has helped to transform divided disciplines by bringing them closer together. Yet one of the largest and most important social sciences economics has so far been almost completely left out of the transformation. Economics and Hermeneutics takes a significant step towards filling this gap by introducing scholars on (...) both sides of the divide to ways that hermeneutics might help economists address some of their most important problems. Among the topics addressed are entrepreneurship, price theory, rational expectations, monetary theory, welfare economics, and economic policy. The approaches to economics represented include the Austrian school, McCloskey's "rhetoric" approach, Marxian critical theory and institutionalism. (shrink)

The “good farmer” literature, grounded in Bourdieu’s concepts of field, habitus, and capital, has provided researchers with a socio-cultural approach to understanding conservation adoption behavior. The good farmer literature suggests that conservation practices may not be widely accepted because they do not allow farmers to demonstrate symbols of good farming. This lens has not been applied to the adoption of conservation tillage, a practice increasingly used to improve conservation outcomes, farming efficiency and crop productivity. Drawing from in-depth interviews with dryland (...) wheat farmers in the US inland Pacific Northwest, this research seeks to understand how farmers’ engagement with CT is shaped by identity as a good farmer. Some farmers also sought to bolster social capital through CT by maintaining and strengthening relationships with peers, landowners, and future generations. We further found that engagement with CT provided a link for some participants between productivist values and stewardship values within the good farming identity. The findings from this research may help contextualize the barriers and opportunities to the adoption of agricultural conservation practices within farmer-specific social, cultural, and economic forms of capital. (shrink)

Euthanasia remains controversial in Canada and an issue of debate among physicians. Most studies have explored the opinion of health professionals regarding its legalization, but have not investigated their intentions when faced with performing euthanasia. These studies are also considered atheoretical. The purposes of the present study were to fill this gap in the literature by identifying the psychosocial determinants of physicians’ intention to practice euthanasia in palliative care and verifying whether respecting the patient’s autonomy is important for physicians.

Cet article s’intéresse à la masculinité dans deux romans historiques du vingtième siècle, dont l’intrigue se déroule au dix-huitième : Ingenious Pain d’Andrew Miller (1997) et The Giant, O’Brien d’Hilary Mantel (1998). Les deux romanciers inventent des protagonistes qui incarnent des attributs considérés comme typiquement masculins, tels que la résistance à la douleur, la force physique et la masse corporelle, ces attributs étant par ailleurs liés à la possibilité de gagner de l’argent. Dans ces textes, cependant, l’exagération des caractéristiques masculines (...) stéréotypées complexifie le portrait des deux personnages, les faisant paraître à différents moments comme des non-hommes ou des hommes inférieurs : ils ressemblent tantôt à des monstres, tantôt à des victimes pitoyablement faibles – comparés à des enfants, voire à des femmes. Paradoxalement, les qualités associées à la virilité dans ces récits dépouillent les hommes de leur autonomie plutôt que de la leur conférer, de sorte qu’ils se trouvent dépossédés de l’idéal masculin et deviennent la propriété d’autres hommes. (shrink)

ABSTRACT Peter Weir's The Truman Show has been studied as an example of Debord's theory of the spectacle; as such, many theorists have shown how Truman is a commodified object constructed for “entertainment” for the masses, also noting how we ourselves are complicit in the consumption of media that dehumanize. In this essay, the author argues that, while a decided exemplar of postmodernism's “society of the spectacle,” the film is also a corporealization of poststructuralist Michel Foucault's concept of the panopticon, (...) illustrating how a consideration of social spaces yields a fuller understanding of Truman's predicament as knowing prisoner/performer. Through an analysis of power, ideology, hegemony, and whiteness as they are re-presented in The Truman Show, we can more thoroughly articulate Truman's condition as a panoptic object who is regulated and hegemonized under the watchful eyes of a Master—himself synecdochic of Authority, Reason, and Truth—and those of a voracious public. The result is an indeterminate, postmodern, dystopian vision of mediated masses and the power apparatuses they/we wield through the act of watching. (shrink)

Jean-Jacques Lavoie | Résumé : L’auteur présente un état de la recherche sur la critique textuelle et la critique des sources de Qohélet 7,19-20 et propose une analyse structurelle et littéraire de ces deux versets. Il poursuit son enquête en s’attardant plus particulièrement aux thèmes de la force meurtrière et de l’imperfection humaine, deux thèmes intimement liés dans quelques textes de la Bible, particulièrement en 1 R 8 et au Ps 143. |: The author presents the state of research (...) about textual and source criticisms concerning Qoheleth 7:19-20, and then provides a structural and literary analysis of these verses. He pursues his inquiry further, focusing more particularly on the themes of the lethal force and the human imperfection, two themes interrelated in some biblical texts, particularly 1 Kings 8 and Psalm 143. (shrink)

Les notions de «mort» et de «mourir», parfois utilisées sans distinctions dans la littérature, font référence à deux dimensions fort différentes pour la personne en fin de vie, de même que pour toutes les personnes appelées à en prendre soin . Alors que la personne malade voit venir la mort, elle doit vivre son mourir. La mort succède ainsi au mourir, dans le temps. Par ailleurs, une réflexion d’ordre philosophique permet de préciser que la mort s’avère une ordonnance de la (...) nature, elle est privation de la vie et un mystère. Et en tant que mystère, elle prendra forme selon les différentes croyances attribuées à l’immortalité de l’âme. Quant au mourir, il est l’épreuve par excellence d’une situation-limite. De plus, en dépit du caractère unique et individuel de cette expérience nouvelle pour tous, il assume différents visages. Si l’espoir de «connaître une belle mort» se conçoit aisément, le mourir n’en demeure pas moins le moment le plus tragique de l’existence humaine. (shrink)

Le féminisme a réussi à transformer partiellement le monde dans lequel nous vivons. Mais la résistance de la société traditionnelle à ces changements, ainsi que la remontée de la droite et la valorisation forcenée de l'individualisme, risquent de compromettre ses acquis. Dans ce contexte, l'avènement d'un discours pseudo-féministe qui véhicule les valeurs traditionnellement considérées comme « féminines » par les hommes risque d'embrouiller le message féministe pour tous ceux qui y accordaient créance et espéraient le voir aller plus loin dans (...) sa quête d'une société nouvelle. Nous voulons analyser ce discours en montrant comment il tend à remettre en question l'effort de transformation sociale amorcé par le féminisme.Feminism has partly transformed our world. Traditionnal society's resistance to these changes together with the rise of the Right and individualism endanger these gains. In that context, the advent of pseudo-feminist discourse carrying the values traditionnally seen by men as "féminine" might blur the feminist message for those who give it credit and hope to see it progress in its quest for a new society. We wish to analyse that discourse and show how it tends to challenge the social transformation effort launched through feminism. (shrink)

Le présent article porte sur la trame relationnelle tissée autour de l’enfant né par gestation pour autrui ou conçu grâce à un don d’ovules, et plus spécifiquement sur les affiliations familiales qui émergent de ce processus inédit d’enfantement à plusieurs. La démonstration s’appuie sur les récits de 38 femmes canadiennes impliquées dans une entente de procréation assistée avec autrui en tant que mères, femmes porteuses ou donneuses. Deux cas de figure mettant en lumière la construction des liens d’apparentement entre les (...) personnes concernées sont présentés, qu’il s’agisse d’une inscription dans le réseau de parenté de l’enfant ou d’une reconnaissance symbolique mutuelle basée sur l’amitié. La proximité relationnelle entre les adultes est au cœur d’une filiation métissée qui témoigne de leur préoccupation commune envers l’intérêt de l’enfant. (shrink)

OBJECTIVES: This study was designed to identify and compare the attitudes of patients and health care professionals towards advance directives. Advance directives promote recognition of the patient's autonomy, letting the individual exercise a certain measure of control over life-sustaining care and treatment in the eventuality of becoming incompetent. DESIGN: Attitudes to advance directives were evaluated using a 44-item self-reported questionnaire. It yields an overall score as well as five factor scores: autonomy, beneficence, justice, external norms, and the affective dimension. SETTING: (...) Health care institutions in the province of Québec, Canada. Survey sample: The sampling consisted of 921 subjects: 123 patients, 167 physicians, 340 nurses and 291 administrators of health care institutions. RESULTS: Although the general attitude of each population was favourable to the expression of autonomy, multivariate analysis of variance (MANOVA) indicated that physicians attached less importance to this subscale than did other populations (p < .001). Above all, they favoured legal external norms and beneficence. Physicians and administrators also attached less importance to the affective dimension than did patients and nurses. Specifically, physicians' attitudes towards advance directives were shown to be less positive than patients' attitudes. CONCLUSION: More attention should be given to the importance of adequately informing patients about advance directives because they may not represent an adequate means for patients to assert their autonomy. (shrink)

Ocherk 1. Voprosy ontologii -- Ocherk 2. Voprosy ėtiki i ėstetiki -- Ocherk 3. Voprosy gnoseologii i aksiologii.

THE MYTH OF THE PLAN: LESSONS OF SOVIET PLANNING EXPERIENCE by Peter Rutland. LaSalle, Illinois: Open Court, 1985. 286 pp., $26.95. LENIN AND THE END OF POLITICS by A. J. Polan. Berkeley: University of California Press, 1984. 240 pp., $22.50, $9.95 (paper).

Although a number of microfinance initiatives have improved financial inclusion in various regions of developing countries, the transferability of their foundations from one context to another is still a challenge. This study proposes an innovative process-based model targeting the initial stages of the transfer process that links three interconnected categories: local contextual conditions, transferring practices, and initial developmental consequences. The results were produced through a longitudinal study of the implementation of three community development banks on the periphery of Sao Paulo (...) based on a highly successful Brazilian model known as Banco Palmas. In addition to the process-based model, our findings contribute to the microfinance and bottom of the pyramid literatures, showing a cross-fertilization that has been insufficiently explored. (shrink)

Le prologue du livre de Ben Sira est le seul texte biblique qui nous livre une réflexion sur l’acte de traduire. Cet article vise deux objectifs : 1) mieux comprendre ce que le petit-fils de Ben Sira dit au sujet de la traduction du livre de son grand-père ; 2) comparer sa conception de la traduction avec celles que l’on trouve dans d’autres textes judéens et alexandrins relatifs à la traduction de la Bible hébraïque en grec, afin de mettre en (...) évidence le caractère singulier des propos du petit-fils de Ben Sira. (shrink)

Jean-Jacques Lavoie | : Cet article présente une centaine de livres publiés depuis l’an 2000 sur le texte de Qohélet. L’état de la recherche est divisé en six parties qui correspondent à autant d’approches : critique textuelle, analyse philologique et sémantique, histoire de la réception, analyse comparée, critique structurelle et lecture canonique et pastorale. Ce choix n’a rien d’arbitraire. Au contraire, il est adapté aux livres publiés depuis l’an 2000 et permet de mettre en évidence les principaux résultats de (...) la recherche récente sur le livre de Qohélet. | : This article presents about a hundred books that have been published on the text of Qohelet since 2000. The presentation of the state of research is divided in six parts, corresponding to the following approaches : textual criticism, philological and semantic analysis, history of reception, comparative study, analysis of the logical structure of the book, and canonical and pastoral reading. This choice is not arbitrary. On the contrary, it reflects and highlights the main tendencies of literature published since 2000 on the book of Qohelet. (shrink)

On the extreme wing of libertarian ideology are the individualist anarchists, who wish to dispense with government altogether. The quasi-legitimate functions now performed by government, such as the administration of justice, can, the anarchists claim, be provided in the marketplace. George H. Smith.

Jean-Jacques Lavoie L’auteur présente un état de la recherche des critiques textuelles et des sources de Qohélet 7,15-18 et propose une analyse structurelle et littéraire de ces quatre versets, afin de montrer que Qohélet souligne les limites de la sagesse et de la justice et dénonce toute forme de démesure, car celle-ci ne peut garantir le succès et peut même conduire à la ruine. Craindre Dieu est le contraire de la démesure ; c’est reconnaître que l’on ignore tout de (...) la manière dont Dieu agit et c’est accepter de vivre dans un monde absurde. (shrink)

Jean-Jacques Lavoie | : L’auteur présente un état de la recherche des critiques textuelle et des sources ainsi que des analyses structurelle et littéraire de Qohélet 2,1-3, afin de montrer comment Qohélet relativise, non sans ironie, la valeur de la jouissance. | : The author presents the state of research about textual and source criticisms, as well as structural and literary analyses concerning Qoheleth 2:1-3, in order to show how Qoheleth seeks to relativize, not without irony, the value of (...) enjoyment. (shrink)

Jean-Jacques Lavoie | : L’auteur présente un état de la recherche des critiques textuelle et des sources de Qo 2,25 et propose une analyse structurelle de Qo 2,24-26 ainsi qu’une analyse littéraire de Qo 2,25, afin de montrer que le propos de la péricope qui conclut la fiction royale est de nature théologique : rien n’est possible pour l’être humain — pas même pour le roi Qohélet! — sans l’intervention divine. Autrement dit, le Dieu qui donne est également celui (...) qui détermine les conditions de l’existence humaine, aussi bien celles qui sont heureuses et avantageuses que celles qui sont malheureuses et désavantageuses. | : The author presents the state of research regarding textual criticism as well as source criticism concerning Qo 2,25, and then offers a structural analysis of Qo 2,24-26, and a literary analysis of Qo 2,25, in order to show that the subject of the section that concludes the royal fiction is of theological nature : nothing is possible for the human being — not even for the king Qohelet! — without divine intervention. In other words, the God who gives is also the one who determines the conditions of human existence, both the happy and advantageous ones, as well as the unhappy and disadvantageous ones. (shrink)

Jean-Jacques Lavoie | Résumé : L’auteur présente un état de la recherche de la critique textuelle de Qo 2,12 en montrant qu’il faut maintenir le texte massorétique, puisque c’est le texte le plus difficile. Puis, il présente un état de la recherche de la critique des sources ainsi que de l’analyse structurelle et littéraire, afin de montrer que ce verset doit être lu à la lumière de son contexte immédiat. En effet, la comparaison de la sagesse et de la (...) folie, au v. 12a, annonce la question de l’avantage de la sagesse sur la folie et du sage sur le fou, en 2,13-16. Quant au v. 12b, il annonce la question portant sur la valeur du successeur, en 2,19a, et souligne, non sans ironie, que la valeur du successeur est dérisoire et que celui-ci ne vaut que ce que le prédécesseur, aussi incomparable soit-il, a fait de lui. Ainsi compris, le v. 12 peut aussi se lire comme une allusion à Roboam en 1 R 12. |: The author presents a state of research about textual criticism concerning Qo 2,12 by showing that it is necessary to maintain the Masoretic Text, since it is the most difficult text. Then, he presents the state of the research about source criticism, as well as structural and literary analyses, in order to show that this verse should be read in the light of its immediate context. Indeed, the comparison between wisdom and folly, in v. 12a, announces the question of the advantage of wisdom over folly, and of the wise over the fool in 2.13-16. As to v. 12b, it announces the question concerning the value of the successor in 2.19a, and emphasizes, not without irony, that the value of the successor is derisory, and that it is worth only what the predecessor, however incomparable he may be, has made of him. Thus understood, v. 12b can also be read as an allusion to Rehoboam in 1 K 12. (shrink)

Koheleth 1,12-18 is a text free of commentary (gloss), well delimited and structured in two symmetrical parts : 1,12-15 and 1,16-18. The thought behind this pericope can be resumed as follow : Koheleth parodies the legendary texts about Salomon and the propagandist praise of the royal autobiography of the Ancient Near Eastern, in order to relativise the value of wisdom and knowledge, and to emphasize the impotence of the people to modify, to improve or to enrich the work that God (...) has made crooked. (shrink)