La chambre à coucher des couples ordinaires ne relevant aucunement de la justice est souvent le théâtre d’une cruauté qui peut se manifester de manière subtile ou brutale. Mieux appréhender la violence sexuelle implique d’en approfondir les origines et la fonction. Les exemples cliniques montrent jusqu’où peut aller ce type de violence. Celle-ci demeure souvent cachée mais est source de grande souffrance. L’auteur souligne l’interaction des partenaires dans ces passages à l’acte. Il envisage une typologie des sadismes sexuels névrotiques.

La chambre à coucher des couples ordinaires ne relevant aucunement de la justice est souvent le théâtre d’une cruauté qui peut se manifester de manière subtile ou brutale. Mieux appréhender la violence sexuelle implique d’en approfondir les origines et la fonction. Les exemples cliniques montrent jusqu’où peut aller ce type de violence. Celle-ci demeure souvent cachée mais est source de grande souffrance. L’auteur souligne l’interaction des partenaires dans ces passages à l’acte. Il envisage une typologie des sadismes sexuels névrotiques.

Croire ne peut s’appréhender sans son corollaire, douter. Le doute revêt des formes diverses que l’on retrouve en particulier chez les couples en thérapie. Dans ce cadre, pour tenter d’en approcher l’origine et la nature, l’auteur s’appuie sur les concepts d’identification projective, intrusive, adhésive, et de contenance développés par Meltzer. Dans cette perspective, un lien peut être fait entre la relation de couple et celle du bébé à son premier objet. La thérapie de couple est envisagée comme une tentative pour (...) chacun de passer du doute destructeur au doute positif, constructeur, permettant un véritable croire en l’autre et au couple. (shrink)

Moral distress is a phenomenon of increasing concern in nursing practice, education and research. Previous research has suggested that moral distress is associated with perceptions of ethical climate, which has implications for nursing practice and patient outcomes. In this study, a randomly selected sample of registered nurses was surveyed using Corley’s Moral Distress Scale and Olson’s Hospital Ethical Climate Survey (HECS). The registered nurses reported moderate levels of moral distress intensity. Moral distress intensity and frequency were found to be inversely (...) correlated with perceptions of ethical climate. Each of the HECS factors (peers, patients, managers, hospitals and physicians) was found to be significantly correlated with moral distress. Based on these findings, we highlight insights for practice and future research that are needed to enhance the development of strategies aimed at improving the ethical climate of nurses’ workplaces for the benefit of both nurses and patients. (shrink)

In the first part of this paper I characterize a minimal form of self-consciousness, namely pre-reflective self-consciousness. It is a constant structural feature of conscious experience, and corresponds to the consciousness of the self-as-subject that is not taken as an intentional object. In the second part, I argue that contemporary cognitive neuroscience has by and large missed this fundamental form of self-consciousness in its investigation of various forms of self-experience. In the third part, I exemplify how the notion of pre-reflective (...) self-awareness can be of relevance for empirical research. In particular, I propose to interpret processes of sensorimotor integration in light of the phenomenological approach that allows the definition of pre-reflective self-consciousness. (shrink)

Bernadette M Tobin; Development in Virtues, Journal of Philosophy of Education, Volume 20, Issue 2, 30 May 2006, Pages 201–214, https://doi.org/10.1111/j.1467-9.

Philosophical considerations as well as several recent studies from neurophysiology, neuropsychology, and psychophysics converged in showing that the peripersonal space is structured in a body-centred manner and represented through integrated sensory inputs. Multisensory representations may deserve the function of coding peripersonal space for avoiding or interacting with objects. Neuropsychological evidence is reviewed for dynamic interactions between space representations and action execution, as revealed by the behavioural effects that the use of a tool, as a physical extension of the reachable space, (...) produces on visual–tactile extinction. In particular, tool-use transiently modifies action space representation in a functionally effective way. The possibility is discussed that the investigation of multisensory space representations for action provides an empirical way to consider in its specificity pre-reflexive self-consciousness by considering the intertwining of self-relatedness and object-directness of spatial experience shaped by multisensory and sensorimotor integrations. (shrink)

Les événements culturels internationaux constituent-ils un système symbolique indépendant des médias? Le propos de cet article s'inscrit dans une théorie générale de la trivialité, c'est-à-dire de la circulation des concepts entre la sphère de la production culturelle et celle des médias. Sans remettre en cause l'apport fondamental de Davidson à la théorie de l'événement - à savoir qu'un événement existe indépendamment de toute reconstruction ultérieure notamment par les médias - et, au contraire, en soulignant les apports d'une sémantique de l'histoire (...) pour comprendre une production culturelle, il cherche à mettre en évidence les interactions entre ces deux sphères, notamment les rôles du dispositif et du répertoire d'actions dans la pré-construction de l'information et l'incorporation de certains éléments du débat mené dans les médias par la sphère culturelle. S'il ne peut pas proposer une définition arrêtée de l'événement culturel international, en revanche, le chercheur peut observer le travail permanent de reconfiguration que couvre la catégorisation de ces événements.The international cultural events they are a symbolic system independent media? The purpose of this article is part of a general theory of triviality, that is to say, the circulation of concepts between the sphere of cultural production and the media. Without jeopardizing the fundamental contribution of Davidson's theory of the event - ie an event exists independently of any subsequent reconstruction by the media - and, instead, highlighting the contributions of the semantics history to understand cultural production, it seeks to highlight the interactions between these two spheres, including the roles of the device and directory actions in the pre-construction information and the incorporation of some elements of the debate conducted in the media by the cultural sphere. If they can not provide a conclusive definition of the international cultural event, however, the researcher can observe the work of permanent reconfiguration covers the categorization of these events. (shrink)

Bernadette M Tobin; Richard Peters's Theory of Moral Development, Journal of Philosophy of Education, Volume 23, Issue 1, 30 May 2006, Pages 15–27, https://doi.

In many countries grappling with the politics of equal recognition, the experiences, beliefs and reasons for action of people who identify as non-binary are starting to be seen as valid and intelligible.1 And, despite some gender clinics still responding cautiously to requests for non-standard medical interventions, their treatment needs are now recognised in major clinical guidelines. This is the current social context in which Notini and colleagues outline the case of ‘Phoenix’, an 18-year-old birth-assigned woman, who has requested the indefinite (...) continuation of puberty suppression, a treatment that was initiated when the client was 11 years old to mitigate their intense distress at the onset of puberty. Drawing on a conception of health as overall well-being, the authors conclude that OPS is ‘consistent with the proper goals of medicine’, and that there are ‘equity-based reasons’ for offering OPS to adults as a group. They concede that the physical risks are greater for OPS than for hormonal interventions generally provided to people with a binary gender identity. They also acknowledge the need for ‘a fine-grained ethical evaluation of Phoenix’s particular situation’ to assess whether the potential benefits of OPS outweigh the potential harms for this individual. Here I respectfully raise three points to amplify the authors’ discussion. First, there seem to be significant ethical issues of a general, not a particular, kind arising from the type of individual evaluation they call for. Following initial screening for significant mental distress and other major vulnerabilities, the key undertaking …. (shrink)

This article draws from cultural studies, political theory, international relations, art history and museum studies in order to consider `China Design Now' — the blockbuster exhibition, recently held at the V&A. It argues that, despite the inclusion of a number of interesting exhibits, the attempt to frame contemporary Chinese design independently of political contextualization has led to an exhibition which is largely unsatisfying. The approach taken by the V&A is further shown to have produced several ironic outcomes. First, by attempting (...) to avoid `contentious' political issues, the museum has, in fact, forced the `political' to the fore. Second, by taking such an approach, the V&A demonstrates that it has failed to understand the essentially political nature of the design problem. Third, it has produced an exhibition which appears to advocate a neoliberal agenda — one which insists on an inexorable drive towards greater global economic integration. Finally, it has failed to mention its own embeddedness within larger strategies of `cultural diplomacy' and the significance of such strategies for international relations and for cultural production. As well as drawing on a range of relevant literature, the article makes direct reference to exhibition wall texts, exhibit labels and quotations from the catalogue in order to support its argument. (shrink)

This paper forms part of a project to describe and analyse historically and anthropologically nomadic pastoralism. It reflects on mobility, its forms and scale, and more especially on the critique of predominant classical, even banal ideas which assimilate nomadism to mobility. Nomadic pastoral mobility occurs in a context that separates it radically from migratory movement. In fact, nomadic mobility constitutes a strategy that stabilizes resources and populations and whose basic foundation is the appropriation of a territorial base that is established (...) as durably as possible. Just as, and following sedentary settlement, nomadic pastoralism puts an end to migratory mobility. Thus it seems that a single idea of mobility is inappropriate to describe the two fundamentally independent phenomena represented by transcontinental migration, partly arising from the effects of the ice age, and nomadic pastoralism. (shrink)

Bernadette M Tobin; An Aristotelian Theory of Moral Development, Journal of Philosophy of Education, Volume 23, Issue 2, 30 May 2006, Pages 195–211, https://doi.

This paper is an exploration of the state of ‘clinical unease’ experienced by clinicians in contexts where professional judgement—grounded in clinical knowledge, critical reflection and a sound grasp of the law—indicates that there is more than one ethically defensible way to proceed. The question posed is whether the courts can be viewed as an appropriate vehicle to settle clinical unease by providing a ruling that clarifies the legal and ethical issues arising in the case, even in situations where there is (...) no dispute between the patient (or her proxies) and the healthcare team.The concept of ‘clinical unease’ is framed with reference to the broader experience of clinical decision-making, and distinguished from other widely discussed phenomena in the healthcare literature like moral distress and conscientious objection. A number of reported cases are briefly examined where the courts were invited to rule in circumstances of apparent ‘unease’. The respective responsibilities of clinicians and courts are discussed: in particular, their capability and readiness to respond to matters of ethical concern.Four imagined clinical scenarios are outlined where a clinical team might welcome a court adjudication, under current rules. Consideration is given to the likelihood of such cases being heard, and to whether there may be better remedies than the courts. There are final reflections on what clinicians may actually wish for in seeking court involvement, and on whether a willingness to engage with the experience of clinical unease may lead to greater sensitivity towards the value perspectives of others. (shrink)

This book contains a series of essays that explore the concept of unconsciousness as it is situated between phenomenology and psychoanalysis. A leading goal of the collection is to carve out phenomenological dimensions within psychoanalysis and, equally, to carve out psychoanalytical dimensions within phenomenology. The book examines the nature of unconsciousness and the role it plays in structuring our sense of self. It also looks at the extent to which the unconscious marks the body as it functions outside of experience (...) as well as manifests itself in experience. In addition, the book explores the relationship between unconsciousness and language, particularly if unconsciousness exists prior to language or if the concept can only be understood through speech. The collection includes contributions from leading scholars, each of whom grounds their investigations in a nuanced mastery of the traditional voices of their fields. These contributors provide diverse viewpoints that challenge both the phenomenological and psychoanalytical traditions in their relation to unconsciousness. (shrink)

Approaches to business ethics can be roughly divided into two streams: ‹codes of behavior’ and ‹forms of subjectification’, with code-oriented approaches clearly dominating the field. Through an elaboration of poststructuralist approaches to moral philosophy, this paper questions the emphasis on codes of behaviour and, thus, the conceptions of the moral and responsible subject that are inherent in rule-based approaches. As a consequence of this critique, the concept of a practice-based ‹ethics of responsiveness’ in which ethics is never final but rather (...) always ‹to come’, is investigated. In such an approach the ethical self is understood as being continuously constituted within power/knowledge relations. Following this line, we ask how one can become a responsible subject while also acknowledging certain limits of full responsibility. We thereby explore responsibility as a considered but unconditional openness in response to the other. (shrink)

Summary With regard to the dynamics of human experience and behavior, Gestalt theoretical psychotherapy (GTP) relies mainly on Kurt Lewin’s dynamic field theory of personality. GTP is carried out by including a re-interpretation of Lewin’s theory in some aspects of psychotherapeutic practice in relation to critical realism. Human experience and behavior are understood to be functions of the person and the environment (including the other individuals therein) in a psychic field (life space), which encompasses both of these mutually dependent factors. (...) The anthropological model of this approach is, therefore, not mono-personal but, a priori, structural and relational in nature. It does not one-sidedly focus on the “inner components” of a person, but on the interrelation of the individual and a given environment, which affects experience and behavior. After a brief introduction of these basic concepts, this lecture will focus especially on Lewin’s concept of tension-systems, which may be considered as the Gestalt theoretical counterpart of Freud’s drive theory. Further, we define the basic assumptions which underlie GTP and explain how the person moves through her/his life experience in terms of Gestalt psychology. (shrink)

Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners (...) have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight key insights from the symposium and the papers in the series, propose to redefine moral distress, and outline directions for an agenda for action on moral distress in health care. (shrink)

One of the core goals of Digital Health Technologies (DHT) is to transform healthcare services and delivery by shifting primary care from hospitals into the community. However, achieving this goal will rely on the collection, use and storage of large datasets. Some of these datasets will be linked to multiple sources, and may include highly sensitive health information that needs to be transferred across institutional and jurisdictional boundaries. The growth of DHT has outpaced the establishment of clear legal pathways to (...) facilitate the collection, use and transfer of potentially sensitive health data. Our study aimed to address this gap with an ethical code to guide researchers developing DHT with international collaborative partners in Singapore. We generated this code using a modified Policy Delphi process designed to engage stakeholders in the deliberation of health data ethics and governance. This paper reports the outcomes of this process along with the key components of the code and identifies areas for future research. (shrink)

Dans un territoire de la République de plus en plus fragmenté, l’appréciation du bon ordre est de plus en plus difficile pour l’autorité civile de police municipale, maire ou préfet. L’occupation de l’espace et les conflits qui en résultent sont mal anticipés par la planification de l’urbanisme comme l’illustrent les grands rassemblements d’hommes, le désarroi des campagnes et les quartiers sensibles. L’ordre public doit s’exercer dans la proximité mais sous bonne régulation zonale.

Stakeholder theory provides a framework for investigating the relationship between corporate social performance (CSP) and corporate financial performance. This relationship is investigated by examining how change in CSP is related to change in financial accounting measures. The findings provide some support for a tenet in stakeholder theory which asserts that the dominant stakeholder group, shareholders, financially benefit when management meets the demands of multiple stakeholders. Specifically, change in CSP was positively associated with growth in sales for the current and subsequent (...) year. This indicates that there are short-term benefits from improving CSP. Return on sales was significantly positively related to change in CSP for the third financial period, indicating that long-term financial benefits may exist when CSP is improved. (shrink)

Family members do not have an official position in the practice of euthanasia and physician assisted suicide in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and ethical questions. Therefore, the aim of this review is to explore how family members are involved in the Dutch practice of EAS according to empirical research, and to map out themes that could serve as a starting point (...) for further empirical and ethical inquiry. A systematic mixed studies review was performed. The databases Pubmed, Embase, PsycInfo, and Emcare were searched to identify empirical studies describing any aspect of the involvement of family members before, during and after EAS in the Netherlands from 1980 till 2018. Thematic analysis was chosen as method to synthesize the quantitative and qualitative studies. Sixty-six studies were identified. Only 14 studies had family members themselves as study participants. Four themes emerged from the thematic analysis. 1) Family-related reasons to request EAS. 2) Roles and responsibilities of family members during EAS decision-making and performance. 3) Families’ experiences and grief after EAS. 4) Family and ‘the good euthanasia death’ according to Dutch physicians. Family members seem to be active participants in EAS decision-making, which goes hand in hand with ambivalent feelings and experiences. Considerations about family members and the social context appear to be very important for patients and physicians when they request or grant a request for EAS. Although further empirical research is needed to assess the depth and generalizability of the results, this review provides a new perspective on EAS decision-making and challenges the Dutch ethical-legal framework of EAS. Euthanasia decision-making is typically framed in the patient-physician dyad, while a patient-physician-family triad seems more appropriate to describe what happens in clinical practice. This perspective raises questions about the interpretation of autonomy, the origins of suffering underlying requests for EAS, and the responsibilities of physicians during EAS decision-making. (shrink)

Bernadette M Tobin; Development in Virtues, Journal of Philosophy of Education, Volume 20, Issue 2, 30 May 2006, Pages 201–214, https://doi.org/10.1111/j.1467-9.

In lieu of an abstract, here is a brief excerpt of the content:diacritics 30.2 (2000) 25-42 [Access article in PDF] What is Political Feeling? Bernadette Meyler Anthony Cascardi. Consequences of Enlightenment. Cambridge: Cambridge UP,1999. As disaffection with poststructuralism increases, but new paradigms have not yet emerged, theorists have begun to reconsider the ties that current thought maintains with the tradition it critiques, in particular, its affiliations with the Enlightenment. Focus has inevitably fallen on the writings of Immanuel Kant, which (...) in the act of codifying Enlightenment rationality simultaneously initiated its dissolution. Disputes tend to arise, however, over the precise nature and cause of the hairline fracture that prevents Kant's Critiques from attaining the unity to which they aspire. Even greater controversy centers on the advisability of possible responses: should we set the bones, break open the gap, or provide an entirely new limb? In Consequences of Enlightenment, Anthony Cascardi undertakes a detailed discussion of how various theoretical schools interpret the fissure, and the problems posed by their accounts. Not simply remaining content with this critique of critiques, Cascardi presents his own stance, advising that we embrace Kant's recourse to "feeling" in the Critique of Judgment as an inevitable entailment of the Kantian system. Whereas Horkheimer and Adorno's Dialectic of Enlightenment argues that the opposition between Kantian reason and Nietzschean irrationalism represents the undoing of the Enlightenment, Cascardi responds that Kant's own writings encompass the duality. As an essential moment of what he terms the Enlightenment's "aesthetic critique," the resistance that feeling poses to "the unity of experience"--or to the unity of the Critique of Pure Reason and the Critique of Practical Reason--should be embraced. Cascardi further maintains that this "should" entails political consequences, although his text does not itself fully elaborate a vision of what these might be.The fact that such a rich suggestion remains relatively undeveloped is perhaps inevitable in a book of such comprehensive scope. Consequences of Enlightenment is a text that seems to call the reader to the task of continuing the multiple projects that Cascardi has initiated. I will attempt to articulate what those endeavors might be, and to propose points in his work upon which future inquiry could be focused. Because Cascardi's goals are two-pronged--to examine twentieth-century thinkers' Kantian inheritance and to engage directly with the "aesthetic critique" of Kant--it is sometimes difficult to ascertain whether Consequences of Enlightenment attributes certain positions to Kant or to his interpreters. Although this difference might not seem significant given Cascardi's claims about the persistence of Kantian aporias in the work of his inheritors, returning to Kant may allow us to ask how we should proceed in developing the political potentials of aesthetic critique. Two principal questions arise in this regard. The first inquires whether and how one can think aesthetics with politics; in other words, [End Page 25] what is political feeling? The second question provides a more limited point of entry into the same problem by focusing on the Critique of Judgment itself; what politics are entailed respectively by the beautiful and the sublime?Cascardi discusses the Kantian sublime only twice in detail during the course of Consequences of Enlightenment, once in chapter 4, "Communication and Transformation: Aesthetics and Politics in Habermas and Arendt," and for the second time, and most provocatively, in chapter 7, "Feeling and/as Force." In treating Hannah Arendt, who, in her 1970 Lectures on Kant's Political Philosophy, attempted to derive a Kantian account of the political from the Critique of Judgment, Cascardi explains that she tried to complete the Enlightenment by erroneously "turning from the indeterminacy of the aesthetic in Kant to a politics that designates democratic community as its field or object-domain"; he then asserts that, "Specifically, the politics that Arendt would claim to derive from Kant's aesthetics is a democratic politics of the beautiful..." [156]. Subsequently elaborating on the reasons that Arendt overemphasized the beautiful, seemingly at the expense of the sublime, Cascardi writes, "Arendt's tendency to privilege the beautiful over the sublime must be seen as part of her larger effort to construct a rational politics. For this effort, she takes... (shrink)