Ethical dilemmas in community mental health care is the focus of this article. The dilemmas are derived from a discussion of the results of a qualitative research project that took place in five countries of the European Union. The different stakeholders are confronted with the following dilemmas: community care versus hospital care ; a life with care versus a life without care ; stimulation of the client toward greater responsibility versus protection against such responsibility ; budgetary control versus financial incentives (...) , and respect for the client versus particular private needs . These dilemmas are interpreted against the background of a value based ethical model. This model offers an integral approach to the dilemmas and can be used to determine policy. The dilemmas are discussed here as the result of conflicting values—namely autonomy and privacy, support and safety, justice and participation, and trust and solidarity. (shrink)

Values in dialogue offers a practical and theoretical model for ethics in care, that has grown from experience and research. The foundation of this ethical model is laid in the care relationship and in relational personalism. It consists of three pillars: values, dialogue, and attitudes. On this basis, a practical model for ethical reflection is developed. The aim is to empower professionals in their own ethical reflection and responsibility in concrete care situations. The model is applied on several topics, such (...) as collaboration between professionals, collaboration with clients and significant others, restriction of freedom and use of coercion, and exchange of information and confidentiality. 'Values in dialogue' is written for care professionals in their daily practice and in ethics commitees, but also for teachers and students in ethics courses. It focuses in particular on mental healthcare, support for people with mental disabilities, and care for elderly persons. (shrink)

In psychiatry, caregivers try to get free and informed consent of patients, but often feel required to restrict freedom and to use coercion. The present article develops ethical advice given by an Ethics Committee for Mental Health Care. The advice recommends an ethical ideal of shared deliberation, consisting of information, motivation, consensus and evaluation. For the exceptional use of coercion, the advice develops three criteria, namely incapacity to deliberate, threat of serious harm and proportionality between harm and coercion.The article also (...) discusses the viewpoints of the ethical advice and of the European Convention on Human Rights and Biomedicine: is the advice in agreement with the Convention and can the advice refine the guidelines of the Convention for the particular context of psychiatry? Although the Convention emphasises the autonomy of the individual patient, whereas the advice focuses on the relationships between the partners involved, the advice enjoys a complementary and supportive function in the application of the Convention. (shrink)

Freedom and security are often portrayed as things that have to be traded off against one another, but this view does not capture the full complexity of the freedom-security relationship. Rather, there seem to be four different ways in which freedom and security connect to each other: freedom can come at the cost of security, security can come at the cost of freedom, freedom can work to the benefit of security, and security can work to the benefit of freedom. This (...) paper analyses each of these connections in turn. It shows that particular understandings of freedom can help us to see particular connections between freedom and security. The practical examples used to illustrate these connections are drawn from the context of the COVID-19 pandemic. It will be suggested that, in the face of challenges such as this one, taking into account all four connections between freedom and security can ultimately help decision-makers in upholding both. (shrink)

The central thesis of this essay is that basic income experiments are justified if their expected benefits in terms of justice exceed their expected costs in terms of justice. The benefits are a function of basic income’s effect on the level of justice attained in the context in which it is implemented, and the experiment’s impact on future policy-making. The costs comprise the sacrifices made as a result of the experiment’s interventional character, as well as the study’s opportunity costs. In (...) light of the proposed standard of justification for basic income experiments, the factors that play a role in it, and the way these interact with one another, this essay provides some practical recommendations for researchers hoping to conduct such an experiment. (shrink)

In this paper, I argue for a wider application of Archon Fung's (2007) idea of a "pragmatic equilibrium". Would implementation of the practical recommendations that follow from a certain theory really contribute to the realisation of the values on which the theory was built? If political philosophers asked this question more often, this would benefit both the quality and the relevance of their theories. [Dutch].

A decade after the fall of Communism in Europe, the Czech Republic'smembership in the European Union is still a matter of a relatively shortwaiting period of 4 years. Not so the imagination of this membership andthe creation of a political concept created to promote this goal: thespecific Central European policy initiated by Thomas G. Masaryk andrevitalized by Václav Havel. Despite the deep differences in thepolitical thought and philosophical orientations of both Presidents, notto mention the historic rupture of 41 years of (...) Totalitarianism, theirperceptions of Europe as an Imagined Community are identical. (shrink)

The present ethical advice tackles the question as to how caregivers in a Catholic mental health service can take care of psychiatric patients requesting euthanasia because of their unbearable mental suffering. The question arises because the Belgian act on euthanasia allows euthanasia under certain conditions, while the Roman Catholic Church forbids euthanasia in all circumstances. The ethical advice is based on the assessment of fundamental values: the inviolability of life, the patient’s autonomy, and the care relationship between caregivers and patient. (...) To integrate these values, caregivers should in a timely fashion make clear that life is inviolable, attentively respect the patient’s autonomy, and provide the best possible care relationship, including counseling for existential questions. If the request for euthanasia persists, the only sensible option is to refer the patient to another physician, guaranteeing the continuity of the care relationship. In the tension between the inviolability of life and the patient’s autonomy, the care relationship is the binding value. (shrink)

La confrontation Kant/Wittgenstein qui se dessine ici n'a pas pour objectif principal de présenter les doctrines des deux auteurs. Il s'agit plutôt de marier ces pensées qui ne le désirent pas, de profiter de la confrontation pour faire avancer le débat. Quel débat? Contrairement à I'ordre historique, il tire son origine de Wittgenstein: comment faut-il comprendre les prorèmes que soulève Wittgenstein, les interdits qu'il pose? Certaines de ses affirmations ne peuvent tout simplement pas être des jugements analytiques, aurait dit Kant. (...) Nombre de ses «remarques grammaticales» ne sont évidemment pas des tautologies, et la question se pose au moins de savoir comment elles sont possibles comme jugements analytiques. (shrink)

Le but de ces quelques remarques sur le jugement est de faire apparaître cette notion sous différents éclairages , tout en assurant une certaine progression d’un point de vue à l’autre. Dans la première section, il sera question non seulement de la synthèse au sens kantien du jugement synthétique fondé sur l’intuition, mais également des trois synthèses predicative, véritative et apophantique distinguées par Heidegger et reprises par Lotz. La deuxième section, plus proche de la pensée de Wittgenstein, s’interroge sur le (...) jugement dans le cadre de la « grammaire philosophique ». Enfin, la troisième section examine l’idée d’un primat du jugement sur la base du primat de la raison théorique soutenu par Jacques Poulain. En apparence, cette thèse prend le contre-pied de celle de Kant dans la Critique de la raison pratique, sans qu’on puisse lui attribuer la volonté de fonder une nouvelle « philosophie théorique ».The aim of the following remarks on judgment is to present this notion from different points of view , with a certain progression from the first to the others point of view. In the first section, it will be question not only of synthesis in the kantian sense which bears upon intuition, but equally of the three syntheses distinguished by Heidegger and Lotz. The second section, more wittgensteinian in spirit, asks the question of judgment in the context of the " philosophical grammar ". Finally, the third section investigates Jacques Poulain’s idea of a primacy of judgment on the basis of the primacy of theoretical reason over practical reason. At first sight, this thesis of Poulain seems to go against Kant’s thesis in the Critic of practical Reason, but we don’t have to attribute to him the will to establish a new " theoretical philosophy ". (shrink)

Pour répondre aux problématiques engendrées par la diffusion de plus en plus massive des corpus linguistiques et à l’hétérogénéité de leurs formats, nous proposons une méthode permettant de prendre en main des corpus langagiers oraux et de les convertir dans un format permettant leur exploitation outillée. Pour cette recherche, le corpus ESLO nous sert d’exemple par sa licence de diffusion, son format, son volume et ses atouts sociolinguistiques et diachroniques. Notre travail se fonde sur la compilation de ce corpus pour (...) le rendre compatible avec l’outil de textométrie TXM. Nous opérons un ensemble de transformations des données pour l’utiliser au mieux. Enfin, pour illustrer les apports de ces avancées méthodologiques, nous proposons une analyse fine et multidimensionnelle de l’usage des interrogatives dans le corpus ESLO. (shrink)

L'article montre que, contrairement à ce qui est généralement admis, il existe de la variation dans le sens des mots même en corpus spécialisés. Mise en relation avec les sous-domaines dont lesquels sont repérés ces différents sens, cette variation peut être assimilée à une variation de point de vue.

Proposed solutions to sustainability often bring different economic sectors into conflict; when a sustainable solution for one sector is non-sustainable for another it creates what we call the dilemma of sustainability. A recent example took place in the Columbia Basin of the Pacific Northwest, involving competing notions of sustainability by fisheries and the energy industry. Taking up some ideas of Eger and Lyotard, we criticize the constructivist approach which treats large ecosystems as constructions and the process of resolving conflicts of (...) sustainability as one solely consisting of negotiations involving the trading off of interests. We propose instead to treat such conflict resolution via a Gadamerian-inspired hermeneutics that sees different economic sectors as having different interpretations of sustainability and that aims at common understanding. (shrink)

INTRODUCTION: LE LIEU SÉMIOTIQUE JULIA KRISTEVA Les stoïciens furent probablement les premiers à developper une théorie détaillée du SIGNE - du ...

Because of the development towards community care, care providers not only exchange information in a team, but increasingly also in networks. This is a challenge to confidentiality. The ethical question is how care providers can keep information about the care receiver confidential, whilst at the same time exchanging information about that care receiver in a team or network? Can shared confidentiality be extended from a team to a network? To clarify this question, the article refers to the advice of an (...) expert ethics committee in mental health care. The advice regards exchange of information in a network as a further step in enhancing collaboration among care providers. Therefore, the good and evident practice of shared confidentiality in a team can be extended to a network if the same conditions are met. First, the care providers participate in a clearly defined and identifiable team or network. Secondly, they have a shared care responsibility. Thirdly, they have a duty of confidentiality. Fourth, they dialogue with the care receiver and obtain his or her consent. Finally, they apply the filter of relevance. Hence, conditional shared confidentiality is an ethical justification for the exchange of information in a team or network. (shrink)

Legal scholars attribute a great deal of importance to the linguistic dimension behind recodification. According to them, language contributes greatly to the improvement of both the accessibility and clarity of the law. Nevertheless, little research on the linguistic aspects of codification exists within both linguistics and legal theory. Consequently, it seems worthwhile to study this linguistic dimension more in depth. To this aim, the recent legislative proposals to recodify various economic, civil and criminal codes in Belgium serve as a useful (...) case study to improve our understanding of the linguistic challenges of recodification. In this article we will look at the linguistic comments made by the Belgian Council of State, a state organ which offers technical advice to the legislator, on the relevant proposals and consider the type of linguistic comments made, and, their implementation by the legislator. On the one hand, such an analysis allows us to single out the linguistic problems accompanying the Belgian recodification and, on the other, to elaborate on them with the help of the insights provided by legal theory. In doing so, we hope for our analysis to be a useful point of reference both for research on the Belgian recodification and other legal/linguistic approaches to recodification in general. (shrink)