How the insane asylum became a laboratory of democracy is revealed in this provocative look at the treatment of the mentally ill in nineteenth-century France. Political thinkers reasoned that if government was to rest in the hands of individuals, then measures should be taken to understand the deepest reaches of the self, including the state of madness. Marcel Gauchet and Gladys Swain maintain that the asylum originally embodied the revolutionary hope of curing all the insane by saving the (...) glimmer of sanity left in them. Their analysis of why this utopian vision failed ultimately constitutes both a powerful argument for liberalism and a direct challenge to Michel Foucault's indictment of liberal institutions. The creation of an artificial environment was meant to encourage the mentally ill to live as social beings, in conditions that resembled as much as possible those prevailing in real life. The asylum was therefore the first instance of a modern utopian community in which a scientifically designed environment was supposed to achieve complete control over the minds of a whole category of human beings. Gauchet and Swain argue that the social domination of the inner self, far from being the hidden truth of emancipation, represented the failure of its overly optimistic beginnings. Madness and Democracy combines rich details of nineteenth-century asylum life with reflections on the crucial role of subjectivity and difference within modernism. Its final achievement is to show that the lessons learned from the failure of the asylum led to the rise of psychoanalysis, an endeavor focused on individual care and on the cooperation between psychiatrist and patient. By linking the rise of liberalism to a chapter in the history of psychiatry, Gauchet and Swain offer a fascinating reassessment of political modernity. (shrink)

This essay reconstructs conceptually and situates historically contemporary French philosopher Marcel Gauchet's theory of the origins and development of modern selfhood. It argues that his history of the self as the interiorization of constitutive alienation, and of the history of self-consciousness as the progressive recognition of this alienation, originated out of a unique combination of historical factors—the radical politics of May 1968, the rise of the antipsychiatry movement, and the new psychoanalysis of Jacques Lacan. The essay considers Gauchet's study, together (...) with his partner Gladys Swain, of the foundations of psychiatry, and investigates the connections of their narrative of origins to Michel Foucault's work. The essay concludes by turning to Gauchet's more recent contributions and considering the implications of his history of the self for Anglo-American scholarship. (shrink)

Inspired by three monographs of Gladys Swain and Marcel Gauchet, my presentation traces the rise of the new science of psychiatry in Revolutionary France, with Philippe Pinel and his student J.-E. Esquirol. As the directors of the division of the aliénés in the Hôpital Bicêtre (Paris), Pinel and Esquirol pioneered a therapeutic programme that spread out between their “traitement moral” (reasoning with the passions) and an “energetic repression,” wherever necessary. The discipline they created sought to gain autonomy from (...) medicine treating diseases of the body, much as pathology would do in regard to physiology, some fifty years later. Using Canguilhem, Foucault’s teacher and significant influence, I show how the unfolding of a science of disorders (for Canguilhem, this was pathology) poses questions of taxonomy and runs the inevitable ‘risk’ of extensive fragmentation. This is what happens in France after Pinel. However, Pinel, above all, will have made one contribution that—by Swain and Gauchet’s argument—stands in stark contrast to the theses of the young Foucault. Rather than sequestering and excluding the fou by forcing him or her into exaggerated, discursive revelations or silence, Pinel and Esquirol “discover” the sense, or sens , at the heart of madness, notably in what Pinel called “manie intermittente.” Esquirol takes this discovery one step further, to discern in various attacks, a certain rationality. This rather modern conception of madness exerts a considerable influence on literature, criticism, philosophy, and medicine in their time. Hegel’s understanding of madness will come directly from Pinel, and it will see in folie the internal division of subjective Reason. From this characterization comes a therapeutics based on the conviction that one could often reintegrate the mad into society, and avoid prolonged sequestration and exclusion. Thus the presentation focuses on Swain and Gauchet’s question to Foucault ( Histoire de la folie à l’âge classique , notably), using the work of Pinel and Hegel to illustrate their claim. (shrink)

This article reveals how Marcel Gauchet and his late wife Gladys Swain revise Foucault's history of madness and modernity by arguing that the history of modern civilization represents a recognition of the mad, rather than their exclusion. Turning to the French Revolution, the article then examines the relationship between disciplinary practices and a wider democratic context. It shows that while Foucault reduces democratic societies to proto totalitarian practices, Gauchet and Swain give a broader and more historically complex (...) account of asylums and the democratic context in which they emerge. This allows them to see resistance in the asylum and in democratic societies in general: while Foucault thought the panoptic asylum revealed modernity's ultimate success, for Gauchet and Swain it proved only its failure. However, the article ends by arguing that, despite all their differences, Gauchet and Swain's critique of contemporary societies remains in some respects indebted to Foucault. (shrink)

A growing body of empirical literature challenges philosophers’ reliance on intuitions as evidence based on the fact that intuitions vary according to factors such as cultural and educational background, and socio-economic status. Our research extends this challenge, investigating Lehrer’s appeal to the Truetemp Case as evidence against reliabilism. We found that intuitions in response to this case vary according to whether, and which, other thought experiments are considered first. Our results show that compared to subjects who receive the Truetemp Case (...) first, subjects first presented with a clear case of knowledge are less willing to attribute knowledge in the Truetemp Case, and subjects first presented with a clear case of nonknowledge are more willing to attribute knowledge in the Truetemp Case. We contend that this instability undermines the supposed evidential status of these intuitions, such that philosophers who deal in intuitions can no longer rest comfortably in their armchairs. (shrink)

A growing body of empirical literature challenges philosophers’ reliance on intuitions as evidence based on the fact that intuitions vary according to factors such as cultural and educational background, and socio‐economic status. Our research extends this challenge, investigating Lehrer’s appeal to the Truetemp Case as evidence against reliabilism. We found that intuitions in response to this case vary according to whether, and which, other thought‐experiments are considered first. Our results show that compared to subjects who receive the Truetemp Case first, (...) subjects first presented with a clear case of knowledge are less willing to attribute knowledge in the Truetemp Case, and subjects first presented with a clear case of non‐knowledge are more willing to attribute knowledge in the Truetemp Case. We contend that this instability undermines the supposed evidential status of these intuitions, such that philosophers who deal in intuitions can no longer rest comfortably in their armchairs. (shrink)

Background Caring is a core function of nurses and it confers upon them ethical obligations as ethical agents. Failure to carry out such ethical obligations raises ethical concerns. This study was not intended to explore ethical concerns, but the reported findings reveal problems which have ethical implications. This paper aims to elucidate the ethical issues inherent in the findings and propose strategies to mitigate them. Research design and methods An exploratory-descriptive qualitative design was used within a larger Action Research Study. (...) Data were collected through focus group discussions with nurse/midwives, and through exit interviews which were conducted with the women who participated in the study on their day of discharge. Six focus group discussions and thirty exit interviews were conducted, and data were analysed through thematic analysis. Participants and research context The study took place at selected maternal and child healthcare settings in Lilongwe, Malawi. The participants were nurse/midwives and women who were admitted in maternal and child healthcare settings and were purposively sampled. Ethical considerations Ethical approval was obtained from the relevant ethics committee and all ethical guidelines were followed in the conduct of the study. Findings The findings are presented under three themes which emerged from the data. The findings reveal effects of staff shortages on patient outcomes, problems experienced in low resource clinical settings and disrespectful nurse/patient communication. Conclusion The findings reveal that institutional factors constrain moral agency and patient safety is severely compromised in some of the clinical settings in Malawi which raises serious ethical concerns. (shrink)

This article reports findings of a hermeneutic phenomenological study that explored the clinical learning experience for Malawian undergraduate student nurses. The study revealed issues that touch on both nursing education and practice, but the article mainly reports the practice issues. The findings reveal the emotions that healthcare workers in Malawi encounter as a consequence of practising in resource-poor settings. Furthermore, there is severe nursing shortage in most clinical settings in Malawi, and this adversely affects the performance of nurses because of (...) the excess workload it imposes on them. The results of the study also illustrate loss of professional pride among some of the nurses, and the article argues that such a demeanour is a consequence of burnout. However, despite these problems, the study also reveals that there are some nurses who have maintained their passion to care. (shrink)

This article examines the role of culture in the metaphorical/metonymic conceptualizations of fear, a primary emotion, in two languages—Akan (a West African, Kwa language) and English. The article adopts the general framework of conceptual metaphor theory (CMT) to compare and contrast the differences and/or similarities in the conceptualizations as well as the language-specific construals or elaborations of shared conceptual metaphors of fear in the two languages. The analysis of the language-specific realizations of the shared metaphorical/metonymic conceptualizations of the emotion concept (...) reveals both similarities and differences in the two languages, showing support for the cultural embodied cognition thesis, namely, the similarities in the conceptualization of emotions across cultures may be explained in terms of universal embodied cognition from which general metaphorical principles derive. However, the differences in language-specific elaborations may be explained in terms of cultural filtering of the general universal conceptualizations to reflect human experiences that are more salient to a particular sociocultural group. This analysis also shows a metaphor–metonymy interaction in the conceptualization of emotions across cultures. (shrink)

In the specialized area of pediatric endocrinology, the use of human growth hormone (hGH) both for children who have a growth hormone abnormality and for the treatment of non-hGH-deficient children who are short is a current clinical reality that raises important ethical questions. Generally speaking, the use of hGH for those children who are clearly lacking it is an efficacious intervention based upon established clinical criteria. The use of hGH for children who are short, but have no growth hormone abnormality (...) is ethically and clinically more controversial. The moral conundrum of how to gain knowledge about new medical treatments that may be beneficial to children while, at the same time, ethically enrolling them in clinical trials with placebo arms in order to gain such knowledge will continue to be a contentious issue in the conduct of research and in the delivery of health care. In addition, there are questions about what ought to be studied and whether a physical characteristic such as short stature ought to be viewed as a circumstance of less than optimal health. (shrink)

The issues of tithes and seed sowing have taken a central focus in contemporary Christianity in Nigeria among the preachers. Many a time, it is assumed that tithes and seed sowing are requirements for salvation, prosperity and total well-being of the members. Making many to believe that Christianity is a money-venture business one can succeed if he knows how to hoodwink the gullible. Many have been deceived that by parting with a substantial amount of money in the name of sowing (...) seed, their problems would be solved. Unfortunately, the person’s problem may remain the same or even be compounded. This paper evaluates the activities, attitude and their inordinate ambitions. It examines the impact of tithe and seed sowing on Christianity in Nigeria. The research method adopted for this work is the qualitative phenomenological method. The paper observed that the value of tithe and seed sowing has changed from what is prescribed in the bible to what is preached on the pulpits. The study recommends among other things, that these preachers should preach the gospel with decorum and as it were in the bible so that its influence on Nigerians will bring about a reduction in crime, corruption and other immoral activities in Nigeria. Contribution: The article is focused on the issues of tithes and seed sowing. It underscores the fact that the message of tithe and seed sowing has become a means of siphoning members and enriching the preachers. It further reveals its negative and positive impacts such as, the promotion of corruption and fraud in the church and society, contribution to the decline of morality in the church and the society, increasing crime rate and increasing poverty rate in Nigeria among others. (shrink)

The evolutionary theory of the knowledge reunites its facts of several independent sources: first of the Biological investigation of the conduct, Second, they constitute the systematic conditions of the evolution. Third it is continuum of the evolution, that comes in support of the thesis that as I ..