Cette introduction au actes du XXe congrès de la Société de philosophie du Québec présente celui-ci comme l'occasion d'un bilan et d'une prospective. La société nouvelle, en effet, c'est d'abord la société actuelle. que l'on peut examiner par rapport aux revendications féministes des trois décennies précédentes: lecture politique. Mais la société nouvelle, c'est aussi celle de demain, celle qu'il faut imaginer pour mesurer les insuffisances de la société actuelle et pour inciter le présent à s'humaniser: lecture hétéropolitique. Il s'agissait donc (...) d'interroger le présent à la lumière des étapes franchies et des effets pervers qu'elles ont parfois entraînés, et de "rappeler les projets mis de l'avant par le mouvement des femmes". (shrink)

Clinical ethics support for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria at Amsterdam University Medical Center. We specifically aimed to integrate CES into daily (...) work processes at the CEGD. In this paper, we describe the CES services offered there in detail and elaborate on the 16 lessons we learned from the process of developing an integrative approach to CES. These learning points can inform and inspire CES professionals, who wish to bring about greater integration of CES services into clinical practice. (shrink)

Clinical ethics support for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria at Amsterdam University Medical Center. We specifically aimed to integrate CES into daily (...) work processes at the CEGD. In this paper, we describe the CES services offered there in detail and elaborate on the 16 lessons we learned from the process of developing an integrative approach to CES. These learning points can inform and inspire CES professionals, who wish to bring about greater integration of CES services into clinical practice. (shrink)

BackgroundIn the Netherlands, patients have the legal right to make a request for euthanasia to their physician. However, it is not clear what it means in a moral sense for a physician to receive a request for euthanasia. The aim of this study is to explore the moral values of physicians regarding requests for euthanasia. MethodsSemi-structured interviews were conducted with nine primary healthcare physicians involved in decision-making about euthanasia. The data were inductively analyzed which lead to the emergence of themes, (...) one of which was about values regarding end-of-life decisions.ResultsFour clusters of values related to euthanasia requests are described: values related to 1) the patient; 2) the family; 3) the physician; and 4) life and death. The data show that the participants value patient autonomy as a necessary but not sufficient condition for meeting a euthanasia request. A good relationship with the patient and the family are important. For the physician, the values physician autonomy, responsibility, understanding the patient and relief of suffering play a role. Life as an intrinsic good and a peaceful death are also important values.ConclusionThis study shows that next to patient autonomy and the relationship with the patient and the family, it is important for the participants to act in accordance with their professional values and to do justice to values related to life and death. The awareness of going against the intrinsic value of life is crucial, even if performing euthanasia may result in a feeling of relief or gratitude afterwards. (shrink)

Ce petit article explicite brièvement le contexte de l�article qui précède et en retrace le parcours en montrant comment le philosophe s�approche prudemment des notions clés de la théologie chrétienne.

El presente artículo busca enfocar la correlación entre el uso de la energía, el espacio, el territorio y el desarrollo local, teniendo en cuenta la utilización del gas natural en las cerámicas de Mato Grosso del Sur/Brasil. La importancia de los hechos geográficos es pautada por muchos parámetros, como el paso del tiempo, los nuevos descubrimientos tecnológicos, las necesidades de materias primas, los objetivos nacionales e internacionales y la ética de las relaciones internacionales. El gas natural no es utilizado aún (...) como fuente alternativa de energía en gran escala en el Estado. Puede ser considerado como uno de los resultados de la valorización de la política socio económica, de la cultura local y del medio ambiente preservado como parte de la identidad local del ser humano al mejorar su calidad de vida. (shrink)

BackgroundThe Dutch Euthanasia Act applies to patients 12 years and older, which makes euthanasia for minors younger than 12 legally impossible. The issue under discussion specifically regards the capacity of minors to request euthanasia.ObjectiveGain insight in paediatric experts’ views about which criteria are important to assess capacity, from what age minors can meet those criteria, what an assessment procedure should look like and what role parents should have.MethodsA Delphi study with 16 experts (paediatricians, paediatric nurses and paediatric psychologists) who work (...) in Children Comfort Teams in Dutch academic hospitals. The questionnaire contained statements concerning criteria for capacity and procedural criteria. Consensus was defined as ≥80% agreement.ResultsThe experts agreed that five criteria for capacity, found in a previous literature study, are all important. They agreed that some children between ages 9 and 11 could meet all the criteria. Consensus was reached for the statements that the entire medical team should be involved in the decision making and that a second independent expert must assess the case. Experts agreed that the parents’ opinion is relevant and should always be taken into account, but it need not be decisive.ConclusionThis study shows that the age limit of 12 years in the Dutch Euthanasia Act is too strong according to paediatric experts. Letting go of the age limit or lowering the age limit combined with adequate capacity assessment for minors younger than 12 are options that should be discussed further. (shrink)

Background There has been little attention paid to research on the outcomes of clinical ethics support or critical reflection on what constitutes a good CES outcome. Understanding how CES users perceive the importance of CES outcomes can contribute to a better understanding, use of and normative reflection on CES outcomes. Objective To describe the perceptions of Dutch healthcare professionals on important outcomes of moral case deliberation, prior to MCD participation, and to compare results between respondents. Methods This mixed-methods study used (...) both the Euro-MCD instrument and semi-structured interviews. Healthcare professionals who were about to implement MCD were recruited from nursing homes, hospitals, psychiatry and mentally disabled care institutions. Results 331 healthcare professionals completed the Euro-MCD instrument, 13 healthcare professionals were interviewed. The outcomes perceived as most important were ‘more open communication’, ‘better mutual understanding’, ‘concrete actions’, ‘see the situation from different perspectives’, ‘consensus on how to manage the situation’ and ‘find more courses of action’. Interviewees also perceived improving quality of care, professionalism and the organization as important. Women, nurses, managers and professionals in mentally disabled care rated outcomes more highly than other respondents. Conclusions Dutch healthcare professionals perceived the MCD outcomes related to collaboration as most important. The empirical findings can contribute to shared ownership of MCD and a more specific use of MCD in different contexts. They can inform international comparative research on different CES types and contribute to normative discussions concerning CES outcomes. Future studies should reflect upon important MCD outcomes after having experienced MCD. (shrink)

Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator. In this paper, we present the first results of a study in which we evaluated the programme. We used a mixed methods design. One hundred and twenty trained healthcare professionals and five trainers from 16 training groups working in different (...) healthcare organisations throughout the Netherlands were included. After completion of the programme, participants feel sufficiently confident and equipped to facilitate an MCD session. Feeling competent does not mean that participants have no doubts or questions left. Rather, they are aware of their limitations and see the need for continuous learning. According to the respondents, the actual exercise of facilitating MCD during and in between the training sessions contributed most to the development of competences necessary for being an MCD facilitator. Respondents without prior experience of participating in MCD sessions felt less competent after the training than those who had participated in MCD sessions before. Self-attributed competence varied between participants with different professional backgrounds. (shrink)

There is considerable support for the idea that an atmosphere of safety can foster learning in groups, especially during ethics training courses. However, the question how safety dynamics works during ethics courses is still understudied. This article aims to investigate safety dynamics by examining a critical incident during a military ethics train-the trainer course during which safety was threatened. We examine this incident by means of a four-factor analysis model from the field of Theme-Centered Interaction (TCI). We show that during (...) ethics training courses a safety paradox can occur, involving a tension between honesty and openness to other perspectives and values. Finally, we discuss how trainers can foster safety during ethics training. (shrink)

Much of what we know and see of ethics support, in literature and during trainings, workshops and conferences, derives from clinical ethicists working at academic medical centers. Besides the probl...

Le premier numéro de Pierre d'angle s'ouvrait par un éditorial qui en proposait l'esprit et les orientations. Il nous a paru opportun, à l'occasion de cettetroisième livraison, d'approfondir sous forme d'une méditation à trois voix, et selon une thématisation plus explicite - à la fois philosophique, historienne et théologique -, les motif et les enjeux de ce dialogue de la foi avec la culture contemporaine, si difficile qu'il soit de saisir celle-ci dans son unité. Nous avons choisi de vous présenter (...) notre démarche sous la forme d'un paradoxe.. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities . This theoretical (...) framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities. This theoretical framework (...) prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Cette édition numérique a été réalisée à partir d'un support physique, parfois ancien, conservé au sein du dépôt légal de la Bibliothèque nationale de France, conformément à la loi n° 2012-287 du 1er mars 2012 relative à l'exploitation des Livres indisponibles du XXe siècle. Pages de début -- I -- Phénoménologies hégelienne et husserlienne Hegel et Husserl sur l'intersubjectivité Itinéraires phénoménologiques La dialectique de l'intentionnalité Essai de synthèse d'une méthode phénoménologique -- II -- Classes sociales selon Marx Imaginaire social et (...) creation des idéologies Production et classes sociales dans Le Capital L'évolution du concept de la lutte des classes dans la pensée de Marx Lesclasses sociales dans la philosophie de l'histoire de Marx Pages de fin. (shrink)

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

On parle depuis longtemps d'une "dialectique de la raison", c'est-à-dire d'un renversement de la raison en son contraire : identifiée à l'origine à un projet d'émancipation, elle se serait subrepticement transformée en "raison du plus fort". C'est à une telle question que le présent livre s'attache de façon critique : analysant la philosophie politique de Leo Strauss, la dialectique de la raison et la force chez Machiavel, Hobbes et Locke, l'approche de la modernité par Foucault et par l'Ecole de Francfort, (...) l'ouvrage se termine sur une mise en question générale de la métaphysique post-kantienne. (shrink)

Borrett, Kelly and Kwan [ Phenomenology, dynamical neural networks and brain function, Philosophical Psychology, 13, 000-000] claim that unbiased, self-evident, direct description is possible, and may supply the data that brain theories account for. Merleau-Ponty's [ Phenomenology of perception, London: Routledge] description of Schneider's apraxia is offered as a case in point. According to the authors, Schneider's apraxia justifies brain components of predicative and pre-predicative experience. The description derives from a bias, however, that parallels modularity's morphological reduction. The presence of (...) biasing presuppositions contradicts the goal of direct description. Moreover, the authors' brain account is not necessary to explain Schneider's apraxia, and morphological reduction is not sufficient to explain emergent phenomena of motor control. (shrink)

The government-opposition scheme of a two-party system does not function that clearly in a multiparty system which is the case in Belgium. To examine to what extent the opposition parties in a multi-partysystem are functional for policymaking, the period 1965-1971 was chosen for Belgium, providing a complete scale of government and opposition parties.A content analysis of all political parties' platforms in 1965 permits to determine the policy objectives, classified in policy areas, so that at the end of the six years (...) a survey could be made about the completely andpartly realised planks of the platforms according to government and opposition parties, according to the party-strength which was congruent with the duration of government participation. In Belgium a distinctioncan also be made between the traditional opposition parties and the nonelitist opposition parties, which during the given period were not accepted as possible government parties by the political elite.To obtain a correct evaluation of the realisations, the approach took successively into account the absolute number of platform-planks, the number of specific items of a party and the degree of importance andsocial repercussion of the distinct planks that could be realised.Although respectively for 6, 4 and 2 years in the government the CVP, the BSP and the PVV realise approximately the same number of planks. The non-elitist opposition party Volksunie realised a smaller butstill considerable number of objectives. So did also, but to a smaller extent the RW, KP and FDP. The interpretation of these results could be the loss of distinctiveness of the government-opposition scheme in amultiparty system, the elite-consensus in Belgium, the function of the «zweeppartij» strategy and the definition of the opposition in terms of action. (shrink)

Le campus virtuel de la filière TIC de Limoges propose depuis 1998, via Internet, des formations diplômantes pour les TIC et par les TIC. Les 600 étudiants sont organisés en communautés virtuelles d'apprentissage. Les communautés virtuelles sont une forme de socialisation propre à Internet. Le travail de groupe évite le sentiment d'isolement et facilite les apprentissages. Les étudiants et les enseignants échangent et partagent au niveau de la communauté globale, au niveau des communautés de promotion et d'unité d'enseignement qui sont (...) des communautés de pratique. Ils pratiquent le travail collaboratif au niveau des communautés de travail, c'est-à-dire qu'ils mutualisent leurs compétences et coordonnent leurs actions pour mener à bien les apprentissages. Pour réussir ce travail collaboratif il ya des règles et une « nétiquette » à respecter. L'intelligence collective naît du travail en commun des étudiants en réseau.The virtual campus of the ICT sector offers Limoges since 1998, via the Internet, diploma courses for ICT and ICT. 600 students are organized in virtual learning communities. Virtual communities are a form of socialization own Internet. Group work prevents isolation and facilitates learning. Students and teachers exchange and share in the global community, community-level promotion and teaching unit which are communities of practice. They practice in collaborative working communities, that is to say, they pool their expertise and coordinate their actions to carry out learning. To achieve this collaboration there are rules and "netiquette" to follow. Collective intelligence born of students working together in a network. (shrink)