Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case (...) and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK.Results: Survey respondents ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision-making capacity , disagreement among caregivers and limitation of treatment at the end of life . The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct , someone capable of providing specific advice , help in weighing outcomes and clarification of the issues . Few of the types of help expected to be useful varied among countries.Conclusion: Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. (shrink)

Inner speech has been shown to vary in form along several dimensions. Along condensation, condensed inner speech forms have been described, that are supposed to be deprived of acoustic, phonological and even syntactic qualities. Expanded forms, on the other extreme, display articulatory and auditory properties. Along dialogality, inner speech can be monologal, when we engage in internal soliloquy, or dialogal, when we recall past conversations or imagine future dialogues involving our own voice as well as that of others addressing us. (...) Along intentionality, it can be intentional (when we deliberately rehearse material in short-term memory) or it can arise unintentionally (during mind wandering). We introduce the ConDialInt model, a neurocognitive predictive control model of inner speech that accounts for its varieties along these three dimensions. ConDialInt spells out the condensation dimension by including inhibitory control at the conceptualization, formulation or articulatory planning stage. It accounts for dialogality, by assuming internal model adaptations and by speculating on neural processes underlying perspective switching. It explains the differences between intentional and spontaneous varieties in terms of monitoring. We present an fMRI study in which we probed varieties of inner speech along dialogality and intentionality, to examine the validity of the neuroanatomical correlates posited in ConDialInt. Condensation was also informally tackled. Our data support the hypothesis that expanded inner speech recruits speech production processes down to articulatory planning, resulting in a predicted signal, the inner voice, with auditory qualities. Along dialogality, covertly using an avatar’s voice resulted in the activation of right hemisphere homologues of the regions involved in internal own-voice soliloquy and in cerebellar deactivation, consistent with internal model adaptation. Switching from first-person to third-person perspective resulted in activations in precuneus and parietal lobules. Along intentionality, compared with intentional inner speech, mind wandering with inner speech episodes was associated with greater bilateral inferior frontal activation and decreased activation in left temporal regions. This is consistent with the reported subjective evanescence and presumably reflects condensation processes. Our results provide neuroanatomical evidence compatible with predictive control and in favor of the assumptions made in the ConDialInt model. (shrink)

Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (...) (23%), consultation in individual cases (17.6%), and individual ethicists (8.8%), but also to other kinds of less formal ethics support (23.6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed. Although most respondents (81%) reported that they would find help useful in facing ethical difficulties, they reported having used the available services infrequently (14%). Physicians with greater confidence in their knowledge of ethics (P = 0.001), or who had had ethics courses in medical school (P = 0.006), were more likely to have used available services. Access to help in facing ethical difficulties among general physicians in the surveyed countries is provided by a mix of official ethics support services and other resources. Developing ethics support services may benefit from integration of informal services. Development of ethics education in medical school curricula could lead to improved physicians sensititity to ethical difficulties and greater use of ethics support services. Such support services may also need to be more proactive in making their help available. (shrink)

The extremely successful _Standard Model of Particle Physics_ allows one to define the so-called _Elementary Particles_. From another point of view, how can we think of them? What kind of a status can be attributed to Elementary Particles and their associated quantised fields? Beyond the unprecedented efficiency and reach of quantum field theories, the current paper attempts at understanding the nature of what these theories describe, the enigmatic reality of the quantum world.

Background Decisions regarding Cardio-Pulmonary Resuscitation (CPR) and Do Not Attempt Resuscitation (DNAR) orders remain demanding, as does including patients in the process. Objectives To explore physicians’ justification for CPR/DNAR orders and decisions regarding patient inclusion, as well as their reports of how they initiated discussions with patients. Methods We administered a face-to-face survey to residents in charge of 206 patients including DNAR and CPR orders, with or without patient inclusion. Results Justifications were provided for 59% of DNAR orders and included (...) severe comorbidity, patients and families’ resuscitation preferences, patients’ age, or poor prognosis or quality of life. Reasons to include patients in CPR/DNAR decisions were provided in 96% and 84% of cases, and were based on respect for autonomy, clinical assessment of the situation as not too severe, and the view that such inclusion was required. Reasons for not including patients were offered in 84% of cases for CPR and in 70% for DNAR. They included absent decision-making capacity, a clinical situation viewed as good (CPR) or offering little hope of recovery (DNAR), barriers to communication, or concern that discussions could be emotionally difficult or superfluous. Decisions made earlier in the patient's management were infrequently viewed as requiring revision. Residents reported a variety of introductions to discussions with patients. Conclusions These results provide better understanding of reasons for CPR/DNAR decisions, reasons for patient inclusion or lack thereof, and ways in which such inclusion is initiated. They also point to potential side-effects of implementing CPR/DNAR recommendations without in-depth and practical training. This should be part of a regular audit and follow-up process for such recommendations. (shrink)

Kant’s religious ethics is grounded in a practical philosophy where ‘God’ is subordinated to moral principles. To accomplish this goal, Kant dismantled the onto-theological groundwork of religion and the conventional method of attaching morality to God, as if morality was a consequence of religious belief. In this essay, I will show how Kant replaces the metaphysics of being with the metaphysics of morality. More importantly, I will show how Kant’s thesis of moral theism argues that the practical philosophy does not (...) end with the categorical imperative, but that Kant also thinks morality inevitably leads to religious belief. (shrink)

The most debated status of the wave function of Quantum Mechanics is discussed in the light of the epistemological vs ontological opposition.

This article is an edited transcript of the roundtable entitled “What is Philo-Performance?” that took place in Paris on 28 June 2014, within the framework of the “Theatre, Performance, Philosophy International Conference: Crossings and Transfers in Anglo-American Thought”. The conference was organized by Julien Alliot, Flore Garcin-Marrou, Liza Kharoubi and Anna Street from the LAPS, a French research group on performance philosophy.

Experimental studies of speech production involving compensations for auditory and somatosensory perturbations and adaptation after training suggest that both types of sensory information are considered to plan and monitor speech production. Interestingly, individual sensory preferences have been observed in this context: subjects who compensate less for somatosensory perturbations compensate more for auditory perturbations, and \textit{vice versa}. We propose to integrate this sensory preference phenomenon in a model of speech motor planning using a probabilistic model in which speech units are characterized (...) both in auditory and somatosensory terms. Sensory preference is implemented in the model according to two approaches. In the first approach, which is often used in motor control models accounting for sensory integration, sensory preference is attributed to the relative precision (i.e., inverse of the variance) of the sensory characterization of the speech motor goals associated with phonological units (which are phonemes in the context of this paper). In the second, ``more original’’ variant, sensory preference is implemented by modulating the sensitivity of the comparison between the predicted sensory consequences of motor commands and the sensory characterizations of the phonemes. We present simulation results using these two variants, in the context of the adaptation to an auditory perturbation, implemented in a 2-dimensional biomechanical model of the tongue. Simulation results show that both variants lead to qualitatively similar results. Distinguishing them experimentally would require precise analyses of partial compensation patterns. However, the second proposed variant implements sensory preference without changing the sensory characterizations of the phonemes. This dissociates sensory preference and sensory characterizations of the phonemes, and makes the account of sensory preference more flexible. Indeed, in the second variant the sensory characterizations of the phonemes can remain stable, when sensory preference varies as a response to cognitive or attentional control. This opens new perspectives for capturing speech production variability associated with aging, disorders and speaking conditions. (shrink)

Cette premiere synthese integrale de la pensee politique d'Emile Chartier (1868-1951, plus connu sous le pseudonyme d'Alain) se propose, a nouveaux frais et de maniere soigneusement contextualisee, de redonner a Alain la place majeure et singuliere qui lui revient dans l'histoire recente des idees : celle d'un penseur citoyen, d'un liberal de gauche compagnon de route du radicalisme, dont l'anti-etatisme, l'individualisme democratique et le rationalisme laique entrent en resonance profonde avec les preoccupations contemporaines. Jerome Perrier entend ainsi rendre justice a (...) cet insatiable chroniqueur, dont l'oeuvre a pati d'avoir ete disseminee en plusieurs milliers de Propos dans la presse de son epoque. Contre le cliche de philosophe pour classes terminales qu'on a parfois cru devoir lui accoler en raison de son style sans jargon, il campe un Alain a la fois clair et profond, soucieux d'etre comprehensible par tous, qui s'inscrit aussi dans la tradition des moralistes francais allant de Montaigne a Camus. (shrink)

Dévoilant une impressionnante galerie de portraits de femmes de la fin du xixe et du début du xxe siècle, l’ouvrage de Christine Peltre explore la collection de cartes postales acquise par Pierre de Gigord. Collectionneur passionné par les mondes ottomans et turcs, celui-ci assembla un rare éventail de cartes postales datant de l’époque où la « photographie timbrée » connaît son apogée et s’impose peu à peu comme un média de masse. Au fil des pages, où dialoguent texte et image, (...) l’ouvrage tém... (shrink)

Chile's ‘Indigenous Peoples Legislation’ goes back to Colonial time, when the Catholic Church and the Spanish Crown sought to ensure access to Indian souls and labour. This chapter offers an analysis of the processes that led to changes in Chile's Indigenous Peoples Legislation, which finally granted legal recognition to the Chilean indigenous population. Focusing on the Aymara of Arica, the ethnographic analysis reveals how a dominant group has tried to impose itself as the core of the newly born state, by (...) formally denying the ethnic heterogeneity of the population. The chapter analyses the Aymara's leaders' struggle for the assertion of their Indian identity, by looking at their participation in the political processes that eventually led to the 1993 Indigenous law. Finally, it examines the consequences of the implementation of the law for present-day Aymara leadership in North Chile. (shrink)

The goal of this article is to demonstrate that, following Derrida, in order to develop a theory of animality it is necessary to renounce to the implicit use of concepts related to subjectivity. The deconstruction of subjectivity is thus the only way to establish an ethical requirement concerning animals, a requirement which is no longer conceived from the point of view of our “humanity.” In the first part of the paper, I attempt to locate Derridean ethics within phenomenology in a (...) way which situates ethics in relation to the experience of aporia. In the second part, I focus on what Derrida calls the “carnivorous sacrifice” and try to outline a concretization of the ethics of hospitality and of responsibility that reconfigures our relationships with animals. (shrink)

Au regard de trois œuvres – Conrad, Au Cœur des ténèbres, Homère, L’Odyssée, Jankélévitch, L’Aventure, l’ennui, le sérieux – et d’un sujet de dissertation.