Family Medicine Groups (FMGs) are the most recently developed primary care organizations in Quebec (Canada). Nurses within FMGs play a central role for patients with chronic diseases (CD). However, this complex role and the nursing activities related to this role vary across FMGs. Inadequate knowledge of nursing activities limits the implementation of exemplary nursing practices. This study aimed to describe FMG nursing activities with patients with CD and to describe the facilitators and barriers to these activities. A multiple‐case study was (...) performed with ten nurses practicing among patients with CD in FMGs. Five data sources were used to provide an in‐depth description of nursing activities and the facilitators and barriers to the development of these activities. After qualitative data analysis, findings show that nursing activities are clustered into five domains: Global assessment of the patient, Care management, Health promotion, Nurse–physician collaboration, and Planning services for patients with CD. Activities vary depending on contextual factors identified in each case. This multiple‐case study provides a clear description of nursing activities with patients with CD. There is a need for improved nursing activities and expertise in domains of activities that are less present in FMGs, such as case management and interprofessional collaboration. (shrink)

For better or worse, places matter to us. Especially the familiar places we call home—the ones that embody our personal and cultural histories, give our lives a sense of stability, and support the routines of everyday life. Global Climate Change (GCC) poses an existential threat to these places, engendering nonmaterial losses that threaten subjective well-being and overall mental health. Unfortunately, these nonmaterial losses are often overlooked or underappreciated. My aim in this article is to counter this tendency and explore the (...) relationship between people and place in a way that sheds light on the nonmaterial threat of GCC. I approach this task from the lens of everyday aesthetics. While finding adequate compensation for these nonmaterial losses is unlikely, I suggest that sensitivity to the aesthetic texture of everyday life can provide a source of aesthetic consolation that can make the challenges of GCC easier to manage. (shrink)

The rise of Islamic activism in Egypt during the 1970s relied in large part on the production and mass dissemination of religiously oriented periodicals. Islamic social movement organizations ranging from the established al-Gamʿiyya al-Sharʿiyya to the revived Muslim Brotherhood utilized magazines to inform, orient, and mobilize Egyptians while engaging the state directly during Anwar al-Sadat’s ‘Infitah’. By comparing the framing processes within three of the most prominent Islamist periodicals of this period, this article investigates the process by which movement leaders (...) actively constructed the frames around which activists recruited and mobilized supporters. I argue that Islamist magazines attempted to offer historical continuity with prior movements, authenticity in their teaching of religious thought and practice, and a reframing of a political agenda that was traditionally dominated by state institutions. More significantly, by forging a message that attempted to unify all of these elements, these publications aided in the construction of new communities of believers that charted the course for the next era of Islamic activism in Egypt. (shrink)

Practicing Islam in Egypt: Print Media and Islamic Revival By Rock-SingerAaron, xii + 211 pp. Price HB £75.00. EAN 978–1108492058.

Although medicolegal challenges to the use of neurologic criteria to declare death in the USA have been well-described, the management of court cases in the United Kingdom about objections to the use of neurologic criteria to declare death has not been explored in the bioethics or medical literature. This article (1) reviews conceptual, medical and legal differences between death by neurologic criteria (DNC) in the United Kingdom and the rest of the world to contextualize medicolegal challenges to DNC; (2) summarizes (...) highly publicized legal cases related to DNC in the United Kingdom, including the nuanced 2022 case of Archie Battersbee, who was transiently considered dead by neurologic criteria, but ultimately determined to be in a vegetative state/unresponsive-wakeful state; and (3) provides an overview of ethical issues raised by medicolegal challenges to DNC in the United Kingdom and a comparison to the management of these challenges in the USA. (shrink)

This collective book analyzes seriality as a major phenomenon increasingly connecting audiovisual narratives (cinematic films and television series) in the 20th and 21st centuries. The book historicizes and contextualizes the notion of seriality, combining narratological, aesthetic, industrial, philosophical, and political perspectives, showing how seriality as a paradigm informs media convergence and resides at the core of cinema and television history. By associating theoretical considerations and close readings of specific works, as well as diachronic and synchronic approaches, this volume offers a (...) complex panorama of issues related to seriality including audience engagement, intertextuality and transmediality, cultural legitimacy, authorship, and medium specificity in remakes, adaptations, sequels, and reboots. Written by a team of international scholars, this book highlights a diversity of methodologies that will be of interest to scholars and doctoral students across disciplinary areas such as media studies, film studies, literature, aesthetics, and cultural studies. It will also interest students attending classes on serial audiovisual narratives and will appeal to fans of the series it addresses, such as Fargo, Twin Peaks, The Hunger Games, Bates Motel, and Sherlock. (shrink)

Braiding together strands of literary, phenomenological and art historical reflection, Modernism and Phenomenology explores the ways in which modernist writers and artists return us to wonder before the world. Taking such wonder as the motive for phenomenology itself, and challenging extant views of modernism that uphold a mind-world opposition rooted in Cartesian thought, the book considers the work of modernists who, far from presenting perfect, finished models for life and the self, embrace raw and semi-chaotic experience. Close readings of works (...) by Paul Cézanne, Gertrude Stein, Franz Kafka, Gerard Manley Hopkins, Wallace Stevens, Paul Klee, and Virginia Woolf explore how modernist texts and artworks display a deep-rooted openness to the world that turns us into "perpetual beginners." Pushing back against ideas of modernism as fragmentation or groundlessness, Mildenberg argues that this openness is less a sign of powerlessness and deferred meaning than of the very provisionality of experience. (shrink)

This article explores the dynamics of the discourse and practice of corporate social responsibility (CSR) in France to illustrate the interplay between endogenous and exogenous factors in the development of CSR in a country. It shows how the cultural, socioeconomic, and legal traditions influence the way ideas are raised, the kinds of questions considered relevant, and the sorts of solutions conceived as desirable and possible. Furthermore, the article traces how expectations and practices evolve as a result of various social and (...) economic factors within a country, and increasingly, as a result of global influences such as the international academic discourse, the international practices of multinational companies, nongovernmental organizations and trade unions, and initiatives of supranational organizations. The article closes with reflections about what can be learned from the French experience with CSR and how to stimulate such cross-border learning. (shrink)

The American Policy Sciences, Complexity and the Crisis of Government: On the Social Embeddedness of Concept Formation in the Social Sciences. By analyzing debates about social “complexity” in the American policy sciences and in intellectual discourse of the 1970s, this article draws attention to the social embeddedness of concept formation and theory building in the social sciences. In the 1970s, a new concept of social “complexity” emerged in the social sciences, when scholars transferred and adapted elements of complexity theory from (...) mathematics, computer science, cybernetics, and general systems theory to refine social theory. The article analyzes the context and conditions in which this transfer occurred. It shows that the scholarly debates about social complexity were entwined with broader public-political discourses, dealing in particular with the challenges of government and public policy in the advanced Western democracies. The discourse on complexity among social scientists had additional layers of meaning: even in academic discourse, “complexity” was also used as a buzzword and as a metaphor. (shrink)

Rare diseases, defined as having a prevalence inferior to 1/2000, are poorly understood scientifically and medically. Appropriate diagnoses and treatments are scarce, adding to the burden of living with chronic medical conditions. The moral significance of rare disease experiences is often overlooked in qualitative studies conducted with adults living with rare diseases. The concept of morally problematic situations arising from pragmatist ethics shows promise in understanding these experiences. The objectives of this study were to (1) acquire an in-depth understanding of (...) morally problematic situations experienced by adults living with rare diseases in the province of Québec and (2) to develop an integrative model of the concept of morally problematic situations. To this end, an online survey targeting this population was developed through a participatory action research project. Respondents provided 90 long testimonies on the most important morally problematic situations they faced, often in healthcare settings. An integrative model was developed based on various qualitative analyses of these testimonies and relevant literature. The integrative model showcases that morally problematic situations have causes (i.e., contextual and relational factors, personal factors, jeopardized valuations), have affective repercussions (i.e., emotions and feelings, internal tensions), prompt action (i.e., through empowerment strategies leading to the evolution of situations), and elicit outcomes (i.e., factual consequences, residual emotions and feelings, positive or negative resolutions). In sum, this study advances understanding of the moral experiences of adults living with rare diseases while proposing a comprehensive conceptual tool to guide future empirical bioethics research on moral experiences. (shrink)

Since the 90’s, neurolaw is on the rise. At the heart of heated debates lies the recurrent theme of a neuro-revolution of criminal responsibility. However, caution should be observed: the alleged foundations of criminal responsibility (amongst which free will) are often inaccurate and the relative imperviousness of its real foundations to scientific facts often underestimated. Neuroscientific findings may impact on social institutions, but only insofar as they also engage in a political justification of the changes being called for, convince populations, (...) and take into consideration the ensuing consequences. Moreover, the many limits of neuroscientific tools call for increased vigilance when, if ever, using neuroscientific evidence in a courtroom. In this article, we aim at setting the basis for future sound debates on the contribution of neuroscience to criminal law, and in particular to the assessment of criminal responsibility. As such, we provide analytical tools to grasp the political and normative nature of criminal responsibility and review the current or projected use of neuroscience in the law, all the while bearing in mind the highly-publicized question: can neuroscience revolutionize criminal responsibility? Answering this question implicitly requires answering a second question: should neuroscience revolutionize the institution of criminal responsibility? Answering both, in turn, requires drawing the line between science and normativity, revolution and dialogue, fantasies and legitimate hopes. (shrink)

This article examines Elisabeth of Bohemia's account of the emotions. I argue that Elisabeth's objections against Descartes' ethics, which is often characterized as ‘Neo-Stoic’, show striking similarities to the arguments that the ancient Peripatetics made against classical Stoic approaches. Like the Peripatetics, she challenges the feasibility as well as the desirability of Descartes' ethical injunctions regarding emotional control. In particular, Elisabeth joins the Peripatetics in holding that certain external goods are essential for happiness and that the emotions are necessary for (...) motivating, guiding and correcting action. In aligning Elisabeth's thinking about the emotions with the Aristotelian tradition, I depart from various other interpretations, especially from those who see her position as a precursor of later feminist accounts, or as embodying a distinctively female perspective. (shrink)

Whereas evidence-based medicine (EBM) encourages the translation of medical research into decision-making through clinical practice guidelines (CPGs), patient-centred care (PCC) aims to integrate patient values through shared decision-making. In order to successfully integrate EBM and PCC, I propose a method of orienting physician decision-making to overcome the different obligations set out by a formally-rational EBM and substantively-rational ethics of care. I engage with Weber’s concepts “the ethic of responsibility” andverstehenas a new model of clinical reasoning that reformulates the relationship between (...) medical knowledge and social values, while demonstrating the relevance of the classical sociological cannon to contemporary medical humanities. (shrink)

Although death by neurologic criteria is legally recognized throughout the United States, state laws and clinical practice vary concerning three key issues: the medical standards used to determine death by neurologic criteria, management of family objections before determination of death by neurologic criteria, and management of religious objections to declaration of death by neurologic criteria. The American Academy of Neurology and other medical stakeholder organizations involved in the determination of death by neurologic criteria have undertaken concerted action to address variation (...) in clinical practice in order to ensure the integrity of brain death determination. To complement this effort, state policymakers must revise legislation on the use of neurologic criteria to declare death. We review the legal history and current laws regarding neurologic criteria to declare death and offer proposed revisions to the Uniform Determination of Death Act and the rationale for these recommendations. (shrink)

Differences between men and women in the performance of tests designed to measure spatial abilities are explained by evolutionary psychologists in terms of adaptive design. The Hunter-Gatherer Theory of Spatial Ability suggests that the adoption of a hunter-gatherer lifestyle (assuming a sexual division of labor) created differential selective pressure on the development of spatial skills in men and women and, therefore, cognitive differences between the sexes. Here, we examine a basic spatial skill—wayfinding (the ability to plan routes and navigate a (...) landscape)—in men and women in a natural, real-world setting as a means of testing the proposition that sex-based differences in spatial ability exist outside of the laboratory. Our results indicate that when physical differences are accounted for, men and women with equivalent experience perform equally well at complex navigation tasks in a real-world setting. We conclude that experience, gendered patterns of activity, and self-assessment are contributing factors in producing previously reported differences in spatial ability. (shrink)

Recently, there have been a number of lawsuits in the United States in which families objected to performance of apnoea testing for determination of brain death. The courts reached conflicting determinations in these cases. We discuss the medicolegal complications associated with apnoea testing that are highlighted by these cases and our position that the decision to perform apnoea testing should be made by clinicians, not families, judges, or juries.

In 1968, the definition of death in the United States was expanded to include not just death by cardiopulmonary criteria, but also death by neurologic criteria. We explore the way the definition has been modified by the medical and legal communities over the past 50 years and address the medical, legal and ethical controversies associated with the definition at present, with a particular highlight on the Supreme Court of Nevada Case of Aden Hailu.

Background Debates and controversies have shaped the understanding and the practices related to death determined by neurological criterion . Confusion about DNC in the public domain could undermine this notion. This confusion could further jeopardise confidence in rigorous death determination procedures, and raise questions about the integrity, sustainability, and legitimacy of modern organ donation practices.Objective We examined the depictions of ‘brain death’ in major American and Canadian print media to gain insights into possible common sources of confusion about DNC and (...) the relationship between expert and lay views on this crucial concept.Methods We gathered 940 articles, available in electronic databases, published between 2005 and 2009 from high-circulation Canadian and American newspapers containing keywords ‘brain dead’ or ‘brain death’. Articles were systematically examined for content using the NVivo 8 software.Results Our results showed problematic aspects in American and Canadian media, with some salient differences. DNC was used colloquially in 39% of the articles and its medical meaning infrequently defined . The neurological criterion for determination of death was mentioned in less than 10% of the articles, and life support in about 20% of the articles. Organ donation issues related to DNC were raised more often in Canadian articles than in American articles .Interpretation Further discussion is needed to develop innovative strategies to bridge media representations of DNC with experts’ views in connection with organ donation practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 41, no. 2. © 2015 by Feminist Studies, Inc. 409 Ariane Cruz Beyond Black and Blue: BDSM, Internet Pornography, and Black Female Sexuality I have been the meaning of rape I have been the problem everyone seeks to eliminate by forced penetration with or without the evidence of slime and/ but let this be unmistakable in this poem is not consent I do not consent —June (...) Jordan, Poem about My Rights Introduction: The Evidence of Slime Slavery, itself a kind of “slime,” remains an active marketplace for the production of Black female sexuality and its representations.1 The impact of chattel slavery and the pervasive rape of Black female slaves on modern 1. In using the term “Black women,” I am referring to African American women for whom the history of chattel slavery in the Americas has produced the socio-historical conditions that uniquely inform Black female subjectivity and sexual politics. My use of this term is not to essentialize Black American womanhood; rather, like Black feminist scholar Patricia Hill Collins, I use the term to gesture to a Black women’s standpoint influenced by the condition and experience of gendered and racialized abjection, a “common experience of being Black women in a society that denigrates women of African descent.” Patricia Hill Collins, Black Feminist Thought: Knowledge, Consciousness and the Politics of Empowerment (London: Routledge, 1990), 22. In this essay, I focus on Black women who practice BDSM, a small but nonetheless heterogeneous group of women in the already-marginalized larger kink community. 410 Ariane Cruz constructions and representations of Black women has been well theorized, in particular by a number of Black feminist scholars who have worked to rupture what Darlene Clark Hine terms the “culture of dissemblance,” the politics of silence shrouding expressions of Black female sexuality.2 While the antebellum legacy of sexual violence on Black women is substantive, what has not been effectively considered is how Black women deliberately employ the shadows of slavery in the deliverance and/or receiving of sexual pleasure. That is, how the “slime”—a staining sludge of pain and violence—becomes a type of lubricant to stimulate sexual fantasies, access sexual pleasure, and heighten sexual desire. In this paper, I explore how Black women facilitate a complex and contradictory negotiation of pain, pleasure, and power in their performances in the fetish realm of BDSM.3 Situating my analysis in the context of hardcore BDSM Internet pornography and the controversial praxis of race play, I argue that BDSM is a critical site from which to reimagine the formative links between Black female sexuality and violence. Race play is a BDSM practice that explicitly uses race to script power exchange and the dynamics of domination and submission. Most commonly an interracial erotic play, race play employs racism, often involving the exchange of racist language, role-playing, and the construction of racist scenes. Eroticizing not just racism, but the miscegenation taboo, racial difference, and (hyper) 2. See Darlene Clark Hine, “Rape and the Inner Lives of Black Women in the Middle West,” Signs 14, no. 4 (1989): 912–920. For more on Black female slave sexual assault and its aftermath, see Hazel V. Carby, Reconstructing Womanhood: The Emergence of the Afro-American Woman Novelist (Oxford: Oxford University Press, 1987); Ann duCille, “‘Othered’ Matters: Reconceptualizing Dominance and Difference in the History of Sexuality in America,” Journal of the History of Sexuality 1, no. 1 (1990): 102–27; Elsa Barkley Brown, “Imaging Lynching: African American Women, Communities of Struggle, and Collective Memory,” in African American Women Speak Out on Anita Hill-Clarence Thomas, ed. Geneva Smitherman (Detroit, MI: Wayne State University Press, 1995), 100–24; and Cheryl Harris, “Whiteness As Property,” Harvard Law Review 106, no. 8 (June 1993): 1707–91. 3. BDSM is an umbrella term that stands in for bondage/discipline (B/D), domination /submission (D/S), and sadism/masochism or sadomasochism (S/M). For the purposes of this paper I exchange S/M, S&M, and/or SM with the more contemporary label BDSM. For more about the terminology of BDSM, see Margot Weiss, Techniques of Pleasure: BDSM and the Circuits of Sexuality (Durham, NC: Duke University Press, 2011). Ariane Cruz 411 racialization itself... (shrink)

Freud proposes that in unconscious processing, logical connections are also (heavily) based upon phonological similarities. Repressed concerns, for example, would also be expressed by way of phonologic ambiguity. In order to investigate a possible unconscious influence of phonological similarity, 31 participants were submitted to a tachistoscopic subliminal priming experiment, with prime and target presented at 1ms. In the experimental condition, the prime and one of the 2 targets were phonological reversed forms of each other, though graphemically dissimilar (e.g., “nice” and (...) “sign”); in the control condition the targets were pseudo-randomly attributed to primes to which they don’t belong. The experimental task was to “blindly” pick the choice most similar to the prime. ERPs were measured with a focus on the N320, which is known to react selectively to phonological mismatch in supraliminal visual word presentations. The N320 amplitude-effects at the electrodes on the midline and at the left of the brain significantly predicted the participants’ net behavioral choices more than half a second later, while their subjective experience is one of arbitrariness. Moreover, the social desirability score (SDS) significantly correlates with both the behavioral and the N320 brain responses of the participants. It is proposed that in participants with low SDS the phonological target induces an expected reduction of N320 and this increases their probability to pick this target. In contrast, high defensive participants have a perplexed brain reaction upon the phonological target, with a negatively peaking N320 as compared to control and this leads them to avoid this target more often. Social desirability, which is understood as reflecting defensiveness, might also manifest itself as a defense against the (energy-consuming) ambiguity of language. The specificity of this study is that all of this is happening totally out of awareness and at the level of very elementary linguistic distinctions. (shrink)

In today's globalized world, we need to communicate values clearly and constructively across cultures and religions to avoid misunderstanding and conflict and to find shared solutions to the issues affecting human communities across the world. This communication is not easy to implement and requires a considerable amount of commitment and empathy. To be effective, intercultural and interreligious dialogues on ethics demand, first of all, an accommodation of different epistemologies coupled with a sincere respect for their richness and internal coherence. Furthermore, (...) our values are so closely rooted in our identity that expressing them becomes a cultural act—even an act of faith in the case of interreligious dialogue. In this paper, I argue that we need to reiterate or embrace this act of faith in the other's values if we are to properly understand them. How is this possible? The answer calls for a theoretical discussion of the hermeneutics of interreligious dialogue. When applied to intercultural and interreligious dialogues, I contend that the theory of hermeneutics needs a specific epistemological dimension—namely that of "appropriation"—that entails that we borrow the other's epistemological outlook, adopt the other's ad hoc modes of communication or transmission of values, and integrate the other's values into the constellation of our sources of meaning. (shrink)

In Ovid, Heroides 10.79ff. Ariadne starts to consider various dangers which to her mind threaten her life as that of any deserted woman . She lists some of these dangers in the following catalogue.

Sir Sayyid Ahmad Khan was a prominent South Asian reformer of Islam who focused on the reconciliation of science and Islam in his most influential texts. This article aims to analyze the implications of science becoming the dominant discourse in nineteenth-century South Asia for the conception of Islam and religion in general. Sayyid Ahmad is an intriguing example because he actively participated in religious as well as scientific discourses since as early as the 1830s. After a concise outline of his (...) early writings, his stances toward science and reason shall be compared with his later writings, primarily those written after 1870, to uncover the impact of the increasing influence of science in South Asia during the latter half of the nineteenth century. In his later writings, Sayyid Ahmad accomplishes a complex effort of translation, claiming mutual compatibility of science and Islam. The question of how this influences his conception of Islam and religion will be addressed, exploring whether this process should be described as a mere adoption of foreign discourse? Or does it trigger transformative effects? (shrink)

Future prize-winning writer Chava Rosenfarb was seventeen years old when she was incarcerated in the Łódź ghetto. In 1972, she published The Tree of Life [Der boym fun lebn] (1972), a fictional chronicle of that experience of the Holocaust. In this three-volume epic novel, Rosenfarb narrates and interlaces the fates of ten Jewish families from pre-war Poland in 1939 to the liquidation of the ghetto in 1944. The "Tree of Life" is revealed to be the name given by the "ghettoniks" (...) to an iconic cherry tree that stands in the shared backyard of a group of apartment complexes inhabited by many of the protagonists in the ghetto. Far from being an anecdotal presence, the cherry tree becomes the center of Rosenfarb's reflections on the impacts of the environment on one's physical and mental health. In this article, The Tree of Life is analyzed from an ecocritical perspective to examine the interconnections between genocidal intent and environmental precariousness. The first part considers the perpetration angle of the Łódź ghetto establishment as a Nazi tool of ecological violence through its excessive economic program of forced labour and its structural health determinants leading to epidemics. We will then investigate the characters' attempts to reconnect to nature through tangible acts of agency (the development of small gardens to grow one's own food) and symbolism (the cherry tree evoking the freedom of the outside world). The purpose of this article is to explore the links between genocide and ecocide within the framework of literary memory, while appreciating the relevance of Chava Rosenfarb's representations of the Holocaust to our era of renewed ecological awareness. (shrink)

Gertrude Stein may be regarded as one of the most innovative and obscure modernist writers. At the core of Tender Buttons (1914), her most experimental work, lies a dialectical tension between meaning and non-meaning, order and disorder, the opacity of which some of the earliest critical studies of Stein described as both “an eloquent mistake” and “the ravings of a lunatic,” resisting interpretation. In this paper, I show that phenomenology offers an appropriate tool for opening up the much-discussed dialectic of (...) this work. By “bracketing” the hard facts of our object-world, Stein enacts an epoché of sorts, allowing us to “see fine substances strangely” before the conventional structures of objectivity and factuality take over. (shrink)

Stem cells did not become a proper research object until the 1960 s. Yet the term and the basic mind-set—namely the conception of single undifferentiated cells, be they embryonic or adult, as the basic units responsible for a directed process of development, differentiation and increasing specialisation—were already in place at the end of the nineteenth century and then transmitted on a non-linear path in the form of tropes and diagrams. Ernst Haeckel and August Weismann played a special role in this (...) story. The first coined the term Stammzelle (stem cell), the second was the author of the first cellular stem-tree diagram. Even today, I shall argue, the understanding of stem cells, especially the popular perception, is to a large extent a Haeckelian–Weismannian one. After having demonstrated this, by analysing the terminology, in this essay I will focus on the use of cytogenetic tree diagrams between 1892 and 1925 and on the tacit understanding of stem cells that they transmit. (shrink)

Background Rare diseases are generally poorly understood from scientific and medical standpoints due, to their complexity and low prevalence. As a result, individuals living with rare diseases struggle to obtain timely diagnoses and suitable care. These clinical difficulties add to the physical and psychological impacts of living with chronic and often severe medical conditions. From the standpoint of pragmatist ethics, the morally problematic situations that adults living with rare diseases experience matter crucially. However, there is little known about these experiences.Methods (...) A survey study was conducted with 121 adults living with rare diseases in Québec, Canada, to identify morally problematic situations encountered in the healthcare system and everyday life as part of a participatory action research project. Morally problematic situations elicited internal tensions and constraints to agency.Results Adults living with rare diseases experienced morally problematic situations of stigmatization, disbelief, and sometimes abuse in the healthcare system. These situations were compounded by diagnostic delays, inadequate care, and suboptimal follow-up, and led some individuals to opt-out of medical care. In their personal lives, these individuals sometimes found themselves in situations of physical and financial dependency. They often also had to give up professional occupations, academic training, or life projects.Conclusions Adults living with rare diseases experience important morally problematic situations navigating the healthcare system and their everyday lives, some of which could be alleviated through interventions developed through future participatory action research. (shrink)

Debates about how knowledge is made and valued in evidence-based medicine (EBM) have yet to understand what discursive, social, and historical conditions allowed the EBM approach to stabilize and proliferate across western medical education. This paper uses a genealogical approach to examine the epistemological tensions that emerged as a result of various problematizations of uncertainty in medical practice. I explain how the problematization of uncertainty in the literature and the contingency of specific social, political, economic, and historical relations allowed the (...) EBM approach to become a programmatic and pedagogical focus of the Faculty of Medicine at McMaster University and beyond. (shrink)

A long-standing theme in discussion of perception and thought has been that our primary cognitive contact with individual objects and events in the world derives from our perceptual contact with them. When I look at a duck in front of me, I am not merely presented with the fact that there is at least one duck in the area, rather I seem to be presented withthisthing (as one might put it from my perspective) in front of me, which looks to (...) me to be a duck. Furthermore, such a perception would seem to put me in a position not merely to make the existential judgment that there is some duck or other present, but rather to make a singular, demonstrative judgment, that that is a duck. My grounds for an existential judgment in this case derives from my apprehension of the demonstrative thought and not vice versa. (shrink)

English summary: This ambitious volume examines the Foucaults later writings from the 1980s. Foucaults contemporaries were baffled by his new perspective from this period in which he explored the modalities of a relationship with the self and the truth, seeming to blur the image of a Foucault concerned with describing and denouncing the forms of contemporary power. This study brings to light the theoretical and practical aspects of this period, in order to a reinvention of our own actuality. French description: (...) Les recherches menees par Foucault au cours des annees quatre-vingt demeurent, a beaucoup d'egards, indecidables. Doit-on parler, a leur propos, d'un retour aux questions classiques du sujet, de la morale, de la liberte? D'un abandon de la mise en perspective politique? D'un dandysme esthetisant? Les contemporains furent profondement deconcertes par des analyses qui, en se concentrant sur les modalites du rapport a soi et a la verite dans l'Antiquite ou le christianisme primitif, paraissaient brouiller l'image d'un Foucault attache a decrire et denoncer les formes du pouvoir moderne. Le present ouvrage se propose de relever le defi pose par ce dernier moment, aussi fecond que provocateur, de la pensee foucaldienne, d'en degager les enjeux theoriques et pratiques, et de se donner les moyens, a partir d'eux, de reinventer notre actualite. (shrink)