Digital communication between a patient and their clinician offers the potential for improved patient care, particularly for young people with long term conditions who are at risk of service disengagement. However, its use raises a number of ethical questions which have not been explored in empirical studies. The objective of this study was to examine, from the patient and clinician perspective, the ethical implications of the use of digital clinical communication in the context of young people living with long-term conditions. (...) A total of 129 semi-structured interviews, 59 with young people and 70 with healthcare professionals, from 20 United Kingdom -based specialist clinics were conducted as part of the LYNC study. Transcripts from five sites were read by a core team to identify explicit and implicit ethical issues and develop descriptive ethical codes. Our subsequent thematic analysis was developed iteratively with reference to professional and ethical norms. Clinician participants saw digital clinical communication as potentially increasing patient empowerment and autonomy; improving trust between patient and healthcare professional; and reducing harm because of rapid access to clinical advice. However, they also described ethical challenges, including: difficulty with defining and maintaining boundaries of confidentiality; uncertainty regarding the level of consent required; and blurring of the limits of a clinician’s duty of care when unlimited access is possible. Paradoxically, the use of digital clinical communication can create dependence rather than promote autonomy in some patients. Patient participants varied in their understanding of, and concern about, confidentiality in the context of digital communication. An overarching theme emerging from the data was a shifting of the boundaries of the patient-clinician relationship and the professional duty of care in the context of use of clinical digital communication. The ethical implications of clinical digital communication are complex and go beyond concerns about confidentiality and consent. Any development of this form of communication should consider its impact on the patient-clinician-relationship, and include appropriate safeguards to ensure that professional ethical obligations are adhered to. (shrink)

Marie-Anne Boivin a été en son temps une des sages-femmes françaises les plus célèbres. Son parcours professionnel et scientifique est présenté ici, illustrant l’espace laissé aux femmes dans les professions médicales. Reconnue d’abord pour ses ouvrages techniques concernant l’obstétrique, elle sort de son champ traditionnel de compétence pour aborder de façon novatrice la gynécologie naissante, à l’instar des médecins, avec son Traité pratique des maladies de l’utérus (1833), devenu un classique. Cette œuvre scientifique lui vaut un succès d’estime, mais ne (...) lui permet pas d’atteindre une véritable reconnaissance institutionnelle dans son pays. (shrink)

Alexis de Tocqueville asserted that America had no truly great literature, and that American writers merely mimicked the British and European traditions of the eighteenth and nineteenth centuries. This new edited collection masterfully refutes Tocqueville's monocultural myopia and reveals the distinctive role American poetry and prose have played in reflecting and passing judgment upon the core values of American democracy. The essays, profiling the work of Mark Twain, F. Scott Fitzgerald, John Updike, Edith Wharton, Walt Whitman, Henry James, Willa Cather, (...) Walker Percy, and Tom Wolfe, reveal how America's greatest writers have acted as society's most ardent cheerleaders and its most penetrating critics. Christine Dunn Henderson's exciting new work offers literature as a portal through which to view the philosophical principles that animate America's political order and the mores which either reinforce or undermine them. (shrink)

Working at the bedside and within communities as patient advocates, nurses frequently intervene to advance individuals’ health and well-being. However, the International Council of Nurses’ Code of Ethics asserts that nurses should expand beyond the individual model and also promote a rights-enabling environment where respect for human dignity is paramount. This article applies the results of an ethnographic human rights study with displaced populations in Rwanda to argue for a rights-based social advocacy role for nurses. Human rights advocacy strategies include (...) sensitization, participation, protection, good governance, and accountability. By adopting a rights-based approach to advocacy, nurses contribute to health agendas that include more just social relationships, equitable access to opportunities, and health-positive living situations for all persons. (shrink)

This paper gives a concise overview of the history and meaning of Socratic Dialogue and how it has been developed and used in modern times. The process of Socratic dialogue is seen as an environment for enhancing learning and in enabling the emergence of new meaning to be articulated in language, thereby making the understanding more accessible to the group. The authors also share their perspective as participants in Socratic dialogues. It is suggested that Socratic dialogue enables open communication and (...) empathic listening, development of shared meaning, enhanced insight and increased moral accountability. (shrink)

Background In 2001 a report on the provision of clinical ethics support in UK healthcare institutions identified 20 clinical ethics committees. Since then there has been no systematic evaluation or documentation of their work at a national level. Recent national surveys of clinical ethics services in other countries have identified wide variation in practice and scope of activities. Objective To describe the current provision of ethics support in the UK and its development since 2001. Method A postal/electronic questionnaire survey administered (...) to the chairs of all 82 clinical ethics services registered with the UK Clinical Ethics Network in July 2010. Results Response rate was 62% with the majority of responding services situated in acute trusts. All services included a clinical ethics committee with one service also having a clinical ethicist. Lay members were present in 72% of responding committees. Individual case consultation has increased since 2001 with 29% of chairs spending more than 50% of their time on this. Access to and involvement in the process of case consultation is less for patients and families than for clinical staff. There is wide variation in committee processes and levels of institutional support. Over half of the responding committees undertook some form of evaluation. Conclusion Clinical ethics services in the UK are increasing as is their involvement in case consultation. However, the significant variation in committee processes suggests that further qualitative research is needed to understand how these committees function and the role they play in their institution. (shrink)

La Colombiade war bis zur französischen Revolution ein in Frankreich und in den westeuropäischen Ländern vielbeachtetes Epos. Aus heutiger Sicht ist das gut lesbare Gedicht erneut von Interesse: es wägt Segnungen und Schäden der Kolonialisierung gegeneinander ab, propagiert die Idee eines auf wissenschaftlichem und humanistischem Ethos gegründeten Europas, und artikuliert das aufklärerische Selbstbewusstsein einer schreibenden Frau. Die Einführung der Herausgeberin stellt das Gedicht in den Wissenshorizont der Entstehungszeit und skizziert die Rezeption. Der Anhang informiert über Textvarianten, bringt erläuternde Anmerkungen und (...) einen bibliographischen Informationsteil. (shrink)

This book explores five Platonic dialogues: Lysis, Charmides, Protagoras, Euthydemus, and the Republic. This book uses Socrates’ narrative commentary as its primary interpretive framework. No one has engaged in a sustained attempt to explore the Platonic dialogues from this angle. As a result, it offers a unique contribution to Plato scholarship. The portrait of Socrates that emerges challenges the traditional view of Socrates as an intellectualist and offers a holistic vision of philosophical practice.

A virtue centred approach to ethics has been criticized for being vague owing to the nature of its central concept, the paradigm person. From the perspective of the practitioner the most damaging charge is that virtue ethics fails to be action guiding and, in addition to this, it does not offer any means of act appraisal. These criticisms leave virtue ethics in a weak position vis-à-vis traditional approaches to ethics. The criticism is, however, challenged by Hursthouse in her analysis of (...) the accounts of right action offered by deontology, utilitarianism and virtue ethics. It is possible to defend the action guiding nature of virtue ethics: there are virtue rules and exemplars to guide action. Insights from Aristotle’s practical approach to ethics are considered alongside Hursthouse’s analysis and it is suggested that virtue ethics is also capable of facilitating action appraisal. It is at the same time acknowledged that approaches to virtue ethics vary widely and that the challenges offered here would be rejected by those who embrace a radical replacement virtue approach. (shrink)

A rough categorization of issues in the field of Technology and Society Studies is provided and the kinds of values and value issues under discussion are examined. It is argued that value theory is not sufficiently well-developed to address some of the value issues that arise. Three approaches to values with which the author disagrees are discussed: the atomistic view of values; the ordinary language approach; and, an approach the author calls the "rationality approach". Under the latter, an analysis of (...) value offered by Kurt Baier in "Fact and Value" is criticized. (shrink)

ABSTRACT When Heidegger wrote Being and Time he was hopeful that his ontological phenomenology would lead thinking back to its “proper ground.” In a brief essay with the theme as the title, he premised “the end of philosophy.” This “end” has nothing to do with a closed-off finality but, rather, heralds a “new” return to a deeper, primordial thinking. As we move toward one hundred years marking the first publication of Sein und Zeit, his transcendental phenomenology of Dasein still remains (...) opaque. One reason for this is that his work has been engaged with in the traditional philosophical mode rather than as he meticulously outlined in the introduction to Being and Time. Unless this task as he describes it is taken seriously, the profound insights embedded in his work will remain undisclosed. Michael Zimmerman declared that reading Heidegger should be transformative; if it is not, then the deficiency lies with the reading. In this essay I carry through a brief and very simple illustration of the kinds of insights that the experience of authentic engagement with Heidegger's Being and Time opens up. (shrink)

Anne-Marie Søndergaard Christensen presents a new account of the role of moral philosophy and its relationship to our ordinary moral lives. She challenges the idea that moral theories have an authoritative explanatory or action-guiding role, and develops instead a descriptive, pluralistic, and elucidatory conception of moral philosophy.

In "Implementing Expanded Prenatal Genetic Testing: Should Parents Have Access to Any and All Fetal Genetic Information?," Bayefsky and Berkman argue in favor of establishing three categorie...

This article is presented as a defence of voluntary active euthanasia from a virtue perspective and it is written with the objective of generating debate and challenging the assumption that killing is necessarily vicious in all circumstances. Practitioners are often torn between acting from virtue and acting from duty. In the case presented the physician was governed by compassion and this illustrates how good people may have the courage to sacrifice their own security in the interests of virtue. The doctor's (...) action created huge tensions for the nurse, who was governed by the code of conduct and relevant laws. Appraising active euthanasia from a virtue perspective can offer a more compassionate approach to the predicament of practitioners and clients. The tensions arising from the virtue versus rules debate generates irreconcilable difficulties for nurses. A shift towards virtue would help to resolve this problem and support the call for a change in the law. The controversial nature of this position is acknowledged. The argument is put forward on the understanding that many practitioners will not agree with the conclusions reached. (shrink)

Anne-Marie Schultz explores Plato’s presentation of Socrates as a philosopher who tells narratives about himself in the Theaetetus, Symposium, Apology, and Phaedo. She argues that scholars should regard Socrates as a public philosopher, while examining Socratic self-disclosive practices in the works of bell hooks, Kathy Khang, and Ta-Neishi Coates.

The aim of this article is to add to the research surrounding nurses' work in hospitals. Throughout history, nurses have faced adverse working conditions, an aspect of their work that remains remarkably unchanged today. Prevailing historical ideologies and sociopolitical conditions influences the context of nurses' work in contemporary hospitals. This research revealed how ruling patriarchal power and nurses' altruistic ways normalize the conditions in hospitals as nurses' work. Moving discourses further add to the work of nurses in hospitals. For example, (...) cost containment strategies, overcapacity and short staffing have resulted in practices to accommodate these problems. While contemporary hospitals may look different, clearly, inside, little has changed since the early days; hospital issues have clearly become an ordinary part of nurses' work. This article discusses how the conditions in hospitals have become an ordinary part of nurses' work. The research in this article emphasizes how prevailing ideologies and institutional discourses make invisible and taken‐for‐granted, how this normalizing of nurses' work contributes to sustaining the hospital's power. (shrink)

Until the mid-20th century, biomedical research centered on the study of specific diseases, concerned with short periods of time and small groups of living research participants. However, the growth of longitudinal population studies and long-term biobanking now forces the research community to examine the possibility of the death of their research participants.The death of a research participant raises numerous ethical and legal issues, including the return of deceased individuals’ research results to related family members. As with the return of individual (...) research results for living research participants, the question of the obligation to return a deceased person’s research results to family members has yet to be settled. This question is particularly acute in the context of genetic research since the research results from one individual may have health implications for all biological relatives. (shrink)

Ce colloque devenu livre comble une lacune. Alors que le sujet a été labouré pour le xviiie siècle, aucune synthèse n’existait jusque-là sur le mariage dans la littérature du xixe siècle. Or, la rupture avec les Lumières est frappante comme l’attestent, par exemple, les réécritures d’Inès de Castro étudiées par Maurizio Melai. Le thème du « mariage interdit », inspiré par la tragédie d’Houdar de la Motte (1723) mais subverti un siècle plus tard, illustre le passage de l’Ancien Régime aristocr...

Hannah James makes a persuasive case for the use of donated bodies and body parts in surgical training, enabling high fidelity training, improved competency of surgeons and reduced risk of harm to patients from trainees ‘learning on the job’.1 She also identifies some pertinent ethical questions that arise from this practice that should be considered by training organisations, regulatory authorities and the trainees themselves. Many countries throughout the world have regulated programmes, governed by strict ethical principles, for donating bodies, usually (...) to academic institutions for the purposes of medical education.2 In the UK the Human Tissue Authority sets out guiding principles for institutions licensed to handle human tissue including donation of bodies for anatomical examination, education and research; consent, dignity, quality, and honesty and openness.3 The Nuffield Council on Bioethics, in its 2011 report, Human Bodies: donation for medicine and research, identified a number of relevant ethical values including autonomy, altruism, justice, dignity, reciprocity, maximising welfare, and honesty and respect.4 While this report did not focus specifically on donation of human tissue for education and training the principles identified are equally relevant in this context. In terms of maximising welfare whole body donation for education and training provides benefit to many patients over a relatively short time frame …. (shrink)

_From Illiteracy to Literature_ presents innovative material based on research with ‘non-reading’ children and re-examines the complex relationship between psychoanalysis and literature, through the lens of the psychical significance of reading: the forgotten adventure of our coming to reading. Anne-Marie Picard draws on two specific fields of interest: firstly the wish to understand the nature of literariness or the "literary effect", i.e. the pleasures we derive from reading; secondly research on reading pathologies carried out at St Anne’s Hospital, Paris. The (...) author uses clinical observations of non-reading children to answer literary questions about the reading experience, using psychoanalytic theory as a conceptual framework. The notion that reading difficulties or phobias should be seen as a symptom in the psychoanalytic sense, allows Picard to shed light on both clinical vignettes taken from children’s case histories and reading scenes from literary texts. Children experiencing difficulties in learning to read highlight the imaginary stakes of the confrontation with the arbitrary nature of the letter and the "price to pay" for one’s entrance into the Symbolic. Picard applies the lesson "taught" by these children to a series of key literary texts featuring, at their very core, this confrontation with the signifier, with the written code itself.. This book argues that there is something in literature that drives us back, again and again, to the loss we have suffered as human beings, to what we had to undergo to become human: our subjection to the common place of language. Picard shows complex Lacanian concepts "at work" in the field of reading pathologies, emphasizing close reading and a clinical attention to the "letter" of the texts, far from the "psychobiographical" attempts at psychologizing literary authors. _From Illiteracy to Literature_ presents a novel psychodynamic approach that will be of great interest to psychotherapists and language pathologists, appealing to literary scholars and those interested in the process of reading and "literariness.". (shrink)

Although previous studies have found that video games induce stress, studies have not typically measured all salient indicators of stress responses including stress appraisals, cardiovascular indicators, and emotion outcomes. The current study used the Biopsychosocial Model of Challenge and Threat (Blascovich & Tomaka, 1996) to determine if video games induce a cardiovascular stress response by comparing the effects of threat and challenge appraisals across two types of video games that have shown different cardiovascular outcomes. Participants received challenge or threat appraisal (...) instructions, and played a fighting game (Mortal Kombat) or a puzzle game (Tetris). Study outcomes were heart rate variability, systolic and diastolic blood pressure, and positive and negative emotion ratings measured before, during and after gameplay. Results indicated that threat appraisal instructions increased negative emotion ratings and decreased heart rate variability, but not blood pressure, which is an essential marker for cardiovascular stress responses. Increased blood pressure and decreased heart rate variability was associated with fighting game players when compared with the puzzle game players, indicating a cardiovascular stress response; however, fighting game players also reported higher positive emotion ratings. Based on the study findings, video games do not induce stress responses like mental stressors used in previous research, demonstrating that the interactive player experience in video gaming may have more complex effects on stress outcomes. Future research should comprehensively measure biopsychosocial stress indicators and multiple emotional states over time to fully examine the relationship between video games and stress. (shrink)

In an historic first, two ethics committees - one from Laos, the other from France - met in Vientiane in October 2015. Researchers examined a multitude of ethical issues related to health, the environment, and societies in countries in the Mekong region. Urgent, universal questions were discussed in local contexts ; productive debates illustrated a complex array of possible solutions. This book, born out of that meeting, serves as a guide for those working across the spectrum of scientific fields on (...) paths to promote justice and reduce suffering. Like the Mekong River, the field of research ethics does not run in a straight line ; and like that river, everyone it touches discovers that what may initially appear to separate us ultimately serves to bring us together. (shrink)

Dirigé par Maureen Daly Goggin, professeure de lettres à l’Arizona State University, et par Beth Fowkes Tobin, professeure de lettres et de Women Studies à l’University of Georgia, ce livre collectif rassemble vingt contributions (essentiellement venues des États-Unis, mais aussi d’Europe) précédées d’une introduction et complétées d’une forte bibliographie de 27 pages, d’un index des noms propres et des noms communs, d’une présentation des auteurs et accompagnées de 77 illustrations commenté...

Ce travail traite des représentations médicales des organes génitaux féminins et de leur participation à la fécondation. Il étudie la façon dont la topographie de ces organes se modifie progressivement en fonction des théories de la génération qui se succèdent à partir du XVIIe siècle. Il décrit en particulier l’émergence des trompes, qui font l’objet d’une réévaluation qui culmine au XVIIIe siècle. Ce rôle prépondérant des trompes s’efface toutefois au XIXe siècle, avec la découverte de l’ovulation spontanée, qui ramène l’appareil (...) génital féminin à un statut passif. (shrink)

Depuis près d'un demi-siècle, Madame Hélène ACKERMANS a coopéré très activement à l'organisation de l'École des sciences philosophiques et religieuses des F.U.S.L. Avec Monseigneur Henri van Camp, elle a donné à la tribune des leçons publiques sa renommée internationale ; auprès de l'actuel comité de direction, elle n'a cessé de prodiguer ses multiples compétences et ses conseils avisés. En hommage à son travail, il a été demandé à quelques-uns des penseurs avec lesquels Madame Hélène ACKERMANS a noué des liens d'amitié, (...) de réfléchir au rôle de la philosophie dans la Cité. (shrink)

La biologie se comprend en termes d'échanges entre le dedans et le dehors, soi et les autres ; mais toute croissance implique une assimilation d'éléments extérieurs. Les querelles frontalières entre disciplines sont l'équivalent des crises de croissance: phénomènes inévitables, douloureux, mais source de métamorphoses.By offering an anthropological view of attraction and exclusion processes in human as well as animal groups, the author proposes to take a step back from the bitter disciplinary "border" disputes to better perceive the discipline's continuous construction (...) process. (shrink)

L'article met en cause l'efficacité des différentes machines à communiquer dans la mesure où elles ne sont pas centrées sur les besoins humains. D'où le paradoxe d'un lien social effiloché, voire détruit, au fur et à mesure que les outils techniques se multiplient. Les fractures sociales ainsi engendrées se rencontrent en Amérique latine où l'identité culturelle issue des luttes coloniales se heurte de plein fouet aux structures verticales à sens unique des dispositifs de communication. Mais la déchirure s'observe aussi en (...) Europe, où l'on rencontre l'«illectronisme» dans toutes les classes sociales. S'observe aussi une montée des « suspicions » envers les contenus diffusés dont l'authenticité et la neutralité sont mises en doute.The article calls into question the effectiveness of different communication devices insofar as they are not focused on human needs. Hence the paradox of social bonds frayed or destroyed, as and as technical tools multiply. Social divisions thus generated is found in Latin America where cultural identity after colonial struggles collides with vertical structures-way communication devices. But tearing is also observed in Europe, where we meet the "illectronisme" in all social classes. Is also observed a rise in "suspicions" to broadcasting content whose authenticity and neutrality are in doubt. (shrink)