Objective: To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions. Design: Prospective clinical interventional study. Setting: Internal medicine department (70 beds) of the hospital of La Chaux-de-Fonds, Switzerland. Participants: Nine junior physicians in postgraduate training. Intervention: Information on the ethics of DNR and implementation of new DNR orders. Measurements and main results: Accurate understanding, interpretation, and use of (...) DNR orders, especially with respect to the patients’ involvement in the decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% (p<0.01) after the intervention and the patients’ involvement went from 17% to 48% (p<0.01). Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision. Conclusion: An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. (shrink)

Objective: To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions.Design: Prospective clinical interventional study.Setting: Internal medicine department of the hospital of La Chaux-de-Fonds, Switzerland.Participants: Nine junior physicians in postgraduate training.Intervention: Information on the ethics of DNR and implementation of new DNR orders.Measurements and main results: Accurate understanding, interpretation, and use of DNR orders, especially with respect to the (...) patients’ involvement in the decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% after the intervention and the patients’ involvement went from 17% to 48% . Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision.Conclusion: An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. (shrink)

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)

Transparence et opacité fut écrit à la fin des années 1960 et parut pour la première fois en 1975. Cet essai majeur sur les fondements théoriques de l'art moderne avait disparu des librairies depuis près de vingt ans. Partant d'une analyse de la théorie de l'art de Konrad Fiedler, qui écrivit entre 1876 et 1895, Philippe Junod se livre en fait à une archéologie de la modernité et envisage l'ensemble de la théorie de l'art et de l'esthétique depuis Platon (...) et Aristote. Il établit que l'idée d'art moderne naît quand sont abandonnées aussi bien la voie du réalisme que celle de la peinture d'idées, le naturalisme comme le symbolisme, pour en venir à une troisième voie, celle de l'opacité où l'œuvre opère dans son autonomie, sans transparence ni référence, en faisant prévaloir les droits de la vision et du visible sur ceux de la reconnaissance et du déchiffrement. À un moment où le moderne apparaît comme un moment de l'histoire de l'art, l'enquête riche et minutieuse de Philippe Junod permet de comprendre les questionnements et les enjeux de toute une époque dont nous sortons à peine. (shrink)

Durkheim écrit ce livre avec un but double : d'abord il voulait expliquer ce qui crée une société, ce qui la tient ensemble ; ensuite il voulait éclaircir l'influence qu'a la société sur la pensée logique. Pour Durkheim, la religion est la clé utilisée pour déverrouiller ces deux problématiques.Dans ce livre, Durkheim argumente que les représentations religieuses sont en fait des représentations collectives : l'essence du religieux ne peut être que le sacré. Il est une caractéristique qui se trouve universellement (...) dans toutes les religions. Le sacré, être collectif et impersonnel, représente ainsi la société elle-même. Ensuite il argumente que la société a un impact majeur dans la genèse de la pensée logique. C'est la société qui fournit à l'individu les catégories (le temps, l'espace, le nombre etc.) et les concepts nécessaires pour la pensée logique. (shrink)

Au départ, un constat : la question de la «moralité» des rêves a été délaissée par la philosophie, tandis qu�elle a largement inspiré la littérature. Afin d�explorer la question, on recourt à Aristote, premier théoricien naturaliste du rêve et analyste de la psychologie morale. Bien qu�opposé à une «lecture éthique» du rêve (il privilégie les facteurs somatiques), Aristote fournit une échelle extrêmement fine de «demi-actions» (spontanées, désirées, regrettées, etc.) de la veille. La traque d�une hypothétique «action onirique» sera l�occasion d�un (...) parcours tout au long de cette échelle éthique, et d�une étude plus générale du «diagnostic moral» dans la perspective d�Aristote. (shrink)

Cet article présente un service de consultation conjugale situé en Suisse romande, non médicalisé, dont l’orientation psychodynamique et le travail auprès des couples n’est pas sans rappeler la pratique française des conseillers conjugaux-thérapeutes de couple « ancien modèle ». Si l’appellation de consultation conjugale a été retenue, malgré ses inconvénients, c’est qu’elle permet de toucher un très large public, en particulier de nombreuses personnes insuffisamment individuées pour qui l’appartenance au « Nous-couple » est constitutive. Par rapport aux objectifs de travail, (...) l’auteure explore deux voies, illustrées par deux vignettes cliniques : l’une vise à recouvrir une problématique sous-jacente en rétablissant un équilibre antérieur, l’autre à découvrir l’arrangement défensif du couple en introduisant une dynamique de changement. (shrink)

There is a long tradition in philosophy and literary theory defending the view that engagement with literature promotes readers’ empathy. Until the last century, few of the empirical claims adduced in that tradition were investigated experimentally. Recent work in psychology and neuropsychology has now shed new light on the interplay of empathy and literature. This article surveys the experimental findings, addressing three central questions: What is it to read empathically? Does reading make us more empathic? What characteristics of literature, if (...) any, affect readers’ empathy? While experimental studies have delivered no conclusive answers to these questions, it has exposed their psychological complexity and constructed a more nuanced picture of the diverse ways in which literature interacts with our empathic capacities. (shrink)

Издание содержит: хрестоматия; философы; психологи; литературоведы, искусствоведы; мастер изобразительного искусства и др.

When we perceive an object, we perceive the object from a perspective. As a consequence of the perspectival nature of perception, when we perceive, say, a circular coin from different angles, there is a respect in which the coin looks circular throughout, but also a respect in which the coin's appearance changes. More generally, perception of shape and size properties has both a constant aspect—an aspect that remains stable across changes in perspective—and a perspectival aspect—an aspect that changes depending on (...) one's perspective on the object. How should we account for the perspectival aspect of spatial perception? We present a framework within which to discuss the perspectival aspect of perception and put forward three desiderata that any account of the perspectival aspect of perception should satisfy. We discuss views on which the perspectival aspect of perception is analyzed in terms of constitutively mind-dependent appearance properties as well as views on which the perspectival aspect of perception is analyzed in terms of representations of mind-independent perspectival properties. (shrink)

With special emphasis on Foucault's many recently published lecture series this book provides an updated, comprehensive presentation of his most important diagnoses, his many ground-breaking analytical concepts as well as a systematic account of his unique conception of philosophy.

We argue that the trend toward providing users with feasible and actionable explanations of AI decisions—known as recourse explanations—comes with ethical downsides. Specifically, we argue that recourse explanations face several conceptual pitfalls and can lead to problematic explanation hacking, which undermines their ethical status. As an alternative, we advocate that explanations of AI decisions should aim at understanding.

In his Treatise, Hume confronted the tensions between his project of uncovering the causal operations of the human mind and the extreme skeptical tendencies of his system. Louis Loeb argues that Hume overreaches, and he advances a controversial interpretation of Hume's epistemological framework that shows how Hume could have avoided the more destructive positions in his work.

Hume's claim that a state is a belief is often intertwined—though without his remarking on this fact—with epistemic approval of the state. This requires explanation. Beliefs, in Hume's view, are steady dispositions (not lively ideas), nature's provision for a steady influence on the will and action. Hume's epistemic distinctions call attention to circumstances in which the presence of conflicting beliefs undermine a belief's influence and thereby its natural function. On one version of this interpretation, to say that a belief is (...) justified, ceteris paribus, is to say that for all that has been shown the belief would be steady in its influence under suitable reflection. On a second version, it is to say that prima facie justification is an intrinsic property of the state, in virtue of its steadiness. These versions generate different understandings of the relationship between Parts iii and iv of Book I of the Treatise. (shrink)

A dialogue between a foreign philosopher and a powerful statesman outline Plato's reflections on the family, the status of women, property rights, and criminal law.

The Anthropocene is heralded as a new epoch distinguishing itself from all foregoing eons in the history of the Earth. It is characterized by the overarching importance of the human species in a number of respects, but also by the recognition of human dependence and precariousness. A critical human turn affecting the human condition is still in the process of arriving in the wake of an initial Copernican Revolution and Kant's ensuing second Copernican Counter-revolution. Within this landscape, issues concerning the (...) human - its finitude, responsiveness, responsibility, maturity, auto-affection and relationship to itself - appear rephrased and re-accentuated as decisive probing questions. In this book Sverre Raffnsøe explores how the change has ramifications for the kinds of knowledge that can be acquired concerning human beings and for the human sciences as a study of human existential beings in the world. (shrink)