BACKGROUND: There is a growing interest in aggregating more biomedical and patient data into large health data sets for research and public benefits. However, collecting and processing patient data raises new ethical issues regarding patient's rights, social justice and trust in public institutions. The aim of this empirical study is to gain an in-depth understanding of the awareness of possible ethical risks and corresponding obligations among those who are involved in projects using patient data, i.e. healthcare professionals, regulators and policy (...) makers. METHODS: We used a qualitative design to examine Swiss healthcare stakeholders' experiences and perceptions of ethical challenges with regard to patient data in real-life settings where clinical registries are sponsored, created and/or used. A semi-structured interview was carried out with 22 participants (11 physicians, 7 policy-makers, 4 ethical committee members) between July 2014 and January 2015. The interviews were audio-recorded, transcribed, coded and analysed using a thematic method derived from Grounded Theory. RESULTS: All interviewees were concerned as a matter of priority with the needs of legal and operating norms for the collection and use of data, whereas less interest was shown in issues regarding patient agency, the need for reciprocity, and shared governance in the management and use of clinical registries' patient data. This observed asymmetry highlights a possible tension between public and research interests on the one hand, and the recognition of patients' rights and citizens' involvement on the other. CONCLUSIONS: The advocation of further health-related data sharing on the grounds of research and public interest, without due regard for the perspective of patients and donors, could run the risk of fostering distrust towards healthcare data collections. Ultimately, this could diminish the expected social benefits. However, rather than setting patient rights against public interest, new ethical approaches could strengthen both concurrently. On a normative level, this study thus provides material from which to develop further ethical reflection towards a more cooperative approach involving patients and citizens in the governance of their health-related big data. (shrink)

There is a growing interest in aggregating more biomedical and patient data into large health data sets for research and public benefits. However, collecting and processing patient data raises new ethical issues regarding patient’s rights, social justice and trust in public institutions. The aim of this empirical study is to gain an in-depth understanding of the awareness of possible ethical risks and corresponding obligations among those who are involved in projects using patient data, i.e. healthcare professionals, regulators and policy makers. (...) We used a qualitative design to examine Swiss healthcare stakeholders’ experiences and perceptions of ethical challenges with regard to patient data in real-life settings where clinical registries are sponsored, created and/or used. A semi-structured interview was carried out with 22 participants between July 2014 and January 2015. The interviews were audio-recorded, transcribed, coded and analysed using a thematic method derived from Grounded Theory. All interviewees were concerned as a matter of priority with the needs of legal and operating norms for the collection and use of data, whereas less interest was shown in issues regarding patient agency, the need for reciprocity, and shared governance in the management and use of clinical registries’ patient data. This observed asymmetry highlights a possible tension between public and research interests on the one hand, and the recognition of patients’ rights and citizens’ involvement on the other. The advocation of further health-related data sharing on the grounds of research and public interest, without due regard for the perspective of patients and donors, could run the risk of fostering distrust towards healthcare data collections. Ultimately, this could diminish the expected social benefits. However, rather than setting patient rights against public interest, new ethical approaches could strengthen both concurrently. On a normative level, this study thus provides material from which to develop further ethical reflection towards a more cooperative approach involving patients and citizens in the governance of their health-related big data. (shrink)

L'ouvrage Quelles doctrines constitutionnelles pour quel(s) droit(s) constitutionel(s) réuni les contributions des plus éminents spécialistes du droit constitutionnel français, mais aussi étrangers, dans le but de dresser un état des lieux scientifiques de cette discipline : qu'est-ce le droit constitutionnel aujourd'hui? Quellle est son utilité? Et quelles sont ses méthodes, ses évolutuons? Les différentes contributions ici proposées se penchent sur la possible formalisation (ou pas) d'une discipline scientifique autour d'une ou différentes écoles, ainsi que les évolutions qui travaillent les objets, (...) ou encore les domaines politiques et juridiques, mais aussi économiques, sociaux et culturels qu'il se propose d'appréhender. Cet ouvrage se révèle donc un outil précieux pour tous les juristes, mais plus largement, pour tous les citoyens qui s'intéressent aux questions de l'organisation constitutionnelle du Pouvoir au sein des Etats modernes. (shrink)

To many it seems obvious that any reduction of the nature of man to purely physical components involves an indirect attack on the doctrine of human immortality. To so reduce human nature, it may be argued, is to eliminate the soul and it is this essential component of man, rather than his body, which is the foundation of his immortality. This seems to me an altogether mistaken notion. My purpose in this paper, therefore, is to clarify the relation of physicalism (...) and immortality and thereby to reveal the error in this alleged incompatibility. (shrink)

The increased complexity of health information management sows the seeds of inequalities between health care stakeholders involved in the production and use of health information. Patients may thus be more vulnerable to use of their data without their consent and breaches in confidentiality. Health care providers can also be the victims of a health information system that they do not fully master. Yet, despite its possible drawbacks, the management of health information is indispensable for advancing science, medical care and public (...) health. Therefore, the central question addressed by this paper is how to manage health information ethically? This article argues that Paul Ricœur’s ‘‘little ethics’’, based on his work on hermeneutics and narrative identity, provides a suitable ethical framework to this end. This ethical theory has the merit of helping to harmonise self-esteem and solicitude amongst patients and healthcare providers, and at the same time provides an ethics of justice in public health. A matrix, derived from Ricœur’s ethics, has been developed as a solution to overcoming possible conflicts between privacy interests and the common good in the management of health information. (shrink)

The letter to the Ephesians employs various communicative strategies in responding to the rhetorical situation of its implied recipients. Focusing on the recipients' new identity and ethos έν Χριστώ [in Christ], the text emphasises supernatural elements such as resurrection, ascension, heavenly places, revealed mystery, Spirit and power. At the same time, it adopts a rich mosaic of traditional materials, inter alia echoing the Hebrew Scriptures, Hellenistic traditions and early-Christian liturgical traditions. This article explores the dynamic yet complex intertextual fusion and (...) reappropriation of (mainly Jewish) traditions in Ephesians as the author's experience and understanding of the ascended Christ. Special attention is given to the probable functioning of Psalm 68:18 (LXX 67:19) in Ephesians 4:1-16. In conclusion, the essay investigates the intended rhetorical effect of material from the Hebrew Scriptures in the letter - as construction of Christian identity in continuation with the story of Israel and from within the context of Empire. (shrink)

The idea of self-knowledge divides naturally into two parts in accordance with the distinction between knowledge by acquaintance and knowledge by description. I know myself and I know things about myself. The latter I know partly from self-acquaintance, partly from the behavior, especially linguistic, of others, and partly from each of these. All aspects of self-knowledge are controversial, so I shall concentrate in this paper on the question of self-acquaintance. My purpose is both philosophical and historical. It is commonly believed (...) that Hume and Descartes held diametrically opposed, or at least strongly contrasting, views regarding self-acquaintance since Hume is regularly ridiculed for his denial of ability to discover his own Self whereas it would occur to no one to ascribe that same view to the author of the Meditations. In this paper I shall argue that contrary to appearances these two philosophers either held the same position or Descartes occupied the more agnostic extreme; and also that the position usually ascribed to Hume is, when properly understood, both correct and of fundamental philosophical significance. Part of my reason for selecting Hume and Descartes for analysis and comparison is to show thereby that the thesis of this paper is true independently of the rationalist/empiricist schism in philosophy. (shrink)

Les Chants du monde: Le paysage sonore de l’ancienne Mésopotamie. By Anne-Caroline Rendu Loisel. Toulouse: Presses Universitaires du Midi, 2016. Pp. 276, illus. €24.

La 4e de couverture indique : "L'économie politique s'est construite sur le mythe d'un état de nature comme esquisse d'une économie de marché : un monde irénique fondé sur l'échange, la confiance, où la recherche par chacun de son intérêt particulier bénéficie à tous. Le lien social s'y noue naturellement dans une harmonieuse combinaison des intérêts. La nature, autant dire le marché, ressemble à une société d'Arcadie où bergers et bergères échangent, sinon soupirs et baisers, du moins des moutons contre (...) des petits cochons pour le plus grand bonheur de tous. Le monde de Hobbes, à l'inverse, est celui de la peur de l'autre, de la défiance, des pactes trahis, de l'affrontement des pouvoirs. D'où, par les logiques de la raison et le jeu des passions, l'enfer de la guerre de tous contre tous. Et cet enfer, cette peur conduisent les hommes à se soumettre à l'autorité absolue d'un Etat qu'ils construisent afin que l'effroi qu'il inspire se substitue à la crainte de l'autre. Une économie de la peur impose une politique de la terreur. Malgré les horreurs du XXe siècle, les crises, les guerres civiles et étrangères, les terreurs d'État, les pays occidentaux ont réussi à préserver la démocratie et une certaine prospérité, mais ces victoires sont étroitement localisées et elles restent fragiles dans un XXIe siècle hésitant. Cela nous impose de regarder en face une pensée comme celle de Hobbes pour éviter que demain ne ressemble à ses craintes". (shrink)

This theory accords to volitions the status of basic mental actions, maintaining that these are spontaneous exercises of the will--a "two-way" power which ...

La tradition philosophique occidentale recèle des propos éthiques inouïs. Etrangement, ces propos ont été articulés par des penseurs que l'on a souvent considérés comme des "hérétiques" et qui, pour cette raison, ont été diffamés. ostracisés, condamnés, voire exécutés. Héraclite, Socrate, Epicure, Eckhart, Spinoza, Wittgenstein, Arendt et quelques autres exclus ont prononcé des paroles qui n'ont pas été entendues. Sans doute parce qu'elles étaient "hérétiques", c'est-à-dire inaudibles par les pouvoirs en place qu'elles mettaient en cause, directement ou indirectement. Le mot français (...) "hérésie" vient d'une racine grecque qui connote la décision et la pensée. Un hairetikos est quelqu'un qui pense par lui-même et décide de façon autonome. On perçoit immédiatement le renversement sémantique qui caractérise le sens de ce mot, depuis l'Inquisition jusqu'à nos jours, où il désigne plutôt un "déviant", un mouton noir dans un troupeau de moutons blancs, un empêcheur de tourner en rond, un gêneur, un dissident, voire un séditieux. Ce sont pourtant ces "hérétiques" qui ont pensé la nécessité de substituer en éthique l'inclusion à l'exclusion. Une étrange surdité s'est structurée ù travers les siècles ù l'égard de leurs contributions les plus décisives. L'ouvrage tente de dégager des archives de notre culture quelques éléments d'une éthique de l'inclusion. Les éléments demeurés inouïs nous permettraient sans doute, si nous les entendions, de trouver comment surmonter les crises qui nous assaillent de toutes parts. (shrink)

Blood Expiation in Hittite and Biblical Ritual: Origins, Context, and Meaning. By Yitzhaq Feder. Writings from the Ancient World, Supplement Series, vol. 2. Atlanta: Society of Biblical Literature, 2011. Pp. xii + 309. $38.95.

Mythopoeïa ou l’art de forger les “mythes” dans l’“aire culturelle” syro-mésopotamienne, méditerranéenne et indo-européenne. By Jérôme Pace. State Archives of Assyria Studies, vol. 27. Helsinki: The Neo-Assyrian Text Corpus ProJect, 2018. Pp. xxvii + 343. $89.50 (paper). [Distributed by Penn State University Press, State College, PA].