From the timeless wisdom of ancient Greece through to Christianity, the Enlightenment, existentialism and postmodernism, A Brief History of Thought brilliantly and accessibly explains the enduring teachings of philosophy - including its profound relevance in today's world as well as its essential role in achieving happiness and living a meaningful life. This lively journey through the great thinkers challenges every one of us to learn to think for ourselves and asks us the most important question of all: how can we (...) live better? (shrink)

This book is a concise introduction to Maori philosophy, covering the symbolic systems and worldviews of the indigenous people of Aotearoa, New Zealand. This book addresses core philosophical issues including Maori notions of the self, the world, epistemology, the form in which Maori philosophy is conveyed, and whether or not Maori philosophy has a teleological agenda. The book introduces key texts, thinkers and themes and includes pedagogical features including: - A Maori-to-English glossary; - Accessible English translations of primary source material; (...) - Teaching notes, and reflections on how the studied material engages with contemporary debates - End-of-chapter discussion questions that can be used in teaching - Comprehensive bibliographies and guided suggestions for further reading. Maori Philosophy is an ideal text for students studying World Philosophies, or anyone who wishes to use indigenous philosophies or methodologies in their own research and scholarship. (shrink)

For political and literary theorists working on race, Ralph Ellison’s Invisible Man is a canonical text. Most political theorists approach the novel through what this essay calls a “martyr reading,” though martyrdom is just one of several political strategies explored in the work. This essay highlights an alternative in Ellison’s repertoire. The “trickster reading” developed here better accounts for several key scenes in the novel and also shows the limits of martyrdom as a technique of democratic politics. While other democratic (...) theorists have identified Ellison with redemptive or deliberative aims, the novel’s references to Homer’s Odyssey, with its own trickster-hero, license a trickster reading of Invisible Man. Tricksters do not take on suffering, loss, or sacrifice in the hope of redemption nor are they necessarily committed to the virtues of deliberation. Instead, they evade sacrifice by resorting routinely to irony, cunning, and refusal. This reading demonstrates the importance of these techniques to Ellison’s vision and to our politics today. (shrink)

Reproduction is broadly recognised as fundamental to human flourishing. The presumptive priority of reproductive freedom forms the predominant position in the literature, translating in the non-sexual reproductive realm as an almost inviolable right to access assisted reproductive technology (ART). This position largely condemns refusal or restriction of ART by clinicians or the state as discriminatory. In this paper, I critically analyse the moral rights individuals assert in reproductive pursuit to explore whether reproductive rights entitle hopeful parents to ART. I demonstrate (...) that none of the protected actions performed, or entitlements generated are sui generis ‘reproductive’ rights, leading to the claim that there is no such thing as a right to reproduce. Under scrutiny, the reproductive right is a far narrower and weaker rights assertion than is recognised in the literature. I argue that the predominant position is grounded in a fundamental misunderstanding of the scope and strength of reproductive claims.I also highlight a significant conceptual inconsistency in the literature. On one hand, there is broad consensus that reproductive rights are predominantly negative, yet access to fertility treatment is framed as a component of the right. This wrongly contorts the negative nature of reproductive rights into a positive claim-right to ART. I conclude that this mistakenly frames ART access as sitting within the scope of reproductive freedom. I offer a revised conceptual paradigm of reproductive rights that has important clinical and policy implications for the provision and regulation of ART. (shrink)

Aims:The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress.Background:Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon.Design:Systematic literature review and narrative synthesis (November (...) 2015–March 2016).Data sources:Ovid MEDLINE®In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO®1967–Present, CINAHL®Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts.Review methods:Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis.Results:In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity.Conclusion:We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

Fertility clinicians participate in non-sexual reproductive projects by providing assisted reproductive technology (ART) to those hoping to reproduce, in support of their reproductive goals. In most countries where ART is available, the state regulates ART as a form of medical treatment. The predominant position in the reproductive rights literature frames the clinician’s role as medical technician, and the state as a third party with limited rights to interfere. These roles broadly align with established functions of clinician and state in Western (...) liberal democracies, where doctors have duties to provide safe, beneficial and legal healthcare to all who seek it. Recognised state responsibilities include safeguarding equitable access to medical services and protecting and promoting reproductive liberty.I argue against this normative moral framing of clinician and state involvement in non-sexual reproduction, suggesting that clinician and state join the non-sexual reproductive project at the point of triggering conception. Begetting a child is more than just the provision and regulation of healthcare; it generates rights and confers responsibilities on all who join this morally significant project. All who collaborate have the right to join or refuse to join the project. I suggest this is intuitively understood in the sexual realm, but not in the non-sexual realm. My key substantive claim is that non-sexual reproduction is a pluralist pursuit that morally implicates more than the genetic and gestational contributors. I find that while the moral basis of a clinician or the state’s right to refuse to join the ART project is the same as for those providing gestational or genetic input, the reasons that morally underpin their refusal differs. (shrink)

All the great ideals that gave life meaning in earlier societies--God, the nation, revolution, freedom, democracy--are in disarray today, widely questioned, and rejected outright by the many people who have lost faith in them. But there is another value, rooted in the birth of the modern family and in the passage from traditional to modern marriage, which has transformed our lives in profound and often unrecognized ways: love. It affects not only our personal lives but many aspects of our social (...) and collective life, too, from art and education to politics. In this book, Luc Ferry shows how the quiet rise of love as the central value in modern societies has created a new principle of meaning and a new definition of the good life that requires a completely different kind of philosophical thinking. It forms the basis for a new philosophy for the twenty-first century and a new kind of humanism for the modern world--not a humanism of reason and rights, but a humanism of solidarity and sympathy. The ideal behind this new realism has nothing to do with nationalism and revolution: it has moved beyond the organized violence that was driven by deadly and often inhumane principles. Instead, it aims to prepare and ensure a future for those we love most: our future generations."--Jacket. (shrink)

Ces dernières années, la philosophie politique a trouvé un second souffle. Depuis la parution de la Théorie de la justice, au début des années 1970, et sous le double mouvement du déclin des idéologies et de l'écroulement du système communiste, de nouveaux débats sont apparus. Comment combiner le respect des droits individuels et le maintien d'une ambition collective? Comment intégrer au libéralisme politique un projet communautaire? Quelles doivent être les relations entre l'individu, l'Etat et la société? Comment répondre au malaise (...) et au déficit de légitimité que connaissent les démocraties occidentales? Ces interrogations ont permis d'imposer des voix nouvelles - celles de John Rawls ou de Jürgen Habermas -, mais aussi, plus récemment, celles des auteurs dits " communautariens " : Michaël Sandel, Michaël Walzer et Charles Taylor. Ces discussions sont également l'occasion d'en revenir aux fondateurs de la pensée politique contemporaine et de vérifier ainsi l'actualité de la réflexion d'Emmanuel Kant, de Friedrich Hegel, de Karl Marx, d'Alexis de Tocqueville, de John Stuart Mill ou, plus près de nous, de Sigmund Freud et de Max Weber pour penser les problèmes politiques et spirituels de notre temps. Cet ouvrage aimerait donner un aperçu des problématiques actuelles de la théorie politique. Pour la sélection des auteurs étudiés, la question de la liberté a servi de fil conducteur. (shrink)

BackgroundThe phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, and there is a lack of empirical research regarding its impact on nurses in the United Kingdom and its relevance to clinical practice.Research aimTo explore the concept of moral (...) distress in nursing both empirically and conceptually.MethodologyFeminist interpretive phenomenology was used to explore and analyse the experiences of critical care nurses at two acute care trauma hospitals in the United Kingdom. Empirical data were analysed using Van Manen’s six steps for data analysis.Ethical considerationsThe study was approved locally by the university ethics review committee and nationally by the Health Research Authority in the United Kingdom.FindingsThe empirical findings suggest that psychological distress can occur in response to a variety of moral events. The moral events identified as causing psychological distress in the participants’ narratives were moral tension, moral uncertainty, moral constraint, moral conflict and moral dilemmas.DiscussionWe suggest a new definition of moral distress which captures this broader range of moral events as legitimate causes of distress. We also suggest that moral distress can be sub-categroised according to the source of distress, for example, ‘moral-uncertainty distress’. We argue that this could aid in the development of interventions which attempt to address and mitigate moral distress.ConclusionThe empirical findings support the notion that narrow conceptions of moral distress fail to capture the real-life experiences of this group of critical care nurses. If these experiences resonate with other nurses and healthcare professionals, then it is likely that the definition needs to be broadened to recognise these experiences as ‘moral distress’. (shrink)

Aujourd’hui délaissées, parfois devenues gênantes, les collections médicales furent pourtant à l’avant-garde du renouveau de la médecine au début du XIXe siècle, avant que celle-ci ne devienne la médecine telle que nous la connaissons aujourd’hui. Selon une vision courante de l’histoire de la médecine, les collections médicales auraient perdu de leur utilité lorsque la médecine a accédé au statut de science expérimentale, les musées d’anatomie faisant alors place aux laboratoires. Les collections d’anatomie-pathologie comme le musée Dupuytren ne seraient que le (...) reliquat de cette histoire, le témoignage d’un échec méthodologique à opposer aux succès de la physiologie expérimentale. Cette narration de l’histoire de la médecine est-elle cependant correcte ? Dans quels buts épistémologiques les médecins ont-ils créé ces collections ? Quelles connaissances cherchaient-ils à obtenir par ce biais ? Plus généralement, pourquoi collecter en médecine – et en science – et pourquoi collectionner ? Pour répondre à ces questions, je m’intéressai principalement dans cette contribution aux pratiques de collecte et de collection chez les médecins de la Société Anatomique de Paris au XIXe siècle et au rôle joué par ces pratiques dans la construction de la collection Dupuytren. (shrink)

This essay considers the ancient antecedents to the “new field” of the ethics of philanthropy, arguing that key questions such as “to whom should we give our money?” have already been explored by ancient authors and that the answers they give to these questions can be quite different to the answers given by contemporary scholars. By analysing the treatment of giving in Aristotle’s Nicomachean Ethics, Cicero’s De Officiis, and Seneca’s De Beneficiis, I argue that the focus of ancient thinkers upon (...) giving within one’s own community can be viewed as a possible response to a number of issues that have been raised by modern scholars, including the “problem of acting at a distance” and the “problem of accountability.” Moreover, these ancient thinkers have additional, positive reasons for thinking that philanthropy should take place within one’s own community, based upon their ideas of man’s natural duty to his political community, and the social benefits that can be derived from local philanthropy. The integration of ancient perspectives, then, into these modern debates, can serve to complement and broaden research in this emerging field. (shrink)

This paper examines how young peoples’ lived experiences with personal technologies can be used to teach engineering ethics in a way which facilitates greater engagement with the subject. Engineering ethics can be challenging to teach: as a form of practical ethics, it is framed around future workplace experience in a professional setting which students are assumed to have no prior experience of. Yet the current generations of engineering students, who have been described as ‘digital natives’, do however have immersive personal (...) experience with digital technologies; and experiential learning theory describes how students learn ethics more successfully when they can draw on personal experience which give context and meaning to abstract theories. This paper reviews current teaching practices in engineering ethics; and examines young people’s engagement with technologies including cell phones, social networking sites, digital music and computer games to identify social and ethical elements of these practices which have relevance for the engineering ethics curricula. From this analysis three case studies are developed to illustrate how facets of the use of these technologies can be drawn on to teach topics including group work and communication; risk and safety; and engineering as social experimentation. Means for bridging personal experience and professional ethics when teaching these cases are discussed. The paper contributes to research and curriculum development in engineering ethics education, and to wider education research about methods of teaching ‘the net generation’. (shrink)

There has been increasing debate in recent years about the conceptualization of moral distress. Broadly speaking, two groups of scholars have emerged: those who agree with Jameton’s ‘narrow definition’ that focuses on constraint and those who argue that Jameton’s definition is insufficient and needs to be broadened. Using feminist empirical bioethics, we interviewed critical care nurses in the United Kingdom about their experiences and conceptualizations of moral distress. We provide our broader definition of moral distress and examples of data that (...) both challenge and support our conceptualization. We pre‐empt and overcome three key challenges that could be levelled at our account and argue that there are good reasons to adopt our broader definition of moral distress when exploring prevalence of, and management strategies for, moral distress. (shrink)

Among the myriad of technical approaches and abstract guidelines proposed to the topic of AI bias, there has been an urgent call to translate the principle of fairness into the operational AI reality with the involvement of social sciences specialists to analyse the context of specific types of bias, since there is not a generalizable solution. This article offers an interdisciplinary contribution to the topic of AI and societal bias, in particular against the poor, providing a conceptual framework of the (...) issue and a tailor-made model from which meaningful data are obtained using Natural Language Processing word vectors in pretrained Google Word2Vec, Twitter and Wikipedia GloVe word embeddings. The results of the study offer the first set of data that evidences the existence of bias against the poor and suggest that Google Word2vec shows a higher degree of bias when the terms are related to beliefs, whereas bias is higher in Twitter GloVe when the terms express behaviour. This article contributes to the body of work on bias, both from and AI and a social sciences perspective, by providing evidence of a transversal aggravating factor for historical types of discrimination. The evidence of bias against the poor also has important consequences in terms of human development, since it often leads to discrimination, which constitutes an obstacle for the effectiveness of poverty reduction policies. (shrink)

Jean-Marc Ferry est titulaire de la Chaire de Philosophie de l'Europe de l'Université de Nantes, professeur honoraire en Science politique et Philosophie morale à l'Université libre de Bruxelles, auteur notamment des Puissances de l'expérience (1991), l'une des oeuvres les plus importantes récemment publiées dans le champ de la philosophie sociale et politique, de la philosophie tout court (Paul Ricoeur), La Question de l'État européen (2001), Les Grammaires de l'intelligence (2004), La Raison et la Foi (2016).

« Ce que j’appelle la “révolution de l’amour”, c’est-à-dire la naissance de la famille moderne, enracinée dans le passage du mariage arrangé au mariage choisi par et pour l’amour, a transformé nos vies. Elle apporte un nouveau principe de sens, qui requiert une nouvelle philosophie. Elle ne bouleverse pas seulement nos existences privées, mais tout notre rapport au collectif. C’est ce que j’appelle le “deuxième humanisme”». Le premier fut un humanisme de la Loi et de la raison. C’était celui des (...) Lumières et des droits de l’homme, des républicains français et de Kant. Le deuxième humanisme est un humanisme de la fraternité et de la sympathie. Ma conviction est qu’il est désormais la seule vision du monde portée par le souffle d’une utopie positive. Car l’idéal qu’elle vise à réaliser n’est plus celui des nationalismes ni de l’idée révolutionnaire. Il ne s’agit plus d’organiser de grands massacres au nom de principes mortifères qui se voulaient extérieurs et supérieurs à l’humanité, mais de préparer l’avenir de ceux que nous aimons le plus, c’est- à-dire des générations futures... » L. F. Luc Ferry s’entretient ici avec Claude Capelier, agrégé de philosophie et conseiller scientifique du Conseil d’analyse de la société. Luc Ferry est agrégé de philosophie, docteur d’État, agrégé de science politique. Il est philosophe. Ses livres sont traduits à l’étranger dans une trentaine de langues. Il a notamment publié chez Odile Jacob Vaincre les peurs et Qu’est-ce que l’Homme? (en collaboration avec Jean-Didier Vincent), qui ont été d’immenses succès. (shrink)

La 4e de couverture indique : "Quelle place accorder aujourd'hui aux religions dans les démocraties? Que peut-on espérer du dialogue entre croyants et non-croyants dans une société devenue plurielle et sécularisée? Quel rôle peut jouer la religion dans la modernité du XXIe siècle? Le philosophe français Jean-Marc Ferry prend à bras-le-corps ces questions difficiles, laissées en déshérence ou livrées aux excès de tous bords. Refusant les pièges d'un laïcisme souvent ignorant, tout comme les hégémonies religieuses, il reprend le fil (...) d'une longue tradition philosophique qui a toujours pris au sérieux la question religieuse, même quand elle s'y opposait. Dans ce livre qui fera date, le philosophe rassemble pour la première fois sous la forme d'une conversation l'ensemble de sa réflexion sur la religion dans la modernité. Au cours de sa réflexion, Jean-Marc Ferry invite à considérer les "Lumières de la religion", une expression malicieuse par laquelle il entend signifier que les religions ne sont pas en opposition avec la modernité. A la condition de devenir réflexives et critiques, et d'accepter les règles du jeu démocratique, elles peuvent apporter une précieuse participation à la vie commune, au bénéfice de tous.". (shrink)

L'interprétation actuelle de Kant face à la Révolution française se présente sous forme d'un choix : ou bien Kant serait un libéral selon les tendances de la philosophie politique du jour, ou bien il serait un révolutionnaire qui avancerait masqué. L'ouvrage de Christian Ferrié qui repose sur une connaissance précise des inédits a le mérite de sortir de cette alternative. Spectateur enthousiaste de la Révolution en France, Kant réfute pourtant le droit de rébellion et rejette la méthode révolutionnaire. La pensée (...) politique de Kant semble partagée entre une adhésion au dessein républicain de la Révolution et des principes réformistes que cet événement bouleverse. Comment être alors sans contraction réformiste et révolutionnaire? Cet Ouvrage tenté de répondre à cette question sans esquiver les difficultés d'une position entre réforme et révolution. Car Kant paraît osciller entre une réflexion sur l'histoire qui établit de facto l'efficacité des révolutions et une doctrine normative du droit qui préconise la voie de la réforme. L'ambivalence apparente de sa position disparaît dès qu'elle est réinscrite dans le contexte des controverses de son temps en Allemagne. Kant défend la cause de la France en révolution contre l'offensive d'un réformisme antirévolutionnaire qui veut améliorer la société d'ordres pour mieux la sauver. C'est ainsi que Kant est conduit à inventer un réformisme révolutionnaire, inédit en ce qu'il préconise en principe la voie réformatrice tout en reconnaissant en fait la nécessité du moment révolutionnaire. La révolution devient la condition des réformes révolutionnaires qui l'accomplissent. Loin de proposer une synthèse positive, Kant conçoit plutôt un champ de tensions dynamiques entre réforme et révolution. Porté par l'enthousiasme que suscite la Révolution française, Kant donne à penser l'articulation de ces deux moments du politique au sein d'une nouvelle et "difficile" politique de l'émancipation qui parvient à penser une sorte de réformisme en révolution. (shrink)

Quand on a renoncé à démontrer l'existence de Dieu ou l'immortalité de l'âme, est-il encore rationnel de postuler que Dieu existe ou que l'âme est immortelle? Peut-on croire rationnellement dans l'incertitude la plus totale? Jean-Marc Ferry montre précisément en quoi la religion réflexive le permet. Celui qui s'y engage ne se prévaut d'aucun accès privilégié à la vérité. Au départ, cet engagement procède moins d'une croyance que d'une résolution. Il s'agit, en effet, d'un acte de pure liberté, dépourvu d'assise, (...) acte risqué qui fait que l'on accorde ou non sa confiance au réel. Ensuite seulement, entre l'athée et le croyant, les expériences pourront être confrontées ; et c'est quand l'un et l'autre assument pleinement leur absolue ignorance métaphysique que raison et religion peuvent enfin être conciliées. (shrink)

"Par dizaines, des expressions issues de la mythologie grecque se sont inscrites dans le langage courant : une "pomme de discorde", un "dédale de rues", prendre le "taureau par les cornes", toucher le "pactole", "tomber de Charybde en Scylla", suivre un "fil d'Ariane", "jouer les Cassandre", etc. Mille références endormies aux Sirènes, à Typhon, Océan, Triton, Python, Sibylle, Stentor, Mentor, Laïus, Argus, OEdipe et à tant d'autres personnages mythiques habitent encore incognito nos conversations de tous les jours. Je vous propose (...) de les réveiller en racontant les histoires magnifiques qui en sont l'origine. Mais il y a plus. Les grands mythes ne se limitent pas à des "contes et légendes". Ils proposent des leçons de vie et de sagesse d'une profondeur abyssale. La mythologie représente ainsi une tentative grandiose pour apporter des réponses à l'antique question métaphysique de "la vie bonne pour les mortels". Son étude, passionnante en elle-même, constitue pour cette raison une excellente introduction à la philosophie." Luc Ferry. (shrink)

This paper describes the scientific practices of the anatomists from the Société Anatomique de Paris (1803–1873) who were collecting anatomical and pathological specimens in Nineteenth-Century Paris and which led to the building of the anatomy and pathology Musée Dupuytren (1835–2016). The framework introduced by Robert Kohler to describe collecting sciences (2007) is useful as a tool to identify the set of diverse practices within pathological anatomy in nineteenth-century Paris. However, I will argue that anatomy and pathology collecting had specific features (...) compared to most collecting sciences. Two main collecting practices could be distinguished: first, “finding” anatomical specimens and second, keeping these specimens. The first kind of practices were at least rhetorically and explicitly motivated by Auguste Comte’s positive philosophy. But “finding” an anatomy or pathology specimen could not be completely compared to finding an object or making a simple observation, as dissecting as well as some experimental practices were also involved. Heterogeneous practices thus coexisted within collecting in anatomy and pathology. Epistemological as well as pragmatic tensions arose. On top of Kohler’s framework, I introduce Sabina Leonelli’s concept of “data journey” to offer a narrative of the diversity of collecting practices involved in the Société Anatomique de Paris and the Musée Dupuytren. I use the concept to analyse how this diversity of practices impacted knowledge production. (shrink)

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

Cette parole d'Emmanuel Levinas touche le coeur d'une actualité, celle de notre rapport occidental à la mort, qui résume le contexte dans lequel la mort nous fait problème, C'est ce contexte qui permet aussi d'éclairer la difficile question des "fins de vie" sous nos latitudes. S'engage la bataille idéologique : puis-je ou non disposer de mon existence? Des deux côtés, on invoque la dignité humaine, que ce soit pour réclamer le droit de "mourir dans la dignité" ou pour justifier l'interdiction (...) de toute forme d'euthanasie au nom du "caractère sacré" de la vie humaine. La "dignité humaine" devrait-elle justifier tout et son contraire? Il importe plutôt d'en élucider la notion et le fondement, en commençant par faire le clair sur les interprétations concurrentes et leurs implications pratiques. L'approche pluridisciplinaire de l'ouvrage favorisera une lecture critique au sein de laquelle différents points de vue s'inscrivent dans des moments distincts : Moment d'attestation, celui des praticiens aux prises avec la réalité des hôpitaux et des unités de soins palliatifs. Ils expérimentent au jour le jour le drame et la tragédie des passages de la phase curative à la phase palliative puis à la phase terminale ; Moment d'information, d'analyse exégétique et critique, touchant notamment à l'état du droit ; Moment de problématisation. De quoi et vers quoi? Tout logiquement, en direction des fondements philosophiques, c'est-à-dire de ce qui justifie que l'on prenne telle ou telle décision importante concernant les soins, l'arrêt des soins, la fin de vie, voire l'arrêt de la vie. (shrink)

Alongside clinical practice, medical schools now confront mounting reasons to examine nontraditional approaches to ethics. Increasing awareness of systems of oppression and their effects on the experiences of trainees, patients, professionals, and generally on medical care, is pushing medical curriculum into an unfamiliar territory. While there is room throughout medical school to take up these concerns, ethics curricula are well-positioned to explore new pedagogical approaches. Feminist ethics has long addressed systems of oppression and broader structures of power. Some of its (...) established concepts can offer distinct value as medical climates change and adapt in response to increased awareness of the experiences of marginalized individuals and populations. In this essay, we offer a set of concepts from feminist ethics that have a fundamental role to play in medical school curriculum: relationality, relational autonomy, and epistemic justice. Though these concepts are not exhaustive, they can be taught in tandem with the concepts that have historically grounded ethics education in medical school, such as autonomy and beneficence. Ultimately, we contend that these concepts hold particular value in ethics curriculum insofar as they diversify mainstream ethical approaches, directly address the pervasiveness of systems of oppression in medicine, and recognize the voices and concerns that may be marginalized in standard approaches. (shrink)

Suffering is a ubiquitous yet elusive concept in health care. In a field devoted to the pursuit of objective data, suffering is a phenomenon with deep ties to subjective experience, moral values, and cultural norms. Suffering’s tie to subjective experience makes it challenging to discern and respond to the suffering of others. In particular, the question of whether a child with profound neurocognitive disabilities can suffer has generated a robust discourse, rooted in philosophical conceptualizations of personhood as well as the (...) academic and experiential expertise of practiced health-care professionals. The issue remains unresolved because it is difficult, perhaps impossible, to ever truly know an infant’s lived experience. But what if this is not the best question? What if instead of asking “can this infant suffer?” the discourse is broadened to ask “is there suffering here?” This latter question demands attention to patients’ subjective experiences of suffering, but also to the web of relationships that envelop them. Without losing sight of the importance of patients’ experiences, consideration of their relationships may elucidate the presence of suffering when the patients themselves are unable to provide the same clarity. In this essay, care ethics frames an examination of how suffering manifests in the loving and caring relationships that surround an infant with profound neurocognitive disabilities, changing those relationships and affecting the individuals within them. Exploring suffering through these relationships may offer clarity on the presence and content of suffering for infants with profound cognitive disabilities, in turn offering moral guidance for responding to suffering and supporting flourishing in this context. (shrink)

Within this paper, we discuss Moral Distress Reflective Debriefs as a promising approach to address and mitigate moral distress experienced by healthcare professionals. We briefly review the empirical and theoretical literature on critical incident stress debriefing and psychological debriefing to highlight the potential benefits of this modality. We then describe the approach that we take to facilitating reflective group discussions in response to morally distressing patient cases (“Moral Distress Reflective Debriefs”). We discuss how the debriefing literature and other clinical ethics (...) activities influenced the development of our approach. In particular, we focus on the role of the clinical ethicist as a facilitator with particular emphasis on encouraging perspective-taking and nurturing ethical attunement in a supportive manner. We suggest that this approach reduces the narrowing effects of frustration and anger that are often reported when individuals experience moral-constraint distress. Finally, we provide an example of Moral Distress Reflective Debriefs, elucidating how this supportive process complements ethics consultation and can mitigate the negative effects of moral distress. (shrink)

Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom (...) and Europe, it is important to consider the wider effects of the constraints that it imposes in healthcare. Within this paper, we focus specifically on one theorised effect—moral distress. We differentiate between avoidable and unavoidable ethical challenges within healthcare and argue that austerity creates additional avoidable ethical problems that exacerbate clinicians’ moral distress. We suggest that moral resilience is a suitable response to clinician moral distress caused by unavoidable ethical challenges but additional responses are required to address those that are created due to austerity. We encourage clinicians to engage in critical resilience and activism to address problems created by austerity and we highlight the responsibility of institutions to support healthcare professionals in such challenging times. (shrink)

C’est une longue épopée, engagée depuis l’Antiquité, qui se poursuit encore aujourd’hui, une aventure pleine de passions, de révoltes, de revirements et de coups de génie. Telle est l’histoire de la philosophie, vue et racontée par Luc Ferry : une conquête obstinée, menée au fil des siècles par une poignée d’explorateurs qui, soudain, trouvent une nouvelle clef pour donner un sens à la condition humaine et bouleversent fondamentalement notre manière de penser. Pourquoi et quand s’est-on mis à philosopher? Comment (...) les grands concepts se sont-ils succédé au fil des siècles? Comment et pourquoi Platon, Descartes, Montesquieu, Hegel, Schopenhauer, Marx, Nietzsche, Freud, Heidegger, et quelques autres – les grands défricheurs de la pensée ne sont pas si nombreux – ont-ils eu soudain l’intuition qui a tout changé? Dans un dialogue limpide et sans jargon avec Claude Capelier, Luc Ferry déroule le fil chronologique depuis les origines antiques jusqu’à nos jours et décrit les six grandes étapes décisives qui nous ont ouvert un nouvel univers. On le verra, l’histoire de la philosophie, comme celle de l’art, n’aime pas la ligne droite, elle connaît des zigzags, des revirements, parfois des errances, et les grandes idées d’autrefois n’ont pas forcément perdu leur pertinence. Pourtant, Luc Ferry le raconte ici, elle semble quand même avancer dans un certain sens – oserait-on même parler d’un certain progrès? Plus on explore, plus on défriche et plus on s’approche de l’intime, de l’essence de l’homme. Et c’est la grande originalité de ce livre que de nous faire apparaître la philosophie comme une quête essentielle, à la fois millénaire et furieusement actuelle. Où en est-on à l’heure de la globalisation, des espaces virtuels et des intégrismes recyclés d’un autre âge? Comment répondre à notre désarroi face à un monde qui, une fois encore, nous glisse entre les doigts? Par l’amour, suggère le philosophe, ce concept à la fois si banal et si complexe, susceptible de nous offrir une meilleure compréhension de notre temps, et peut-être de nous-mêmes. (shrink)

" Le point de départ de ce livre est une conférence dans laquelle j'ai présenté à un large public les points essentiels de mon livre, Apprendre à vivre.

Studies of implicit learning have shown that individuals exposed to a rule-governed environment often learn to exploit 'rules' which describe the structural relationship between environmental events. While some authors have interpreted such demonstrations as evidence for functionally separate implicit learning systems, others have argued that the observed changes in performance result from explicit knowledge which has been inadequately assessed. In this paper we illustrate this issue by considering one commonly used implicit learning task, the Serial reaction time task, and outline (...) what we see as an important problem associated with each of the commonly used methods used to assess explicit knowledge. This is that each measure requires a form of response which is dependent on the subjects having some knowledge of the serial-order of the sequence. We argue that such methods, or more specifically their analyses, seriously underestimate other sources of knowledge, which may be available to subjects during their performance of the SRT task. In support of this argument we demonstrate that subjects' serial-order knowledge can, in principle, be independent of subjects' knowledge of the statistical structure of the sequence, and we propose an alternative method for analysing performance on the Generate task which avoids this problem. (shrink)

Wittgenstein explores learning through practice in the Philosophical Investigations by means of an extended analogy with games. However, does this concern with learning also necessarily extend to education, in our institutional understanding of the word? While Wittgenstein's examples of language learning and use are always shared or social, he does not discuss formal educational institutions as such. He does not wish to found a ‘school of thought’, and is suspicious of philosophy acting as a theory that can be applied to (...) other areas of life. While Wittgenstein's focus on developing independent thinking was neither individualistic nor anti-institutional, it did, however, focus on developing the thinking of his students rather than theorising about how this could be applied on a large scale. An analysis of Hermann Hesse's novel, The Glass Bead Game will help us to pick up where Wittgenstein deliberately left off—thinking about how (or if) one can institutionalise learning methods that encourage thinking for oneself. These differences in the writers’ treatment of education will become evident in the differences between their game analogies. While language-games combat our ‘craving for generality’ in Philosophical Investigations, the Glass Bead Game represents this craving, and how it manifests itself throughout history in disciplines other than logic and philosophy of language. It also represents the potential for institutions to become insular, exclusive communities. (shrink)

Empathy is sometimes so hard to achieve that one may wonder if it is a virtue for caregivers at all. Perhaps a caregiver cannot always know how a patient feels, and perhaps that knowledge is sometimes too painful to possess. A nuanced understanding of what empathy entails and of the conditions for attaining it can help ground its possibility.

The predominant position in the reproductive rights literature argues that access to assisted reproductive technologies (ART) forms part of an individual’s right to reproduce. On this reasoning, refusal of treatment by clinicians (via provision) violates a hopeful parent’s reproductive right and discriminates against the infertile. I reject these views and suggest they wrongly contort what reproductive freedom entitles individuals to do and demand of others. I suggest these views find their origin, at least in part, in the way we define (...) “reproduction” itself. This paper critically analyses two widely accepted definitions of human reproduction and demonstrates that both are fundamentally flawed. While the process of reproduction includes the biological acts of begetting and bearing a child, I argue that it does not extend to include rearing. This reworked definition has little impact in the realm of sexual reproduction. However, it has significant ethical implications for the formulation and assignment of reproductive rights and responsibilities in the non-sexual realm in two important ways. First, a claim to access ART where one has an intention to rear a child (but does not beget or bear) cannot be grounded in reproductive rights. Second, lacking an intention to rear does not extinguish the reproductive rights and responsibilities for those who collaborate in the process. I conclude that clinicians collaborate in non-sexual reproduction at the point of triggering conception (begetting) and therefore have the right to refuse to be involved in non-sexual reproduction, in some instances, as do all reproductive collaborators. (shrink)