Delivered at the Collège de France between January and March 1980, the lectures entitled On the Government of the Living (Du gouvernement des vivants) seem to be the missing piece in the Foucauldian puzzle. Still unpublished, those eleven lectures were intended to set the theoretical foundation for the book announced as the fourth and last volume of the History of Sexuality, under the title Confessions of the Flesh (Les aveux de la chair). This book, however, was never published, despite the (...) fact that his editor described it as the keystone for the entire History of Sexuality.1 The value of Michel…. (shrink)

End-of-life disputes in Ontario are currently overwhelmingly assessed through the singular lens of patient autonomy. The current dispute resolution mechanism does not adequately consider evidence-based medical guidelines, standards of care, the patient’s best interests, expert opinion, or distributive justice. We discuss two cases adjudicated by the Consent and Capacity board of Ontario that demonstrate the over emphasis on patient autonomy. Current health care policy and the Health Care Consent Act also place emphasis on patient autonomy without considering other ethically defensible (...) factors. We argue that current policy and legislation require amendment, and unless there are measures undertaken to modify them, both the quality of care provided and the long-term capabilities of the health care system to remain publicly-funded, comprehensive and equitable, are at stake. (shrink)

Documenting capacity assessments and identifying substitute decisionmakers in healthcare facilities is ethically required for optimal patient care. Lack of such documentation has the potential to generate confusion and contention among patients, their family members, and members of the healthcare team. An overview of our research at the Ottawa Hospital and issues that influence the consistency of documentation in the Canadian context are presented here, as well as ideas for the mitigation of these issues and ways to encourage better documentation.

Loneliness has been described as endemic among young people. Such feelings of social isolation ‘even in a crowd’ are likely linked to adverse early life experiences that serve to diminish perceptions of social support and intensify negative social interactions. It was suggested in the present series of survey studies that childhood abuse, which compromises a child’s sense of safety in relationships, may affect social processes that contribute to loneliness in young adulthood. Study 1 assessed different adverse childhood and adult experiences (...) in relation to loneliness among young adults. Linear regression analyses indicated that childhood abuse was uniquely associated with greater loneliness, and this relationship was partially mediated by the perceived availability of social support. Study 2 assessed different forms of childhood abuse and demonstrated that early life emotional abuse was a unique predictor of loneliness, and this relationship was fully mediated by lower perceived support or value in social connections and more frequent unsupportive interactions with friends. Study 3 evaluated the implications of the age of occurrence of abuse. Both emotional and sexual abuse predicted young adult loneliness regardless of age; abuse that was recalled to have occurred at very early ages was not predictive of loneliness over and above consideration of events that happened in older childhood. These relationships were at least partially mediated by perceived social support, social connectedness, and in the case of emotional abuse, unsupportive interactions with friends. Our results add to mounting evidence pointing to the prevalence of loneliness among young adults and the links to adverse early life experiences that may serve to shape appraisals of safety, value, and personal worth in social relationships. (shrink)