The American Journal of Bioethics, Volume 12, Issue 9, Page 57-59, September 2012.

The purpose of this paper is to engage with the readers in a theoretical reflection on nursing practices in forensic psychiatric settings. In this paper, we argue that practices of exclusion in forensic psychiatric settings share some common ground with Agamben's description of sovereign power and, consequently, the possible creation of zones of exception in this environment. The concept of exception is, therefore, purposely used to shift our thinking, highlight the political forces surrounding exclusionary practices in forensic psychiatric nursing, and (...) explore the ethical tensions that arise for nurses who become entangled in the control of these zones of exception. We argue that ethical and political discussions regarding this phenomenon are necessary if we wish to further understand the complexities of this field of practice and promote constructive change. (shrink)

In the Canadian forensic psychiatric context, the concepts of risk and dangerousness interact, intersect, and morph into the notion of significant threat to the safety of the public. Stemming from the results of a critical ethnography of the Ontario Review Board, this article unpacks the central role of forensic psychiatric nursing, as an example of a 'psych' discipline (e.g., psychiatry and psychology), in a system that is built to produce risky persons and to legitimize their detention and supervision. By using (...) excerpt of interviews conducted with nurses, ethnographic observations of Review Board hearings, and other documentary artifacts, the findings illustrate how rationalizations of risk and dangerousness are contingent on space, time, and observer. Depending on the time of the assessment or on the health‐care professional who performs it, different elements including, but not limited to, mental illness, interpersonal relationships, financial instability, and sexual vulnerability, are relied upon in very fluid, interchangeable, and discretionary ways to justify findings of dangerousness. Such a dynamic expands the reach of psychiatry's legitimacy at identifying risky conduct and controlling risky persons to domains very loosely associated with the notion of dangerousness. The work of Foucault and Castel provides the theoretical backdrop on which rests the discussion and the implications for nursing. (shrink)

Background:Psychiatric nurses are regularly confronted with the uses and effects of control interventions such as mechanical restraints. Although there are evident tensions in the literature regarding the use of mechanical restraints, very little research has focused on the lived and embodied experience of their use, whether from the patient’s perspective or the perspective of nursing staff responsible for their application.Research aims: to gain access to the bodily phenomenon of being placed in mechanical restraints; to give voice to the intimate experiential (...) understanding of this experience; and through phenomenological interpretation, to understand the subjective processes and meaning-making of this experience.Research design:For this research, we adopted a distinctly ethics-oriented application of the methodology known as interpretative phenomenological analysis, that is, the interpretive dimension of the research focused on ethical practice in mental healthcare – one that is informed by experiential accounts of the lived body.Participants and research context:A total of 40 in-depth semi-structured, nondirected interviews with both nurses and patients we conducted to meet the aims of this article. Participants were recruited from an inpatient psychiatric unit of a Canadian general hospital.Ethical considerations:The research received research ethics board clearance from both the hospital where the study took place and the University of Ottawa.Findings:The comparative analysis is presented under the following headings: context of care, meaning of quality of care, emotional reactions and nurse–patient relationship, meeting the needs and need for alternatives.Discussion/conclusions:The research findings are discussed in light of current literature and implications for practice. (shrink)

Né en 1921, Edgar Morin est un penseur connu, mais heureusement pas toujours reconnu dans les milieux scientifiques. Sa ronflante Méthode, qui établit que les effets d’une action échappent souvent à son auteur en provoquant des conséquences méconnues, comble surtout des médias trop heureux d’avoir sous la main un théoricien tout-terrain aux analyses grandiloquentes. D’ailleurs, la femme, l’entreprise, le football, la France, l’Europe, les pays de l’est, les pays arabes, le monde... sont, pour Edgar Morin, complexes. En quelques années, Edgar (...) Morin a ainsi réussi à amener la gauche à jeter Marx et ses analyses tranchées aux poubelles de l’Histoire. Car avec Edgar Morin, c’est beaucoup plus complexe et parfois même un tantinet ésotérique. Il est donc insensé de faire preuve de volontarisme politique. (shrink)

Humanism in forensic psychiatry: the use of the tidal nursing model The humanist school of thought, which finds resonance in many conceptual models and theories designed to guide nursing practice, needs to be understood in the context of the total institution, where the individual is subjected to a mortification of the self, and denied autonomy. This article will engage in a critical reflection on how humanism has influenced nursing theorists and the subsequent production of conceptual models and theories, especially as (...) they relate to the field of forensic psychiatric nursing. Although humanism provides optimism for nurse–patient relations, this article explores the incapability of such a philosophy to acknowledge the power relationships between individuals and its inability to explain the day‐to‐day realities experienced in forensic nursing, where the possibility of interpersonal violence reshapes nursing care. The tidal model will be discussed in detail as an example of a recently developed humanistic nursing model. Viewed from this perspective, it is clear that humanistic philosophy and its subsequent models of care are in discordance with the highly specialized field of forensic nursing. (shrink)

S'ils défendent des thèse originales, les écologistes partagent pourtant, parfois, les mêmes auteurs de prédilection que les centristes, les socialistes ou les anarchistes! Ce constat n'est pas le fait d'un rapprochement hasardeux mais le fruit d'une enquête inédite et sans précédent menée auprès des leaders écologistes français, invités à définir les contours théoriques de l'écologie politique.

Essentielle au droit, la question de la valeur n'a pourtant jamais été prise au sérieux. Et pour cause, dans le sillage des sciences empiriques, la pensée juridique moderne s'est accommodée d'une épistémologie d'après laquelle toute proposition juridique est réputée vraie ou fausse si elle décrit un état de chose « réel ». Conçu comme un ensemble de faits sociaux, objectivement identifiables, le droit s'appréhende comme une discipline promouvant des idéaux scientifiques, dont la neutralité axiologique de l'observateur. Dans ces conditions, la (...) valeur, indémontrable puisqu'elle n'est pas un fait, est renvoyée aux confins du droit. Cet ouvrage vise à souligner l'articulation fondamentale entre la discipline juridique et le concept de valeur qui en constitue le pivot, et à proposer une définition juridiquement satisfaisante de cet objet central pour le droit. (shrink)