Jusqu’à présent, les discussions au sein de la communauté universitaire et dans la littérature scientifique sur la conduite responsable en recherche (CRR), incluant l’intégrité scientifique et l’éthique de la recherche, ont principalement été menées par les chercheurs en sciences de la santé et en sciences fondamentales. Préoccupés, à juste titre, par des problèmes d’inconduite, leurs effets négatifs sur la rigueur scientifique et la confiance du public dans l’entreprise de la recherche, ces débats ont conduit à l’élaboration et à la mise (...) en œuvre de lignes directrices nationales et de politiques institutionnelles. Ces lignes directrices visent entre autres à promouvoir la CRR, notamment dans le but de prévenir ces inconduites. Cependant, pour garantir la pertinence et une application appropriée de ces normes à tous les domaines universitaires, il est nécessaire que les sciences humaines et sociales (SHS) contribuent plus directement à ces discussions. Un tel engagement devrait permettre d’exprimer les particularités disciplinaires et méthodologiques des SHS, dont certaines peuvent être très différentes des sciences appliquées et fondamentales. Cela permettrait également de s’assurer que la littérature sur la CRR ainsi que les politiques et les directives qui en découlent soient à la fois fondées sur des principes universellement généralisables, mais aussi appliquées avec nuance afin de refléter la diversité des pratiques disciplinaires. Dans ce chapitre, nous explorons trois grands domaines dans lesquels les SHS pourraient contribuer à façonner les discussions dans la littérature sur la CRR, tout en informant les chercheurs en SHS des meilleures pratiques en matière de CRR : l’autorat/paternité, la collaboration et l’autorégulation. (shrink)

In this article, I side with those who argue that the debate about the definition of “disease” should be reoriented from the question “what is disease” to the question of what it should be. However, I ground my argument on the rejection of the naturalist approach to define disease and the adoption of a normativist approach, according to which the concept of disease is normative and value-laden. Based on this normativist approach, I defend two main theses: (1) that conceptual analysis (...) is not the right method to define disease and that conceptual engineering should be the preferred method and (2) that the method of conceptual engineering should be implemented following the principles of Alexandrova’s account of social objectivity in the context of the definition of disease. (shrink)

In this paper, my goal is to use an epistemic injustice framework to extend an existing normative analysis of over-medicalization to psychiatry and thus draw attention to overlooked injustices. Kaczmarek has developed a promising bioethical and pragmatic approach to over-medicalization, which consists of four guiding questions covering issues related to the harms and benefits of medicalization. In a nutshell, if we answer “yes” to all proposed questions, then it is a case of over-medicalization. Building on an epistemic injustice framework, I (...) will argue that Kaczmarek’s proposal lacks guidance concerning the procedures through which we are to answer the four questions, and I will import the conceptual resources of epistemic injustice to guide our thinking on these issues. This will lead me to defend more inclusive decision-making procedures regarding medicalization in the DSM. Kaczmarek’s account complemented with an epistemic injustice framework can help us achieve better forms of medicalization. I will then use a contested case of medicalization, the creation of Premenstrual Dysphoric Disorder in the DSM-5 to illustrate how the epistemic injustice framework can help to shed light on these issues and to show its relevance to distinguish good and bad forms of medicalization. (shrink)

Social networks play a significant role in learning and thus in farmers’ adoption of new agricultural technologies. This study examined the effects of social network factors on information acquisition and adoption of new seed varieties among groundnut farmers in Uganda and Kenya. The data were generated through face-to-face interviews from a random sample of 461 farmers, 232 in Uganda and 229 in Kenya. To assess these effects two alternative econometric models were used: a seemingly unrelated bivariate probit model and a (...) recursive bivariate probit model. The statistical evaluation of the SUBP shows that information acquisition and adoption decisions are interrelated while tests for the RBP do not support this latter model. Therefore, the analysis is based on the results obtained from the SUBP. These results reveal that social network factors, particularly weak ties with external support, partially influence information acquisition, but do not influence adoption. In Uganda, external support, gender, farm size, and geographic location have an impact on information acquisition. In Kenya, external support and geographic location also have an impact on information acquisition. With regard to adoption, gender, household size, and geographic location play the most important roles for Ugandan farmers, while in Kenya information from external sources, education, and farm size affect adoption choice. The study provides insight on the importance of external weak ties in groundnut farming, and a need to understand regional differences along gender lines while developing agricultural strategies. This study further illustrates the importance of farmer participation in applied technology research and the impact of social interactions among farmers and external agents. (shrink)

In this paper, I argue for a new way to understand the integration of facts and values in the concept of mental disorder that has the potential to avoid the flaws of previous hybrid approaches. I import conceptual tools from the account of procedural objectivity defended by Helen Longino to resolve the controversy over the definition of mental disorder. My argument is threefold: I first sketch the history of the debate opposing objectivists and constructivists and focus on the criticisms that (...) led to the emergence of the debate. Second, I offer a reconstruction of the “Natural Function Approach” argument to make explicit an unsound assumption underlying this approach. The reconstruction will allow me to show that the NFO’s argument depends on the ideal of value-free science that I will criticize. Then I propose an alternative ideal for psychiatry: social objectivity. I argue that the concept of mental health should be seen as “socially objective” rather than value-free, moving the debate towards the social procedures by which the definition is produced rather than the normative and factual content of its definition. (shrink)

BackgroundEvolving medical technology, advancing biomedical and drug research, and changing laws and legislation impact patients’ healthcare options and influence healthcare practitioners’ (HCPs’) practices. Conscientious objection policy confusion and variability can arise as it may occasionally be unclear what underpins non-participation. Our objective was to identify, analyze, and synthesize the factors that influenced HCPs who did not participate in ethically complex, legally available healthcare.MethodsWe used Arksey and O’Malley’s framework while considering Levac et al.’s enhancements, and qualitatively synthesized the evidence. We searched (...) Medline, CINAHL, JSTOR, EMBASE, PsychINFO, Sociological Abstracts, and ProQuest Dissertations and Theses Global from January 1, 1998, to January 15, 2020, and reviewed the references of the final articles. We included articles written in English that discussed the factors that influenced physicians and registered nurses (RNs) who did not participate in end-of-life (EOL), reproductive technology and health, genetic testing, and organ or tissue donation healthcare areas. Using Covidence, we conducted title and abstract screening, followed by full-text screening against our eligibility criteria. We extracted the article’s data into a spreadsheet, analyzed the articles, and completed a qualitative content analysis using NVivo12.ResultsWe identified 10,664 articles through the search, and after the screening, 16 articles were included. The articles sampled RNs (n = 5) and physicians (n = 11) and encompassed qualitative (n = 7), quantitative (n = 7), and mixed (n = 2) methodologies. The care areas included reproductive technology and health (n = 11), EOL (n = 3), organ procurement (n = 1), and genetic testing (n = 1). One article included two care areas; EOL and reproductive health. The themed factors that influenced HCPs who did not participate in healthcare were: (1) HCPs’ characteristics, (2) personal beliefs, (3) professional ethos, 4) emotional labour considerations, and (5) system and clinical practice considerations.ConclusionThe factors that influenced HCPs’ who did not participate in ethically complex, legally available care are diverse. There is a need to recognize conscientious objection to healthcare as a separate construct from non-participation in healthcare for reasons other than conscience. Understanding these separate constructs will support HCPs’ specific to the underlying factors influencing their practice participation. (shrink)

Catharine MacKinnon has pioneered a new brand of anti-pornography argument. In particular, MacKinnon claims that pornography silences women in a way that violates their right to free speech. In what follows, we focus on a certain account of silencing put forward by Jennifer Hornsby and Rae Langton, and we defend that account against two important objections. The first objection contends that this account makes a crucial but false assumption about the necessary role of hearer recognition in successful speech acts. In (...) response, we argue that, as silencing primarily concerns communication, Hornsby and Langton are perfectly correct to treat hearer recognition as they do. The second objection contends that their particular account of silencing has the unacceptable result of undermining the responsibility of rapists. We here argue that no such result follows from their account. (shrink)

Christopher Boorse’s Biostatistical Theory of Health has been the main contender among naturalistic accounts of health for the last 40 years. Yet, a recent criticism of this theory, presented by Elselijn Kingma, identifies a dilemma resulting from the BST’s conceptual linking of health and statistical typicality. Kingma argues that the BST either cannot accommodate the situation- specificity of many normal functions or cannot account for many situation-specific diseases. In this article, we expand upon with Daniel Hausman’s response to Kingma’s dilemma. (...) We propose that recalling Boorse’s specification that health is an intrinsic property of its bearers and explicating this intrinsic property in relation to the concept of homeostasis can illuminate how proponents of naturalistic accounts of health should deal with the situation- specificity of normal functions. We argue that beyond what Boorse and Hausman have delineated, the situation- specificity of normal function cannot be fully captured in a simple dichotomy between normal and abnormal environment or between relevant and irrelevant situations. By bringing homeostasis to the fore of the analysis of health, we set out a richer picture of what the various situations that affect living organisms’ functional performance can be. Accordingly, we provide a broader classification of these various situations which, we contend, better accounts for the main intuitions that philosophers of medicine have sought to accommodate than previous naturalistic theories of health. (shrink)

Wearable robots and exoskeletons are relatively new technologies designed for assisting and augmenting human motor functions. Due to their different possible design applications and their intimate connection to the human body, they come with specific ethical, legal, and social issues, which have not been much explored in the recent ELS literature. This paper draws on expert consultations and a literature review to provide a taxonomy of the most important ethical, legal, and social issues of wearable robots. These issues are categorized (...) in wearable robots and the self, wearable robots and the other, and wearable robots in society. (shrink)

Difficulty engaging in reciprocal social interactions is a core characteristic of autism spectrum disorder. The mechanisms supporting effective dynamic real-time social exchanges are not yet well understood. This proof-of-concept hyperscanning electroencephalography study examined neural synchrony as the mechanism supporting interpersonal social interaction in 34 adolescents with autism spectrum disorder, age 10–16 years, paired with neurotypical confederates of similar age. The degree of brain-to-brain neural synchrony was quantified at temporo-parietal scalp locations as the circular correlation of oscillatory amplitudes in theta, alpha, (...) and beta frequency bands while the participants engaged in a friendly conversation. In line with the hypotheses, interpersonal neural synchrony was significantly greater during the social interaction compared to the baseline. Lower levels of synchrony were associated with increased behavioral symptoms of social difficulties. With regard to sex differences, we found evidence for stronger interpersonal neural synchrony during conversation than baseline in females with autism, but not in male participants, for whom such condition differences did not reach statistical significance. This study established the feasibility of hyperscanning during real-time social interactions as an informative approach to examine social competence in autism, demonstrated that neural coordination of activity between the interacting brains may contribute to social behavior, and offered new insights into sex-related variability in social functioning in individuals with autism spectrum disorders. (shrink)

In this paper, we want to take a critical stance towards Tsou’s recent proposal that a neuro-oriented version of the homeostatic property cluster kind model (MPCK) should be an ideal for the DSM. Our strategy will be to discuss the creation of the Social Pragmatic Communication Disorder (SPCD) in DSM-5 to show the limits of MPCK as an ideal for the next DSM deliberations over a set of diagnoses revisions. We argue that an ideal model for the DSM should address (...) the issues of deep uncertainties and pragmatic considerations to be useful in this context. (shrink)

Anne-Marie Gagné-Julien et Pierre-Olivier Méthot Durant les deux dernières décennies, plusieurs questions classiques de la philosophie de la médecine et de la psychiatrie ont connu un renouvellement. Des angles de recherche jusqu’alors peu explorés font désormais l’objet de vifs débats, et les questions traditionnelles ont été réinterprétées à la lumière de ces nouveaux développements. En examinant ces récents thèmes grâce aux contributions de chercheur.e.s francophones, ce dossier vise à nourrir la progression de cette « nouvelle » philosophie de (...) la médecine et de la psychiatrie, à apporter un éclairage inédit sur certains de ses domaines et de ses objets encore méconnus de même que sur ses courants et ses problématiques émergents, et ainsi à faire avancer des débats classiques sous des angles nouveaux. (shrink)

Cet article s’intéresse au phénomène des violences conjugales en montrant l’intérêt de considérer l’articulation des enveloppes psychiques au niveau individuel, familial et « couplal ». Il met le projecteur sur les matériaux psychiques transmis de génération en génération, qui traversent ces contenants. Si certaines traces du passé sont conscientes et élaborées, d’autres demeurent inconscientes et empreintes de traumatismes. Par l’effet d’emboîtement des enveloppes psychiques et par le biais du nouage des alliances inconscientes, ces héritages négatifs se retrouvent impliqués dans les (...) fondations du lien du couple. Une vignette clinique aide à comprendre le rôle des legs familiaux dans l’émergence d’agirs violents entre les partenaires amoureux et leur impact sur l’enveloppe psychique du couple. Les auteures esquissent enfin un modèle de structuration innovant du moi-peau du couple à partir de la théorisation de Didier Anzieu (1985). (shrink)

ABSTRACT:One recent body of work has concerned medicalization and how it can create epistemic injustice. It focuses on medicalization as a hermeneutical process that shapes the conceptual framework(s) we use to refer to some conditions/experiences. In parallel, some scholars with lived experience of madness have started to explore the epistemic harms suffered by the Mad community. Building on this, I argue that the process of medicalization in psychiatry affects the Mad community in a specific way that has been overlooked in (...) the literature on medicalization and epistemic injustice. That is, medicalization can create what is called "contributory injustice." This form of injustice occurs when marginalized communities have been able to create alternative hermeneutical resources, but these resources are dismissed or discredited by the dominant group. I argue that the emerging field of Mad Studies is a victim of this type of injustice when Mad experiences are unilaterally medicalized. (shrink)

The anti-psychiatry movement of the 20th century has notably denounced the role of values and social norms in the shaping of psychiatric categories. Recent activist movements also recognize that psychiatry is value-laden, however, they do not fight for a value-free psychiatry. On the contrary, some activist movements of the 21st century advocate for self-advocacy in sciences of mental health in order to reach a more accurate understanding of psychiatric categories/mental distress. By aiming at such epistemic gain, they depart from the (...) anti-psychiatry movement. Through the analysis of the epistemic and political influence of two of these movements – Neurodiversity and the Mad Studies, we show how this new activism has taken a scientific turn compatible with current philosophical scientific frameworks, while still developing a critical approach on psychiatry. (shrink)

La création récente du diagnostic de trouble dysphorique prémenstruel (TDPM) dans le DSM-5 a été contestée sous de multiples angles. Les principales critiques mettent en avant les lacunes en faveur de la validité du TDPM, ainsi que le risque de pathologisation et de stigmatisation des changements physiques et comportementaux vécus par les femmes pendant leur phase prémenstruelle. Pour éclairer cette controverse, j’emprunte certains outils du cadre conceptuel des injustices épistémiques (IE) développé par Miranda Fricker. Plus précisément, je vais me baser (...) sur de récents travaux qui ont tenté d’appliquer ce cadre aux processus de catégorisation en médecine et en psychiatrie. Cela me permettra de mettre au jour un angle mort du débat actuel sur le TDPM, soit les perspectives des personnes touchées par ces symptômes. Ces points de vue ont été généralement négligés, mais le cadre des IE nous permet de recentrer le débat sur les intérêts et les besoins des personnes affectées par les processus de catégorisation psychiatrique. (shrink)

In the debate over the definition of ‘mental health,’ three different approaches are generally distinguished: the normativist approach, the hybrid approach and the naturalistic approach. This paper qualifies this classification by clarifying the sense in which Christopher Boorse defends a naturalistic approachvis-à-visthe central concepts of psychiatry. This paper also clarifies in what way Boorse is opposed to the normativist approach advocated by some authors of the anti-psychiatric movement, such as Szasz.

First, I want to thank PPP for the privilege of having my work read and commented on by esteemed colleagues. In this response, I briefly review some of the key issues that they have raised. These issues include 1) the usefulness of a definition of mental disorder for North American psychiatry, 2) the absence of a concrete criterion to address the demarcation problem, 3) the place and role of values in such a demarcation, and 4) the worries of over-inclusiveness, problematic (...) values and imposition of values.The first question that needs to be clarified is raised by Waterman's commentary : Is it really necessary to define mental disorder and mental health? Here I feel I should clarify a background assumption of... (shrink)

Legislation enabling pharmacists to prescribe is being drafted and passed in Canada and internationally. But is it a good idea for pharmacists to be prescribing psychotropic medications? In this discussion, the term “pharmacist prescribing” is dei ned, the issues of the potential conl ict of interest of pharmacists discussed, and the education and training of pharmacists reviewed. Finally, an experienced psychiatrist weighs in on the discussion with a personal rel ection on this important discussion, concluding that “we should move forward (...) cautiously but in a spirit of collaboration, mutual respect and above all in the best interests of the patient. (shrink)

L’épreuve projective intitulée « spatiographie projective familiale » a pour objectif de comprendre l’image inconsciente du corps familial à travers l’analyse du dessin groupal de la « maison de rêve ». Par cette méthodologie, les auteurs peuvent établir un diagnostic de la structure des liens inconscients de la famille et en faire un objet médiateur pour la prise en charge psychothérapique et une épreuve projective groupale familiale pour le diagnostic. Le dessin de la « maison de rêve » est un (...) outil original qui investigue les dimensions diachronique et synchronique permettant une approche complète de la structuration de l’image du corps familial. (shrink)

Recent arguments claim that behavioral science has focused – to its detriment – on the individual over the system when construing behavioral interventions. In this commentary, we argue that tackling economic inequality using both framings in tandem is invaluable. By studying individuals who have overcome inequality, “positive deviants,” and the system limitations they navigate, we offer potentially greater policy solutions.

Background The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics- Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. Objectives The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was (...) to describe the Cell’s functions during that period. Research design This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient’s/designated representative’s preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. Participants and research context Only our university hospital’s clinicians could request EST intervention. Ethical considerations The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. Findings/results 33 requests (patients’ mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. Discussion Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. Conclusions COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions. (shrink)

Objective:Prior research examining sexual and intimacy concerns among metastatic breast cancer patients and their intimate partners is limited. In this qualitative study, we explored MBC patients’ and partners’ experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences.Methods:We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews with (...) intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software.Results:Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: the heavy disease/treatment burden leads to significant, long-term sexual concerns and consequent heightened emotional distress for both patients and partners ; viewing the relationship as having “an expiration date” influences patients’ and partners’ concerns related to sex/intimacy and complicates coping efforts; and information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences.Conclusion:Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients’ and partners’ perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients’ health and quality of life. (shrink)

Arts-Based Thought Experiments is a highly visual offering that engages visual arts, photography, poetry, creative non-fiction, memoir and speculative fiction. In this novel book, the authors lean deeply into concepts of the imaginary, and through artful experiments with thought, trouble the tensions between the human, the posthuman and the more than human. In the Anthropocene, with its intractable challenges and cataclysms, engaging posthuman positions when thinking of learning in socioecological terms is paramount to human survival. In this sense, the arts (...) offer creative and critical thought for the possibilities of a post-Anthropocene earth. Contributors are: Raoul Adam, Marilyn Ahearn, William Boyd, Euan Boyd, Adrienne Brown, Shae L. Brown, Teresa Carapeto, Philemon Chigeza, Amy Cutter-Mackenzie-Knowles, David Ellis, Katie Hotko, Marianne Logan, Ferdousi Khatun, Alexandra Lasczik, Yaw Ofosu-Asare, Maia Osborn, Marie-Laurence Paquette, Jemma Peisker, Ziah Peisker, Adrienne Piscopo, David Rousell, Benjamin Ryan, Billy Ryan, Lisa Siegal, Helen Widdop Quinton, Thilinika Wijesinghe and Tracy Young. (shrink)

Framed within theories of fairness and stress, the current paper examines bystanders’ intervention intention to workplace bullying across two studies based on international employee samples (N = 578). Using a vignette-based design, we examined the role of bullying mode (offline vs. online), bullying type (personal vs. work-related) and target closeness (friend vs. work colleague) on bystanders’ behavioural intentions to respond, to sympathise with the victim (defender role), to reinforce the perpetrator (prosecutor role) or to be ambivalent (commuter role). Results illustrated (...) a pattern of the influence of mode and type on bystander intentions. Bystanders were least likely to support the victim and more likely to agree with perpetrator actions for cyberbullying and work-related acts. Tentatively, support emerged for the effect of target closeness on bystander intentions. Although effect sizes were small, when the target was a friend, bystanders tended to be more likely to act and defend the victim and less likely to reinforce the perpetrator. Implications for research and the potential for bystander education are discussed. (shrink)

College campus-based surveys of sexual assault in the United States have generated one of the most high-profile and contentious figures in the history of social science: the ‘1 in 5’ statistic. Referring to the number of women who have experienced either attempted or completed sexual assault since their time in college, ‘1 in 5’ has done significant work in making the prevalence of this experience legible to the public and to policy-makers. Here I examine how sexual assault surveys have participated (...) in structuring the ontology of date/acquaintance rape from the 1980s to today. I review the foundational work of feminist social scientists Diana Russell and Mary Koss, with particular attention to the methodological practices through which the concept of the ‘hidden’ or ‘unacknowledged’ rape victim emerged. I then examine a selection of early 21st-century sexual assault surveys and highlight the ongoing preoccupation with survey methodology in responses to their results. I argue that the survey itself has been a central actor in the ontological politics of sexual assault, and only by closely attending to its performativity can we understand the paradoxical persistence both of critical responses to the ‘1 in 5’ statistic and of its effective deployment in anti-violence policy. (shrink)

Interroger le concept d'identité en le mettant en rapport avec l'altérité renvoie à la célèbre formule de Rimbaud : "Je est un autre" qui, à la charnière des XXe et XXIe siècles, suscite toujours de nombreuses interrogations dans un monde où le moi est de plus en plus instable et en quête de repères, où l'identité se revendique le plus souvent au nom de la différence, que ce soit au niveau individuel ou communautaire. La culture hispanique de part et d'autre (...) de l'Atlantique est particulièrement sensible à ces phénomènes et à l'évolution du rapport à l'autre qui peut créer des métissages culturels inédits. Ainsi, les nombreuses contributions du volume rendent-elles compte de la complexité et de l'intérêt d'un tel questionnement à travers une réflexion sur la langue, la littérature et les arts visuels sans oublier les bouleversements inter-relationnels générés par l'apparition d'Internet. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Removing the Mask: Hopeless Isolation to Intersex AdvocacyAlexandra von KlanStrangers undoubtedly perceive me as female, but I identify as an intersex woman. My karyotype is 46,XY, a typically defined marker of male biological sex, and I was born with undeveloped, non–functioning gonads. As an intersex person, I know firsthand the negative consequences of pathologizing intersex people’s lived experience by categorizing otherwise healthy, functioning organs and bodies as abnormal. The (...) following narrative recounts conversations and interactions with medical providers during my diagnosis and subsequent treatment of pure XY gonadal dys-genesis, sometimes referred to as Swyer Syndrome. I hope to elaborate upon emotionally significant actions and inactions of medical care providers to expose consequential effects on my emotional processing, physical health, and self–actualization.In December 1988, I was born with “typical” female genitalia. No one knew I was an intersex woman with 46,XY karyotype. Thus, there was no hesitation in the announcement of the birth of a girl in the delivery room or later, on my birth certificate. My parents raised me as a girl and dressed their firstborn in culturally normative feminine garments and accessories: lace frilly frocks, oversized bows, white stockings, and black patent leather Mary Jane’s. I embraced femininity and expressed this gender identity throughout my childhood and adolescence. I’m the eldest of six children split between two households.In January 2005, a month after my sixteenth birthday, delayed puberty and absent menstruation prompted an appointment to a local women’s health center. Nurses collected blood samples and administered an MRI scan on my pelvic region. A week later, my father received a perplexing phone call. An inexperienced doctor told him “there must be something wrong” with me, because lab results revealed I was “chromosomally male.” My father recalls the information presented like, based on the evidence, “your daughter may not be completely female,” and that is that. His impression was that she knew little about the subject and was a bit clueless. She did not mention Swyer Syndrome, or any diagnosis for that matter.Up to this point, I was unaware that a member of my extended family also had Swyer Syndrome. Born in the 1950s, secrecy engulfed her medical treatment and doctors warned her parents against revealing her true chromosomal sex in order to prevent the hysterical panic and depression they [End Page E14] thought the truth would bring. Years later, she sought her medical records and unearthed the truth. Shortly after my father received that dubious phone call, my relative’s endocrinologist provided a referral to his mentor, “Doctor A,” a clinical reproductive endocrinologist.Under Doctor A’s care, I experienced the first of many pelvic exams. Much to my discomfort, Doctor A inspected my semi–clothed body with a male resident in the room. As a people–pleasing teen, I granted permission for his presence; I didn’t voice my preference for a female alternative. Doctor A’s cold hands pressed around each undeveloped breast, pulled a gown away from my hips to inspect a sparse patch of pubic hair, and conducted an examination of my vaginal canal.Shortly after the examination, Doctor A charted Swyer Syndrome as the official diagnosis. Speaking to my father and me, he described my condition as an extremely rare genetic mutation. He told us that Swyer Syndrome was an intersex condition, a group of congenital disorders impacting a person’s internal or external reproductive systems, including endocrine function and genitalia. He explained I had atypical streak gonads instead of ovaries and that, despite having typical male sex chromosomes, I was still very much a girl. He disclosed that my vaginal canal was moderate in length, perhaps further evidence—or consolation—that my body possessed normative female reproductive attributes after all.Next, Doctor A identified a pressing medical concern—golf–ball–sized benign tumors had developed on each streak gonad; if allowed to remain, they would pose an increasing risk of malignancy. We scheduled an appointment for laparoscopic gonadectomy six months later. I left his office with a 3–month prescription for estrogen and progesterone oral tablets. On the way home, we drove to an electronics store where my father... (shrink)

Les études féministes s’intéressent depuis les années 1970 à la culture de l’enfance et de la jeunesse, et particulièrement aux représentations du féminin dans les albums (voir notamment les textes pionniers d’Elena Gianini Belotti et les albums d’Adela Turin), mais c’est depuis les années 2000 que les études sur ce domaine se sont multipliées. Études de sociologues pour la plupart, elles reposaient sur des enquêtes systématiques chiffrées et faisaient le constat que, si l’on assistait à un r...

Florence Tamagne présente dans ce livre dense, mais qui aurait parfois gagné à être plus ramassé, l'essentiel d'une thèse soutenue en 1998. Il faut se réjouir de cette publication, les travaux sur l'histoire de la sexualité étant fort rares. L'histoire de l'homosexualité présente de surcroît des difficultés propres. Elle souffre plus encore que l'histoire de l'hétérosexualité du silence des acteurs. L'auteur a donc fait feu de tout bois, combiné iconographie et littérature, discours sc...

Alexandra Shuford's book is primarily designed to address the following question: "What can Deweyan pragmatism contribute to a feminist empiricist epistemology?" (viii). Her answer is Dewey's conception of habit, and in her final chapter, she illustrates the utility of this conception by comparing what she labels the "medicalized" model of labor and birth to that employed by practitioners of midwifery. Before looking at Shuford's reading of this contrast more closely, however, it needs to be noted at the outset that (...) she also regards her constructive project to be one of "augmenting" or "extending" the efforts of Lynn Hankinson Nelson to formulate a feminist empiricism derived from Quine's naturalized epistemology. .. (shrink)

Que la philosophie puisse se pratiquer dans toute sa rigueur conceptuelle en s’appliquant à des notions politiques, voilà qui n’a pas été et n’est pas toujours évident pour tous. Le concept d’idéologie de Nestor Capdevila est une lecture tout indiquée pour les sceptiques. Le pari n’est pourtant pas gagné a priori : ce terme, forgé en 1798 par Destutt de Tracy pour désigner la science des idées prises au sens général de perceptions, est on ne peut plus fuyant. S’il (...) n’a pas, à l’origine, la con.. (shrink)

Since the era of deinstitutionalisation, many clinical approaches have emerged to enable the care and treatment of people suffering from mental illness. In recent years, the use of coercive approaches in the community (e.g., outpatient commitment or community treatment orders) has also increased internationally. Although nurses' role regarding these coercive approaches is central and significant, few empirical and theoretical writings have tackled this controversial nursing practice. The purpose of this paper is to analyse coercive nursing care through the lens of (...) French philosopher Gilles Deleuze's concept of ‘societies of control’. Taking up Michel Foucault's work on disciplinary power, Deleuze explores how the move from the striated spaces of closed institutions to the smooth spaces of societies of control took place since the middle of the 20th century. According to Deleuze, the overall objective of ‘societies of control’ is no longer simply to govern deviant behaviour in closed environments (e.g., psychiatric hospitals and prisons) but to ensure a regime of unrelentless surveillance in the open spaces of our communities. (shrink)