: HIPAA is often described as a privacy rule. It is not. In fact, HIPAA is a disclosure regulation, and it has effectively dismantled the longstanding moral and legal tradition of patient confidentiality. By permitting broad and easy dissemination of patients’ medical information, with no audit trails for most disclosures, it has undermined both medical ethics and the effectiveness of medical care.

Health is one of those everyday words that only seems self-evident in its meaning. Physiological measurements alone fail to capture the subjective dimension of health. "Health" is an end and a means--it is a foundation for achievement, a first achievement itself, and a precondition for further achievement.

Cet article examine comment l’approche structuraliste d’Althusser transforme le concept d’idéologie chez Marx. Ce dernier distingue deux fonctions : l’idéologie-description/distorsion et l’idéologie-légitimation/reproduction, mais l’articulation qu’il propose ne semble pas aboutie car elle maintient en arrière-plan une anthropologie phénoménologique des « individus vivants ». En faisant du « sujet » la production de l’idéologie par le mécanisme d’interpellation des individus, Althusser propose de déconstruire cet impensé marxien du « sujet constituant » pour lui substituer une théorie générale du « sujet constitué (...) », théorie plus en phase avec la Science de l’Histoire que Marx a inauguré. Reste à savoir si le « sujet » épuise toutes les dimensions de la « subjectivité », c’est-à-dire si la lecture « structuraliste » peut se passer de la lecture « phénoménologique » de Marx. (shrink)

Polanyi analyzes the historical deployment of a “formal” economic science starting from the “market-scarcity-instrumental rationality triptych.” This triptych, and the knowledge associated with it, is shown to be more than merely a “substantial” economic science’s interest in the triptych “need-nature-institution.” While we must agree with Polanyi that economism is ill-suited to the first triptych, we hesitate to accept his suggested alternative, a heterogeneous mixture of naturalism and institutionalism, essentialism and historicism.

La théorie économique marxiste rend compte des rapports entre capitalisme et violence à l’aide notamment du concept d’accumulation primitive. Cet article se propose de montrer comment ce concept s’est construit et étoffé en analysant trois étapes : d’abord son élaboration initiale par Karl Marx (l’accumulation primitive comme préhistoire du capital), ensuite une première extension par Rosa Luxemburg (l’accumulation primitive comme mouvement actuel d’extension géographique de la logique du capital du centre vers la périphérie), et enfin une seconde extension par David (...) Harvey (l’accumulation primitive comme mouvement de recolonisation « intérieure » et d’« accumulation par dépossession »). L’article propose d’articuler ces trois étapes à partir de la dialectique entre droit et violence telle que l’a problématisée le philosophe Walter Benjamin (2018). Codes JEL : B14, B24, B5. (shrink)

Au tournant des années 2000, André Gorz (1923-2007) rencontre avec enthousiasme le courant marxiste hétérodoxe de la Critique de la valeur et semble y trouver de quoi appuyer sa propre critique radicale du capitalisme. L’article interroge le statut philosophique de ce rapprochement et défend la thèse que le marxisme existentialiste de Gorz n’est au fond pas compatible avec le structuralisme de ce courant marxiste.Codes JEL : B14, B24, B5.

Labour, Liberty and Necessity in the Communist Utopia : André Gorz and his Reading of Marx What are the relations engaging labour and liberty, when the former is no longer essentially experienced as the social mark of the alienation of liberty in the economic order ? It was Marx who first formulated these questions consistently and rigorously. He did so by formulating the theory of the two orders, necessity and liberty, in the framework of the communist utopia. For all this, (...) Marx’s formulation of the issue failed to dissipate a whole series of ambiguities concerning the relation between these two orders. Drawing on André Gorz’s critical reworking of the Marxian framework of the project of social transformation, our aim is to show that a project of emancipation requires a philosophy of liberty, one which recognises a degree of irreducible density in all human collective groups. Or, to put things differently, which acknowledges a certain ineluctable heteronomy of the human condition. (shrink)

Despite the impressive technological advances in medicine many people feel worse rather than better after entering the medical care system. This article considers the pathogenic effect of physicians, in particular the problems of: 1) noxious communication, and 2) excessive evaluation and overinterpretation of test results.

The referral of a patient for subspecialty consultation and examination is but one facet of the primary care physician's involvement with his patient. Using examples from my practice, I argue that the term “gatekeeper” is an inadequate term for describing what the primary care physician does, or should do, for his patient. “Virgil Role” is offered as an alternative expression based on a proposed parallel between Dante's passage through the Inferno accompanied by his mentor-guide, Virgil, and a sick person's journey (...) through his personal Hell of illness and the labyrinthine medical care system, guided by his physician. (shrink)