The doctor-patient relationship has evolved to respect “the autonomy and patients’ rights”. One of the cornerstones in such autonomy is the opportunity for patients to draw living wills, also known as advance directives. However, information about AD available to patients remains scarce largely due to the lack of involvement of General practitioners for several reasons. The aim of our study was to evaluate current general practitioner residents’ behavior concerning their role in informing their patients about AD. We built a French (...) nationwide survey from GPR class of 2012 to 2014. Two thousand three hundred ten residents completed our survey. 89.8% declared their willingness to offer patients the opportunity of writing AD. When asked about the usefulness of AD, 73.6% of residents responded that these are a suitable help for patients, but 19.7% considered that AD are essentially geared towards frail patients. Among residents who want to inform patients about AD, 14.7% wanted to involve all patients. Only 20.5% thought that elderly people should be systematically informed about AD. When the question involves other frail people in various disease areas, information seems relevant for 60.1% of GPR considering patient with cancer or malignant hematologic disease and for 56.2% about patients affected by neurodegenerative disease. When considering the routine use of AD, 20.5% of GPR would take them into account only if they are in agreement with the patient’s decision. The results of the survey indicate that GPR would rather choose to decide who should be informed about AD, and when to take AD into account for ethical concerns. (shrink)

BackgroundThe ageing of the population and the increased number of chronic diseases are associated with an increased frequency of end of life care in hospital settings. Residents rotating in hospital wards play a major part in their care, regardless of their specialty. General practitioner (GP) residents are confronted to such activities in hospital settings during their training. Our aim was to know how they feel about taking care of dying patients, as end-of-life care are very different from the clinical activity (...) they are trained to.MethodsWe surveyed all GP trainees of “Ile de France”. The survey was made of 41 questions regarding advanced directives divided in 7 sections about patients’ care, communication, mentoring and repercussion on personal life. The survey was done one time, during two pre-specified days.Results525 residents (53.8%) accepted to fulfill the survey. 74.1% of the residents thought that palliative care could have been better. Possible ways of improvements were: a reduction of unreasonable obstinacy (or therapeutic overkill, two terms defined in French law as curative treatment without reasonable hope of efficiency) (59.6%), patient’s (210 answers, 40%) and relative’s communication (information of patients and relatives about the severity of the disease and risk of death) (199 answers 37.9%). Residents also reported a lack of knowledge regarding end-of-life care specific treatments (411 answers, 79.3%) and 298 (47.2%) wished for better mentoring. Those difficulties were associated with repercussion on their private life (353 answers, 67.2%), particularly with their close relatives (55.4%). Finally, 56.2% of trainees thought that a systematic psychologic follow up should be instituted for those working in “at risk” hospital settings.ConclusionSelf-perception management of dying patients by GP resident emphasize their lack of training and supervision. The feeling of suboptimal care is associated with consequences on personal life. (shrink)

Contemporary Native American theater consists of a long list of plays which normally include indigenous and mixed-blood characters who often find themselves living between two worlds, that is, Native culture and white American society. Therefore, it is common to find a significant confrontation and conflict between the two cultures, which is usually solved at the end of the plays with the characters’ reconcilement or synthesis between their Native heritage and the white domineering society. In this way, Native Americans can ensure (...) their Native cultural existence and survival whilst simultaneously adapting to the changes and customs required by white American society. (shrink)

This paper investigates the historical origin and ancestors of typicality, which is now a central concept in Boltzmannian Statistical Mechanics and Bohmian Mechanics. Although Ludwig Boltzmann did not use the word typicality, its main idea, namely, that something happens almost always or is valid for almost all cases, plays a crucial role for his explanation of how thermodynamic systems approach equilibrium. At the beginning of the 20th century, the focus on almost always or almost everywhere was fruitful for developing measure (...) theory and probability theory. It was apparently Hugh Everett III who first mentioned typicality in physics in 1957 while searching for a justification of the Born rule in his interpretation of quantum mechanics. The historically closest concept before these developments is moral certainty, which was invented by the medieval French theologian Jean Gerson, and it became a standard concept at least until the Age of Enlightenment, when Jakob Bernoulli proved the Law of Large numbers. (shrink)

The Sanctuary of Kafizin : New Perspectives The Nymphaeum of Kafizin, a sanctuary located on the summit of a hill of central Cyprus, produced remarkable inscriptions first gathered and published by T. B. Mitford. A close study of the texts shows that several conclusions firmly settled by Mitford, the dating in particular, must be reconsidered. This paper offers the opportunity to bring to light the historical significance of the numerous offerings dedicated to the local Nymph.

Dit boek is een hommage aan de filosoof Hubert Dethier (°21 juli 1933), die we zeker in de rij kunnen plaatsen van denkers als Jaap Kruithof, Hans Achterhuis en Etienne Vermeersch. Deze hommage is geen chronologische biografie. Het is daarentegen wel een verhaal waarin het leven van Hubert Dethier verweven wordt met de geschiedenis van zijn denken. Een denken dat zich situeert in de tweede helft van de vorige eeuw en het begin van de huidige eeuw en zich (...) moeiteloos projecteert naar de toekomst. Ontegensprekelijk een woelige en gewelddadige periode, maar ook een tijdgewricht van hoop en verwachting van het “nieuwe”.0. (shrink)

Dans l'univers des soins de santé, l'éthique doit se construire D à partir de l'expérience de la personne malade et s'adapter à elle. Mais de quelle éthique parle-t-on au juste? Sur les valeurs qui la fondent – l'autonomie, la bienfaisance, la non-malfaisance et la justice –, tout le monde semble s'entendre. Pourtant, à observer un groupe de médecins ou d'infirmières discuter d'une situation problématique, une autre conclusion s'impose : le rapport à l'éthique change selon la conception qu'on se fait de (...) la tâche clinique. Hubert Doucet, spécialiste reconnu, expose ici les principales théories de l'éthique clinique et cherche à les faire dialoguer, en convoquant au passage la pensée du philosophe Paul Ricoeur. Il en présente les fondements et le vocabulaire, s'attarde à son histoire et pose la résolution de problème au coeur de son action. Ce faisant, il apporte une contribution autant théorique que pratique à tous ceux qui, étudiants et professionnels, veulent en comprendre le sens et en tirer le meilleur parti dans le cadre de leur travail. (shrink)

Contemporary society needs the recognition of a moral middle ground, where human behavior can be evaluated as permissible, understandable, or even valuable. As a counterforce to polarization and divisive politics, an identity model is proposed in which individual and group identities are transcended by a human and ecological identity.

A remarkable turnaround by a leader with a remarkable philosophy: Find your noble purpose. Put people at the center. Unleash human magic. "It was Fall in Minnesota. It was getting cold and we were supposed to die." This is how Hubert Joly describes the early, dark days as CEO of Best Buy, a job most thought he was crazy to accept. Amazon was tearing a disruptive path through retail, but in the face of that existential threat Joly did something (...) remarkable: he saved Best Buy and remade it into a thriving company rated as one of the most desirable businesses to work for. Having recently stepped down as Chairman and CEO, Joly is ready to share the leadership principles that underpinned the resurgence of Best Buy and that he believes are at the heart of business: pursue a noble purpose, put people at the center, unleash human magic, and treat profit as an outcome. There was a time when many would call this a soft philosophy. But times are changing. Best Buy and 180 other companies signed the momentous Business Roundtable statement in support of stakeholder capitalism. The Covid-19 pandemic further pushed many businesses to lead from a place of purpose and with humanity. The changes underway are not a revolt, but a revolution. And Joly provides concrete advice on how to implement principles that can serve as beacons for the next era of capitalism. Joly himself was transformed from a hard-charging, deeply analytical McKinsey consultant to a leader who believes in what he calls human magic. He will share how so much of what he initially learned about management is either dated, incomplete, or simply wrong-including how to turn around a business, develop and implement a strategy, mobilize an organization, and what it takes to be a great leader. The leadership principles Joly lays out worked at Best Buy. They can also contribute to the necessary re-foundation of business and capitalism around purpose and humanity. (shrink)

L'idée que comprendre permet de prévoir est une idée moderne. Elle est fondée sur la découverte, que le monde physique obéit à des lois (Galilée, et surtout Newton). Elle a mis fin à la pensée magique, et elle est à la base de la révolution scientifique et du monde moderne. Or nous assistons à la dissociation de ces deux choses. D'une part, on réalise par exemple que les lois mathématiques de certains phénomènes, mêmes parfaitement connues, sont si sensibles à la (...) moindre imprécision dans les données que cela rend la prévision impossible en pratique. C'est le fameux "effet papillon" : un battement d'ailes à Rio pourrait être la cause d'une tornade au Texas. D'un autre côté, la puissance des big data rendrait inutile, selon certains essayistes et quelques scientifiques, le raisonnement théorique. On n'aurait plus besoin de comprendre les causalités puisque la corrélation suffirait. Un retour au CASSINI Moyen Age en somme, aux recettes qui ont marché, mais avec des données des millions de fois plus nombreuses. En termes économiques, on a découvert avec la révolution scientifique qu'une explication théorique coûtait moins cher que certaines observations : Newton avait prévu l'aplatissement de la Terre sans qu'on ait besoin d'aller voir aux pôles ; aujourd'hui grâce à la rapidité des ordinateurs et des réseaux, les termes de la comparaison s'inversent. A ceci, Hubert Krivine répond notamment que les big data et l'intelligence artificielle qui se fonde sur elles sont conservatrices, et que si elles conviennent aux assureurs, elles ne peuvent pas prévoir des choses nouvelles et extraordinaires. Les ordinateurs composent aujourd'hui sur demande du Mozart ou des ballades celtiques, aucun n'invente de musique nouvelle. Ils conduisent des voitures, mais aucun n'explique le mystère de la "matière noire". La machine peut aider l'homme, elle ne le remplacera pas. (shrink)

Le present ouvrage propose une etude systematique de la conception de la condition humaine contenue dans Condition de l'homme moderne de H. Arendt. Il en eclaire l'orientation, a la fois par rapport a la tradition ancienne et classique de la philosophie et par rapport au contexte immediat de la phenomenologie et de l'existentialisme contemporains. Il met en evidence une structure de la condition humaine, un agencement des differentes conditions qui la composent et l'accent mis par Arendt sur un pluriel de (...) conditions de base plus que sur les traits generaux habituellement mis en avant (la finitude, la mortalite). Outre la triade bien connue des trois activites fondamentales, le travail, l'oeuvre, l'action, il explicite une triade d'activites mentales, l'intelligence, la connaissance et la pensee. Il examine le statut de la pensee dans la condition humaine et le paradoxe de sa capacite de retrait par rapport a elle. La conception arendtienne de la condition humaine, non depassee a ce jour, est une reference capitale pour l'humanite, aujourd'hui inquiete de l'avenir de son monde. La version allemande du livre de Arendt, remaniee par rapport a l'edition anglaise originale, est prise en compte. (shrink)

La 4e de couverture indique : "Les thèses de Lacan viennent de sa pratique, mais il avait articulé celles-ci dans un cadre théorique très élaboré. De Platon et Descartes jusqu'à Heidegger ou Wittgenstein, en passant par Kant et Hegel, Lacan a lu avec attention les grands philosophes. Le refondateur de la psychanalyse, à l'encontre des scolastiques de la psyché qu'il a sans cesse combattues, avait à faire à la vérité, à la vérité freudienne, celle des sujets qui s'analysent, mais aussi (...) aux articulations de savoir qui prennent une place primordiale dans l'élaboration de son immense séminaire qui constitue une des créations les plus puissantes de notre temps. Les grands philosophes y sont fréquemment interrogés dans leur pensée fondamentale et jusqu'à leur point de butée que Lacan nommait l'impossible et qu'il tentait de déborder à partir des (quatre) concepts fondamentaux de Freud et en posant avec l'objet a le registre du Réel et le primat de l'écriture.". (shrink)

Philosophy is sometimes perceived as an abstract and nerdy discipline dealing with problems of its own creation in an isolated chamber of the Ivory Tower. And there is some truth to this view. But philosophy can help us deal with common problems, such as the disagreements we have in our everyday lives.

The contemporary astrophysicist today deals with questions that bear on the area known to traditional philosophy as “metaphysics.” Consequently, it is tempting to cross the threshold. One can allow oneself to be tempted by the idea that science is in a position to provide solutions to ancient and venerable metaphysical quests. One can even imagine, according to the wish expressed two thousand years ago by Epicurus, that it can calm our “metaphysical anxieties.”.