Suppose you want to live a happy life. Who should you turn to for advice? We normally think that we know best about our own happiness. But recent work in psychology and neuroscience suggests that we are often mistaken about our own natures, and that sometimes scientists know us better than we know ourselves. Does this mean that to live a happy life we should ask scientists for advice rather than relying on our introspection? In what follows, we highlight ways (...) in which the science of happiness could help us live happy lives, but we also argue that, in other ways, our navel gazing will remain indispensable. (shrink)

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

Background Over the last decade, the return of results (ROR) in precision medicine research (PMR) has become increasingly routine. Calls for individual rights to research results have extended the “duty to report” from clinically useful genetic information to traits and ancestry results. ROR has thus been reframed as inherently beneficial to research participants, without a needed focus on who benefits and how. This paper addresses this gap, particularly in the context of PMR aimed at increasing participant diversity, by providing investigator (...) and researcher perspectives on and questions about the assumed value of ROR in PMR.Methods Semi-structured interviews with a purposive sample of investigators and researchers across federally funded PMR studies in three national consortia, as well as observations of study activities, focused on how PM researchers conceptualize diversity and implement inclusive practices across research stages, including navigating ROR.Results Interviewees (1) validated the value of ROR as a benefit of PMR, while others (2) questioned the benefit of clinically actionable results to individuals in the absence of sufficient resources for translating findings into health care for diverse and disadvantaged populations; (3) expressed uncertainties in applying the presumed value of ROR as a benefit for non-clinical results; and (4) and debated when the promise of the value of ROR may undermine trust in PMR, and divert efforts to return value beyond ROR.Conclusions Conceptualizations of diversity and inclusion among PM researchers and investigators raise unique ethical questions where unexamined assumptions of the value of ROR inform study recruitment efforts to enroll minoritized and under-represented populations. A lack of consideration for resources and infrastructure necessary to translate ROR into actionable information may hinder trustworthy community-research relationships. Thus, we argue for a more intentional interrogation of ROR practices as an offer of benefit and for whom. (shrink)

Background In the wake of mandates for biomedical research to increase participation by members of historically underrepresented populations, community engagement (CE) has emerged as a key intervention to help achieve this goal.Methods Using interviews, observations, and document analysis, we examine how stakeholders in precision medicine research understand and seek to put into practice ideas about who to engage, how engagement should be conducted, and what engagement is for.Results We find that ad hoc, opportunistic, and instrumental approaches to CE exacted significant (...) consequences for the time and resources devoted to engagement and the ultimate impacts it has on research. Critical differences emerged when engagement and research decisionmaking were integrated with each other versus occurring in parallel, separate parts of the study organization, and whether community members had the ability to determine which issues would be brought to them for consideration or to revise or even veto proposals made upstream based on criteria that mattered to them. CE was understood to have a range of purposes, from instrumentally facilitating recruitment and data collection, to advancing community priorities and concerns, to furthering long-term investments in relationships with and changes in communities. These choices about who to engage, what engagement activities to support, how to solicit and integrate community input into the workflow of the study, and what CE was for were often conditioned upon preexisting perceptions and upstream decisions about study goals, competing priorities, and resource availability.Conclusions Upstream choices about CE and constraints of time and resources cascade into tradeoffs that often culminated in “pantomime community engagement.” This approach can create downstream costs when engagement is experienced as improvised and sporadic. Transformations are needed for CE to be seen as a necessary scientific investment and part of the scientific process. (shrink)

L’article fournit un exemple concret des possibilités qu’ouvre l’exploration des données numérisées, et notamment de la Toile, en matière de morphologie dérivationnelle. Il y a une soixantaine d’années, en se fondant sur un exemple unique (silvio-pelliqueste), Edouard Pichon avançait l’hypothèse qu’en contexte vélaire, le suffixe –esque pouvait, par un phénomène de dissimilation préventive, se voir remplacé par la finale –este. Depuis, aucun argument n’était venu étayer cette hypothèse, sinon peut-être des remarques hésitantes de Zwanenburg (1975) et de Björkman (1984) sur (...) la difficulté de trouver des dérivés en –esque après vélaire. Les données réunies confirment que l’adjonction de –esque à une base dont la dernière syllabe comporte une vélaire engendre des tensions dissimi-latives. Lorsque le contexte s’y prête, ces tensions se manifestent tantôt par l’effacement de certaines vélaires finales, tantôt par le maintien inattendu d’une voyelle finale précédée d’une vélaire. Elles se manifestent aussi, comme l’avaient entrevu nos prédécesseurs, par une moindre productivité de cette suffixation après les radicaux en vélaire. Dans l’établissement de ces résultats, l’utilisation d’un outil permettant de récupérer automatiquement sur la Toile des néologismes en fonction de leur terminaison, s’est révélée déterminante. Les recherches automatisées ont joué aussi un rôle capital quand il s’est agi de trouver des dérivés en ‑este et de montrer que ce suffixe n’était utilisé productivement qu’après vélaire, conformément à la conjecture de Pichon. (shrink)

L’article fournit un exemple concret des possibilités qu’ouvre l’exploration des données numérisées, et notamment de la Toile, en matière de morphologie dérivationnelle. Il y a une soixantaine d’années, en se fondant sur un exemple unique (silvio-pelliqueste), Edouard Pichon avançait l’hypothèse qu’en contexte vélaire, le suffixe –esque pouvait, par un phénomène de dissimilation préventive, se voir remplacé par la finale –este. Depuis, aucun argument n’était venu étayer cette hypothèse, sinon peut-être des remarques hésitantes de Zwanenburg (1975) et de Björkman (1984) sur (...) la difficulté de trouver des dérivés en –esque après vélaire. Les données réunies confirment que l’adjonction de –esque à une base dont la dernière syllabe comporte une vélaire engendre des tensions dissimi-latives. Lorsque le contexte s’y prête, ces tensions se manifestent tantôt par l’effacement de certaines vélaires finales, tantôt par le maintien inattendu d’une voyelle finale précédée d’une vélaire. Elles se manifestent aussi, comme l’avaient entrevu nos prédécesseurs, par une moindre productivité de cette suffixation après les radicaux en vélaire. Dans l’établissement de ces résultats, l’utilisation d’un outil permettant de récupérer automatiquement sur la Toile des néologismes en fonction de leur terminaison, s’est révélée déterminante. Les recherches automatisées ont joué aussi un rôle capital quand il s’est agi de trouver des dérivés en ‑este et de montrer que ce suffixe n’était utilisé productivement qu’après vélaire, conformément à la conjecture de Pichon. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Noninvasive, prenatal whole genome sequencing may be a technological reality in the near future, making available a vast array of genetic information early in pregnancy at no risk to the fetus or mother. Many worry that the timing, safety, and ease of the test will lead to informational overload and reproductive consumerism. The prevailing response among commentators has been to restrict conditions eligible for testing based on medical severity, which imposes disputed value judgments and devalues those living with eligible conditions. (...) To avoid these difficulties, we propose an unrestricted testing policy, under which prospective parents could obtain information on any variant of known significance after a careful informed consent process that uses an interactive decision aid to deliver a mandatory presentation on the purposes, techniques, and limitations of genomic testing, as well as optional resources for reflection and consultation. This process would encourage thoughtful, informed deliberation... (shrink)

The sense of agency is a central aspect of human self-consciousness and refers to the experience of oneself as the agent of one’s own actions. Several different cognitive theories on the sense of agency have been proposed implying divergent empirical approaches and results, especially with respect to neural correlates. A multifactorial and multilevel model of the sense of agency may provide the most constructive framework for integrating divergent theories and findings, meeting the complex nature of this intriguing phenomenon.

Hastings Center Report, Volume 52, Issue 3, Page 9-17, May–June 2022.

Plausibly, only moral agents can bear action-demanding duties. Not all groups are moral agents. This places constraints on which groups can bear action-demanding duties. Moreover, if such duties imply ability then moral agents – of both the individual and group varieties – can only bear duties over actions they are able to perform. I tease out the implications of this for duties over group actions, and argue that groups in many instances cannot bear these duties. This is because only groups (...) with the right kind of structure – groups I call ‘collectives’ – have the agency to bear action-demanding duties. Yet neither can individuals bear these duties, assuming that individuals cannot perform group actions and that duty implies ability. This appears to leave us at a loss when assigning duties to perform some group actions. I argue we can solve this problem by assigning collectivization duties to individuals – duties to form a collective that then incurs a duty over the action. I give criteria for when individuals have collectivization duties and discuss the demands these duties place on their bearers. (shrink)

Pragmatic clinical trials offer important benefits, such as generating evidence that is suited to inform real-world health care decisions and increasing research efficiency. However, PCTs also present ethical challenges. One such challenge involves the management of information that emerges in a PCT that is unrelated to the primary research question, yet may have implications for the individual patients, clinicians, or health care systems from whom or within which research data were collected. We term these findings as?pragmatic clinical trial collateral findings,? (...) or?PCT-CFs?. In this article, we explore the ethical considerations associated with the identification, assessment, and management of PCT-CFs, and how these considerations may vary based upon the attributes of a specific PCT. Our purpose is to map the terrain of PCT-CFs to serve as a foundation for future scholarship as well as policy-making and to facilitate careful deliberation about actual cases as they occur in practice. (shrink)

Patientenselbstbestimmung und Patientenverfügungen (PV) haben zunehmende Bedeutung und Beachtung erfahren. In der vorliegenden qualitativen Studie wurden 15 Patientinnen und Patienten mit amyotropher Lateralsklerose (ALS)—einer unheilbaren, chronisch-degenerativen Erkrankung mit vorhersehbarer Symptomatik—interviewt, um zu erfahren, welche Werte und Kriterien sie bei prospektiven Entscheidungen am Lebensende und bei der Abfassung von PV zugrunde legen. Die Auswertung erfolgte nach der Methode der „grounded theory“. Die befragten Patientinnen und Patienten befürworteten einen Verzicht auf lebenserhaltende Behandlungen, wenn sie keine hinreichenden Lebensmöglichkeiten (LM) mehr sahen, d. h. (...) wenn sie die aktuelle Lebensqualität für unzureichend erachteten und die Chance auf Besserung als gering einschätzten. Dem Patientenwillen sprachen sie bei der Entscheidungsfindung ein Vetorecht zu. Patientenverfügungen fassten sie erst ab, als sie keine Hoffnung mehr auf Besserung ihrer Erkrankung hatten. Sie verstanden diese als Instrumente zur vorsorglichen Erklärung ihres Wunsches, auf lebensverlängernde Maßnahmen zu verzichten, wenn die LM inakzeptabel geworden sind. Damit wollten sie sich gegenüber dem Arzt absichern, den sie in der Rolle eines Anwalts des Lebens sahen und mit dem sie daher ihre Behandlungswünsche nicht besprochen haben. Trotz vorhersehbarer Symptomatik legten sie in ihren PV keine spezifischen Behandlungswünsche nieder, sondern verwendeten allgemeine Formularmuster ohne konkreten Bezug zu ihrer Erkrankung. Daher bestehen auch bei dieser Patientengruppe Zweifel, ob die PV in einer konkreten Behandlungssituation hilfreich sind. (shrink)

While rich countries like the USA and UK are starting to vaccinate their populations against COVID-19, poor countries may lack access to a vaccine for years. A global effort to provide vaccines through the COVAX facility Accelerator) aims to distribute 2 billion vaccinations by the end of next year, but the USA has refused to join and even those rich countries that have joined are entering into bilateral deals with pharmaceutical companies to buy up the supply. Canada, for instance, has (...) already secured enough to vaccinate its entire population nine times over, and the USA, European Union, UK, Australia and Japan can vaccinate their populations between 2 and 8 x.1 Vaccine nationalism is neither ethically justified, nor even in rich countries’ long-term self-interest. No one deserves the luck of their birth and few have much control over their country of residence. So, when there are four ventilators per 12 million people in some low-income and middle-income countries, and people are being buried in cardboard boxes in mass graves, it is simply unconscionable to argue that wealthy countries can keep their vaccines to themselves or even help their populations first.2 Vaccine nationalism fails to respect basic human rights and the people who have them. Moreover, many argue that rich countries have contributed to global poverty through a shared and violent history of colonialism and oppression and profit from instituting, upholding and sustaining coercive rules that often exacerbate, rather than alleviate, global poverty.3 Be that as it may, putting basic health systems in place to ensure everyone can get vaccinated, not only against COVID-19 but a host of other terrible diseases, would better protect even the rich from …. (shrink)

In response to growing concerns of bias, discrimination, and unfairness perpetuated by algorithmic systems, the datasets used to train and evaluate machine learning models have come under increased scrutiny. Many of these examinations have focused on the contents of machine learning datasets, finding glaring underrepresentation of minoritized groups. In contrast, relatively little work has been done to examine the norms, values, and assumptions embedded in these datasets. In this work, we conceptualize machine learning datasets as a type of informational infrastructure, (...) and motivate a genealogy as method in examining the histories and modes of constitution at play in their creation. We present a critical history of ImageNet as an exemplar, utilizing critical discourse analysis of major texts around ImageNet’s creation and impact. We find that assumptions around ImageNet and other large computer vision datasets more generally rely on three themes: the aggregation and accumulation of more data, the computational construction of meaning, and making certain types of data labor invisible. By tracing the discourses that surround this influential benchmark, we contribute to the ongoing development of the standards and norms around data development in machine learning and artificial intelligence research. (shrink)

Organizations do moral wrong. States pursue unjust wars, businesses avoid tax, charities misdirect funds. Our social, political, and legal responses require guidance. We need to know what we’re responding to and how we should respond to it. We need a metaphysical and moral theory of wrongful organizations. This book provides a new such theory, paying particular attention to questions that have been underexplored in existing debates. These questions include: where are organizations located as material objects in the natural world? What’s (...) the metaphysical relation between organizations and their members? Can organizations be blameworthy for attitudes and character traits, as well as for actions? What about feelings of guilt, remorse, and shame—can organizations feel these emotions and why does this matter? How and why are members implicated in organizations’ wrongs? How should organizations’ reparative costs be apportioned among members? The book answers these questions. It argues that organizations are material objects with humans as material parts—much like how a pizza is a material object with slices as material parts. This picture helps us make sense of organizations’ blameworthiness, including blame for organization-level actions, attitudes, and character traits. The book argues that organizations can experience moral self-awareness—a crucial component of guilt, remorse, and shame. Members can be implicated in organizations’ actions in numerous ways—and, it is argued, members’ level of implication should determine their share of organizations’ reparative burdens. (shrink)

ABSTRACTAlthough a growing stream of research investigates the role of government in corporate social responsibility, little is known about how governmental CSR interventions interact in financial markets. This article addresses this gap through a longitudinal study of the socially responsible investment market in France. Building on the “CSR and government” and “regulative capitalism” literatures, we identify three modes of governmental CSR intervention—regulatory steering, delegated rowing, and microsteering—and show how they interact through the two mechanisms of layering and catalyzing. Our findings: (...) 1) challenge the notion that, in the neoliberal order, governments are confined to steering market actors—leading and guiding their behavior—while private actors are in charge of rowing—providing products and services; 2) show how governmental CSR interventions interact and are orchestrated; and 3) provide evidence that governments can mobilize financial markets to promote CSR. (shrink)

Scientific modelling is a value-laden process: the decisions involved can seldom be made using ‘scientific’ criteria alone, but rather draw on social and ethical values. In this paper, we draw on a body of philosophical literature to analyze a COVID-19 vaccination model, presenting a case study of social and ethical value judgments in health-oriented modelling. This case study urges us to make value judgments in health-oriented models explicit and interpretable by non-experts and to invite public involvement in making them.

Philosophers often talk as though each ability is held by exactly one agent. This paper begins by arguing that abilities can be held by groups of agents, where the group is not an agent. I provide a new argument for—and a new analysis of—non-agentive groups’ abilities. I then provide a new argument that, surprisingly, obligations are different: non-agentive groups cannot bear obligations, at least not if those groups are large-scale such as ‘humanity’ or ‘carbon emitters.’ This pair of conclusions is (...) important, since philosophers who endorse large-scale non-agentive groups’ abilities almost universally endorse their obligations. More importantly, the twin arguments (one for abilities, one against obligations) make the following novel contribution: abilities imply agency-involving explanations, while obligations imply action-guidance. This general conclusion should be of interest beyond social ontology. (shrink)

Forsyth (J Pers Soc Psychol 39(1): 175-184, 1980) argued that ethical ideology includes the two orthogonal dimensions of relativism and idealism. Relativists determine morality by looking at the complexities of the situation rather than relying on universal moral rules, while idealists believe that positive consequences can always be obtained without harming others. This study examined the role of ethical ideology as a moderator between justice and constructive and deviant reactions to injustice. Students with work experience (N = 200) completed Bennett (...) and Robinson's (J Appl Psychol 85(3): 349-360, 2000) measure of Workplace Deviance, Gill's (Reactions to injustice: Development and validation of a measure. Unpublished doctoral dissertation, University of Western Ontario, 2005) Reactions to Injustice measure, and the Ethics Position Questionnaire (Forsyth, 1980), and provided ratings of justice in their own workplace. Hierarchical regressions revealed a significant main effect of idealism on deviance and constructive behaviors, and three-way interactions between idealism, relativism, and some types of justice. These findings suggest that ethical ideology plays a significant role in predicting responses to injustice. (shrink)

The pregnant female body and, more generally, the generative process tout court have been linked with metaphors since the dawn of Western philosophy, though this history has only recently been taken up and critically discussed (Rigotti 2010; Cavarero 1995). The research hypothesis I test in this paper is that pregnancy and childbirth ought to be considered as absolute metaphors, as per their “indissoluble alogicality” (Blumenberg 2010). Following the analyses presented in Paradigms for a Metaphorology, the goal of the article is (...) to enhance dialogue between Blumenberg’s conception of the metaphor and those philosophical reflections that focus on the pervasiveness of metaphors concerning pregnancy and childbirth. This paper is therefore an investigation on the link between female reproductive functions and philosophical knowledge. (shrink)

This book is the first in-depth investigation of the expression of agency in verbal noun and impersonal/passive constructions in medieval Welsh and Irish, drawing on a database of texts from different genres: narrative, legal, and annalistic. The analysis is primarily data-oriented, rather than theory-oriented, although it draws on methods and concepts from functional grammar approaches and cognitive linguistics. Written with readers from a wide variety of backgrounds in mind, Agents in Early Welsh and Early Irish goes beyond earlier contributions in (...) the field of Celtic syntax and semantics in several important ways: It presents data from both Welsh and Irish It discusses both the internal structure of verbal noun and passive/impersonal constructions and their contributions to their contexts It offers new analyses of agency and its markers in medieval Welsh and Irish, as well as analyses of the marking of instrument, cause, and indirect agency. (shrink)

A theoretical framework is required that explains why and how cross-group contact reduces collective action and how the demobilizing effects can be counteracted. We propose that at least two mechanisms are involved: an affective process whereby the positive affect created offsets negative emotions and action tendencies, and a more strategic process whereby individual advancement comes to seem like a possibility.

Historically, biocentrists have ascribed interests to organisms via an account of function. One promising account of function for this purpose is the organizational or autopoietic account of function, according to which some entity x has a function of self-maintenance when the parts of x contribute to the goal of self-maintenance. In this paper, I will present the autopoietic account of interests and provide some reasons for thinking that this account is promising. I will also present a possible issue for the (...) biocentrist who uses the autopoietic account of function given the following two claims: what it means to be a biological “self” is ambiguous, and the autopoietic account of interests relies on a self boundary. I argue that the proponent of this account then needs to choose a definition of individual and explain why that definition is morally relevant. Otherwise, the proponent of the autopoietic account has not given an account of what constitutes a harm or a benefit for a biological individual, and there are good reasons to believe that this is a necessary component of any account of interests. (shrink)

This article aims at two objectives, the first is to prove the insufficiency of the Kantian ethics matrix to give an account of vulnerability and precarity that are part of human existence. We will show how the “losing” side of ethical theories of modernity, offer a richer frame to asses human interdependency. Our second objective is to pose the hypothesis about a relation between those discourses of freedom as autonomy and the negation of human vulnerability and hence of the relegation (...) or subalterization of the ethical arguments based on care. (shrink)

Passages from the writings of Immanuel Kant concerning how a person should treat her body are often cited in the present‐day debate about a market for human body parts. In this paper, I demonstrate that this has been a misuse of Kant because unlike those who cite him, Kant was not primarily concerned with prohibiting the sale of body parts. In the first section, I argue that once these particular passages are understood against the background of Kant’s moral philosophy, they (...) indicate he had much broader concerns relating to the correct moral relationship a rational person should have with her body. In the second section, I examine Stephen Munzer’s unusually detailed analysis of these passages, but conclude that like those who have provided less detailed analyses, he also fails fully to understand the rationale for Kant’s various prescriptions and prohibitions concerning the treatment of human body parts, and in doing so misrepresents Kant’s position. (shrink)

mHealth refers to the rapidly evolving use of mobile devices for health care treatment purposes, particularly the use of apps and texting as adjuncts to psychotherapy. Although there is currently an extensive literature on issues related to telehealth, to date little guidance has been developed to help professionals function ethically in the rapidly emerging area of mHealth. This article identifies the major ethical considerations that need attention and proposes several recommendations to address mHealth use as an adjunct to psychotherapy, including (...) the pressing need for relevant American Psychological Association practice guidelines to assist mental health providers in the ethical implementation of mHealth. (shrink)

We asked whether and how generations vary in their perceptions on moral matters ranging from their justifications of crime and questions concerning bodily autonomy. In our exploratory study using data from the World Values Survey, we found that Generations Y and Z are more likely than their older counterparts to justify crimes, such as cheating on taxes or stealing property, and to favor greater bodily autonomy in issues such as suicide and abortion. They also rank lower the importance of God (...) and national pride. Implications are offered for employers who wish to motivate and incentivize a multi-generational workforce. (shrink)

Multiple studies have been performed to identify the most common ethical dilemmas encountered by ethics consultation services. However, limited data exists comparing the content of ethics consultations requested by specific hospital specialties. It remains unclear whether the scope of ethical dilemmas prompting an ethics consultation differ between specialties and if there are types of ethics consultations that are more or less frequently called based on the specialty initiating the ethics consult. This study retrospectively assessed the incidence and content of ethics (...) consultations called by surgical vs. non-surgical specialties between January 1, 2013 to December 31, 2018 using our RedCap Database and information collected through the EMR via our Clinical and Translational Science Center. 548 total ethics consultations were analyzed. Our results demonstrate that more surgical consults originated from the ICU, as opposed to lower acuity units, and surgical patients were more likely to have a DNR in place. Surgical specialties were more likely to call about issues relating to withholding/withdrawing life-sustaining treatment, while non-surgical specialties were more likely to call about issues related to discharge planning. There appear to be morally relevant differences between consults classified as the “same” that are not entirely captured by the usual ethics consultations classification system. In conclusion, this study highlights the unique ethical issues experienced by surgical vs. non-surgical specialties. Ultimately, our data can help ethics consultation services determine how best to educate various hospital specialties to approach ethical issues commonly experienced within their field. (shrink)

One hundred years ago, most wars occurred between nations; today, large-scale violent conflict consists almost exclusively of civil wars in which civilians constitute 30 percent of casualties.’ According to a recent World Bank study of conflict, the poorest one-sixth of the worlds population suffers four-fifths of the consequences of civil wars. While poverty is the greatest risk factor determining a nation’s likelihood of entering into conflict, it is also one of instability’s most predictable consequencet—thus, war is a vicious cycle, and (...) poor nations may remain at risk for intense violence for years or even decades. (shrink)

L’accompagnement de fin de vie est devenu une pratique usuelle, conseillée, en France, dans les établissements d’hébergement pour personnes âgées dépendantes. Il fait l’objet de formation continue et est inscrit dans les recommandations des sociétés de soins palliatifs. Mais l’accompagnement de fin de vie est-il un concept ? Une pratique ? Une fonction ? Qui sont les acteurs de cet accompagnement ? Est-ce une attribution des professionnels de santé ou de tout un chacun dans la société ? Nous tenterons, d’abord, (...) de cerner le concept d’accompagnement dans le champ des pratiques sociales. Nous verrons qu’il s’agit bien d’une pratique qui s’appuie sur des fondements théoriques du souci de l’autre, de la bienveillance, de l’être-avec. Puis la description sociohistorique de l’accompagnement et du soin palliatif nous montrera l’idéal humain qu’il recouvre. Cependant les valeurs communes à l’un et l’autre tendent à la confusion entre accompagnement de fin de vie et soin palliatif. C’est pourquoi certains auteurs nous invitent à une réflexion éthique sur l’accompagnement. Ils nous proposent de préciser la fonction et la posture professionnelle qu’il requiert. Enfin, nous verrons l’importance de délimiter le contexte dans lequel s’insère cette pratique. (shrink)