In this analysis we discuss the change in criteria for triage of patients during three different phases of a pandemic like COVID-19, seen from the critical care point of view. Availability of critical care beds has become a hot topic, and in many countries, we have seen a huge increase in the provision of temporary intensive care bed capacity. However, there is a limit where the hospitals may run out of resources to provide critical care, which is heavily dependent on (...) trained staff, just-in-time supply chains for clinical consumables and drugs and advanced equipment. In the first phase, we can still do clinical prioritisation and decision-making as usual, based on the need for intensive care and prognostication: what are the odds for a good result with regard to survival and quality of life. In the next, the resources are mostly available, but the system is stressed by many patients arriving over a short time period and auxiliary beds in different places in the hospital being used. We may have to abandon admittance of patients with doubtful prognosis. In the last phase, usual medical triage and priority setting may not be sufficient to decrease inflow and there may not be enough intensive care unit beds available. In this phase different criteria must be applied using a utilitarian approach for triage. We argue that this is an important transition where society, and not physicians, must provide guidance to support triage that is no longer based on medical priorities alone. (shrink)

Psychoanalysis in Social and Cultural Settings examines the theory and practice of psychoanalysis with patients who have experienced deeply traumatic experiences, through war, forced migration, atrocities and other social and cultural dislocations. The book is divided into 3 main sections, covering terrorism, refugees, and traumatisation, with another 2 with specific focus transcultural issues establishing psychoanalysis in China, and on research related to themes outlined in the book. Major key psychoanalytic themes run through the work, focusing on identity and the self, (...) fundamentalism, resilience, dehumanisation, cultural differences, and enactment. Offering key theory and clinical guidance for working with highly traumatised patients, this book will be essential for all psychoanalysts and therapists working with victims of terrorism, refugees, and other deeply traumatic life events. (shrink)

This essay attempts to distinguish and discuss the importance and limitations of different ways of being wrong. At first it is argued that strictly falsifiable knowledge is concerned with simple (instrumental) mistakes only, and thus is incapable of understanding more complex errors (and truths). In order to gain a deeper understanding of mistakes (and to understand a deeper kind of mistake), it is argued that communicative aspects have to be taken into account. This is done in the theory of communicative (...) action, which adds to our knowledge of errors the notion of communicative mistakes: mistakes as obstacles for sincere communication. However, to overcome this still purely negative judgement of errors, two processes are examined in which mistakes are best regarded as developmental steps, that is, steps not only meaningful in their own right (as containing some truth), but also as necessary preconditions for further progress. This would suggest that truth is born out of errors. But if so, one has to understand the wrongness of such errors; how is it that they are erroneous if they (somehow) contain the truth? At the end of this essay, a tentative answer to this question is given. (shrink)

Most studies on refugee populations are organized around trauma-related issues and focus on explaining pathological factors. Few studies are anchored in general developmental psychology with the aim of exploring normal age-specific developmental tasks and how the special circumstances associated with forced migration can influence how developmental tasks are negotiated. This study is part of a larger mixed method study seeking to identify resilience-promoting and resilience-inhibiting factors, on individual and contextual levels, among asylum seekers and refugees on the move and settled (...) in reception centers in Norway. A strategic sample of 20 adolescent and young adult refugees/asylum seekers during flight in Serbia and after arrival in Norway was chosen from a sample of 178 refugees interviewed in depth in Serbia and at receptions centers in Norway. The sample reflects the focus of this paper, which is to explore adolescent and young adult refugees/asylum seekers’ psychological and social needs and resources during flight to and after arrival in the host country, including how developmental tasks are negotiated. Through qualitative analysis, experiences associated with the developmental changes the participants experienced before, during, and after flight are contextualized. Their sense of self, their relationships with their families and their perceptions of their situation as adolescents or young adults in a highly unpredictable situation are presented in the light of relevant theory and findings from similar refugee studies. All the participants have fled from dangerous and intolerable situations in their home countries. They describe extreme dangers during flight in contexts that are unpredictable and where they feel lonely and unsupported. Most have unmet psychosocial needs and have received little support or help for their mental health issues during flight or after arrival in Norway. Suggestions for interventions and resilience-promoting actions are given based on the findings of the study. (shrink)

Today, it is becoming increasingly common for companies to harness the spirit of play in order to increase worker engagement and improve organizational performance. This paper examines the ethics of play in a business context, focusing specifically on the phenomenon of workplace gamification. While critics highlight ethical problems with gamification, they also advocate for more positive, transformative, and life-affirming modes of organizational play. Gamification is ethical, on this view, when it allows users to reach a state of authentic happiness or (...) _eudaimonia._ The underlying assumption, here, is that the ‘magic circle’ of play—a sphere that exists entirely for its own sake—should be protected in order to secure meaningfulness at work. However, we argue that this faith in play is misguided because play, even at its most autotelic, is ethically ambivalent; it does not lead inexorably to virtuous work environments, but may in fact have an undesirable impact on those who are playing. Our study thus contributes to research on the ‘dark side’ of organizational play, a strand of scholarship that questions the idea that play always points toward the good life. (shrink)

Using data generated from questionnaires containing select items from the Baylor Religion Survey, the current study proposes to examine the paranormal interests and beliefs of participants in two specific alternative spiritual movements, contemporary Paganism and the Movement of Spiritual Inner Awareness. The analysis will be framed by a discussion of the larger alternative spiritual milieu in which these movements are rooted, and how belief in the paranormal is correlated more with this milieu than with involvement in these NRMs.

Traumatisierte Menschen haben mit vorübergehenden oder anhaltenden Symbolisierungsschwierigkeiten zu kämpfen. Diese treten entweder in psychisch eingekapselter, umgrenzter Form in Erscheinung oder als psychische Funktionsabläufe, die sich in umfassenderer Weise auf die Lebensprojekte, politischen Einstellungen und kulturellen Normvorstellungen der Person auswirken, und zeigen sich in ihrer Körper-Welt-Beziehung, ihrer Individuum-Gruppen-Beziehung und/oder ihrer Individuum-Diskurs-Beziehung. Die Schwierigkeiten können in imaginativen und symbolischen Funktionsmodi auftreten. Gravierende Störungen der Symbolisierung lassen sich aus psychoanalytischer Sicht beschreiben als Begleiterscheinungen der paranoid-schizoiden und der autistisch-berührenden Position (Ogden), als Evakuierung (...) von Beta-Elementen in den Körper (Bion), als Verwerfung (Lacan) und als Urverdrängung (Freud). Der vorliegende Beitrag stellt einige psychoanalytisch fundierte semiotische Überlegungen vor, die dem Forschungsfeld Trauma und Psychose entstammen. Anhand von Fallbeispielen werden der Zusammenbruch der Symbolisierung, Fixierungen auf den nichtsymbolischen Modus der psychischen Repräsentation und die Re-Symbolisierung erläutert, die sich dank der kreativen transformativen Intervention des Analytikers vollzieht. (shrink)

La notion de dispositif est déterminante dans I’analytique foucaldienne de la société. Et pourtant, son étude demeure négligée par la réception internationale. Après avoir discuté brièvement des difficultés rencontrées avec la traduction du terme de dispositif par Dreyfus et Rabinow dans Beyond Structuralism and Hermeneutics, I’article développe une analytique sociale à partir de la pensée « dispositionelle » de Foucault. L’esquisse de I’histoire du terme de dispositif permettra, en outre, de mieux saisir la pertinence de son usage par Foucault.

The Anthropocene is heralded as a new epoch distinguishing itself from all foregoing eons in the history of the Earth. It is characterized by the overarching importance of the human species in a number of respects, but also by the recognition of human dependence and precariousness. A critical human turn affecting the human condition is still in the process of arriving in the wake of an initial Copernican Revolution and Kant's ensuing second Copernican Counter-revolution. Within this landscape, issues concerning the (...) human - its finitude, responsiveness, responsibility, maturity, auto-affection and relationship to itself - appear rephrased and re-accentuated as decisive probing questions. In this book Sverre Raffnsøe explores how the change has ramifications for the kinds of knowledge that can be acquired concerning human beings and for the human sciences as a study of human existential beings in the world. (shrink)

With special emphasis on Foucault's many recently published lecture series this book provides an updated, comprehensive presentation of his most important diagnoses, his many ground-breaking analytical concepts as well as a systematic account of his unique conception of philosophy.

La notion de dispositif est déterminante dans I’analytique foucaldienne de la société. Et pourtant, son étude demeure négligée par la réception internationale. Après avoir discuté brièvement des difficultés rencontrées avec la traduction du terme de dispositif par Dreyfus et Rabinow dans Beyond Structuralism and Hermeneutics, I’article développe une analytique sociale à partir de la pensée « dispositionelle » de Foucault. L’esquisse de I’histoire du terme de dispositif permettra, en outre, de mieux saisir la pertinence de son usage par Foucault.

Since the Enlightenment, critique has played an overarching role in how Western society understands itself and its basic institutions. However, opinions differ widely concerning the understanding and evaluation of critique. To understand such differences and clarify a viable understanding of critique, the article turns to Kant’s critical philosophy, inaugurating the “age of criticism”. While generalizing and making critique unavoidable, Kant coins an unambiguously positive understanding of critique as an affirmative, immanent activity. Not only does this positive conception prevail in the (...) critique of pure and practical reason and the critique of judgment; these modalities of critique set the agenda for three major strands of critique in contemporary thought, culminating in among others Husserl, Popper, Habermas, Honneth, and Foucault. Critique affirms and challenges cognition and its rationality, formulates ethical ideals that regulate social interaction, and further articulates normative guidelines underway in the ongoing experimentations of a post-natural history of human nature. In contradistinction to esoteric Platonic theory, philosophy at the threshold of modernity becomes closely linked to an outward-looking critique that examines and pictures what human forms of life are in the process of making of themselves and challenges them, by reflecting upon what they can and what they should make of themselves. As a very widely diffused practice, however, critique may also become a self-affirming overarching end in itself. (shrink)

Responding to Guattari’s call for a ‘mutation of mentality’, the article explores unconventional horse-assisted leadership learning as promising ways of embodied learning to be affected and response-able. By drawing on and continuing the work of Guattari and posthuman feminist scholars, we aim to show that studying the affective pedagogics of opening up the senses and learning to be affected is of vital importance. We analyse a posthuman auto-ethnography of developing capabilities to live and breathe together that allow us to relate (...) in alternative ways. Experiments with affective pedagogy are conducted as they affect bodies through indeterminate and liminal contact zones and use aesthetics to evoke transformation in senses and thoughts, care and response. Since they are both domesticated and non-human, horses are promising companions in this endeavour of entrainment. However, these sensorial experiments also call for an ethics of cutting connections and, not least, of permitting refusals of refusals. (shrink)

La notion de dispositif est déterminante dans I’analytique foucaldienne de la société. Et pourtant, son étude demeure négligée par la réception internationale. Après avoir discuté brièvement des difficultés rencontrées avec la traduction du terme de dispositif par Dreyfus et Rabinow dans Beyond Structuralism and Hermeneutics, I’article développe une analytique sociale à partir de la pensée « dispositionelle » de Foucault. L’esquisse de I’histoire du terme de dispositif permettra, en outre, de mieux saisir la pertinence de son usage par Foucault.

This essay argues that what makes Michel Foucault’s oeuvre not only stand apart but also cohere is an assiduous philosophical practice taking the form of an ongoing yet concrete self-modification in the medium of thought. Part I gives an account of three essential aspects of Foucault’s conception of philosophical activity. Beginning with his famous characterization of philosophy in terms of ascēsis, it moves on to articulate his characterization of philosophical practice as a distinct form of meditation, differing from both Cartesian (...) meditation and Hegelian meditation, as it aims to stand vigil for the day to come and operates as a preface to transgression. Part II begins the articulation of crucial traits left implicit in this understanding of philosophy by turning to Foucault’s in-depth investigation of philosophy in Antiquity during his lectures at the Collège de France in the 1980s. First, it develops how philosophy here begins to constitute and distinguish itself by establishing itself as an activity that has a privileged relationship to truth and truth-telling as an unremitting, existentially determining challenge for the philosopher. Further, it instantiates how Platonism elaborates the need for a sustained ‘auto-ascetic’ ethical non-compliant differentiation as the condition of possibility for accessing and stating truth, and then describes how the assertion of an ethical differentiation and attitude in Cynicism takes the form of an insistent combat for another world in this world. Finally, it underlines how the ethical-practical philosophical work upon oneself in Antiquity is developed in an ongoing critical and political exchange with others. Part III indicates how ethical differentiation according to Foucault remains an essential precondition for the practice of philosophy and is further developed in the modern age. This is particularly perspicuous in Kant’s determination of the Enlightenment, in the attitude of modernity exemplified by Baudelaire, and in the history of revolt since the beginning of early Modernity. On this background, Part IV develops how philosophy as an ongoing meditative practice of self-modification leads to an affirmative critique, confirming the virtuality of this world in order to investigate the potentiality in the examined. In this manner, the essay presents Foucault’s philosophical practice as well as an outline of the history of ideas of a seemingly alternate, yet still agenda-setting conception of philosophical practice today. (shrink)

Ethical approval must be obtained before medical research can start. We describe the differences in EA for an pseudonymous, non-interventional, observational European study. Sixteen European national coordinators of the international study on very old intensive care patients answered an online questionnaire concerning their experience getting EA. N = 8/16 of the NCs could apply at one single national ethical committee, while the others had to apply to various regional ECs and/or individual hospital institutional research boards. The time between applying for (...) EA and the first decision varied between 7 days and 300 days. In 9/16 informed consent from the patient was not deemed necessary; in 7/16 informed consent was required from the patient or relatives. The upload of coded data to a central database required additional information in 14/16. In 4/16 the NCs had to ask separate approval to keep a subject identification code list to de-pseudonymize the patients if questions would occur. Only 2/16 of the NCs agreed that informed consent was necessary for this observational study. Overall, 6/16 of the NCs were satisfied with the entire process and 8/16 were unsatisfied. 11/16 would welcome a European central EC that would judge observational studies for all European countries. Variations in the process and prolonged time needed to get EA for observational studies hampers inclusion of patients in some European countries. This might have a negative influence on the external validity. Further harmonization of ethical approval process across Europe is welcomed for low-risk observational studies. Getting ethical approval for low-risk, non-interventional, observational studies varies enormously across European countries. (shrink)

This essay argues that what makes Michel Foucault’s oeuvre not only stand apart but also cohere is an assiduous philosophical practice taking the form of an ongoing yet concrete self-modification in the medium of thought. Part I gives an account of three essential aspects of Foucault’s conception of philosophical activity. Beginning with his famous characterization of philosophy in terms of ascēsis, it moves on to articulate his characterization of philosophical practice as a distinct form of meditation, differing from both Cartesian (...) meditation and Hegelian meditation, as it aims to stand vigil for the day to come and operates as a preface to transgression. Part II begins the articulation of crucial traits left implicit in this understanding of philosophy by turning to Foucault’s in-depth investigation of philosophy in Antiquity during his lectures at the Collège de France in the 1980s. First, it develops how philosophy here begins to constitute and distinguish itself by establishing itself as an activity that has a privileged relationship to truth and truth-telling as an unremitting, existentially determining challenge for the philosopher. Further, it instantiates how Platonism elaborates the need for a sustained ‘auto-ascetic’ ethical non-compliant differentiation as the condition of possibility for accessing and stating truth, and then describes how the assertion of an ethical differentiation and attitude in Cynicism takes the form of an insistent combat for another world in this world. Finally, it underlines how the ethical-practical philosophical work upon oneself in Antiquity is developed in an ongoing critical and political exchange with others. Part III indicates how ethical differentiation according to Foucault remains an essential precondition for the practice of philosophy and is further developed in the modern age. This is particularly perspicuous in Kant’s determination of the Enlightenment, in the attitude of modernity exemplified by Baudelaire, and in the history of revolt since the beginning of early Modernity. On this background, Part IV develops how philosophy as an ongoing meditative practice of self-modification leads to an affirmative critique, confirming the virtuality of this world in order to investigate the potentiality in the examined. In this manner, the essay presents Foucault’s philosophical practice as well as an outline of the history of ideas of a seemingly alternate, yet still agenda-setting conception of philosophical practice today. (shrink)