In this path breaking volume, leading researchers from psychology, linguistics, philosophy and primatology offer complementary perspectives on the role of intersubjectivity in the context of human development, comparative cognition and...

Objectives: To assess whether according to healthcare providers, the creation of an ethics service responds to a need; assess the importance of an ethics service for healthcare providers; determine what ethics services should be offered and the preferred formats of delivery; and identify key issues to be initially dealt with by the ethics service.Design: A survey of healthcare providers in Québec’s Centre Local de Services Communautaires , healthcare institutions dedicated to community health and social services.Findings: 96 respondents agreed that an (...) ethics service was needed, and on average the ethics service project was judged to be very important. Preferred formats for ethics consultation and education were identified, as well as key concerns such as the need of respect for the patient as a person, elder abuse and ethical issues in home care.Conclusion: This survey is helping in the implementation of an ethics service and can guide others in similar healthcare institutions. (shrink)

A recent discussion on cognitive enhancers has caused some controversy in the ethics and neuroscience fields by coming out in favour of making neuropharmaceuticals with enhancing properties available for general consumption. We highlight in this brief commentary why concerns regarding efficacy and safety, demands on resources, and public health are substantive enough to warrant serious reconsideration before pharmaceutical performance enhancement can be widely supported.

The history and genesis of major public clinical ethics controversies is intimately related to the publication of opinions and responses in media coverage. To provide a sample of public response in the media, this paper reports the results of a content analysis of letters to editors published in the four most prolific American newspapers for the Schiavo controversy. Opinions expressed in the letters sampled strongly supported the use of living wills and strongly condemned public attention to the case as well (...) as political interventions. Letters tended to be against withdrawal of life support, proxy consent and associated procedures as well as against court decisions and legal procedures. In comparison with reports written by journalists, letters to editors contained fewer controversial claims about Schiavo''s neurological condition and behavioural repertoire but similar loaded language to describe withdrawal of life support. Distinct public discourses can be encountered in different stakeholders suggesting complex and extensive pluralism even within the media. (shrink)

In this article, we analyse content from two recent reports to examine how a public health framework to cognitive enhancement is emerging. We find that, in several areas, these reports provide population-level arguments both for and against the use of cognitive enhancers. In discussing these arguments, we look at how these reports are indicative of potentially innovative frameworks—epidemiological, risk/benefit and socio-historical—by which to explore the public health impact of cognitive enhancement. Finally, we argue that these reports are suggestive of both (...) tensions between the bioethical and public health approaches and are also indicative of how these two frameworks can, in part, be seen as complementary. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

Stigma can influence the prevention and identification of fetal alcohol spectrum disorder, a leading cause of developmental delay in North America. Understanding the effects of public health practices and policies on stigma is imperative. We reviewed social science and biomedical literatures to understand the nature of stigma in FASD and its relevance from an ethics standpoint in matters of health practices and policies. We propose a descriptive model of stigma in FASD and note current knowledge gaps; discuss the ethical implications (...) of stigma based on two distinct criteria ; and describe two cases and the concerns associated with inadvertent stigmatization by public health initiatives for FASD. We recommend further empirical and ethical analyses to examine whether public health policies and practices inadvertently stigmatize and impact the success of public health initiatives and programs for FASD. (shrink)

Common understandings of neuroethics, i.e., of its distinctive nature, are premised on two distinct sets of claims: (1) neuroscience can change views about the nature of ethics itself and neuroethics is dedicated to reaping such an understanding of ethics; (2) neuroscience poses challenges distinct from other areas of medicine and science and neuroethics tackles those issues. Critiques have rightfully challenged both claims, stressing how the first may lead to problematic forms of reductionism while the second relies on debatable assumptions about (...) the nature of bioethics specialization and development. Informed by philosophical pragmatism and our experience in neuroethics, we argue that these claims are ill-founded and should give way to pragmatist reconstructions. Namely, neuroscience, much like other areas of empirical research on morality, can provide useful information about the nature of morally problematic situations but it does not need to promise radical and sweeping changes to ethics based on neuroscientism. Furthermore, the rationale for the development of neuroethics as a specialized field need not to be premised on the distinctive nature of the issues it tackles or of neurotechnologies. Rather, it can espouse an understanding of neuroethics as both a scholarly and a practical endeavor dedicated to resolving a series of problematic situations raised by neurological and psychiatric conditions. (shrink)

Living labs are interdisciplinary and participatory initiatives aimed at bringing research closer to practice by involving stakeholders in all stages of research. Living labs align with the principles of participatory research methods as well as recent insights about how participatory ways of generating knowledge help to change practices in concrete settings with respect to specific problems. The participatory, open, and discussion‐oriented nature of living labs could be ideally suited to accompany ethical reflection and changes ensuing from reflection. To our knowledge, (...) living labs have not been explicitly trialed and reported in ethics literature. In this discussion paper, we report and discuss four initial issues that marked the process of setting up a living lab in ethics: (1) determining the goals and expected outcomes of an ethics living lab; (2) establishing operational procedures; (3) selecting communities and defining pilot projects; and (4) adopting a lens to tackle emerging questions and challenges. We explain these four issues and present the paths taken based on the novel and specific orientation, that is, living ethics, at the basis of this project. In alignment with living ethics and É‐LABO, we approach challenges as learning opportunities to ask not only “how” questions but also “why” questions. We hope that this discussion paper informed by our experience helps to clarify the theoretical, methodological, and practical approaches necessary to successfully adopt and employ living labs in ethics. (shrink)

The concept of vulnerability is widely used in research ethics to signal attention to participants who require special protections in research. However, this concept is vague and under‐theorized. There is also growing concern that the dominant categorical approach to vulnerability (as exemplified by research ethics regulations and guidelines delineating vulnerable groups) is ethically problematic because of its assumptions about groups of people and is, in fact, not very guiding. An agreed‐upon strategy is to move from categorical towards analytical approaches (focused (...) on analyzing types and sources of vulnerability) to vulnerability. Beyond this agreement, however, scholars have been advancing competing accounts of vulnerability without consensus about its appropriate operationalization in research ethics. Based on previous debates, we propose that a comprehensive account of vulnerability for research ethics must include four components: definition, normative justifications, application, and implications. Concluding that no existing accounts integrate these components in a functional (i.e., practically applicable) manner, we propose an integrative and functional account of vulnerability inspired by pragmatist theory and enriched by bioethics literature. Using an example of research on deep brain stimulation for treatment‐resistant depression, we illustrate how the integrative‐functional account can guide the analysis of vulnerability in research within a pragmatist, evidence‐based approach to research ethics. While ultimately there are concerns to be addressed in existing research ethics guidelines on vulnerability, the integrative‐functional account can serve as an analytic tool to help researchers, research ethics boards, and other relevant actors fill in the gaps in the current landscape of research ethics governance. (shrink)

Stimulant drugs, transcranial magnetic stimulation, brain-computer interfaces, and even genetic modifications are all discussed as forms of potential cognitive enhancement. Cognitive enhancement can be conceived as a benefit-seeking strategy used by healthy individuals to enhance cognitive abilities such as learning, memory, attention, or vigilance. This phenomenon is hotly debated in the public, professional, and scientific literature. Many of the statements favoring cognitive enhancement (e.g., related to greater productivity and autonomy) or opposing it (e.g., related to health-risks and social expectations) rely (...) on claims about human welfare and human flourishing. But with real-world evidence from the social and psychological sciences often missing to support (or invalidate) these claims, the debate about cognitive enhancement is stalled. In this paper, we describe a set of crucial debated questions about psychological and social aspects of cognitive enhancement (e.g., intrinsic motivation, well-being) and explain why they are of fundamental importance to address in the cognitive enhancement debate and in future research. We propose studies targeting social and psychological outcomes associated with cognitive enhancers (e.g., stigmatization, burnout, mental well-being, work motivation). We also voice a call for scientific evidence, inclusive of but not limited to biological health outcomes, to thoroughly assess the impact of enhancement. This evidence is needed to engage in empirically informed policymaking, as well as to promote the mental and physical health of users and non-users of enhancement. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/uws) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/uws more respondents agreed with treatment withdrawal when they considered that VS/uws patients did not feel pain (77%) as compared to those who thought VS/uws did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

Concerns about the possibility of a sharp rise in the prevalence of Alzheimer’s disease in Western nations have led to both the significant deployment of resources and the development of national research and healthcare plans. Although often focused on treatment, substantial efforts have also been dedicated toward preventing or delaying AD onset. As a result, recent technological and biomedical advances have greatly improved the understanding of AD pathophysiology. While some new tests can assess only risk ), some tests for certain (...) biomarkers (e.g., amyloid beta accumulation in the brain detected via positron... (shrink)

Comment concilier le relatif et l’universel? C’est à cette délicate tâche que s’était attelée il y a déjà quelques années Madame Delmas-Marty, spécialement dans le domaine des droits de l’homme. Le présent ouvrage envisage une difficulté supplémentaire en croisant les interrogations sur le pluralisme juridique avec la question de l’effectivité du droit économique. La prise en compte des pluralismes, notamment du pluralisme juridique, contribue-t-elle à une meilleure effectivité du droit économique? Ou bien, au contraire, le pluralisme juridique est-il un facteur (...) d’ineffectivité du droit économique? Dans cette recherche, les auteurs se sont attachés au pluralisme aussi bien dans la production du droit économique que dans le règlement des différends. C’est ainsi que le lecteur est appelé à cheminer dans la diversité des formes nouvelles qu’empruntent les régulations juridiques pour partir à la recherche des multiples intérêts que peut prendre en charge le droit économique, qu’ils soient individuels, collectifs ou même futurs. Le voyage se poursuit, là encore dans les mondes aussi bien des formes que de la substance. L'ouvrage, après avoir cherché à cerner la notion d’effectivité au regard de notions voisines comme l’efficacité ou l’efficience, s’interroge in fine sur l’éventualité des voies d’un dépassement de la notion de pluralisme juridique. (shrink)

In the article “Nudging and Informed Consent”, Cohen argues that the use of “nudging” by physicians in the clinical encounter may be ethically warranted because it results in an informed consent where obligations for beneficence and respect for autonomy are both met. However, the author's overenthusiastic support for nudging and his quick dismissal of shared decision-making leads him to assume that “soft” manipulation is un-problematic and that “wisdom” on the side of medical professionals will suffice to guard against abuse. Opposing (...) this view, we propose that: 1) patient preferences and values should not be boiled down to rational or irrational decisions based on cognitive reasoning alone, 2) potential threats to the physician-patient must be mitigated and could be minimized by employing alternative strategies that acknowledge the impact of cognitive heuristics in shaping decision-making but maintain transparency and trust, and 3) patient preferences and values can be legitimately influenced only under specific circumstances. The latter include: (1) exhaustion of other means; (2) evidence that nudging is effective in a specific context; (3) evidence of clear and active public misinformation (e.g., industry promoting smoking); (4) explicit pubic dialogue between various stakeholders including medical professional societies about nudging; (5) upholding shared decision-making as a preferred approach; and (6) a rich understanding of clinical reality beyond the simple dichotomy of beneficence-autonomy. (shrink)

The debate on “cognitive enhancement” has moved from discussions about enhancement in adults to enhancement in children and adolescents. Similar to positions expressed in the adult context, some have argued that pediatric cognitive enhancement is acceptable and even laudable. However, the implications differ between the adult and the pediatric contexts. For example, in the debate over cognitive enhancement in adults, i.e., those who have legal majority, respect for autonomy demands that personal preferences not be overridden in absence of strong arguments (...) because competent adults are in the best position to recognize and protect their own interests. However, the concepts of best interest and autonomy provide a different picture in the case of pediatric enhancement. In the context of decision-making involving minors, it is assumed that the parents are in the best position to promote and protect the interests of their children and this is chiefly why they are granted the authority to make decisions on their behalf. However, we argue in favor of guarding the physical integrity of children from intrusive medical interventions without medical need and with clear and detrimental effects. We also support leaving open other legitimate life trajectory and career choices, as this is in the best interest of the child, even if they are less in line with the expectations of parents or success in educational settings. In addition, parental decision-making in favor of cognitive enhancement suffers from a lack of information about cognitive enhancers and potential biases. Thus, bearing in mind these issues and the development of volitional capacities of children, we argue that pediatric enhancement is not a morally acceptable practice and “inevitability” can be curbed with clear and fair rules that establish duties of state representatives, physicians, and public institutions. We conclude by canvassing evidence-based policy options that could protect the open future of minors and define the parameters of parental decision-making analogous to the cases of nicotine and alcohol. (shrink)

BackgroundResearch ethics and the measures deployed to ensure ethical oversight of research (e.g., informed consent forms, ethics review) are vested with extremely important ethical and practical goals. Accordingly, these measures need to function effectively in real-world research and to follow high level standards.MethodsWe examined approved consent forms for Magnetic Resonance Imaging (MRI) and functional Magnetic Resonance Imaging (fMRI) studies approved by Canadian research ethics boards (REBs).ResultsWe found evidence of variability in consent forms in matters of physical and psychological risk reporting. (...) Approaches used to tackle the emerging issue of incidental findings exposed extensive variability between and within research sites.ConclusionThe causes of variability in approved consent forms and studies need to be better understood. However, mounting evidence of administrative and practical hurdles within current ethics governance systems combined with potential sub-optimal provision of information to and protection of research subjects support other calls for more scrutiny of research ethics practices and applicable revisions. (shrink)

Since the 1960s, scientists, engineers, and healthcare professionals have developed brain–computer interface (BCI) technologies, connecting the user’s brain activity to communication or motor devices. This new technology has also captured the imagination of publics, industry, and ethicists. Academic ethics has highlighted the ethical challenges of BCIs, although these conclusions often rely on speculative or conceptual methods rather than empirical evidence or public engagement. From a social science or empirical ethics perspective, this tendency could be considered problematic and even technocratic because (...) of its disconnect from publics. In response, our trinational survey (Germany, Canada, and Spain) reports public attitudes toward BCIs (N = 1,403) on ethical issues that were carefully derived from academic ethics literature. The results show moderately high levels of concern toward agent-related issues (e.g., changing the user’s self) and consequence-related issues (e.g., new forms of hacking). Both facets of concern were higher among respondents who reported as female or as religious, while education, age, own and peer disability, and country of residence were associated with either agent-related or consequence-related concerns. These findings provide a first look at BCI attitudes across three national contexts, suggesting that the language and content of academic BCI ethics may resonate with some publics and their values. (shrink)

Conflicts of interest. None to report Healthcare is a context where individuals with disability confront important ethical and social challenges. Adolescents and young adults with cerebral palsy (CP) seem to face additional challenges but we have little insight into their perspectives. This qualitative study aimed to identify and better understand such challenges. We interviewed 14 participants with CP aged 18 to 25. Participants described a range of challenges experienced when using health services, including: lack of long-term follow-up, shortcomings in physical (...) access to infrastructures, and situations of injustice. Challenges specific to medical consultations were reported (e.g., rude attitudes, belittlement, inadequate communication, lack of consideration). We discuss and explain further that: (1) the ethical principle of respect for persons needs to be concretely specified to improve current practices; (2) respect for autonomy calls for further direct empowerment of individuals with CP and, (3) gaps in dedicated healthcare resources for CP and the long-term needs associated should be addressed. (shrink)

Addiction is a common condition affecting millions of people worldwide of which only a small proportion receives treatment. The development and use of healthcare services is influenced by how addiction is understood (e.g., a condition to treat, a shameful condition to stigmatize), notably with respect to how volition is impacted (e.g., addiction as a choice or a disease beyond one’s control). Through semi-structured qualitative interviews, we explore the implicit views and understandings of addiction and volition across three stakeholder groups: people (...) with lived experience of addiction, clinicians with experience treating addiction, and members of the public without lived experience of addiction. We notably examine whether three paradigms, i.e., three philosophical sets of understandings about the nature of reality and knowledge (realism, relativism, pragmatism) reflect how stakeholders envision addiction and volition in the context of addiction. The use of these paradigms allows for the characterization of different stances on addiction and volition and an assessment of the coherence of beliefs about these matters. Our findings demonstrate that few participants relied on a single epistemic paradigm when describing their views. Furthermore, there were notable differences in understandings of volition between the clinician group, who were more oriented toward pragmatism, and people with lived experience of addiction, who were less oriented toward realism. Despite its limitations, our study suggests that a greater appreciation for the complexity of views held by different stakeholders about addiction and volition could help critically assess the search for coherence expressed in academic and policy debates. (shrink)

Disorders of consciousness (DOC) are a family of related neurological syndromes characterized by deficits of varying degrees of wakefulness (e.g., sleep–wake cycles and arousal) or awareness (e.g., reacting to stimuli, interacting with the environment). Although coma rarely persists for more than a few weeks, some patients remain in a subsequent vegetative state or a minimally conscious state for months or years. Caring for patients with DOC raises ethical questions, but the perspectives of healthcare providers on these questions remain poorly documented. (...) We conducted a qualitative study involving healthcare providers with different backgrounds. Semistructured interviews were used to explore attitudes toward ethical issues. We found that contextual (e.g., time, resource allocation) and relational aspects (e.g., communication process, families) shaped how ethical challenges surfaced and were managed. We call for greater awareness of contextual, institutional and social aspects and focus on these issues in training programs. (shrink)

Rare diseases, defined as having a prevalence inferior to 1/2000, are poorly understood scientifically and medically. Appropriate diagnoses and treatments are scarce, adding to the burden of living with chronic medical conditions. The moral significance of rare disease experiences is often overlooked in qualitative studies conducted with adults living with rare diseases. The concept of morally problematic situations arising from pragmatist ethics shows promise in understanding these experiences. The objectives of this study were to (1) acquire an in-depth understanding of (...) morally problematic situations experienced by adults living with rare diseases in the province of Québec and (2) to develop an integrative model of the concept of morally problematic situations. To this end, an online survey targeting this population was developed through a participatory action research project. Respondents provided 90 long testimonies on the most important morally problematic situations they faced, often in healthcare settings. An integrative model was developed based on various qualitative analyses of these testimonies and relevant literature. The integrative model showcases that morally problematic situations have causes (i.e., contextual and relational factors, personal factors, jeopardized valuations), have affective repercussions (i.e., emotions and feelings, internal tensions), prompt action (i.e., through empowerment strategies leading to the evolution of situations), and elicit outcomes (i.e., factual consequences, residual emotions and feelings, positive or negative resolutions). In sum, this study advances understanding of the moral experiences of adults living with rare diseases while proposing a comprehensive conceptual tool to guide future empirical bioethics research on moral experiences. (shrink)

Berenicen statim ab urbe dimisit invitus invitam.As for Berenice, he immediately dismissed her from the city against his will, against her will. Suetonius' laconic description of Titus' dismissal of his consort, the Herodian Berenice, after his accession to the Principate has attracted the attention of readers across the centuries. The biographer's use of polyptoton, invitus invitam, to describe the mental states of the Roman princeps and Judaean princess has been read as particularly moving. Perhaps most notably, Racine turned the (...) emperor's banishment of his lover into the central dilemma of his tragedy Bérénice. At the start of his preface to the text of the play, the dramatist amalgamates this sentence with another from earlier in the chapter, retaining the striking repetition, ‘Titus reginam Berenicen cui etiam nuptias pollicitus ferebatur, statim ab Urbe dimisit invitus invitam’. Racine claims that this account of the dismissal of Berenice provides appropriate subject matter for tragic poetry and, to support his case, he compares Virgil's treatment of the separation of Aeneas and Dido to the situation of Titus and Berenice. Suetonius is not normally read as a literarily sophisticated writer, but we should take a cue from Racine's response to this sentence. In this article, I argue that Suetonius himself chose to compare Titus and Berenice with Dido and Aeneas by an allusion in this sentence to Virgil's Aeneid and to Catullus' translation of the Coma Berenices. Within a rather matter-of-fact presentation of the relationship between the Flavian emperor and his Herodian consort, Suetonius evoked a more dramatic model. (shrink)

La crise écologique planétaire a des racines philosophiques fortes : elle questionne nos habitudes, notre modèle de société, mais également notre système de croyances et nos représentations du monde. Comprendre les enjeux profonds de cette crise nous plonge dans l'histoire de nos représentations de la nature et de l'humain. À l'attentisme ambiant, l'auteure oppose l'élaboration collective d'un nouveau sol écophilosophique qui serve d'humus pour l'émergence d'une civilisation "soutenable".

Qu’est-ce qu’une spécialiste de la philosophie grecque peut bien avoir à transmettre à un auditoire de 500 juristes débutant(e)s? Le plaisir de penser, dans la rigueur et l’audace. Le goût foncièrement démocratique pour le débat, c’est-à-dire la nécessité de confronter sa pensée à celle d’autrui, fût-elle sous-tendue par une raison contradictoire. Comment faire? Plutôt qu’un parcours classique dans l’histoire de la philosophie, l’auteur a choisi de construire le cheminement d’une enquête en deux étapes. La première, placée sous le signe d’Oedipe, (...) interroge l’énigme de l’humain. Elle fera voyager de la description poétique de l’homme comme mortel éphémère chez Homère à l’être-vers la- mort selon Heidegger, de la définition de l’homme comme animal rationnel d’Aristote à son retournement en animal fou par Castoriadis. La seconde étape prolongera ce questionnement en l’axant sur le collectif. Elle portera sur l’invention de la politique : de la cité grecque à l’État moderne, comment les sociétés humaines se sont-elles organisées? Qu’ont-elles institué comme fondement à leur communauté? Une grande attention sera également accordée à l’étude de philosophes contemporains, qui, en se fondant sur la discussion des penseurs grecs et modernes, ont proposé de nouvelles manières de penser la démocratie, la liberté et le pouvoir, les formes de vie et les types humains, les actions et les passions propres au politique. Plongeant dans les racines du passé pour mieux comprendre le présent et inventer le futur, cet ouvrage intéressera en réalité toutes les personnes désireuses de s’engager dans une réflexion citoyenne. (shrink)

Les cinq penseurs présentés ici par Patrick Chastenet partagent le même amour de la liberté et de la nature. Trois se réclament de l'anarchisme, deux en sont proches, tous ont profondément enrichi le terreau libertaire de l'écologie politique. L'auteur s'est lié d'amitié avec Jacques Ellul, dont il est un spécialiste reconnu. Il a sympathisé avec Ivan Illich et Bernard Charbonneau avant de découvrir les oeuvres d'Élisée Reclus et de Murray Bookchin. Son livre, rigoureux et vivant, nous introduit aux pensées de (...) ces précurseurs encore trop méconnues mais dont l'actualité n'a pas fini de nous étonner"--Page 4 of cover. (shrink)

L’Ésotérisme shi‘ite: Ses racines et ses prolongements / Shi‘i Esotericism: Its Roots and Developments. Edited by M. A. Amir-Moezzi, M. de Cillis, D. de Smet, and O. Mir-Kasimov. Bibliothèque de l’École des Hautes Etudes, sciences religieuses, vol. 177. Turnhout, Belgium: Brepols, 2016. Pp. v + 870. €95.

À plusieurs reprises, Heidegger a présenté sa pensée comme inachevée et seulement préparatoire. Comme le signale l'exergue même de la Gesamtausgabe - "Des chemins, pas des oeuvres", il s'agit d'un cheminement et non pas d'une oeuvre aboutie. Or, Heidegger nous invite, semble-t-il, bel et bien par là, à essayer de prolonger sa démarche et finalement à tenter de le comprendre mieux qu'il ne s'est compris lui-même. Ce bref essai, qui s'efforce de mettre en relation sa pensée, non seulement avec celle (...) de Kant, mais aussi avec celles de Bataille et de Lacan, afin que les unes soient éclairées par les autres, tente d'accomplir, précisément, cette démarche périlleuse qui consiste à essayer de comprendre la philosophie heideggérienne en dépassant sa lettre et en montrant qu'on peut ainsi parfois la "traduire" dans un autre langage que le sien (ce qui permettrait d'en finir avec le "jargon heideggérien"). Ainsi éclairée par cette intersection entre sa propre démarche et celles des trois auteurs convoqués dans cet essai, la pensée heideggérienne permettra alors de comprendre, de manière renouvelée et novatrice, le sens ontologique secret de l'existence humaine en tant qu'elle a affaire avec ce que Lacan a nommé la jouissance comme ouverture à la "Chose". Par là, on le verra, la signification de notre histoire occidentale, qui débouche sur le règne de la technique planétaire, apparaîtra sous un jour tout à fait nouveau."--Page 4 of cover. (shrink)

Pour rendre compte de la première démonstration d’existence d’une grandeur irrationnelle, les historiens des sciences et les commentateurs d’Aristote se réfèrent aux textes sur l’incommensurabilité de la diagonale qui se trouvent dans les Premiers Analytiques, les plus anciens sur la question. Les preuves usuelles proposées dérivent d’un même modèle qui se trouve à la fin du livre X des Éléments d’Euclide. Le problème est que ses conclusions, passant par la représentation des fractions comme rapport de deux entiers premiers entre eux, (...) i.e. la proposition VII.22 des Éléments, ne correspondent pas aux écrits aristotéli­ciens. Dans cet article, nous proposons une nouvelle démonstration, conforme aux textes des Analytiques, fondés sur des résultats très anciens de la théorie du pair et de l’impair. Ne passant pas par la proposition VII.22, ni par aucune autre propriété établie par l’absurde, cette irrationalité apparaît comme le premier résultat que l’on ne pouvait établir par une autre méthode. L’importance de ce résultat, révélant un nouveau domaine mathématique, celui des grandeurs irrationnelles, rend compte de la centralité que cette forme de raisonnement acquiert alors, d’abord en mathématique, puis dans tout type de discours rationnel. À partir des conséquences qui suivent de cette nouvelle démonstration, on peut interpréter très simplement la leçon sur les irrationnels du passage mathématique figurant dans le Théétète de Platon (147d-148b), ce que nous ferons dans un article à paraître dans un prochain numéro. (shrink)

In Essai sur le don (Essay on Gifts), a work that the author himself noted was only indicative and incomplete, Marcel Mauss recommended in his conclusions on general sociology and morality that the analysis should be taken further and future research should focus on certain cultural areas that he had not been able to take into account: Micronesia, Indochina, Tibet, Burma, and North Africa, among others. And he stressed the existence, among the Berbers, of “remarkable practices of taoussa,” the study (...) of which, he said, had been the business of Doutté and Maunier (Mauss 1968b: 274, n. 1). (shrink)

What is the difference between the earthly paradise, the Golden Age and the ideal city? This question is most important for whoever is interested in the various ways human societies have had for imagining an ideal state of perfection or social harmony. If we are not to confuse such different systems of representation as mythical thought, millenarianism and Utopia, it is absolutely necessary that we do not reduce the descriptions of an earthly paradise and a Golden Age to simple precursors (...) of the ideal city of the Utopians. It is especially important not to call “Utopian” every representation of the ideal society, Utopia being only one— and the most, recent—of its modalities. The Utopian dream Translated by Jeanne Ferguson takes up and at the same time alters the paradisiacal and millenarian imagination: it would be difficult to believe that the passage of primitive societies to great urban civilizations, then to modern society occurred without major repercussions on the vision of these societies, that the ideal state of social perfection did not vary from one to the other. (shrink)

Beyond Clinical Dehumanisation Toward the Other offers a rare and intimate portrayal of the moral process of a mental health clinician that interrogates the intractable problem of systemic dehumanization in community mental health care, and looks to the notion of 'wonder,' and the visionary relational ethics of Emmanuel Levinas, for a possible cure. This book is an ethical primer for mental health professionals, researchers, educators, advocates and service users working to re-imagine and heal a broken system by challenging the underpinnings (...) of entrenched dehumanization and standing with those they "serve". (shrink)

Les auteurs de cet essai, spécialistes reconnus de l'écologie, reviennent sur le sens de l'écologie, notion cruciale et pourtant sujette à toutes les confusions. Ils retracent avec force et simplicité son origine historique et philosophique afin d'en saisir les enjeux politiques, économiques et urbains dans le monde d'aujourd'hui. Cette mise au point est l'occasion de redéfinir le sens du progrès ou de la modernité, à l'heure où la planète souffre d'une surexploitation de ses ressources par l'Homme. Cet ouvrage critique nous (...) offre l'opportunité de redéfinir la place de l'Homme dans un monde où l'hégémonie d'un anthropocentrisme inconsidéré n'est plus viable. C'est enfin un hymne à la beauté du monde et une revendication : le droit de chacun à préserver ses racines et ses repères. L'écologisme politique doit s'opposer à l'effacement des signes naturels, culturels et historiques qui donnent aux territoires leurs personnalités et les ancrent dans une histoire. L'écologisme ne peut se résumer à une simple tendance : il s'agit d'un humanisme se souciant des générations à venir, qui s'attache à préserver et à transmettre un héritage commun à tous. (shrink)

Que dire à des jeunes de vingt ans pour leur conduite dans ce monde qui part à la dérive? La civilisation s'effondre, les valeurs s'inversent, la culture se rétrécit comme une peau de chagrin, les livres comptent moins que les écrans, l'école n'apprend plus à penser mais à obéir au politiquement correct, la famille explosée, décomposée, recomposée se retrouve souvent composée d'ayants droit égotistes et narcissiques. De nouveaux repères surgissent, qui contredisent les anciens : le racisme revient sous forme de (...) racialisme, la phallocratie sous prétexte de néo-féminisme, l'antisémitisme sous couvert d'antisionisme, le fascisme sous des allures de progressisme, le nihilisme sous les atours de la modernité, l'antispécisme et le transhumanisme passent pour des humanismes alors que l'un et l'autre travaillent à la mort de l'homme, l'écologisme se pare des plumes anticapitalistes bien qu'il soit le navire amiral du capital--il y a de quoi perdre pied. J'ai rédigé une série de lettres à cette jeune génération pour lui raconter les racines culturelles de notre époque : elles ont pour sujet la moraline, le néo-féminisme, le décolonialisme, l'islamo-gauchisme, l'antifascisme, la déresponsabilisation, la créolisation, l'antisémitisme, l'écologisme, l'art contemporain, le transhumanisme, l'antispécisme. L'une d'elles explique en quoi consiste l'art d'être français : d'abord ne pas être dupe, ensuite porter haut l'héritage du libre examen de Montaigne, du rationalisme de Descartes, de l'hédonisme de Rabelais, de l'ironie de Voltaire, de l'esprit de finesse de Marivaux, de la politique de Hugo."--Back cover. (shrink)

Ethics designates a structured process by which important human values and meanings of life are understood and tackled. Therein, the ability to discuss openly and reflect on (aka deliberation) understandings of moral problems, on solutions to these problems, and to explore what a meaningful resolution could amount to is highly valued. However, the indicators of what constitutes a high-quality ethical deliberation remain vague and unclear. This article proposes and develops a pragmatist approach to evaluate the quality of deliberation. Deliberation features (...) three important moments: (1) broadening and deepening the understanding of the situation, (2) envisioning action scenarios, (3) coming to a judgment based on the comparative evaluation of scenarios. In this paper, we propose seven criteria to evaluate ethical deliberations: (1) collaborative diversity, (2) experiential literacy, (3) organization of experiences, (4) reflective capacity to instrumentalize the experiences of others, (5) interactional creativity, (6) openness of agents, (7) quality of the reformulation of scenarios. These criteria are explained and applied to the three moments of deliberation. Based on these criteria, three kinds of outcomes for deliberations are identified and discussed: good ethical deliberations, partial ethical deliberations, bad ethical deliberations. Our proposal will guide researchers and practitioners interested in the evaluation of the quality of ethical deliberations. It provides a reference tool that allows them to identify the possible limitations of a deliberation and to implement actions aimed at correcting these limitations in order to achieve the desired qualitative objectives. (shrink)

Direct-to-consumer advertising of healthcare products refers to a variety of marketing practices based on a combination of information and promotion strategies directed at consumers through different media such as radio and television broadcasts, newspaper and magazine ads, and, more recently, through the Internet. The principal form of marketing used by the pharmaceutical industry is the distribution of free samples to physicians but DTCA is an increasing part of global promotional spending for prescription drugs. Latest estimates suggest that DTCA now represents (...) an annual $3.2 billion enterprise for the U.S. pharmaceutical industry. Findings from the literature show that these substantial efforts are geared toward the newer pharmaceuticals for chronic conditions with huge market potentials. The lion's share is going to the 20 most prescribed pharmaceuticals. (shrink)

Walter Benjamin est le penseur de la reproductibilité technique au XXe siècle, et il nous a donné de nombreuses pistes de lecture pour comprendre ce que la technique fait et défait dans nos sociétés industrielles fondées sur l'exploitation de l'autre. Déclin de l'aura, disparition de l'original, exposition généralisée, vulgarisation, performance, émergence de la star et du dictateur, choc, contrôle des masses et émancipation, il nous laisse un précieux viatique de fragments, célèbres ou méconnus, qui nous permettent de poser cette question (...) : Comment appréhender le monde digital qui est en train de révolutionner notre siècle? Dans cet essai, nous faisons l'hypothèse, soufflée par Benjamin lui-même, que nombre de ses intuitions fulgurantes, suscitées par l'essor de la photographie et l'irruption du cinéma, puis de la radio, sont restées en sommeil à son époque, et se réveillent maintenant à la faveur de l'irruption du monde digital. La logique de l'accessibilité mondiale prend racine dans le monde de la reproductibilité mécanique et en révèle le sens. De la même façon que le philosophe a pris au sérieux la technique de la radiodiffusion, au point de devenir lui-même réalisateur d'émissions à la fin des années 20, nous proposons de relire ses textes à l'aune d'une observation matérialiste du monde numérique, où chaque lecteur est en train de devenir auteur et producteur, témoin de sa propre existence en voie de dédoublement."--Page 4 of cover. (shrink)

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of (...) carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point - even a backbone - for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge. (shrink)

Brain-Computer Interface is a set of technologies that are of increasing interest to researchers. BCI has been proposed as assistive technology for individuals who are non-communicative or paralyzed, such as those with amyotrophic lateral sclerosis or spinal cord injury. The technology has also been suggested for enhancement and entertainment uses, and there are companies currently marketing BCI devices for those purposes as well as health-related purposes. The unprecedented direct connection created by BCI between human brains and computer hardware raises various (...) ethical, social, and legal challenges that merit further examination and discussion. To identify and characterize the key issues associated with BCI use, we performed a scoping review of biomedical ethics literature, analyzing the ethics concerns cited across multiple disciplines, including philosophy and medicine. Based on this investigation, we report that BCI research and its potential translation to therapeutic intervention generate significant ethical, legal, and social concerns, notably with regards to personhood, stigma, autonomy, privacy, research ethics, safety, responsibility, and justice. Our review of the literature determined, furthermore, that while these issues have been enumerated extensively, few concrete recommendations have been expressed. We conclude that future research should focus on remedying a lack of practical solutions to the ethical challenges of BCI, alongside the collection of empirical data on the perspectives of the public, BCI users, and BCI researchers. (shrink)

In the debate on the ethics of the non-medical use of pharmaceuticals for cognitive performance enhancement in healthy individuals there is a clear division between those who view “cognitive enhancement” as ethically unproblematic and those who see such practices as fraught with ethical problems. Yet another, more subtle issue, relates to the relevance and quality of the contribution of scholarly bioethics to this debate. More specifically, how have various forms of speculation, anticipatory ethics, and methods to predict scientific trends and (...) societal responses augmented or diminished this contribution? In this paper, we use the discussion of the ethics of cognitive enhancement to explore the positive and negative contribution of speculation in bioethics scholarship. First, we review and discuss how speculation has relied on different sets of assumptions regarding the non-medical use of stimulants, namely: terminology and framing; scientific aspects such as efficacy and safety; estimates of prevalence and consequent normalization; and the need for normative reflection and regulatory guidelines. Second, three methodological guideposts are proposed to alleviate some of the pitfalls of speculation: acknowledge assumptions more explicitly and identify the value attributed to assumptions; validate assumptions with interdisciplinary literature; and adopt a broad perspective to promote more comprehensive reflection. We conclude that, through the examination of the controversy about cognitive enhancement, we can employ these methodological guideposts to enhance the value of contributions from bioethics and minimize potential epistemic and practical pitfalls in this case and perhaps in other areas of bioethical debate. (shrink)

The prospects of enhancing cognitive or motor functions using neuroscience in otherwise healthy individuals has attracted considerable attention and interest in neuroethics (Farah et al., Nature Reviews Neuroscience 5:421–425, 2004; Glannon Journal of Medical Ethics 32:74–78, 2006). The use of stimulants is one of the areas which has propelled the discussion on the potential for neuroscience to yield cognition-enhancing products. However, we have found in our review of the literature that the paradigms used to discuss the non-medical use of stimulant (...) drugs prescribed for attention deficit/hyperactivity disorder (ADHD) vary considerably. In this brief communication, we identify three common paradigms—prescription drug abuse, cognitive enhancement, and lifestyle use of pharmaceuticals—and briefly highlight how divergences between paradigms create important “ethics blind spots”. (shrink)