Objective: Ethical guidelines are designed to ensure benefits, protection and respect of participants in clinical research. Clinical trials must now be registered on open-access databases and provide details on ethical considerations. This systematic survey aimed to determine the extent to which recently registered clinical trials report the use of standard of care and post-trial obligations in trial registries, and whether trial characteristics vary according to setting. Methods: We selected global randomized trials registered on http://www.clinicaltrials.gov and http://www.controlled-trials.com. We searched for intervention (...) trials of HIV/AIDS, malaria, and tuberculosis from 9 October 2004, the date of the most recent version of the Helsinki Declaration, to 10 April 2007. Results: We collected data from 312 trials. Fifty-eight percent (58%, 95% CI = 53 to 64) of trial protocols report informed consent. Fifty-eight percent (58%, 95% CI = 53 to 64) of trials report active controls. Almost no trials (1%, 95% CI = 0.5 to 3) mention post-trial provisions. Most trials measure surrogate outcomes. Twenty percent (20%, 95% CI = 16 to 25) of trials measure patient-important outcomes, such as death; and the odds that these outcomes are in a low income country are five times greater than for a developed country (odds ratio (OR) 5.03, 95% CI = 2.70 to 9.35, p = < 0.001). Pharmaceutical companies are involved in 28% (CI = 23 to 33) of trials and measure surrogate outcomes more often than nonpharmaceutical companies (OR 2.45, 95% CI = 1.18 to 5.09, p = 0.31). Conclusion: We found a large discrepancy in the quality of reporting and approaches used in trials in developing settings compared to wealthier settings. (shrink)
Health care systems throughout the developed world face ‘crises’ of quality, financing and sustainability. These pressures have led governments to look for more efficient and equitable ways to allocate public resources. Prioritisation of health care services for public funding has been one of the strategies used by decision makers to reconcile growing health care demands with limited resources. Priority setting at the macro level has yet to demonstrate real successes. This paper describes international approaches to explicit prioritisation at the macro-governmental (...) level in the six experiences most published in the English literature; analyzes the ways in which values, principles and other normative concepts were presented in these international priority setting experiences; and identifies key elements of a more robust framework for ethical analysis which could promote meaningful and effective health priority setting. (shrink)
Delivered at the Collège de France between January and March 1980, the lectures entitled On the Government of the Living (Du gouvernement des vivants) seem to be the missing piece in the Foucauldian puzzle. Still unpublished, those eleven lectures were intended to set the theoretical foundation for the book announced as the fourth and last volume of the History of Sexuality, under the title Confessions of the Flesh (Les aveux de la chair). This book, however, was never published, despite the (...) fact that his editor described it as the keystone for the entire History of Sexuality.1 The value of Michel…. (shrink)
I would like to suggest another way to go further toward a new economy of power relations, a way which is more empirical, more directly related to our present situation, and which implies more relations between theory and practice. It consists of taking the forms of resistance against different forms of power as a starting point. To use another metaphor, t consists of using this resistance as a chemical catalyst so as to bring to light power relations, locate their position, (...) and find out their point of application and the methods used. Rather than analyzing power from the point of view of its internal rationality, it consists of analyzing power relations through the antagonism of strategies.[…]Let us come back to the definition of the exercise of power as a way in which certain actions may structure the field of other possible actions. What, therefore, would be proper to a relationship of power is that it be a mode of action upon actions. That is to say, power relations are rooted deep in the social nexus, not reconstituted "above" society as a supplementary structure whose radical effacement one could perhaps dream of. In any case, to live in a society is to live in such a way that action upon other actions is possible-- and in fact ongoing. A society without power relations can only be an abstraction. Which, be it said in passing, makes all the more politically necessary the analysis of power relations in a given society, their historical formation, the source of their strength or fragility, the conditions which are necessary to transform some or to abolish others. For to say that there cannot be a society without power relations is not to say either that those which are established are necessary or, in any case, that power constitutes a fatality at the heart of societies, such that it cannot be undermined. Instead, I would say that the analysis, elaboration, and bringing into question of power relations and the "agonism" between power relations and the instransitivity of freedom is a permanent political task inherent in all social existence.[…]In effect, between a relationship of power and a strategy of struggle there is a reciprocal appeal, a perpetual linking and a perpetual reversal. At every moment the relationship of power may become a confrontation between two adversaries. Equally, the relationship between adversaries in society may, at every moment, give place to the putting into operation of mechanisms of power. The consequence of this instability is the ability to decipher the same events and the same transformations either from inside the history of struggle or from the standpoint of the power relationships. The interpretations which result will not consist of the same elements of meaning or the same links or the same types of intelligibility, although they refer to the same historical fabric, and each of the two analyses must have reference to the other. In fact, it is precisely the disparities between the two readings which make visible those fundamental phenomena of "domination" which are present in a large number of human societies.Michel Foucault has been teaching at the Collège de France since 1970. His works include Madness and Civilization , The Birth of the Clinic , Discipline and Punish , and History of Sexuality , the first volume of a projected five-volume study. (shrink)
This book is the first to provide a sustained, coherent analysis of Foucault's work as a whole. To demonstrate the sense in which Foucault's work is beyond structuralism and hermeneutics, the authors unfold a careful, analytical exposition of his oeuvre. They argue that during the of Foucault's work became a sustained and largely successful effort to develop a new method - "interpretative analytics" - capable of explaining both the logic of structuralism's claim to be an objective science and the apparent (...) validity of the hermeneutical counterclaim that the human sciences can proceed only by understanding the deepest meaning of the subject and his tradition. (shrink)
Like the latter, it unites into one and the same function the possibility of giving things a sign, of representing one thing by another, and the possibility of causing a sign to shift in relation to what it designates. The four functions that define the ...
Marking a major development in Foucault's thinking, this book derives from the lecture course which he gave at the Collège de France between January and April, 1978. Taking as his starting point the notion of "bio-power," introduced in his 1976 course Society Must be Defended , Foucault sets out to study the foundations of this new technology of power over population. Distinct from punitive, disciplinary systems, the mechanisms of power are here finely entwined with the technologies of security, and it (...) is to 18th century developments of these technologies with which the first chapters of the book are concerned. By the fourth lecture however Foucault's attention turns, focusing on a history of "governmentality" from the first centuries of the Christian era to the emergence of the modern nation state. As Michel Sennelart explains in his afterword, the effect of this change of direction is to "shift the center of gravity of the lectures from the question of biopower to that of government, to such an extent that the former almost entirely eclipses the former ..." Consequently, in light of Foucault's later work, it is tempting to see these lectures as the moment of a radical turning point at which the transition to the problematic of the "government of self and others" would begin. (shrink)
Michel Serres is a major twentieth-century thinker who has made decisive contributions to major debates across disciplines ranging from the history of science to literary studies and philosophy. This is the first monograph to offer a comprehensive assessment of Serres’ thought from his early work on Leibniz to his final publications in 2019. The first three chapters carefully explore Serres’ ‘global intuition’, how he understands and engages with the world, and his characteristic ‘figures of thought’, the repeated intellectual moves (...) that characterize his unique approach. Chapters Four to Six explore in detail Serres’ revolutionary contributions to three key areas: language, objects, and ecology. (shrink)
Politics, Philosophy, Culture contains a rich selection of interviews and other writings by the late Michel Foucault. Drawing upon his revolutionary concept of power as well as his critique of the institutions that organize social life, Foucault discusses literature, music, and the power of art while also examining concrete issues such as the Left in contemporary France, the social security system, the penal system, homosexuality, madness, and the Iranian Revolution.
Influential philosopher Michel Serres’s foundational work uses fable to explore how human relations are identical to that of the parasite to the host body. Among Serres’s arguments is that by being pests, minor groups can become major players in public dialogue—creating diversity and complexity vital to human life and thought. Michel Serres is professor in history of science at the Sorbonne, professor of Romance languages at Stanford University, and author of several books, including _Genesis._ Lawrence R. Schehr is (...) professor of French at the University of Illinois, Urbana-Champaign. Cary Wolfe is Bruce and Elizabeth Dunlevie Professor of English at Rice University. His books include _Zoontologies: The Question of the Animal _. (shrink)
An examination of the relation between war and politics, by one of the twentieth century’s most influential thinkers From 1971 until 1984 at the College de France, Michel Foucault gave a series of lectures ranging freely and conversationally over the range of his research. In Society Must Be Defended , Foucault deals with the emergence in the early seventeenth century of a new understanding of war as the permanent basis of all institutions of power, a hidden presence within society (...) that could be deciphered by an historical analysis. Tracing this development, Foucault outlines the genealogy of power and knowledge that had become his dominant concern. (shrink)
The Hermeneutics of the Subject is the third volume in the collection of Michel Foucault's lectures at the College de France, one of the world's most prestigious institutions. Faculty at the college give public lectures, in which they can present works-in-progress on any subject of their choosing. Foucault's were more speculative and free-ranging than the arguments of such groundbreaking works as The History of Sexuality or Madness and Civilization . In the lectures comprising this volume, Foucault focuses upon the (...) ways the "self" and consequently "self-study" have been conceived since the days of antiquity, starting with Socrates. Definitions and conceptions of "self-study" in Greek and Roman literature, Foucault argues, remain in force today, and underlie modern interpretations of the self. Engaging, engrossing, and provocative, The Hermeneutics of the Subject reveals Foucault at the height of his powers. (shrink)
The second volume in an unprecedented publishing event: the complete College de France lectures of one of the most influential thinkers of the last century Michel Foucault remains among the towering intellectual figures of postmodern philosophy. His works on sexuality, madness, the prison, and medicine are classics his example continues to challenge and inspire. From 1971 until his death in 1984, Foucault gave public lectures at the world-famous College de France. These lectures were seminal events. Attended by thousands, they (...) created benchmarks for contemporary critical inquiry. The lectures comprising Abnormal begin by examining the role of psychiatry in modern criminal justice, and its method of categorizing individuals who "resemble their crime before they commit it." Building on the themes of societal self-defense in the first volume of this series, Foucault shows how and why defining "abnormality" and "normality" were prerogatives of power in the nineteenth century, shaping the institutions--from the prison system to the family--meant to deal in particular with “monstrosity,” whether sexual, phsyical, or spiritual. The College de France lectures add immeasurably to our appreciation of Foucault's thought, and offer a unique window on his singular worldview. (shrink)
L'œuvre de Michel Henry aura été de « recueillir » et développer le côté affectif de la phénoménologie, que Husserl, dans un passage clé de ses « Idées directrices », a délaissé au profit du côté intentionnel de la subjectivité - tout comme trois siècles plus tôt Descartes avait « recueilli » la subjectivité écartée par Galitée. Le texte qui suit compare le concept de soubassement, ou âme, chez Husserl avec celui de chair chez Michel Henry. On verra (...) que les deux philosophes parlent d'une couche sensible, qu'on peut d'une certaine manière situer entre corps et esprit, de deux points de vue diamétralement opposés. Au-delà de l'opposition entre les deux philosophies, cette recherche mène à une interprétation topologique du rapport ente corps, âme et esprit, tel que suggéré par le terme husserlien de soubassement, et propose un éclairage différent de la notion henryenne d'auto-affection. (shrink)