Off-label prescribing is an integral part of contemporary medicine. Many patients benefit when they receive drugs or devices under circumstances not specified on the label approved by the Food and Drug Administration. An off-label use may provide the best available intervention for a patient, as well as the standard of care for a particular health problem. In oncology, pediatrics, geriatrics, obstetrics, and other practice areas, patient care could not proceed without off-label prescribing. When scientific and medical (...) evidence justify off-label uses, physicians promote patients’ interests by prescribing products off label.Off-label prescribing can also harm patients, however. The potential for harm is greatest when an offlabel use lacks a solid evidentiary basis. A 2006 study examining prescribing practices for 169 commonly prescribed drugs found high rates of off-label use with little or no scientific support. Researchers examining off-label use in U.S. children’s hospitals concluded, “[W]e still have incomplete knowledge about the safety and efficacy of many medications commonly used to treat children across a range of drug classes and clinical diagnoses.”. (shrink)

Under current U.S. law, physicians may prescribe drugs and devices in situations not covered on the label approved by the Food and Drug Administration. Those supporting this system say that requiring FDA approval for off-label uses would unnecessarily impede the delivery of benefits to patients. Patients do benefit from off-label prescribing that is supported by sound scientific and medical evidence. In the absence of such evidence, however, off-label prescribing can expose patients to risky and ineffective treatments. (...) The medical community and federal authorities should more actively promote patients' interests in receiving beneficial off-label treatments. To exercise responsible self-regulation, members of the medical community must determine whether available evidence justifies specific off-label uses and must promote information-gathering when the evidence is inadequate. Physicians should also discuss with patients the uncertainties accompanying off-label uses. Federal authorities should more closely monitor the effects of off-label prescribing and adopt other measures to reduce harm and enhance benefits produced by off-label prescribing. (shrink)

Can Covid-19 vaccines be used off-label? Should they be? These were questions on the minds of parents, pediatricians, and the media when the FDA fully approved the Pfizer-BioNTech Covid-19 vaccine for people aged 16 and up. Yet the American Academy of Pediatrics cautioned against pediatric off-label use of the vaccine, and the CDC Covid-19 Vaccine Provider Agreement appears to prohibit it. After briefly contextualizing ethical and legal precedents regarding off-label use, we offer an analysis of the ethical (...) permissibility of and considerations for pediatric off-label Covid-19 vaccination based on individual benefits, risks, and available alternatives. Our analysis challenges the ethics of a blanket prohibition on off-label pediatric Covid-19 vaccination, as it limits clinician ability to provide care they may determine to be clinically and ethically appropriate. At the same time, our analysis acknowledges that Covid-19 creates population-level ethical considerations that are at times in tension with individual health interests. (shrink)

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in (...) patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)

We argue that the universal recommendations against “off-label” pediatric use of approved COVID-19 issued by the FDA, CDC, and AAP are overbroad. Especially for higher-risk children, vaccination can be ethically justified even before FDA authorization or approval – and similar reasoning is relevant for even younger patients. Legal risks can also be managed, although the FDA, CDC, and Department of Health and Human Services (HHS) should move quickly to provide clarity.

The term “off-label drug use” refers to drugs that have not yet acquired “approved” status or drugs that have acquired “approved” status but are used with a different dosage, route, or administration method other than that for which the drug has been approved. In New Zealand, the Medicines Act 1981 specifically allows for off-label drug use. However, this authority is limited by the Health and Disability Commissioner Regulations 1996 and the common law, which require that off-label drug (...) use is of an acceptable standard, that the patient should be fully informed, and that the patient should give informed consent. Off-label drug use is an important issue because the current law provides medical practitioners very wide discretionary power, without providing clarification for what is required of the practitioner in exercising his or her discretion in prescribing off-label. This paper discusses possible solutions to this issue, for example, establishing protocol for off-label use, an electronic database of off-label use, and the amendment of legal provisions. (shrink)

Anti-vascular endothelial growth factor therapy has revolutionised the treatment of a variety of ophthalmic conditions and has become the first-line therapy for a range of retinal diseases. Bevacizumab, a VEGF inhibitor first approved for the treatment of colorectal cancer, has been shown to be nearly or virtually as effective and safe as other anti-VEGF therapies in the treatment of certain retinal diseases but is not approved or registered by the Food and Drug Administration or European Medicines Agency. While other anti-VEGF (...) options are approved and registered, they are generally more expensive and less accessible. Accordingly, despite its off-label status, bevacizumab is frequently used for a variety of disabling retinal diseases. Indeed, bevacizumab is included on the World Health Organization’s list of essential medicines. However, its use in some parts of the world remains restricted due to its off-label status. How, then, should healthcare authorities approach this situation? What are the ethical and societal implications of adhering to a standard and generally effective evaluation and approval system while restricting access to a potentially cost-saving therapy? In countries where its use is not restricted, how should providers approach off-label treatment with bevacizumab? By examining the evidence behind bevacizumab’s efficacy and safety and evaluating the individual and societal implications of off-label use and restriction, this paper illustrates the ethical factors providers and policy makers must consider in the off-label use of bevacizumab and ultimately argues for increased access to bevacizumab in the treatment of retinal disease. (shrink)

Although there are exceptions, the principle of primum nil nocere remains the cornerstone of the practice of medicine. In the well known handbook, Goodman and Gilman’s The Pharmacological Basis of Therapeutics1 a case is presented which raises doubts about the permissibility of off-label administration of certain drugs to healthy troops as a preventive measure. The following citation from this handbook gives a clear description of the problem:"Prophylaxis in cholinesterase inhibitor poisoning. Studies in experimental animals have shown that pretreatment with (...) pyridostigmine reduces the incapacitation and mortality associated with “nerve agent” poisoning, particularly for agents, such as soman, that … ". (shrink)

In the United States, while it is legal for physicians to prescribe drugs for “off-label” indications (uses for which the drugs do not have Food and Drug Administration approval), it is largely—though not entirely—illegal for drug manufacturers to promote off-label uses of their drugs to physicians. In recent months, the rules against off-label marketing have been rigorously enforced: in October, Allergan reached a $375 million settlement over off-label promotion of Botox; in September, Novartis settled an off- (...) class='Hi'>label marketing dispute for $422.5 million, and Forest Laboratories settled one for $313 million. These were only the latest in a series of criminal and civil settlements on off-label promotion, the most .. (shrink)

Unter Off-Label-Use versteht man den zulassungsüberschreitenden Einsatz eines Arzneimittels außerhalb der von Zulassungsbehörden genehmigten Anwendungsgebiete. Er ist in der medizinischen Praxis weit verbreitet und fächerübergreifend zu beobachten. Der Beitrag gibt eine Einschätzung der Off-Label-Anwendung aus ethischer Sicht. Dazu wird die Off- Label-Anwendung zunächst von anderen, sachlich verwandten Anwendungsweisen abgegrenzt. Danach wird über die aktuelle Verbreitung des Off-Label- Use informiert. Sodann wird gezeigt, dass sich bekannte Problemlagen aus der Medizinethik bei der Off-Label-Anwendung in spezifischer Weise verschärfen. (...) Schließlich wird diskutiert, wie eine ethisch akzeptable Off-Label-Anwendung von Arzneimitteln ausgestaltet werden könnte und auf welchen Ebenen sie ansetzen müsste. (shrink)

We wish to point out an additional consequence of the Catch-22 described by Andreae and colleagues (Andreae et al. 2016). The decades-long research gridlock of controlled drugs has unintentionally...

Volume 19, Issue 6, June 2019, Page 22-25.

The Food and Drug Administration authorizes the marketing of a drug only for uses that the manufacturer has demonstrated to be safe and effective, based on evidence from at least two clinical trials. However, the FDA does not regulate the practice of medicine, so physicians may prescribe drugs in any manner they choose. Prescribing drugs in ways that deviate from the uses specified in the FDA-approved drug label, package insert, and marketing authorization is referred to as off-label prescribing. (...) This occurs when physicians prescribe a drug for a therapeutic purpose other than the one approved by the FDA; treat patients in a different age cohort or gender than the population on which it was tested; or prescribe a different dose, for a different duration of use, or a different mode of administration than indicated on the label. (shrink)

Prescribing drugs for uses that the FDA has not approved — off-label drug use — can sometimes be justified but is typically not supported by substantial evidence of effectiveness. At the root of inappropriate off-label drug use lie perverse incentives for pharmaceutical firms and flawed oversight of prescribing physicians. Typical reform proposals such as increased sanctions for manufacturers might reduce the incidence of unjustified off-label use, but they do not remove the source of the problem. Public policy (...) should address the cause and control the practice. To manage inappropriate off-label drug use, off-label prescriptions must be tracked in order to monitor the risks and benefits and the manufacturers’ conduct. Even more important, reimbursement rules should be changed so that manufacturers cannot profit from off-label sales. When off-label sales pass a critical threshold, manufacturers should also be required to pay for independent testing of the safety and effectiveness of off-label drug uses and for the FDA to review the evidence. Manufacturers should also finance, under FDA supervision, programs designed to warn physicians and the public about the risks of off-label drug use. (shrink)

Previous research conducted in 1999 highlighted ethical concerns behind challenge studies inducing psychosis with ketamine and made recommendations to enhance ethical standards. Recently, a plethora of clinical trials have evaluated the efficacy of ketamine to treat mood disorders, which lead to complex ethical issues. Pharmaceutical companies and researchers hope to profit by developing patentable variations on ketamine for treating depression. Media have labeled ketamine as a “miracle” antidepressant. Some clinics offer expensive off-label use of ketamine to treat mood disorders. (...) This article examines the ecological validity of ketamine trials, measures to protect patients, informed consent procedures, financial inducements to participants and conflict of interest of researchers, therapeutic misconception, concealment, and deception. Further recommendations are purposed to improve ethical standard of clinical research involving ketamine. (shrink)

Coronavirus disease 2019 is a fast-developing viral pandemic spreading across the globe. Due to lack of availability of proven medicines against COVID-19, physicians have resorted to treatments through large trials of investigational drugs with poor evidence or those used for similar diseases. Large trials randomize 100–500+ patients at multiple hospitals in different countries to either receive these drugs or standard treatment. In order to expedite the process, some regulatory agencies had also given permission to use drugs approved for other diseases, (...) despite a lack of evidence of efficacy in COVID-19. In this review, we highlight the potential ethical issues that should be addressed during the use of investigational drugs with little prior evidence as a treatment options during a pandemic. We discuss the impact of design of randomized clinical trials using LOTUS trial as an example and that of off-label use of drugs like chloroquine/hydroxychloroquine on the safety of patients during COVID-19. We conclude that the adaptive randomized clinical trial designs offer a flexible and efficient approach, enabling patients to quickly switch to successful treatments, while minimizing the number of patients on standard of care. Randomized clinical trial design should consider blinding of investigators and only representative patients who can provide consent should be included. We also conclude the emergency approvals of drugs should be carefully issued and off-label use should be restricted in pandemics. Streamlined regulatory guidelines for emergency drug use in a pandemic can also help in providing benefit and minimizing harm to patients in the future. (shrink)

People have a love/hate relationship with rapidly changing healthcare technology. While consumer demand for medical apps continues to grow as rapidly as does supply, healthcare professionals and safety experts worry about the impact of these apps on the health consumer. In response to the rapidly growing mobile healthcare sector, the Food and Drug Administration has put forth guidelines to regulate ‘mobile medical apps’, those health-related apps that are designated as medical devices. In this article, I argue that this decision, to (...) only regulate apps that bill themselves as medical devices, will create a market for ‘off-label’ app use. Further, I will talk about the oft used analogy between off-label apps and off-label pharmaceuticals, showing that off-labeling apps will provide patients none of the benefits that come with a physician prescribing a drug off-label, while exposing the mobile healthcare consumer to significant risks that go significantly beyond those that we know of from prescription drugs. Recognizing that the Food and Drug Administration is not going to be able to significantly change its policies on oversight, I will suggest specific actions to at least mitigate some of the risks associated with off-label app use. (shrink)

It is generally assumed that the debate between theory‐theory and simulation theory is an empirical one, but this view of the structure of the debate is misleading. It is an a priori truth that theory‐theory is mistaken and equally a priori that simulation in one sense (here labelled ‘co‐cognition’) is central in thinking about the thoughts of others. Given this, it is a further question how our co‐cognitive powers are realized in sub‐personal machinery. Here simulation in quite another sense (that (...) involving such ideas as ‘pretend states’ and ‘off‐line’ mental processes) may provide one possible answer. (shrink)

In this article I offer an account and analysis of several patterns of valuation of the cardinal directions in medieval Scandinavian texts. While my topic is not altogether novel—ideas about space, along with those of time, have been matters of widespread and perennial concern to scholars of culture and religion, and those interested in the Norse context have proven no exception—I seek to go beyond previous examinations in several ways. First, many of the scholars who have focused on directionality in (...) Old Norse sources have been concerned with catalogu-ing and elucidating terminology for the cardinal points and for movement along and between them, with a particular emphasis on assessing the “correctness” of such terms' application in respect to ultimate or relative orientation. While I draw on the insights of such studies, my interests lie less in efforts to map or to describe movement in the real world known to medieval Scandinavians than in the values that they can be shown to have attached to the cardinal directions. My focus, therefore, is on imagined or moral as opposed to physical or topographical space. Of the studies that have taken a similar interest in Norse ideas about space, most have focused mainly or exclusively on the attempt, often from a structuralist perspective, to reconstruct from available sources pagan cosmography, to discover or assemble a systematic summa of the pre-Christian Norse mythical Weltbild. While pre-Christian ideas, or their traces, are also a focus of my article, I pay more than equal attention to conceptualizations and valuations of space held by Christian northerners. “Mythical,” then, is not a label that I reserve for heathen or patently fantastic materials but one under which I also subsume data from Christian and historiographical sources. (shrink)

In this commentary, I explore the ethically relevant dimensions of menu labelling. The evidence that menu labelling changes purchasing or consumption behaviour is contentious and inconclusive; there is some suggestion that menu labelling may preferentially influence the behaviour of healthier and wealthier citizens. Some suggest that menu labelling is unjust, as it fails to direct resources towards those who most need them. An alternative is to see menu labels as just one of a set of strategies that can increase people’s (...) real opportunities to be healthy. Complementing strategies will be necessary to ensure that all citizens can consider and value food choices, which may include becoming a more critical consumer in the food marketplace. Menu labels may also have the potential to shift our attention from people to food, reallocate responsibility in the food environment and facilitate structural change. It would be a mistake to expect too much of menu labels alone: rather, they should be integrated into a broader programme that supports health opportunities, especially for the least well off. (shrink)

Growing supermarket dominance and the expansion of own-label market share in Australia has put considerable pressure on agri-food manufacturers, and the recent movement of a number of manufacturing operations off-shore has attracted widespread attention. This paper examines the pursuit of an international manufacturing base by SPC Ardmona, one of Australia’s major fruit and vegetable processors, with a focus on strategic alliances formed with Siam Foods in Thailand and Rhodes Food Group in South Africa/Swaziland. Strategic horizontal alliances have become increasingly (...) important for manufacturers seeking to counter retailer dominance, yet have received little attention in the agri-food literature. The two alliances examined in this paper illustrate the profound importance of prevailing societal and institutional environments in which production networks ‘touch-down’, and their influence on firm-level dynamics of trust, motivation, corporate values, and strategic objectives. Horizontal alliances can offer a promising alternative to cut-throat competition and a ‘race- to-the-bottom’ between agri-food manufacturers. However, with own-label sourcing strategies deepening competition between geographically-disparate manufacturers, identifying compatible alliance partners is likely to become an increasingly greater challenge. (shrink)

Luck egalitarians need to address the question of cost-responsibility: If an individual is responsible for being worse off than others, then what benefits, if any, is that individual uniquely cost-responsible for? By applying luck egalitarianism to justice in health I discuss different answers to this question inspired by two different interpretations of luck egalitarianism, namely ‘standard luck egalitarianism’ and ‘all luck egalitarianism’, respectively. Even though I argue that the latter is more plausible than the former, I ultimately suggest and defend (...) a third interpretation of luck egalitarianism, which I label ‘universal luck egalitarianism’. Finally, I adjust my findings to a (all things considered) more plausible currency, namely welfare. (shrink)

Il y a un peu plus de vingt ans, Marcel Gauchet livrait ses réflexions sur le long et lent processus de désenchantement du monde qui, de l’intérieur même de la compréhension religieuse du monde, a abouti à l’affirmation de l’autonomie humaine et à la prise en main par les hommes de leur destin collectif. Cette thèse a fait l’objet de nombreuses discussions et controverses qui portaient sur la validité de la reconstruction historique générale, sur la méthode guidant cette dernière, et (...) enfin sur la vérité du diagnostic final. Ces questions ont leur intérêt et ont été déjà vivement débattues. Ce livre sur et à partir de la pensée de Gauchet sera toutefois différemment orienté. Il porte davantage sur les effets du désenchantement sur la démocratie elle-même que sur l’origine du désenchantement du monde. Il semble en effet que la démocratie contemporaine, en gros la démocratie des individus et des identités, subisse à son tour les effets du désenchantement et qu’elle tende à devenir une démocratie "contre elle-même". C’est du moins dans ce sens que l’on pourrait lire les ouvrages plus récents de Gauchet, La religion dans la démocratie (1998), La démocratie contre elle-même (2002) et La condition politique (2007). L’avènement de cette démocratie désenchantée ouvre tout un ensemble d’interrogations qui seront au coeur de cet ouvrage : un tel diagnostic est-il juste? Jusqu’à quel point la démocratie peut-elle se retourner contre elle-même? Un régime politique qui effacerait toute trace de croyable est-il possible? Comment la démocratie doit-elle réagir devant les tentatives idéologiques de réenchantement du monde? Quelles seraient les ressources internes à la démocratie pour corriger les excès provoqués par son propre désenchantement? (shrink)

Authored by leading sound studies scholar Brandon LaBelle, this book focuses on questions of acoustics as the basis for challenging normative structures.

This study investigates the engagement of family firms in corporate social responsibility. We first compare their corporate social performance to non-family firms. Then, following recent evidence on the heterogeneity of family firms, we examine two factors that may influence CSP within family firms: the level of family control and the governance orientation of the country in which they operate. This research is based on a theoretical framework which considers both agency and socioemotional wealth influences on family firms CSR engagements. Overall, (...) we find that family firms exhibit lower CSP than non-family firms. But when focusing on family firms, our analyses show a curvilinear relationship between family control and CSP. At lower levels of control, family owners invest more in social initiatives to protect their SEW. Beyond a threshold level of control that we estimate at 36 % in our sample, economic considerations prevail over SEW and social performance starts decreasing. We also find that family firms operating in stakeholder-oriented countries are more attentive to social concerns than those operating in more shareholder-oriented countries. (shrink)

This article proposes and empirically tests a theoretical framework incorporating Reidenbach and Robin’s (J Bus Ethics 10(4):273–284, 1991 ) conceptual model of corporate moral development. The framework is used to examine the relation between governance and business ethics, as proxied by diversity management (DM), and financial reporting quality, as proxied by the magnitude of earnings management (EM). The level of DM and governance quality are measured in accordance with the ratings of Jantzi Research (JR), a leading provider of social and (...) governance research for institutional investors. This DM score is part of an index developed by JR that investment managers use to integrate DM criteria into their investment decisions. As expected, a negative relation between corporate DM development and financial reporting quality is found while controlling for other factors known in the literatures on governance and accounting choices to affect earnings quality. Despite some caveats presented in conclusion, this study contributes to the ethics, governance, and financial reporting literatures by studying the dynamics between governance and ethics in the prevention of EM. (shrink)

Contradictions of the Welfare State is the first collection of Offe's essays to appear in a single volume in English, and it contains a selection of his most important recent work on the breakdown of the post-war settlement.

Should the Western democracies, contrary to their prevailing self-image as "planned" and "managed," be seen as highly disorganized systems of social power and political authority? If so, what are the symptoms, consequences of, and possible remedies for these disorganizing tendencies?In these ten essays, Claus Offe seeks to answer such questions. Moving beyond the boundaries of both Marxism and established forms of political sociology, he focuses on the growth of serious divisions within the work force, the importance of the "informal" sector, (...) the severe difficulties faced by trade unions in coping with the present economic crisis, the vulnerability of neocorporatist mechanisms, and the failures of state policymaking based on either majority rule or bureaucratic administration.In examining these and other fundamental problems of advanced capitalist democracies, Offe also contests some widely held assumptions of contemporary social science. He calls into question the neutrality of liberal democratic mechanisms of participation and representation, the centrality of the category of work and the division between labor and capital, and the feasibility and desirability of full employment.Claus Offe is the author of numerous books and essays, including Contradictions of the Welfare State. He is currently Professor of Political Science and Sociology in the Faculty of Sociology, University of Bielefeld, West Germany. John Keane is Senior Lecturer in Political Theory and Sociology at the Polytechnic of Central London. Disorganized Capitalism is included in the series, Studies in Contemporary German Social Thought, edited by Thomas McCarthy. (shrink)

In this paper I examine two theories of democracy that can be found in contemporary French philosophy. Both Cornelius Castoriadis and Jacques Rancière offer a critique of modern democracy with the purpose of refounding it. The ‘refoundation narratives’ they propose are both based on an account of the origins of democracy in ancient Greece. According to Castoriadis, ancient democracy is grounded in a ‘magma’ of ‘social imaginary significations’ in which ‘autonomy’ is considered the correct response to Being defined as an (...) insurmountable ‘Chaos’. On the contrary, modern democracy defines Being as a determinacy and consequently fails to grasp the notion of autonomy. According to Rancière, the origins of democracy are to be found in the invasion of the public space by ‘those without a part’ who consequently have no title to govern. The problem with the ‘domesticated’ modern democracy is that it denies the existence of Otherness; that is, of non-citizens excluded from the public space. Therefore it appears incapable of letting the ‘dis-agreement’ manifest itself and consequently incapable of transforming the ‘police’ order. After examining the meaning of both theories, I attempt to elucidate the difficulties encountered by each author in the attainment of his goal, which is that of refounding modern democracy. (shrink)

The book proposes a multi-dimensional understanding on sound and listening as capacities for challenging social and political structures of inequality and domination, supporting interpersonal exchange and modes of community-building based on empathy, care and compassion.

Modernity and the State, a dozen essays written over thelast decade, develops his earlier lines of interest and extends them to the new societies emergingin Central-Eastern Europe.Offe frames the essays by suggesting that the key question ...

L’antéposition d’un verbe non conjugué (participe passé, infinitif) en ancien et en moyen français a été assimilée à l’antéposition stylistique de l’islandais. Nous montrons que dans le cas du français, ces antépositions illustrent trois constructions différentes, toutes distinctes de l’antéposition stylistique de l’islandais. Dans la construction la plus fréquente, étiquetée déplacement stylistique à gauche, l’expression antéposée s’insère dans une position interne à la proposition plutôt que dans la périphérie gauche, à la droite immédiate de la position canonique du sujet, qui (...) peut y être réalisé, contrairement à ce que l’on observe en islandais. La même analyse est étendue aux cas où le sujet est nul ou déplacé plus à gauche. Les deux autres cas sont ceux où 1) l’expression antéposée est l’élément initial d’une construction V2, une situation rare, ou 2) il y a mise en relief du verbe non fini à la gauche immédiate de la position canonique du sujet. (shrink)

The paper starts by exploring the negative contingencies that are associated with the core institution of capitalist societies, the labour contract: unemployment, poverty, and denial of autonomy. It argues that these are the three conditions that basic income schemes can help prevent. Next, the three major normative arguments are discussed that are raised by opponents of basic income proposals: the idle should not be rewarded, the prosperous don’t need it, and there are so many things waiting to be done in (...) the world. After demonstrating that proponents of basic income stand in no way empty-handed when facing these objections, a third part considers basic income in functional terms: would its introduction help to resolve problems of social and economic order that are unlikely to be resolved in more conventional ways? (shrink)