Les études sur le corps du siècle des Lumières se sont longtemps appuyées sur les traités de médecine, reprenant ainsi les représentations médicales plutôt que celles des malades. Les écrits ordinaires, parmi lesquels on peut compter les consultations épistolaires, permettent toutefois d’appréhender les perceptions corporelles des femmes du xviiie siècle. Ces lettres, envoyées par les malades à leur médecin, forment de véritables biographies médicales et constituent des sources d’une grande richesse pour explorer les écritures féminines du corps. On peut ainsi (...) mettre en évidence des manières spécifiques d’écrire le corps au féminin tout en soulignant les points communs avec les écritures masculines. (shrink)

L’amour conjugal existe au Moyen Âge, la littérature en est un lieu d’expression privilégié. Visible également dans les sources épistolaires ou notariales, il est cependant plus difficile à aborder à travers les archives judiciaires, notamment les procès matrimoniaux ecclésiastiques. L’officialité de Saragosse au xve siècle est par excellence la cour où sont jugés les litiges conjugaux. Les procès consultés offrent un récit récurrent de la relation conflictuelle entre époux et laissent à penser que l’amour n’y a guère sa place. Ce (...) n’est pas totalement vrai. Les affaires d’adultère, les unions clandestines, les demandes de solennisation de mariage ne sont pas toutes déposées ou dénoncées au seul motif de haine et de discorde. Les sentiments sont parfois bien présents, sous-jacents, et attendent seulement d’être lus à travers des actes, des mots précis (amor, affectio, cavalgar, enamorar) ou même des silences. (shrink)

We have become estranged from the cosmic movements, according to Bataille. We are confined by the error linked to the representation of ‘the stationary earth’. We have negated the immersive immanence of the whole and made nature into a fixed world of tools and things. How then do we recognise ourselves as part of the ‘rapture of the heavens’? Bataille urges us to consider life as a solar phenomenon, the free play of solar energy on the earth. This paper argues (...) how Bataille’s cosmic vision anticipates both planetary and ecological thinking. This entails a base materialism of difference based on a radical Nietzschean and Heraclitean theory of becoming and flux. This thought is developed along Bataillean concepts such as the movement of the whole, the labyrinthine, and compound beings, ipseity, as well as the concept of a communifying movement. This materialism paired with Vladimir Vernadsky’s biosphere lays the foundation for the laws of the general economy, which also constitutes an economy inclusive of a general ecology: a tragic vision of Gaia and Dionysos. Finally, poetry is considered, as a way we might reconnect with the universe and stimulate ecological imagination. (shrink)

In order to maximize human performance, defence forces continue to explore, develop, and apply human performance enhancement (HPE) methods, ranging from pharmaceuticals to (bio)technological enhancement. This raises ethical, legal, and societal concerns and requires organizing a careful reflection and deliberation process, with relevant stakeholders. We discuss a range of ethical, legal, and societal aspects (ELSA), which people involved in the development and deployment of HPE can use for such reflection and deliberation. A realistic military scenario with proposed HPE application can (...) serve as a starting point for such an iterative and participatory process. Stakeholders can discuss this application, modify its features, and design appropriate processes around it – for instance, procedures for informed consent. We propose that organizing aspects into these three categories – ethical, legal, and societal – can help involve appropriate interlocutors at different moments: legal aspects with people in strategy or management roles, from the start of a project; ethical aspects with people in operations and medical roles, during development; and societal aspects with people in communication and personnel roles, during deployment. Notably, we developed and discussed this framework and the three aspects in close collaboration with personnel from the military. (shrink)

The carbon emissions of global health care activities make up 4–5% of total world emissions, placing it on par with the food sector. Carbon emissions are particularly relevant for health care because of climate change health hazards. Doctors and health care professionals must connect their health care delivery with carbon emissions and minimize resource use when possible as a part of their obligation to do no harm. Given that reducing carbon is a global ethical priority, the informed consent process in (...) health care delivery must change. I argue that the expanded role of bioethicists in this climate crisis is to promote and support “green informed consent:” the sharing of climate information with patients, offering options for lower-carbon health care, and accepting the patient’s right to decline treatments which are deemed too carbon intensive for their values. (shrink)

Bioethics has received important criticisms for its perceived privileging of biomedical authority with longstanding calls for greater recognition of the social, political, economic, historical, and...

The nature, possibility, and implications of ethics expertise in general and of bioethics expertise in particular has been the focus of extensive debate for over thirty years. What is ethics expertise and what does it enable experts to do? Knowing what ethics expertise is can help answer another important question: What, if anything, makes a claim of expertise legitimate? In other words, how does someone earn the appellation “ethics expert?” There remains deep disagreement on whether ethics expertise is possible, and (...) if so, what constitutes such expertise and what it entails and legitimates. Discussion of bioethics expertise has become particularly important given the growing presence of bioethicists in the clinical setting as well as efforts to professionalize bioethics through codes of ethics and certification efforts. Unlike in the law or in engineering, where there may be a body of knowledge that professional organizations or others have articulated as important for education and training of experts, ethics expertise admits of no such body of knowledge or required experience. Nor is there an entity seen as having the authority to articulate the necessary scope of knowledge. Questions about whether there is such a body of knowledge for particular areas within bioethics have emerged and played a central role in professionalization efforts in recent years, especially in the area of clinical ethics. (shrink)

Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in (...) the U.S., and in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

The American Journal of Bioethics, Volume 12, Issue 8, Page W1-W3, August 2012.

Baby A1 was born prematurely with severe encephalopathy, injured brainstem, and a potentially injured spinal cord. He had no response to pain or other external stimuli. The neonatal team unanimousl...

Over the past several years, the bioethics community has seen considerable attention being given in the bioethics literature and in various initiatives to the matter of standards and quality in hea...

Answering the design questions inherent to building and deploying machine learning tools —based on algorithms that can learn from and make predictions on large data sets without being explicitl...

BackgroundThe purpose of this study is to make a philosophical argument against the phenomenological critique of standardization in clinical ethics. We used the context of clinical ethics in Saudi Arabia to demonstrate the importance of credentialing clinical ethicists.MethodsPhilosophical methods of argumentation and conceptual analysis were used.ResultsWe found the phenomenological critique of standardization to be flawed because it relies on a series of false dichotomies.ConclusionsWe concluded that the phenomenological framing of the credentialing debate relies upon two extreme views to be navigated (...) between, not chosen among, in the credentialing of clinical ethicists. (shrink)

Counter storytelling, used in critical race theory and narrative ethics, is a tool used to contradict and expose the oppression in a dominant narrative, by focusing attention on the stories of the...

In the clinical setting, questions of medical ethics raise a host of perplexing problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists and physicians provide a nuanced, in-depth approach to the difficult issues involved in bioethics consultation. Addressing the needs of researchers, clinicians, and other health professionals on the front lines of bioethics practice, the contributors focus primarily on practical concerns -- whether ethics consultation is best done by individuals, teams, (...) or committees how an ethics consult service should be structured the need for institutional support and techniques and programs for educating and training staff -- without neglecting more theoretical considerations, such as the importance of character or the viability of organizational ethics. (shrink)

In 2017, Jameton reflected on the conceptual evolution of “moral distress” in the near-forty years since he coined the term in his book: Nursing Practice, The Ethical Issues. Jameton based the book...

Guiding our response in this essay is our view that current efforts to demarcate the role of the clinical ethicist risk reducing its complex network of authorizations to sites of power and payment. In turn, the role becomes susceptible to various ideologies—individualisms, proceduralisms, secularisms—that further divide the body from the web of significances that matter to that body, where only she, the patient, is located. The security of policy, standards, and employment will pull against and eventually sever the authorization secured (...) by authentic moral inquiry. Instead of asking “What do I need to know?”, the question animating the drive to standardize will be “What is the policy or standard?” The claims of the authors in this issue of HEC Forum confirm these suspicions. (shrink)

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...

In “Deception and the Clinical Ethicist,” Christopher Meyers defends that view that deception practiced by clinical ethicists is legitimate if it satisfies a series of justifying conditions (Meyers...