Objectives To determine the frequencies and types of limitation of medical treatment performed by physician members of the German Society for Palliative Medicine and to analyse the findings with respect to clinical and ethical aspects of end-of-life practices. Design Cross-sectional postal survey. Setting Data collection via the secretary of the German Society for Palliative Medicine using the German language version of the EURELD survey instrument. Subjects All 1645 physician members of the German Society for Palliative Medicine. Main outcome measures Types (...) and frequencies of limitation of treatment and possible determinants. Results 901 physicians participated in the study (response rate 55.8%). Participants reported limitation of treatment in 69.1% of cases. These decisions most often affected artificial nutrition (19%), chemotherapy (14%), antibiotics (11%) and medication other than antibiotics (11%). In the majority of eligible cases, physicians estimated the life-shortening effect of limitation of treatment to be <7 days. However, estimations differ depending on the medical measures in question. Bivariate statistical analysis indicated that withholding of treatment was performed significantly more frequently for patients aged ≥65 years (p=0.019). In addition, there were significant associations between the incidence of limitation of treatment and the different diseases reported by respondents as the underlying cause of death. Conclusion The findings of this study provide information on the current state of an ethically and clinically challenging aspect of clinical practice and can serve as a starting point for further interdisciplinary research on normative and empirical aspects of treatment decision-making at the end of life. (shrink)

Pour les révolutionnaires américains, Montesquieu est d’abord une figure d’autorité dont on révère les « axiomes ». Mais durant le débat très virulent auquel donne lieu la Constitution fédérale, ce sont les « antifédéralistes » qui invoquent le plus souvent son autorité, pour refuser la possibilité d’une république étendue, revendiquer une stricte « séparation » des pouvoirs, déplorer l’effacement de la vertu, etc. Ils contraignent donc les fédéralistes à une réponse paradoxale. Il s’agit de lire Montesquieu plus finement et d’en (...) assimiler les leçons tout en récusant de plus en plus fermement son autorité, au nom de l’exorcisme de l’héritage historique (tout particulièrement anglais) et de la rumination de l’expérience propre. Montesquieu est d’autant plus présent qu’il est rejeté, ce qui engage un tout nouveau rapport à l’histoire et à la tradition. (shrink)

Intersectoral collaboration (IC) plays a significant role in the delivery of diabetes care and treatment of patients with type 2 diabetes (DM2), as the treatment and care of these patients take place in both primary care and specialist settings. The collaboration involves a large number of actors from primary and secondary healthcare sectors, who are expected to fulfil various roles when they engage in IC. We explored the actors' roles by applying the framework of positioning theory with the aim of (...) revealing seemingly embedded understandings of such roles. The empirical data consisted of individual and focus group interviews. Our results indicate that naturalised understandings of the roles of actors interact with the way in which health professionals, patients, managers and relatives strive to develop IC that aims to help and guide patients who live with DM2. (shrink)

The object of this article, which analyses Statesman 291a1-303d3, is to show how the good, the object of politics qua knowledge, makes the regime with which it is associated a utopia. The good cannot be actualized anywhere in the sensible realm, because no city can be governed without laws, and the laws define what is good most often for the greatest number. A government of the good, without laws, is a utopia, but the laws, to the extent that they aim (...) at the common interest, are in themselves the imprint of the good. I defend the thesis, at first sight paradoxical, that the true politicians are not those who know the good and imitate it, but those who recognise the utility of laws and agree to submit themselves to their authority. Thus Plato dismisses all existing regimes as sophistic regimes where power is exercised in the interest of the rulers and not of the ruled. Not every regime, however, bears the imprint of the good equally. By making politics a branch of knowledge, Plato imposes a numerical criterion on the classification of regimes; he crosses the criterion of number with that of law. I therefore argue for another paradox: the best possible regime is a monarchy in which the rulers obey the laws, the best existing regime is none other than democracy. (shrink)

Many philosophers have defended the view that we are subject to the following evidential ought: “One ought to believe in accordance with one's evidence.” Although they agree on this, a more fundamental question keeps dividing them: from where does the evidential ought derive its normative force? The instrinsicalist answer to this question is sometimes described as the claim that "there is a brute epistemic value in believing in accordance with one's evidence" (Cowie, 2014, 4005). But what does this really mean? (...) Intrinsicalists' negative claim is that the normative source of the evidential ought has nothing to do with the fulfilment of our epistemic purposes. But what is their positive claim exactly? This paper aims at improving our understanding of intrinsicalism. Its conclusion is that there is only one possible way of being an intrinsicalist. Intrinsicalists need to be constitutivists. (shrink)

L’encadrement aporétique est une méthode d’animation en Philosophie Pour Enfants et Adolescents basé sur la confrontation d’idées, et par là d’argumentations divergentes. Il s’agit d’inviter les jeunes à toucher aux limites de leur entendement en les amenant dans l’impasse générée par les mises en contradiction de leurs opinions, les mises en opposition de leurs explications, les mises en demeure de leurs certitudes. Ce qui est pensé est remis en question, du seul fait qu’une autre manière de le penser existe. La (...) cohabitation de ses variétés de pensées engendre la nécessité de parfaire la réflexion et d’approfondir le raisonnement. L’aporie se conçoit alors comme un moyen de contrainte privilégié permettant la progression de la pensée. Il s’agit ici, dans un premier temps, de présenter les fondements théoriques d’un tel encadrement philosophique basé sur l’aporie, et dans un second temps, d’exposer sa praticabilité. (shrink)

L’article propose un nouvel examen de FD III 2, 106 visant à rendre son identité à l’Athénien Pyladès dit aussi Olympios. La transcription en vers du décret de Delphes lui accordant la citoyenneté fut, dès la première publication, à l’origine de confusions qui firent de ce citoyen, trop soucieux de distinction – il ne s’était point satisfait du banal résumé en usage – un pantomime honoré pour ses prestations à Olympie et à Delphes et dûment enregistré comme tel dans des (...) recueils prosopographiques professionnels et ethniques. (shrink)

Nous revenons sur la restitution de quatre trésors de Delphes bien connus. La barrière de cippes qui ferme à l’est la terrasse orientale du trésor des Athéniens invite à s’interroger sur la fonction de cet enclos. De nouvelles données permettent de proposer des hypothèses de restitution du plan de la lesché des Cnidiens et de son élévation tenant compte des nécessités liées à la présence de peintures, mais aussi de réinterpréter le mur de soutènement au sud. Le réexamen du trésor (...) des Thébains conduit à changer son orientation et à interpréter la fenêtre de la publication comme une ouverture destinée à la ventilation du prodomos. Le trésor des Cyrénéens est doté d’une nouvelle porte, plus conforme aux usages de l’architecture grecque classique. Les circonstances de sa consécration sont revues dans le cadre de la nouvelle datation imposée par sa nouvelle situation sur la fondation SD 302. (shrink)

The nature of freedom has been discussed extensively by Paul Ricoeur in his book Freedom and Nature. This article critically engages with this notion of freedom in the context of survivors of sex trafficking and their lack of experience of freedom. We indicate to what extent Ricoeur’s notion of freedom, as the reciprocal relationship between the voluntary and the involuntary, offers a relational and dynamic understanding of freedom which is highly relevant in the context of survivors of sex trafficking. A (...) mere bodily freedom, an escape from captivity, as often found in reductionist definitions of freedom, does not warrant freedom as volition for survivors of sex trafficking. The development of the full possibilities of freedom remains lacking in this context. This compels one to reconsider freedom as “voluntary-involuntary” freedom and to develop a much more complex, holistic and relational notion of freedom. Aspects like imagination, the affective, fear, desires and human dignity, should all be incorporated in the concept of freedom, which remains bodily, but does not exclude volition in the abstract or even idealistic sense. Such a comprehensive understanding of freedom is paramount for survivors of sex trafficking, but also for further philosophical considerations of freedom. (shrink)

ABSTRACT: The Smith Report has generated central questions about the mathematics education of UK adolescents. This paper highlights the close match between the goals of school mathematics, adolescence and exploratory pedagogy. This is contrasted with the prescriptive nature of current regimes. In particular, without careful attention to pedagogy it is possible that the introduction of different pathways may lead to a failure to achieve the outcomes desired by employers and universities, and to inequity in provision for students.

Dans les Esquisses pyrrhoniennes, Sextus Empiricus entreprend de réfuter le sunèmmenon, qui correspond en logique à notre « implication ». Sa réfutation procède circulairement, chacun des quatre critères proposés se voyant réfuté par le critère qui lui succède, de sorte que la dernière réfutation marque implicitement le retour à la première. Une telle situation est exemplaire parce qu’elle trouve un étrange écho dans la controverse qui oppose les logiciens du xx e siècle : savoir si la conséquence logique peut être (...) réduite à la validité du conditionnel matériel ou si elle n’exige pas plutôt ce que les logiciens appellent la « pertinence ». Envisagée dans cette perspective, la batterie des réfutations sceptiques se réduit au rôle d’adjuvant dans une controverse qui la dépasse, comme si la logique elle-même devenait sceptique lorsqu’elle se heurte à une aporie constitutive. (shrink)

This paper explores legislative provision and pre-school education policy in England over the course of the twentieth century. The paper argues that there has been a significant ideational shift over this period, from a policy focus on nursery education for poor children to universal early childhood education. Not only have ideas changed but provision and funding have changed. Although there have been major revisions to legislative provision, there are elements of continuity as regards the institutions delivering early childhood education, particularly (...) maintained nursery schools and nursery classes, but with layering of private-for-profit and not-for-profit institutions to ‘fill the gap’ in provision. At the same time, the central state has taken increasing control of publicly funded early childhood education through legislative provision. (shrink)

This paper derives from an exploration of the ways in which the letters of Holocaust writer Etty Hillesum, which are seemingly resistant to many of the interests of current trauma theory, can be read in relation to contemporary writing on testimonial. In particular, the three theorists I shall discuss here, Derrida, Caruth and Irigaray, directly address Freud's Beyond the Pleasure Principle, a central text in the current refiguring of trauma. This paper traces the ways in which Hillesum's letters can be (...) read across the theoretical accounts. An interpretation of Hillesum's writing emerges in which the conventional emphasis on the mystical aspect of her texts is reinterpreted in terms of Caruth's emphasis on the life drive. Viewed as forging a creative language of departure, Hillesum's letters are situated in a central relation to the most recent developments in the theoretical discourse around testimony. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy of Music Education Review 12.1 (2004) 64-66 [Access article in PDF] Response to Bennett Reimer, "Once More with Feeling: Reconciling Discrepant Accounts of Musical Affect" Anne Sinclair Indiana University Mary Reichling's exploration of form, feeling, and isomorphism in the writings of Susanne Langer accomplishes its goal to examine and elucidate aspects of these concepts. I find several of the ideas presented very engaging. Musical form and feeling (...) are very real to me in my experience as a music and liturgy director in the Catholic Church. I wholeheartedly agree with the concept of the processual nature of both, which has been well articulated. In my life experience, the musical form, the feeling inherent in it, and its process of coming to life in a given moment, is a near-weekly event. The church continually solemnizes life events, and musical form is an integral part of that solemnization. My response centers on the following claim: "Feeling is not a product but a process, it follows that the feeling ends when the music stops"; and question, "How can it be educational?"The example of the drama, King Lear, is very interesting. Indeed, as we get caught up in the action of the production, we become connected to the feelings and lives of the characters. I agree that it might be easier to experience feeling in a drama or epic, rather than in the visual arts, or in our sonorous art. The drama connects us to the human condition and we "feel" for the characters. In my position [End Page 64] as a liturgist, I find myself in a situation similar to that of the director of a play. Indeed, at times there is a very fine line between drama and good liturgy. However, in the liturgy we are connecting with real lives, the lives of our assembly members, not the lives of fictitious characters. Good musician liturgists strive to give voice to the emotions of the assembly. While I admit this is not always accomplished in weekly Sunday liturgies, I think especially of funeral liturgies where the music strives to speak of the hope and promise of eternal life for the departed loved one and also of the feelings of grief experienced by the assembled family and friends.I take issue with the idea "that the feeling stops when the music does." Throughout the body of the paper, Reichling highlights Langer's ideas on music's "sonorous image of feeling in an imaginatively perceptible form" and her use of the terms "semblance," "illusion," and "virtual" in regard to feeling. However, in contemplating the points brought forth, I mentally wrestled with the idea of feeling stopping when the music did. Could this position be held because it was based on what might be referred to as a "virtual" experience (for example, a musical concert or show) rather than a "real-life" moment?During the process of this contemplation, I had the occasion to attend the funeral of a friend's husband. This funeral occurred in a faith tradition other than Catholicism and I participated in the service as a member of the congregation. My friend is a music educator, her husband had been a musician, and both had been active in the music ministry of their church for nearly thirty years. As one might imagine, music was a central element in the solemnization of this man's life. The music was brought to life by an extraordinary group of musicians, including many graduate students and faculty members of the Indiana University School of Music. The music was superb and each piece had relevance to the life being celebrated as well as to the moment at hand, saying goodbye. The choir was wonderful, sharing movements from both the Brahms and Fauré Requiems, which were very moving. The soloist was renowned soprano, Sylvia McNair, an "adopted" member of the family since her days years ago as an Indiana University graduate student. Musical form and feeling came together in a powerful way for me during her singing of Fauré's Pie Jesu as she... (shrink)

During mitosis, cells comprehensively restructure their interior to promote the faithful inheritance of DNA and cytoplasmic contents. In metazoans, this restructuring entails disassembly of the nuclear envelope, redistribution of its components into the endoplasmic reticulum (ER) and eventually nuclear envelope reassembly around the segregated chromosomes. The microtubule cytoskeleton has recently emerged as a critical regulator of mitotic nuclear envelope and ER dynamics. Microtubules and associated molecular motors tear open the nuclear envelope in prophase and remove nuclear envelope remnants from chromatin. (...) Additionally, two distinct mechanisms of microtubule‐based regulation of ER dynamics operate later in mitosis. First, association of the ER with microtubules is reduced, preventing invasion of ER into the spindle area, and second, organelle membrane is actively cleared from metaphase chromosomes. However, we are only beginning to understand the role of microtubules in shaping and distributing ER and other organelles during mitosis. (shrink)

La profession d’assistante maternelle s’appuie sur les compétences maternelles des assistantes maternelles, ce qui les implique subjectivement dans leur rapport à l’enfant accueilli. Le dispositif de l’accueil (c’est-à-dire placement d’un enfant «étranger » dans une famille) appelle les assistantes maternelles à se confronter à cette question du lien à l’enfant accueilli. Si l’aliénation au désir de l’Autre est nécessaire à la construction du sujet, cette confrontation de l’assistante maternelle avec son propre désir est fondatrice du lien avec les enfants accueillis.

En écho de Court traité du fragment - l'essai décisif qu'elle a donné à l'esthétique en 1986 -, Anne Cauquelin propose, avec De la nature des lièvres et à partir d'une attention vive et affectueuse à l'oeuvre de Daniel Arasse, une réflexion aiguë, enjouée, sur la question du pan, du fragmentaire, de la diffraction du sens en peinture, en art, dans le texte. Interrogation générique se portant à sauts et à gambades sur les petites formes, sur le paragraphe et (...) les isolats, sur la suspension, sur le dandysme du retrait et quelques singularités animales ; affaire elle-même coupée-découpée, elle-même fragmentaire comme il ne pouvait en l'occurrence que se devoir. Dans les rebonds paragraphés de la pensée, ses bouffées autobiographiques, dans un dispositif où images, rêves, idées, souvenirs et sons se versent en écriture, en elle se déposent selon leur ordre propre et s'y composent comme naturellement, De la nature des lièvres, livre d'immédiate tension- instauration ludique (et savante, c'est tout comme), donne à lire une poétique de l'éclat-multiple : un feu artiste - une philosophie dansée. (shrink)

The article investigates the implications of mediatization for the legitimation strategies of humanitarian organizations. Based on a corpus of ~400 pages of brochure material from 1970 to 2007, the micro-textual processes involved in humanitarian organizations’ efforts to legitimate themselves and their moral claim were examined. A time trend analysis of the prioritization of actors in the material indicates that marked shifts in legitimation loci have taken place during the past 40 years. A discourse analysis unfolds the three dominant discourses behind (...) these shifts, namely legitimation by accountancy, legitimation by institutionalization, and legitimation by compensation. The analysis relates these changes to a problem of trust associated with mediatization through processes of mediation. (shrink)

Frédéric Bourdier est un anthropologue, docteur en géographie tropicale et membre de l’équipe CNRS « Sociétés, Santé, Développement ». Son livre est l’aboutissement d’une enquête de deux ans et demi financée par l’ANRS (Agence nationale de recherche sur le Sida) et confiée au laboratoire CNRS en 1994. Une équipe pluridisciplinaire (ethnologues, géographes, psychosociologues, membres d’ONG) composée d’universitaires, d’étudiants indiens, de responsables dans le secteur de la santé et d’enquête...

Give and Take: Poverty and the Status Order in Early Modern Japan. By Maren A. Ehlers. Harvard East Asian Monographs, vol. 413. Cambridge, MA: Harvard University Asia Center, 2018. Pp. xvi + 351. $49.95.

William Reddy, professeur d’histoire et d’anthropologie culturelle à l’université Duke, auteur du livre The Navigation of Feeling, est un pionnier de l’histoire des émotions. Son dernier ouvrage, The Making of Romantic Love, est le résultat de dix années de recherche. Il y traite des origines de l’amour courtois dans une perspective comparatiste, ayant trait à l’histoire globale. Son ouvrage ambitieux s’adresse à la fois aux étudiants et aux chercheurs qui s’intéressent au genre, à l’amour, a...

Si l ’ on peut bien affirmer que certains Sceptiques s ’ auto-réfutent, ce n ’ est pas le cas de Sextus Empiricus. En distinguant entre les modèles auto-référentiel et performatif de l ’ auto-réfutation auxquels on confronte les problèmes anciens du Menteur et du renversement ( peritropè ), on peut montrer que Sextus recourt à ce qu ’ il désigne par le mot sumperigraphè, qu ’ il convient de considérer comme un schème topologique verbal (une boucle récursive). Il ressort (...) que Sextus circonscrit la logique dont relève l ’ auto-réfutation, dans un effet réfléchissant et abyssal, rejoignant la grande tradition sceptique du théâtre grec. (shrink)

Unter dem Vorzeichen der Frühaufklärung beschäftigt sich Friedrich der Große in seinen philosophischen Schriften mit der Rolle des Fürsten und der Staatsführung sowie mit Fragen der Moral, Humanität und des Fortschritts der Menschheit. Zugleich reflektiert er Probleme des neuen Denkens, das er insbesondere bei den französischen Aufklärungsphilosophen aufmerksam beobachtet und nicht selten vehement kritisiert.

A treasury of teachings, stories, and sayings in the words of the Buddha himself--now part of the Shambhala Pocket Library series. Here is the core of the Buddha's teaching in his own words, as it was memorized word-for-word by his disciples and written down two hundred years after his death. These selections from the Buddhist scriptures deal with the search for truth, the way of contemplation, life and death, living in community, and many other topics, serving as an excellent introduction (...) to the Buddha's teaching. Whether addressed to monks and nuns, householders, outcastes, or thieves, the Buddha's teachings are characterized by one main concern: conveying the reality of our bondage to suffering--and the supremely good news that liberation is possible. It is a concern as relevant for people today as it was for the people of north India more than 1,000 years ago. This book is part of the Shambhala Pocket Library series. The Shambhala Pocket Library is a collection of short, portable teachings from notable figures across religious traditions and classic texts.The covers in this series are rendered by Colorado artist Robert Spellman.The books in this collection distill the wisdom and heart of the work Shambhala Publications has published over 50 years into a compactformat that is collectible, reader-friendly, andapplicable to everyday life. (shrink)

What can we learn from pre-industrial societies and organizations to achieve a sustainable development? As the pressure on organizations for a more sustainable world is increasing, some suggest that pre-industrial societies have lessons to teach. Organizations studies have borrowed very little from anthropology studies and have therefore not benefited from the cultural analysis they provide. This paper digs into this untapped reservoir of knowledge, and suggests a twofold discussion. The first part presents counterintuitive results that dismiss common assumptions: indigenous organizations (...) are not more conservationist than modern organizations, their dependence upon nature has translated into cultural practices which were hastily interpreted as forms of respect, their interest for the natural environment being rather guided by survival and cultural autonomy. Whereas tribal groups are dependent upon natural resources and cycles, modern societies and organizations have used technology to exploit the natural world. Yet, modern societies and organizations can benefit from knowledge withheld by indigenous cultural groups. I conclude on the idea that a sustainable model is yet to be found, and that a new paradigm of individual and group behavior has to emerge to confront environmental degradation and scarcity of natural resources. (shrink)

This paper develops insights from Foucault and Lyotard to examine the Darfur crisis and the transformative potential of spaces of alterity. We show that Foucault’s quest for an aesthetics of existence is an attempt to found an alternative form of ethics based on wakefulness, sensibility, and suspicion on the part of the subject. In the final part of the paper we link this idea to Lyotard’s sensibility of the sublime. We show how aesthetic sensibility can be transformed in a political (...) sensibility which bears witness to political injustices that result from the incommensurability of different genres of discourse. We illustrate this point using aesthetic representations of Darfur. (shrink)