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)

Institutional economics and discourse theory stand unconnected next to each other, in spite of the fact that they both ask for the legitimacy of institutions (normative) and the functioning and effectiveness of institutions (positive). Both use as theoretical constructions rational individuals and the concept of consensus for legitimacy. Whereas discourse theory emphasizes the conditions of a legitimate consensus and could thus enable institutional economics to escape the infinite regress of judging a consensus legitimate, institutional economics has a tested social science (...) paradigm (rational choice) of explaining and predicting the functioning of institutions. The article outlines a theoretical synthesis of the two theories by finding points in common and possibilities of fruitful combinations concerning the problem of legitimacy, institutional design and effectiveness of legal norms. (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)

This paper investigates the uses that self-help literature makes of Nietzsche’s philosophy. Some specific concepts of his philosophy, as well as his choices in terms of expression, made Nietzsche a topmost reference for self-help authors in the U.S. and in France. As a philosopher and a nearly legendary figure, Nietzsche, in a strange way, fits more easily than other philosophers in the self-help project of leading people, through practical advices, to peace and happiness. Through examples taken from American and French (...) self-help literature, and with comparisons made with other philosophers, this paper shows how self-help functions when it comes to borrowing from other people’s works. (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)

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)

The goal of this book is to help the reader gain knowledge on ethical and legal issues in the field of student affairs and develop competency to follow the profession’s principles and standards of conduct. The significance of the book is due to its focus on the practical value of ethics and legal issues and its aim to address the knowledge, skills, and dispositions required of student affairs educators to develop and maintain integrity in their life and work as described (...) by the ACPA/NASPA. The text offers readers a number of major unique features: It offers multiple ethical decision-making models to guide student affairs educators in their ethical decision-making process. It proposes that ethics is not an individual but an organizational responsibility. It offers that ethical decision making is a professional skill that can be practiced and applied in student affairs educators’ day-to-day practice. It presents the reader with the most current legal issues in student affairs and higher education. Finally, it reflects three themes: integration of ACPA/NASPA competency areas; development of professional identity; and application of knowledge and theory to practice. The book is critical and timely. A book that focuses on ethical and legal issues in student affairs is needed for faculty in preparation programs, new professionals navigating their identity as student affairs educators, and a resource for mid- and senior-level professionals facilitating ongoing professional development. The book begins to address what it means to have a professional identity, which is ground in the shared ethical and legal values espoused within the profession and academia. Each chapter uniquely contributes to the complexity embedded in the study of ethics and how that is applied to practice. Additionally, the volume is a balance of procedural knowledge, case illustrations, and guided practice exercises to facilitate the reader’s ability to translate the theory and research discussed into professional decision making and application. (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)

A poem delivered upon the memorial of Viola Cordova in honor of indigenous women everywhere. "Two millennia of indigenous diasporas, yet we are all indigenous to this planet . . . There is a transnational indigenist agenda at work here to preserve and protect the human race for humans to remain among all our relations" .

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)

Les titres donnés à la parabole de Luc 15,11-32 évoquent le plus souvent l’un de ses personnages, le fils cadet. Les deux frères ont cependant chacun leur importance. L’élément inattendu du récit n’est ni le retour du cadet ni l’accueil qui lui est fait. Les v. 12-24, centrés sur lui, ont suscité l’empathie du lecteur et certains acquis de lecture l’ont préparé à cet accueil. La surprise du récit se trouve dans l’intervention du fils aîné: son arrivée et le sommaire (...) du v. 27 révèlent le décalage entre cette fête et celles évoquées au début du chapitre 15: la thématique ‘perdu / trouvé’ et la dimension collective de la fête ont ici disparu. Alors que l’aîné est pris dans une logique de rétribution, le père évoque la fraternité en plus de la filiation, le basculement de valeurs en plus de la rétribution. L’irruption du fils aîné, en provoquant un décalage entre l’attente du lecteur et la situation racontée, est l’occasion de réaffirmer l’importance du retournement provoqué par «trouvé / perdu». Ce changement-là permet d’entrer dans la vraie joie, celle du royaume. Le retour du cadet n’est donc pas ce qui exclut l’aîné de la fête, mais au contraire ce qui permet la fête, et permet à l’aîné d’y être invité. (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.

This syllabus engages dialogue about indigenous philosophical ideas and issues that frame contemporary global indigenous thought, perspective, and worldview. We explore how presuppositions of indigenous philosophy, including epistemology (how/what we know), metaphysics (what is), science (stories), and ethics (practices), affect global research programs, intellectual cultural property, economic policies, ecology, biodiversity, taxonomy, health, housing, food, employment, economic sustainability, peace negotiations, climate justice, human/treaty rights, colonial law, refugees and incarceration, self-determination, sovereignty, nation building, and digital information. Readings provide an understanding of traditional (...) and contemporary indigenous philosophical frameworks of interpretation, developments of the 1994-2004 United Nations Decade of Indigenous Peoples, the UN Permanent Forum of Indigenous Peoples, and the recent Indigenous Conference in Cancun (philosophical importance of the World Trade Organization [WTO], the World Bank [WB], the International Monetary Fund [IMF], and NAFTA). (shrink)

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)

Qualitative validation consists in showing that a model is able to mimic available observed data. In population level biological models, the available data frequently represent a group status, such as pool testing, rather than the individual statuses. They are aggregated. Our objective was to explore an approach for qualitative validation of a model with aggregated data and to apply it to validate a stochastic model simulating the bovine viral-diarrhoea virus (BVDV) spread within a dairy cattle herd. Repeated measures of the (...) level of BVDV-specific antibodies in the bulk-tank milk (total milk production of a herd) were used to summarise the BVDV herd status. First, a domain of validation was defined to ensure a comparison restricted to dynamics of pathogen spread well identified among observed aggregated data (new herd infection with a wide BVDV spread). For simulations, scenarios were defined and simulation outputs at the individual animal level were aggregated at the herd level using an aggregation function. Comparison was done only for observed data and simulated aggregated outputs that were in the domain of validation. The validity of our BVDV model was not rejected. Drawbacks and ways of improvement of the approach are discussed. (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)