AimsThis study evaluates a protocol for early, routine ethics consultation for patients on extracorporeal membrane oxygenation to support decision-making in the context of clinical uncertainty with the aim of mitigating ethical conflict and moral distress.MethodsWe conducted a single-site qualitative analysis of EC documentation for all patients receiving ECMO support from 15 August 2018 to 15 May 2019. Detailed analysis of 20 ethically complex cases with protracted ethics involvement identifies four key ethical domains: limits of prognostication, bridge to nowhere, burden of (...) treatment and system-level concerns. There are three subthemes: relevant contextual factors, the role of EC and observed outcomes. Content analysis of transcripts from interviews with 20 members of the multidisciplinary ECMO team yields supplemental data on providers’ perceptions of the impact of the early intervention protocol.ResultsLimited outcome data for ECMO, unclear indications for withdrawal, adverse effects of treatment and an obligation to attend to programme metrics present significant ethical challenges in the care of this patient population. Upstream EC mitigates ethical conflict by setting clear expectations about ECMO as a time limited trial, promoting consistent messaging among multiple services and supporting surrogate decision-makers. When ECMO becomes a ‘bridge to nowhere’, EC facilitates decision-making that respects patient values yet successfully sets limits on non-beneficial use of this novel therapy.ConclusionData from this study support the conclusion that ECMO poses unique ethical challenges that necessitate a standardised protocol for early, routine EC—at least while this medical technology is in its nascent stages. (shrink)

The commons is a concept increasingly used with the promise of creating new collective wealth. In the aftermath of the economic and financial crises, finance and money have been criticized and redesigned to serve the collective interest. In this article, we analyze three types of complementary currency systems: community currencies, inter-enterprise currencies, and cryptocurrencies. We investigate whether these systems can be considered as commons. To address this question, we use two main theoretical frameworks that are usually separate: the “new commons” (...) in organization studies and the “common good” in business ethics. Our findings show that these monetary systems and organizations may be considered as commons under the “common good” framework since they promote the common interest by creating new communities. Nevertheless, according to the “new commons” framework, only systems relying on collective action and self-management can be said to form commons. This allows us to suggest two new categories of commons: the “social commons,” which fit into both the “new commons” and the “common good” frameworks, and the “commercial commons,” which fit the “common good” but not the “new commons” framework. This research advances a new conceptualization of the commons and of the ethical implications of CCs. (shrink)

It has been argued that there is something morally objectionable about moral realism: for instance, according to realism, we are justified in believing that genocide is wrong only if a certain moral fact obtains, but it is objectionable to hold our moral commitments hostage to metaphysics in this way. In this paper, I argue that no version of this moral argument against realism is likely to succeed. More precisely, minimal realism―the kind of realism on which realist theses are understood as (...) internal to moral discourse―is immune to this challenge, contrary to what some proponents of the moral argument have suggested, while robust non-naturalist realists might have good answers to all versions of the argument as well, at least if they adopt a certain stance on how to form metaphysical beliefs in the moral domain. (shrink)

The following scenario seems possible: a community uses concepts that play the same role in guiding actions and shaping social life as our normative concepts, and yet refer to something else. As Eklund argues, this apparent possibility poses a problem for any normative realist who aspires to vindicate the thought that reality itself favors our ways of valuing and acting. How can realists make good on this idea, given that anything they might say in support of the privileged status of (...) our normative concepts can be mirrored by the imagined community? E.g., the realist might claim that using our concepts is what we ought to do if we are to describe normative facts correctly, but members of the other community can claim the same about their concepts, using their own concept of ought. A promising approach to this challenge is to try to rule out the possibility of alternative normative concepts, by arguing that any concepts that have the same normative role must share a reference as well. In this paper I argue that normative quasi-naturalism, a view that combines expressivism about normative discourse with a naturalist metaphysics of normativity, supports referential normativity and solves the problem of alternative normative concepts. (shrink)

L'intérêt des sciences humaines pour les rapports entre TIC, langues et savoirs n'est pas nouveau. Cependant l'intelligibilité d'une construction épistémologique des relations reste un domaine en friche dans le contexte de la mondialisation. Le présent article essaie de s'en prendre à ce vide épistémologique en interrogeant particulièrement les enjeux des langues africaines dans le travail de structuration et de dissémination du savoir global et des savoirs locaux. Ces savoirs, chacun à sa manière, tentent de se construire un statut nouveau en (...) s'insérant dans les divers marchés de la connaissance. Pour cela, ils tirent profit du renouvellement des thématiques occidentales vis-à-vis des consommateurs africains d'information scientifique. En conséquence, des politiques de productivité et de circularité des savoirs s'érigent dans des stratégies d'uniformisation épistémologique. Parallèlement, la mode de la «diversité linguistique et culturelle», censée protéger les langues et savoirs locaux, risque de les transformer en de simples objets ethnographiques.The interest of the humanities to the relationship between ICT and language knowledge is not new. However, the intelligibility of a construction epistemological relations remains a fallow field in the context of globalization. This article tries to take this empty epistemological questioning particularly the issues of African languages ​​in the work of structuring and dissemination of global knowledge and local knowledge. This knowledge, in their own way, trying to build a new status by inserting themselves into the various markets for knowledge. For this, they benefit from the renewal of western themed vis-à-vis African consumers of scientific information. As a result, productivity and political knowledge circularity themselves up in uniform epistemological strategies. Meanwhile, the fashion of the "linguistic and cultural diversity," intended to protect indigenous knowledge and languages, may turn them into mere ethnographic objects. (shrink)

Review of Ronald Dworkin, Religion without God , (Harvard University Press, 2013), 180 pages.

This collection of essays looks at the distinctively English intellectual, social and political phenomenon of Latitudinarianism, which emerged during the Civil War and Interregnum and came into its own after the Restoration, becoming a virtual orthodoxy after 1688. Dividing into two parts, it first examines the importance of the Cambridge Platonists, who sought to embrace the newest philosophical and scientific movements within Church of England orthodoxy, and then moves into the later seventeenth century, from the Restoration onwards, culminating in essays (...) on the philosopher John Locke. These new contributions establish a firmly interdisciplinary basis for the subject, while collectively gravitating towards the importance of discourse and language as the medium for cultural exchange. The variety of approaches serves to illuminate the cultural indeterminacy of the period, in which inherited models and vocabularies were forced to undergo revisions, coinciding with the formation of many cultural institutions still governing English society. (shrink)

A revival of the dialogue between phenomenology and psychiatry currently takes place in the best international journals of psychiatry. In this article, we analyse this revival and the role given to phenomenology in this context. Although this dialogue seems at first sight interesting, we show that it is problematic. It leads indeed to use phenomenology in a special way, transforming it into a discipline dealing with empirical facts, so that what is called “phenomenology” has finally nothing to do with phenomenology. (...) This so-called phenomenology tallies however with what we have always called semiology. We try to explain the reasons why phenomenology is misused in that way. In our view, this transformation of phenomenology into an empirical and objectifying discipline is explained by the role attributed to phenomenology by contemporary authors, which is to solve the problems raised by the Diagnostic and Statistical Manual of Mental Disorders. (shrink)

This article offers a descriptive and analytic view of the different stages leading to the constitution of a corpus that is representative of the issues of climate and energy justice. Overall, the corpus contains over five million words and gathers reports, newsletters and web-pages dealing with the most equitable ways of moving to a low-carbon future in the aim of limiting climate change. It can be divided into six sub-corpora, according to types of discourse communities, and methods of constitution. We (...) begin by presenting the small Do It Yourself (DIY) corpora which were used as a starting point. Three discourse communities were selected to observe possible variation in their treatment of the issue: Non-Governmental Organisations (NGOs), United-Nation institutions, and the Renewable Energy Sector (RES). The sources are selected according to author, date, keywords in title. Using the concordance Antconc and WMatrix software we test the reliability of the corpora for their thematic content, terminology and lexical unit classification. Our first results enable us to confirm variation between the discourse communities. The discrepancy in sizes and the time-consuming nature of the initial DIY corpus constitution lead us to use BootCat to extend them, using keywords from the corpora as seeds to retrieve and download webpages. We thus contrast a more traditional approach to corpus building to web-as-corpus data gathering methods. We compare the results found in the BootCat corpora to test if they are as specific as those in the DIY corpora. This enables us to draw conclusions on the possible uses and advantages of relatively small corpora for the study of specialised discourse. (shrink)

While often presented as promising assistive technologies for motor-impaired users, electroencephalography (EEG)-based Brain-Computer Interfaces (BCIs) remain barely used outside laboratories due to low reliability in real-life conditions. There is thus a need to design long-term reliable BCIs that can be used outside-of-the-lab by end-users, e.g., severely motor-impaired ones. Therefore, we propose and evaluate the design of a multi-class Mental Task (MT)-based BCI for longitudinal training (20 sessions over 3 months) of a tetraplegic user for the CYBATHLON BCI series 2019. In (...) this BCI championship, tetraplegic pilots are mentally driving a virtual car in a racing video game. We aimed at combining a progressive user MT-BCI training with a newly designed machine learning pipeline based on adaptive Riemannian classifiers shown to be promising for real-life applications. We followed a two step training process: the first 11 sessions served to train the user to control a 2-class MT-BCI by performing either two cognitive tasks (REST and MENTAL SUBTRACTION) or two motor-imagery tasks (LEFT-HAND and RIGHT-HAND). The second training step (9 remaining sessions) applied an adaptive, session-independent Riemannian classifier that combined all 4 MT classes used before. Moreover, as our Riemannian classifier was incrementally updated in an unsupervised way it would capture both within and between-session non-stationarity. Experimental evidences confirm the effectiveness of this approach. Namely, the classification accuracy improved by about 30% at the end of the training compared to initial sessions. We also studied the neural correlates of this performance improvement. Using a newly proposed BCI user learning metric, we could show our user learned to improve his BCI control by producing EEG signals matching increasingly more the BCI classifier training data distribution, rather than by improving his EEG class discrimination. However, the resulting improvement was effective only on synchronous (cue-based) BCI and it did not translate into improved CYBATHLON BCI game performances. For the sake of overcoming this in the future, we unveil possible reasons for these limited gaming performances and identify a number of promising future research directions. Importantly, we also report on the evolution of the user's neurophysiological patterns and user experience throughout the BCI training and competition. (shrink)

The authors examine the nursing practice of disposing unaltered controlled substances into public water systems as an issue for nurses concerned with the environmental harm it can cause. A summary of the history of controlled substance management reveals inconsistencies in the interpretation of current regulations that have led to disposal policies that vary by institution, according to a benchmarking survey of regional hospitals. Much attention has been given to the phenomenon of conscientious objection in the context of patient care that (...) conflicts with a nurse’s moral integrity. Nurses who are compelled to dispose narcotics down drains may also face this struggle. The authors submit that this disposal method is based on a type of double effect logic where preventing diversion is viewed as a good effect of flushing unused controlled substances that outweighs any harm it may cause, though there is little evidence to support this conclusion. Consequently, the topic deserves further study so that nurse managers and administrators can support and offer alternatives to nurses who object to flushing drugs down the drain. (shrink)

It is often claimed that there is an explanatory divide between an expressivist account of normative discourse and a realist conception of normativity: more precisely, that expressivism and realism offer conflicting explanations of (i) the metaphysical structure of the normative realm, (ii) the connection between normative judgment and motivation, (iii) our normative beliefs and any convergence thereof, or (iv) the content of normative thoughts and claims. In this paper I argue that there need be no such explanatory conflict. Given a (...) minimalist approach to the relevant metaphysical and semantic notions, expressivism is compatible with any explanation that would be acceptable as a general criterion for realism. (shrink)

This article presents a critique of an article previously featured in Nursing Philosophy by Ursula Naue and Thilo Kroll, who suggested that people living with dementia are assigned a negative status upon receipt of a diagnosis, holding the identity of the ‘demented other’. Specifically, in this critique, we suggest that unwitting use of the adjective ‘demented’ to define a person living with the condition is ill‐informed and runs a risk of defining people through negative attributes, which has a deleterious (...) impact upon that person's social and relational personae. Moreover, use of the locution ‘demented’ reinforces a divide between the ‘demented’ and the ‘healthy others’ . Social constructionist theory, malignant positioning and viewing people with dementia as semiotic subjects are the philosophical pillars through which we construct the main arguments of the critique. The article concludes with the voice of one of the authors, a younger person with dementia, asking for language in dementia care to be carefully reconsidered and reframed and for the recognition of the diagnosed person's agency in the conduct of their day‐to‐day lives. (shrink)

Are human beings essentially good or evil? Immanuel Kant responds, “[H]e [man] is as much the one as the other, partly good, partly bad.” Given this, I’d like to explore the following: What does Kant mean by human nature and how is it possible to be both good and evil? What is “original sin” and does it place limits on free will? In what respect might Kant’s views be significant for non-believers? More specifically, is Kant saying that human beings need (...) God in order to be good or is morality possible without faith? (shrink)

Le mouvement laïque du Moyen Age nous est apparu, en gros, comme un phénomène chrétien, parce qu'inhérent à la structure même du christianisme médiéval. Georges de Lagarde le définit comme la revendication par les princes chrétiens d'attributions exercées par les autorités ecclésiastiques, tant dans l'ordre spirituel que dans l'ordre temporel. Il reflète un état social caractéristique du Moyen Age chrétien. D'une part, en effet, les nations chrétiennes appartiennent à une même et unique chrétienté où la distinction entre le citoyen et (...) le chrétien n'a de conséquences pratiques que pour d'infimes minorités juives ou hérétiques vivant en marge de la communauté. D'autre part, l'autorité civile se présente plus volontiers comme une participation à la plénitude de puissance du pape, au temporel comme spirituel, que comme une institution de droit naturel. (shrink)

In this manuscript we describe Proteogenomics Viewer, a web‐based tool that collects MS peptide identification, indexes to genomic sequence and structure, assigns exon usage, reports the identified protein isoforms with genomic alignments and, most importantly, allows the inspection of MS2 information for proper peptide identification. It also provides all performed indexing to facilitate global analysis of the data. The relevance of such tool is that there has been an increase in the number of proteogenomic efforts to improve the annotation of (...) both genomics and proteomics data, culminating with the release of the two human proteome drafts. It is now clear that mass spectrometry‐based peptide identification of uncharacterized sequences, such as those resulting from unpredicted exon joints or non‐coding regions, is still prone to a higher than expected false discovery rate. Therefore, proper visualization of the raw data and the corresponding genome alignments are fundamental for further data validation and interpretation. (shrink)

This chapter argues for determinable dispositions. Determinable dispositions are characterized by a certain type of non-specificity. Put roughly, a determinable disposition to M is a disposition to M in some but no particular way. So, if a vase is disposed to break and that disposition is a determinable disposition, then the vase is disposed to break in some but no particular way. The chapter argues that determinable dispositions undermine standard approaches to multi-track dispositions and provide support for a teleological understanding (...) of dispositions. (shrink)

A la fin du XIXe siècle, alors que l'Europe assiste au retour triomphal de la métaphysique dont Henri Bergson est une figure de proue, sur le positivisme, l'Espagne de la Restauration bourbonienne fait figure de résistante. La répartition bipolaire de l'intellectualité espagnole, entre les conservateurs néo-thomistes et les réformateurs de plus en plus attirés par la psychologie scientifique notamment, rend le dialogue primordialement impossible avec le bergsonisme. Seul Leopoldo Alas, dit Clarin, tente alors de faire entendre la "philosophie nouvelle", dans (...) son pays. Après que le bergsonisme a été boudé durant ces premières décennies d'existence par l'Espagne, la crise théologique moderniste de 1907 précipite son entrée dans la péninsule. Les premiers acteurs "philosophiques" du bergsonisme sont anti-bergsoniens et catholiques. Cet anti-bergsonisme religieux se double d'un rejet politique, pendant la Grande Guerre, principalement lors de la visite diplomatique de Bergson à Madrid, en mai 1916. Parallèlement, les réformateurs, férus de pédagogie, qui ont créé en 1876 la Institucion Libre de Ensenanza, découvrent la conceptualité bergsonienne qu'ils intègrent progressivement, entre 1900 et 1930, dans leur nouvelle science psychopédagogique. Toutefois, les grands acteurs espagnols de la régénération métaphysique sont les littéraires, les poètes symbolistes, appelés "modernistes" dans ce pays, puis les avant-gardes esthétiques. Ce sont eux qui métabolisent le bergsonisme en une (méta-)physique intime et organique. Ce n'est que dans un second temps, dans les années 1910, et non sans obstacles, que les spécialistes espagnols de philosophie intègrent et diffusent le bergsonisme. (shrink)

Il existe une différence fondamentale entre la science et la philosophic, différence que marque la frontière mobile entre la spéculation et la vérification. Telle est la thèse dont tout l'ouvrage de M. Piaget veut se présenter comme la défense et l'illustration.

Cette contribution propose l’analyse des temporalités de la patrimonialisation de l’héritage minier dans le bassin minier du Nord et du Pas-de-Calais à partir d’un travail de thèse réalisé entre 2013 et 2019, de retours réguliers sur le terrain depuis associés au maintien d’une veille sur les politiques patrimoniales menées. Je tenterai dans un premier temps d’identifier comment la mise en patrimoine de l’héritage minier, observée sur un temps long, permet de faire émerger différentes logiques et moteurs de mise en patrimoine (...) en fonction des jeux d’acteurs et des enjeux d’échelles tout en gardant une fonction stabilisatrice. La deuxième partie consiste plutôt à réfléchir sur la catégorie d’inscription Unesco « paysage culturel évolutif vivant », qui comporte un paradoxe temporel, et de la faire dialoguer avec des propositions conceptuelles comme l’omnipatrimonialisation, le temps-paysage et la patrimondialité. Ces deux axes de réflexion ont été pensés comme complémentaires pour envi... (shrink)

Cet article saisit la question des fondements philosophiques de la formation des adultes en faisant fond sur les thèses du penseur critique de la modernité tardive Zygmunt Bauman (1925-2017). Le texte s’ouvre par un regard englobant et synthétique sur l’oeuvre intellectuelle de Bauman (1). Il isole ensuite plus spécifiquement ce qui en son sein nous aide à prendre la mesure de la centralité de l’éducation tout au long de la vie comme défi majeur de ce que l’auteur appelle une vie (...) liquide (3). La focale est ensuite encore resserrée sur ce qui, dans la pensée baumanienne, permet de faire signe vers un type polymorphe de formation des adultes à même de permettre aux individus contemporains tout à la fois d’apprendre à naviguer et d’apprendre en naviguant dans un monde problématique (3). Une ouverture conclusive permet enfin de récapituler les apports les plus décisifs de Bauman dans le cadre problématique qui est celui du présent numéro et de dégager les linéaments ou les têtes de pont de ce qu’une discussion de fond du diagnostic baumanien sur le monde hypermoderne et la philosophie de l’éducation qu’il requiert pourrait être (4). (shrink)

In this paper, I support a hybrid view regarding the metaphysics of worlds. I endorse Lewisian Modal Realism for possible worlds (LMR). My aim is to come up with a hybrid account of impossible worlds that provides all the plenitude of impossibilities for all fine-grained intentional contents. I raise several challenges for such a plenitudinous hybrid theory. My version of hybrid modal realism builds impossible worlds as set-theoretic constructions out of genuine individuals and sets of them, that is, as set-theoretic (...) constructions from parts and sets of parts of genuine Lewisian worlds. _Structured worlds_ are defined as sets of tuples: structured entities built out of Lewisian ‘raw material’. These structured worlds are ersatz worlds, some of which are impossible. I claim that propositions must be sets of worlds rather than members of sets. Once the construction is in place, I evaluate the proposal and show that my hybrid account is able to supply a plenitude of impossibilities and thus giving the resources to make all the hyperintensional distinctions we are looking for, whilst remaining Lewisian-conservative. (shrink)

I argue for a teleological account of events in progress. Details aside, the proposal is that events in progress are teleological processes. It follows from this proposal that final causes are ubiquitous: anything happening at any time is an event with a telos.