In this controversial and provocative book, Mary Anne Franks examines the thin line between constitutional fidelity and constitutional fundamentalism. The Cult of the Constitution reveals how deep fundamentalist strains in both conservative and liberal American thought keep the Constitution in the service of white male supremacy. Constitutional fundamentalists read the Constitution selectively and self-servingly. Fundamentalist interpretations of the Constitution elevate certain constitutional rights above all others, benefit the most powerful members of society, and undermine the integrity of the document as (...) a whole. The conservative fetish for the Second Amendment (enforced by groups such as the NRA) provides an obvious example of constitutional fundamentalism; the liberal fetish for the First Amendment (enforced by groups such as the ACLU) is less obvious but no less influential. Economic and civil libertarianism have increasingly merged to produce a deregulatory, "free-market" approach to constitutional rights that achieves fullest expression in the idealization of the Internet. The worship of guns, speech, and the Internet in the name of the Constitution has blurred the boundaries between conduct and speech and between veneration and violence. But the Constitution itself contains the antidote to fundamentalism. The Cult of the Constitution lays bare the dark, antidemocratic consequences of constitutional fundamentalism and urges readers to take the Constitution seriously, not selectively. (shrink)

The visual attention (VA) span is defined as the amount of distinct visual elements which can be processed in parallel in a multi-element array. Both recent empirical data and theoretical accounts suggest that a VA span deficit might contribute to developmental dyslexia, independently of a phonological disorder. In this study, this hypothesis was assessed in two large samples of French and British dyslexic children whose performance was compared to that of chronological-age matched control children. Results of the French study show (...) that the VA span capacities account for a substantial amount of unique variance in reading, as do phonological skills. The British study replicates this finding and further reveals that the contribution of the VA span to reading performance remains even after controlling IQ, verbal fluency, vocabulary and single letter identification skills, in addition to phoneme awareness. In both studies, most dyslexic children exhibit a selective phonological or VA span disorder. Overall, these findings support a multi-factorial view of developmental dyslexia. In many cases, developmental reading disorders do not seem to be due to phonological disorders. We propose that a VA span deficit is a likely alternative underlying cognitive deficit in dyslexia. (shrink)

The implicit activities of the living body in sports (such as heart rate, involuntary gestures, stress, reflex, emotional regulation and interaction expressions) emerge in the consciousness of the lived body without our voluntary control. We demonstrate physiological emersion, and how, including in dramaturgical perception, physiological flows and processes collide with the image of a whole body. In this paper, we introduce corporeal non-property as the missing (?) link between phenomenology and neuroscience, renewed by research on the cerebral unconscious and the (...) perception of their lived body. Rather than mindfulness, physical activity obliges the subject to learn the unconscious and his motor skills from his living body: a new psychoanalysis of sport is thus established by studying what emerges from the activity of the living body up to the level of the conscious description of motor action. In this paper, we explain why that awareness occurs, and why it matters for the understanding of unconscious activity of the athlete’s living body. This is potentially interesting, although it needs, as a theory, to overcome the obvious reliance of the body on unconscious or habitual/automated physiological processes. But the incorporation of body techniques forms a habitus. (shrink)

La gnose est selon Pierre Hadot un courant de spiritualité et de représentation du réel qui excède largement le gnosticisme religieux des sectes et écoles des premiers siècles de notre ère et que combattaient Plotin et les Pères de l’Église chrétienne. Ce gnosticisme historique a cependant eu le mérite de théoriser clairement les éléments les plus importants de cette tendance existant dans la plupart des religions, comme dans une bonne partie de la philosophie, et qui consiste à voir, dans le...

This qualitative study examined hospital nurses’ methods in handling meal and nutrition care during inpatient time, with an underlying focus on undernourished older adult. Observations and interviews were used to document nurses’ methods through the span of a transition (defined by an entry, passage, and exit). The study finds inconsistencies in care methods due to institutional processes restricting both mealtime care and nutritional logging of information throughout hospitalization. It is concluded that the consequences of these inconsistencies must be recognized and (...) that new approaches to meals and nutritional care should be introduced in order to provide greater flexibility. Based on the assumption that mobilizing patient resources is pivotal for meal and nutritional care, it is argued that it may be important to mobilize patient resources during mealtime and in nutritional logging of information in order to increase the visibility of meal and nutritional care in patient transitions within the institution and across settings. Both nurses’ methods and institutions developmental initiatives regarding meal and nutritional care need to accommodate the differences between what in this paper is defined as social‐bodily care and text‐based care. This could be met through care methods that take place with, more than for the patient. (shrink)

Au polyhandicap sévère, la société a réagi de trois manières différentes : par une « hémiplégie » visuelle d’abord, en l’ignorant, par une atteinte de son narcissisme, liée à sa culpabilité de le rejeter, et par une effraction enfin des enveloppes familiales. Pour les familles et les équipes éducatives, c’est la rencontre pérenne avec la différence, le traumatisme, mais aussi avec le déni. Même si historiquement cette prise en compte évolue, un travail de lien est à réaliser, ce que l’auteure (...) illustre par diverses situations issues de sa pratique. (shrink)

Diverse legal and regulatory measures are used internationally to control the information provided during pharmaceutical sales visits. Little is known about the comparative effectiveness of these measures however. We analyzed the perceptions of regulators, pharmaceutical industry officials, health professionals, and consumer respondents concerning these approaches in Canada, France, and the United States using an empirical realist interests-based approach. Interviews focused on the aims and effectiveness of regulation, barriers and enablers to regulation and suggestions for improvement. An alignment was found in (...) North America regulator and industry respondents' satisfaction with the status quo and their view that further intervention is unfeasible and unnecessary. Health professionals generally expressed a lack of confidence in the impact of regulations on sales visit information while consumer advocates voiced their disappointment in both regulators and health professionals for their failure to counteract the influence of pharmaceutical marketing. Regulator and industry respondents in France differed from their North American counterparts in their willingness to increase and diversify the scope of regulatory interventions. As the first international comparison of regulatory experiences in this sector, the findings highlight the universal need for more focused and inclusive discussions among groups about how to tailor regulations to achieve public health goals. (shrink)

How to participate proactively in a process of change and transformation, to shape our path within an uncertain future? With this publication, the State Of The Art Network marks a waypost on a journey which started in 2018, when like-minded Nordic and Baltic art organisations and professionals initiated this network as a multidisciplinary collaboration facing the Anthropocene. Over five years, ten organisations and around 80 practitioners from different disciplines, like the arts, natural sciences and humanities came together, online and in (...) person, for workshops, seminars and discussions. The aim was to find ways to create resilience and concrete actions on how to live through the change in culture, economy and the environment and to find concrete, hands-on methods to deal with the Anthropocene and the environmental crisis. As an outcome of this process, this publication takes a closer look at how we as practising artists, researchers and cultural actors can create elements for critical thinking and doing which can assist us in navigating the complexities of the present. -/- Edited for the State Of The Art Network by Erich Berger, Mari Keski-Korsu, Marietta Radomska and Line Thastum. -/- Produced and published by Bioart Society 2023. (shrink)

Erich Hatala Matthes’s (2021)Drawing the Line is about what we ought to do when we discover that an artist whom we love has committed a great moral wrong. As it turns out, Matthes and I agree almost entirely on the moral obligations of the individual consumer. We both agree that it is necessary to ascertain whether the life of the artist affects the aesthetic quality of their work, and that we should attend to how continuing to engage with their work (...) publicly expresses our ethical values. Both of us wind up with a morally permissive stance, according to which individuals can, in some contexts, continue to engage with the artwork of immoral artists.There is one distinct difference in how we approached the problem. Matthes took up the question of the role and responsibility of institutions in his third chapter, a question I set aside almost entirely. In this article, I want to delve more deeply into the question of art institutions and their responsibilities to reform themselves. I will argue that the nature of aesthetic practice means that it is harder for an institution to tread the desirable middle ground between uncritically endorsing an immoral artist and cancelling them. (shrink)

Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within “dysfunction-requiring” accounts of disease, such as (...) those of Christopher Boorse and Jerome Wakefield. We then provide several detailed examples to establish that biological dysfunction cannot provide a boundary. We examine potential ways of resolving the line-drawing problem, either by dropping one of the claims that generates it, or by appealing to additional criteria. We argue that two of these options are plausible, and that each of these can be applied with regard to different diseases. (shrink)

Notre expérience de constitution d’une base de données orale (au sein du Groupe aixois de recherches en syntaxe) nous a servi à constituer, à la fin des années 90, une base de données d’écrits scolaires manuscrits (élèves de 5 à 11 ans). L’article rend compte des questions inhérentes à la constitution d’un tel corpus : du recueil de données à leur transcription et à leur édition. Si les méthodes d’analyse de l’oral peuvent résoudre certains des problèmes rencontrés, elles ne peuvent (...) le faire sur l’ensemble des textes. En effet, les écrits des élèves comportent des spécificités linguistiques qui interrogent les conventions de transcription et des décisions sont à discuter au sein de la communauté scientifique, comme nous le montrerons en nous appuyant sur des textes de jeunes élèves (6 à 8 ans). (shrink)

En France, les personnes issues des minorités, principalement d'origine extra-européenne , sont susceptibles de connaître la discrimination, la stigmatisation mais aussi l'exclusion. La télévision, en tant que « lieu de reconnaissance », constitue un enjeu important pour ces populations. Cependant, le petit écran semble marginaliser depuis toujours ces minorités visibles non seulement en leur laissant une place limitée à l'antenne mais aussi en leur renvoyant des images majoritairement caricaturales et dévalorisantes d'elles-mêmes. Une enquête qualitative auprès de 43 individus d'origine africaine (...) et antillaise montre que les minorités sont capables de mettre en place des réactions défensives ou stratégies identitaires afin de réduire le décalage certain entre leur identité sociale - souvent dépréciatrice - et leur identité personnelle , prenant les médias comme ressources pour l'action.In France, persons belonging to minorities, mainly non-European origin , are likely to experience discrimination, stigmatization but also exclusion. Television as a "place of recognition," is an important issue for these people. However, the small screen seems to marginalize always visible minorities by giving them not only a limited role in the antenna but also by returning images mostly caricatures and demeaning to themselves. A qualitative survey of 43 individuals of African and Caribbean origin shows that minorities are able to implement defensive reactions or identity strategies to reduce the gap between some social identity - often dépréciatrice - and their personal identity , taking the media as resources for action. (shrink)

This study shows that double thymidine block treatment efficiently arrests the EO771 cells in the S‐phase without altering cell growth or survival. A long‐term analysis of cell behavior, using 5(6)‐carboxyfluorescein diacetate N‐succinimidyl ester (CFSE) staining, show synchronization to be stable and consistent over time. The EO771 cell line is a medullary breast‐adenocarcinoma cell line isolated from a spontaneous murine mammary tumor, and can be used to generate murine tumor implantation models. Different biological (serum or amino acid deprivation), physical (elutriation, mitotic (...) shake‐off), or chemical (colchicine, nocodazole, thymidine) treatments are widely used for cell synchronization. Of the different methods tested, the double thymidine block is the most efficient for synchronization of murine EO771 cells if a large quantity of highly synchronized cells is recommended to study functional and biochemical events occurring in specific points of cell cycle progression. (shrink)

The use of deception during social interactions is a serious ethical concern for business. Interpersonal Deception Theory (IDT) proposes that strategies for using deception are influenced by personal factors. We tested this proposal by assessing participants’ strategies for using deception during an employment interview. Specifically, we examined three personal factors [gender, Machiavellianism, and self-monitoring (SM)] and intentions toward four types of deceptive behaviors (Extensive Image Creation, Image Protection, Ingratiation, and Slight Image Creation). We used path analysis to examine the intentions (...) of 125 undergraduate students. Our results partially confirm the proposal of IDT by showing that intentions toward using Extensive Image Creation (i.e., generating wholly untrue personal information) are higher for men than women. Intentions toward Image Protection (i.e., hiding unattractive personal truths) are higher for men and for women high in Machiavellianism relative to women low in Machiavellianism. Intentions toward using deceptive Ingratiation are highest for men and high Machiavellianism women, but only when sufficient SM skills are present. For intentions toward Slight Image Creation (i.e., mild exaggerations to personal truths) there are no gender, Machiavellianism, or SM effects. Our research has implications for understanding how deception in the workplace can begin before an individual is hired, and we offer suggestions for several lines of future research. (shrink)

This volume studies the teaching of Aristotle’s Nichomachean Ethics (the standard textbook for moral philosophy) in the universities of Renaissance Italy. Special attention is given to how university commentaries on the Ethics reflect developments in educational theory and practice and in humanist Aristotelianism. After surveying the fortune of the Ethics in the Latin West to 1650 and the work’s place in the universities, the discussion turns to Italian interpretations of the Ethics up to 1500 (Part Two) and then from 1500 (...) to 1650 (Part Three). The focus is on the universities of Florence-Pisa, Padua, Bologna, and Rome (including the Collegio Romano). Five substantial appendices document the institutional context of moral philosophy and the Latin interpretations of the Ethics during the Italian Renaissance. Largely based on archival and unpublished sources, this study provides striking evidence for the continuing vitality of university Aristotelianism and for its fruitful interaction with humanism on the eve of the early modern era. (shrink)

Discussion of Wittgenstein's Tractatus is currently dominated by two opposing interpretations of the work: a metaphysical or realist reading and the 'resolute' reading of Diamond and Conant. Marie McGinn's principal aim in this book is to develop an alternative interpretative line, which rejects the idea, central to the metaphysical reading, that Wittgenstein sets out to ground the logic of our language in features of an independently constituted reality, but which allows that he aims to provide positive philosophical insights into (...) how language functions. McGinn takes as a guiding principle the idea that we should see Wittgenstein's early work as an attempt to eschew philosophical theory and to allow language itself to reveal how it functions. By this account, the aim of the work is to elucidate what language itself makes clear, namely, what is essential to its capacity to express thoughts that are true or false. However, the early Wittgenstein undertakes this descriptive project in the grip of a set of preconceptions concerning the essence of language that determine both how he conceives the problem and the approach he takes to the task of clarification. Nevertheless, the Tractatus contains philosophical insights, achieved despite his early preconceptions, that form the foundation of his later philosophy. -/- The anti-metaphysical interpretation that is presented includes a novel reading of the problematic opening sections of the Tractatus, in which the apparently metaphysical status of Wittgenstein's remarks is shown to be an illusion. The book includes a discussion of the philosophical background to the Tractatus, a comprehensive interpretation of Wittgenstein's early views of logic and language, and an interpretation of the remarks on solipsism. The final chapter is a discussion of the relation between the early and the later philosophy that articulates the fundamental shift in Wittgenstein's approach to the task of understanding how language functions and reveal the still more fundamental continuity in his conception of his philosophical task. (shrink)

Cet article se base sur des résultats d’enquête récents montrant que, chez des adolescents marocains âgés de dix à dix-huit ans, les manifestations de pensée critique dialogique se si-tuent majoritairement dans une « perspective épistémologique » appelée « relativisme » par un modèle développemental élaboré dans les quinze dernières années avec la méthode de la théorie ancrée. Pour comprendre ces résultats de recherche, qui contrastent avec ceux obte-nus auprès d’adolescents québécois et français appartenant aux mêmes groupes d’âge, nous décrivons, dans (...) un premier temps, le modèle développemental dans lequel ils prennent sens. Nous illustrons ensuite les manifestations de « perspective épistémologique relativiste » chez les adolescents marocains à l’aide d’extraits de verbatim. Les élèves ont tendance à se décen-trer de leur vécu personnel, à se représenter le point de vue d’autrui en général et à co-construire des points de vue convergents avec les pairs. Dans un deuxième temps, prenant appui sur une approche de la représentation sociale en tant que « scène », et sur la littérature touchant aux rôles des aînés dans les sociétés africaines, nous éclairons ces résultats de re-cherche par l’analyse d’une représentation sociale fréquemment mobilisée par les jeunes Ma-rocains interviewés : celle de la hiérarchie des âges et du devoir d’écoute envers les plus âgés. L’analyse de cette « scène » met en lumière des attitudes sociales inculquées aux adolescents en contexte culturel marocain, susceptibles de favoriser le développement d’une « perspective épistémologique relativiste » en matière de pensée critique dialogique. (shrink)

The aim of this work is to respond to the following question: how did Charles S. Peirce find unity for his pragmatist philosophy through the formulation of Scholastic Realism? The author proposes the said doctrine to be a reading guide, leading us through the different stages of Peirce's work as a philosopher. By understanding his realist doctrine, we can see why he believed it was a viable theory for understanding the problem of Universals. This book demonstrates why, in Peirce's mind, (...) such a problem has pervaded the history of philosophy. The author's line of argument reveals that Scholastic Realism is crucial to the understanding of his philosophy, which is a new approach in Peirce scholarship. It provides a useful framework for asking questions about reality in the same way that Peirce himself did. As a result, the author shows that Peirce's realism addresses different yet related philosophical problems, leading Peirce to brand the final version of his philosophy as "Scientific Metaphysics". The conclusion offers an interpretation of the Scholastic Realism principle as a solution to Peirce's concerns -- a useful idea to achieve a better theory of reality in his struggle to realize metaphysics a posteriori. Peirce's doctrine is presented alongside some of its uses, especially in the fields of abstraction theory, and also in the fundamental principles of mathematics. This work should advance our comprehension of the problems related to Peirce's philosophy as well as shedding light on pragmatism and its origins as well as the battle between realism and nominalism. (shrink)

Bien que les droits des personnes handicapées soient légalement reconnus dans le monde entier, le coût des mesures en faveur des personnes handicapées semble constituer un obstacle majeur à leur mise en œuvre. La recherche dans le champ du handicap doit donc prendre cette question à bras-le-corps. S’appuyant sur la théorie de la citoyenneté, cet article examine le rôle des coûts dans le développement de la citoyenneté pour différents groupes de citoyens, en fonction du contexte socioéconomique. Il met en évidence (...) le rôle des mouvements sociaux dans ce développement et la nécessité de résoudre le dilemme reconnaissance/redistribution. Il montre ensuite que les revendications écrites des militants du handicap offrent un matériau empirique riche pour explorer la complexité de la question des coûts dans les politiques du handicap. Se concentrant sur le cas de la Suède, l’article examine 312 articles de blog et 162 tribunes de presse. Trois manières différentes d’analyser ces coûts sont distinguées, selon que les écrits analysés critiquent, acceptent ou recadrent la question des coûts dans les politiques du handicap. (shrink)

Companies that contribute to charitable organizations rightly hope that their philanthropic work will also be good for the bottom line. Marketers of good corporate conduct must be especially careful, however, to market such conduct in a morally acceptable fashion. Although marketers typically engage in mild deception or take artistic license when marketing goods and services, these sorts of practices are far more morally troublesome when used to market good corporate conduct. I argue that although mild deception is not substantially worrisome (...) with respect to the marketing of most goods and services, it is a far greater moral blunder to use such methods in the marketing of good corporate character. These erode trust and demonstrate alack of adequate respect for the moral good. In light of these concerns, I suggest that such practices must be re-examined when applied to the marketing of corporate character and good conduct. Finally, I develop a revised set of ethical guidelines that are needed in order to address the problems peculiar to the marketing of morally praiseworthy behavior. (shrink)

The Quest for Learning: How to Maximize Student Engagement affirms that traditional classroom learning experiences, in which you plan lessons and voice instruction at the front of the room, do not meet 21st century students learning needs. Questing is a customizable pedagogy that readers and their students together tailor to a students abilities, needs, and interests. Side by side, and aligned with learning targets, readers learn how teachers and students determine what a student will learn about and at what pace. (...) Authors Marie Alcock, Michael Fisher, and Allison Zmuda propose three tenets of engagement (1) the learner engages with relevant, worthy inquiries and experiences that are interesting or emotionally gripping, (2) the learner engages in an active, intentional cycle with clear goals and right-sized, actionable steps, and (3) the learner engages in social, collaborative opportunities that grow expertise that allow students to take ownership of their learning. To further that ownership, students decide which design type they want to use to explore their quest topic (1) question, (2) game, or (3) network. Students then pursue lines of inquiry, design or play games, or communicate with peers and experts in online and physical spaces. Each is a method for becoming an expert on chosen topics. (shrink)

La tradition romaine oppose à la femme étrusque, présente aux spectacles et aux banquets, symbole de toutes les licences, la chaste matrone filant la laine au milieu de ses servantes. Mais l’évolution des mœurs et du droit à Rome – à la différence du monde grec – donne à la femme une place reconnue dans la société, et notamment dans les banquets publics et privés. Cette place de la matrone à table reste subordonnée à la présence du mari, mais des (...) femmes païennes, puis chrétiennes ont l’initiative de fondations funéraires comportant des repas sur les tombes. (shrink)

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)

Based on ethnographic fieldwork with panhandlers who provide services while asking for money, informal interviews with pedestrians who have interacted with them, and formal interviews with twenty people who regularly interact with panhandlers, this article unpacks the relationship between temporality and ambiguity of meaning in exchange. In line with previous research, I find that providing a service while asking for money allows panhandlers to manage stigma by recasting their relationship with pedestrians who give as a market exchange. More surprisingly, I (...) find that this kind of recasting makes giving less compelling for the pedestrians in fleeting encounters with panhandlers: they resist service provision in fleeting encounters with panhandlers on the grounds that the exchange is experienced as a coldly rational quid pro quo. In contrast, pedestrians who have long-term relationships with panhandlers experience the interaction as a gift exchange and the service as an expression of gratitude and subservience. The development of an open-ended temporal horizon and of a cycle of exchange, I argue, allows the service and the money given to operate as boundary objects, enabling panhandlers and pedestrians to attach different meanings to the exchange of money for services. This emergent ambiguity allows them to carry out interaction and exchange successfully. Contrary to models of interaction and everyday economic transactions that frame shared definitions of the situation as necessary for successful and repeated interactions, I find that ambiguity and polysemy may be productive and sustaining in interactions between participants from distinct social worlds. (shrink)

Although health and disease occupy opposite ends of a spectrum, distinguishing between them can be difficult. This is the “line-drawing” problem. The papers in this special issue engage with this challenge of delineating the boundaries of disease. The authors explore different views as to where the boundary between disease and nondisease lies, and related questions, such as how we can identify, or decide, what counts as a disease and what does not; the nature of the boundary between the two categories; (...) and what sorts of considerations could justify the location of that boundary. In exploring these questions, the papers draw on detailed clinical examples, provide theoretical critiques of existing approaches to disease definition, and offer new ways to conceptualize key features in debates about disease, including harm and biological dysfunction. (shrink)

I aim to clarify the argument for space that Newton presents in De Gravitatione (composed prior to 1687) by putting Newton's remarks into conversation with the account of geometrical knowledge found in Proclus's Commentary on the First Book of Euclid's Elements (ca. 450). What I highlight is that both Newton and Proclus adopt an epistemic progression (or “order of knowing”) according to which geometrical knowledge necessarily precedes our knowledge of metaphysical truths concerning the ontological state of affairs. As I argue, (...) Newton's commitment to this order of knowing clarifies the interplay of the imagination and understanding in geometrical inquiry and illuminates how geometrical knowledge of space can lead to knowledge that space depends on and is related to God. In general, appreciating the Proclean elements of Newton's argument brings added light to the significance of geometrical inquiry for his general natural philosophical program and grants us insight into the philosophical grounding for the notion of absolute space that is presented in the Principia mathematica (1687). (shrink)

Background: In psychiatry, the issue of providing palliative and end-of-life care for what would be a “terminal psychiatric condition” or considering a palliative approach to severe and persistent mental health problems is still a taboo. Methodology: This question is addressed through an analysis of a case arising during a clinical ethics consultation, using Hubert Doucet’s scenario method. It is about Mrs. Sanchez, a patient over 90 years of age with a psychiatric profile, expressing the desire to die by suicidal gestures, (...) refusing the proposed treatments, and refusing as well to drink and eat. Her clinical history is told through the filter of reflexive support offered in clinical ethics to the various stakeholders. Results: The case analysis, far from responding to the challenges posed by the concept of palliative and end-of-life care in a psychiatric context, nevertheless presents an opportunity to name its main ethical issues: psychic suffering, refusal to eat and drinking as well as refusal of treatment, palliative sedation and medical assistance in dying, wishes and advanced medical directives and clinical-organizational challenges for geriatric psychiatry clients. Conclusion: There are still many challenges for professionals and decision-makers to meet the needs of older mental health clients. We call for further development of knowledge on this specific topic. (shrink)