La métaphysique fut souvent critiquée depuis le développement du rationalisme moderne. Les postmodernes vont-ils continuer les critiques portées contre sa rigidité épistémologique, vont-ils répéter les attaques contre son totalitarisme éthique et politique? Beaucoup de philosophes contemporains le pensent. Mais ils peuvent se tromper. Notre temps a besoin d'une nouvelle définition de l'élément humain qui s'accorderait avec l’humanisme démocratique. Seule la métaphysique est capable de poser les fondations d’une philosophie des droits de l’homme, établissant l’égale dignité des personnes et des peuples (...) en tant que sujets. (shrink)

" De quoi demain sera-t-il fait? " interroge Victor Hugo. Un philosophe, une historienne répondent au long d'un dialogue serré, exigeant. Pourquoi ont-ils choisi de faire ce livre ensemble? En raison d'une longue amitié, au nom d'une histoire commune, en vertu de la qualité d'un débat qui n'a jamais cessé entre eux depuis qu'à la fin des années soixante la jeune étudiante découvrit l'importance de ce penseur de quinze ans son aîné qui, avec d'autres, réveillait l'esprit critique de toute une (...) génération. Si les points de vue sont différents, l'héritage intellectuel est commun. Et c'est cet héritage qu'ils s'attachent à inventorier avant de circonscrire des enjeux majeurs de notre temps : comment penser la différence dans l'universel? La famille a-t-elle encore un avenir? La liberté se réduira-t-elle demain pour l'homme à l'intelligibilité des contraintes qui pèsent sur lui, ou le désir et l'imprévisible auront-ils encore leur place? Que nous dit la souffrance des animaux que nous massacrons? La page de la révolution est-elle définitivement tournée après l'échec du communisme? Est-il envisageable d'en finir une fois pour toutes avec la peine de mort? Quelles seront demain les formes nouvelles de l'antisémitisme et comment les combattre? L'échange s'achève sur un éloge de la psychanalyse, référence commune tout au long du dialogue. (shrink)

While pharmaceutical industry involvement in producing, interpreting, and regulating medical knowledge and practice is widely accepted and believed to promote medical innovation, industry-favouring biases may result in prioritizing corporate profit above public health. Using diabetes as our example, we review successive changes over forty years in screening, diagnosis, and treatment guidelines for type 2 diabetes and prediabetes, which have dramatically expanded the population prescribed diabetes drugs, generating a billion-dollar market. We argue that these guideline recommendations have emerged under pervasive industry (...) influence and persisted, despite weak evidence for their health benefits and indications of serious adverse effects associated with many of the drugs they recommend. We consider pharmaceutical industry conflicts of interest in some of the research and publications supporting these revisions, and in related standard-setting committees and oversight panels. We raise concern over the long-term impact of these multifaceted involvements. Rather than accept industry conflicts of interest as normal, needing only to be monitored and managed, we suggest challenging that normalcy, and ask: what are the real costs of tolerating such industry participation? We urge the development of a broader focus to fully understand and curtail the systemic nature of industry’s influence over medical knowledge and practice. (shrink)

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. (...) Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress. (shrink)

(2005). Freedom in Responsibility: On the Relevance of “Sin” As a Hermeneutic Guiding Principle in Bioethical Decision Making. Christian Bioethics: Vol. 11, No. 2, pp. 147-165.

BackgroundInternationally, clinical ethics support has yet to be implemented systematically in community health and care services. A large-scale Norwegian project attempted to increase ethical competence in community services through facilitating the implementation of ethics support activities in 241 Norwegian municipalities. The article describes the ethics project and the ethics activities that ensued.MethodsThe article first gives an account of the Norwegian ethics project. Then the results of two online questionnaires are reported, characterizing the scope, activities and organization of the ethics activities (...) in the Norwegian municipalities and the ethical topics addressed.ResultsOne hundred and thirty-seven municipal contact persons answered the first survey, whereas 217 ethics facilitators from 48 municipalities responded to the second. The Norwegian ethics project is vast in scope, yet has focused on some institutions and professions whilst seldom reaching others. Patients and next of kin were very seldom involved. Through the ethics project employees discussed many important ethical challenges, in particular related to patient autonomy, competence to consent, and cooperation with next of kin. The “ethics reflection group” was the most common venue for ethics deliberation.ConclusionsThe Norwegian project is the first of its kind and scope, and other countries may learn from the Norwegian experiences. Professionals have discussed central ethical dilemmas, the handling of which arguably makes a difference for patients/users and service quality. The study indicates that large scale implementation of CES structures for the municipal health and care services is complex, yet feasible. (shrink)

Thomas Aquinas wrote for the first time in the history of philosophy a systematic treatise on the human passions that considered them from an anthropological as well as from a moral point of view. His theory of the passions belongs to this third or what we could call “Aristotelian” approach. The aim of this article is to bring out the richness of Aquinas’s insights by analyzing his theory within the broader framework of his anthropology.

Idealized versus Real-Life Reciprocity: How to Strike the Balance? Rawls’s ’idealized’ notion of reciprocity is compared with the ’real-life’ concept of reciprocity as it has been developed in social scientific theory. The two perspectives appear to differ significantly as concerns dimensions related to equality, human motivation, the temporal aspects of reciprocity, and the supposed mental origin of reciprocity. Whereas norms of obligation and feelings of moral indebtedness are constitutive for reciprocity in real-life encounters, equality, freedom and rationality are the basis (...) for reciprocity in the hypothetical world of the ’conjectural account’. Rather than being fundamentally incompatible, the idealized and the real-life perspectives on reciprocity seem to apply to different spheres of social life, the first requiring greater formality and universality than the second, which allows for more variation and particularities. (shrink)

When rape by an armed organization occurs frequently, it is often said to be a strategy of war. But some cases of conflict-related rape are better understood as a practice, violence that has not been explicitly adopted as organization policy but is nonetheless tolerated by commanders. The typology of conflict-related rape in this article emphasizes not only vertical relationships between commanders and combatants but also the horizontal social interactions among combatants. It analyzes when rape is likely to be prevalent as (...) a practice, emphasizing not only gendered norms and beliefs of the society from which combatants come but also how those might be transformed by the organization’s socialization processes. In the conclusion, I suggest that the typology is relevant for analysts of all forms of of political violence and also for prosecutors, policy advocates, and policymakers concerned with conflict-related rape. (shrink)

BackgroundThe significant increase of digital collaboration, driven by the current COVID-19 pandemic, is resulting in changes in working conditions and associated changes in the stress-strain perception of employees. Due to the evident leadership influence on employees' health and well-being in traditional work settings, there is a need to investigate leadership in virtual remote work contexts as well. The objective of this scoping review was to assess the extent and type of evidence concerning virtual leadership in relation to employees' mental health, (...) job satisfaction and perceptions of isolation.MethodA search was undertaken in five databases, PubMed, Cochrane Library, PsycINFO, PSYNDEX and Web of Science, as well as reference lists of included articles on 9th February 2021 and an update on 28th September 2021. The search strategy was limited to English, German and French language, peer reviewed journal articles published from January 2000 onwards. This scoping review was conducted in accordance with the JBI methodology for scoping reviews. The methodological quality of the included studies was assessed using the JBI critical appraisal tools. A narrative synthesis was conducted.ResultsNineteen studies met the eligibility criteria for this review. Overarching review findings suggested a positive link between virtual leadership and well-being, job satisfaction, and a negative link to psychological strain, stress and perceptions of isolation of digitally collaborating employees.ConclusionsBy mapping the available evidence on virtual leadership in relation to health and work-related employee outcomes, the review identified many research gaps in terms of content and methodology. Due to limited data, causal relationships were not derived. Future research is needed to examine the complex cause-and-effect relationships of virtual leadership in more detail. (shrink)

The term ‘sustainability’ is vague and open to interpretation. In this paper we analyze how firms use the term in an effort to make the concept their own, and how it becomes a premise for further decisions, by applying a bottom-up approach focusing on the interpretation of ‘sustainability’ in the Norwegian salmon-farming industry. The study is based on a strategic selection of informants from the industry and the study design rests on: 1) identification of the main drivers of sustainability, and (...) 2) the application of five different discursive strategies to analyze how the firms maneuver to legitimize ‘sustainability’ in their conduct. We employ the Critical Discourse Analysis framework, which emphasizes how discourses provide different concepts of meaning. The sustainability concept is assessed based on how sustainability is brought into action by social actors in a legitimate way, and how this action results in sustainable practices. The empirical case of the study is the verbal justification of sustainability practices among representatives of the Norwegian salmon-farming industry. We aim to find out how these representatives translate the rather vague directives of the sustainability concept into legitimate choices that resonate with the firms’ contextual environment, hence, how the salmon farmers perceive, explore, interpret, explain, enact, and defend the diverse landscape of sustainability when implementing professional decisions. We found a trend of passive adaptation to external requirements, such as public regulations and regulative requirements from certification bodies. At the same time, there are progressive forces that attempt to improve the sustainability of the farming practices by involvement in research and innovation projects or cooperation with other firms, e.g. the contribution from offshore engineers in developing high seas farms. The strategies outlined and discussed cannot be seen as a typology to categorize the firms. More than one discursive strategy may be involved in one firm’s choice, and the strategies may work on different levels. (shrink)

Much debate concerning ‘precedent autonomy’ – that is, the authority of former, competent selves to govern the welfare of later, non-competent selves – has assumed a radical discontinuity between selves, and has overlooked the ‘bridging’ role of intimate proxy decision-makers. I consider a recent proposal by Lynn et al. (1999) that presents a provocative alternative, foregrounding an imagined dialogue between the formerly competent patient and her/his trusted others. I consider what standards must be met for such dialogues to have moral (...) force, appealing to narrative and feminist ethics. I then critique the dualistic construction of selves implicit in much of the advance directive literature, noting the continuities of dependence, character, and body, as well as the social dimension of the construction of selves. (shrink)