The purpose of this text is to tell the story of the implementation of the _Act Respecting End-of-Life Care,_ referred to hereafter as _Law 2_ (Gouvernement du Québec, 2014) with an emphasis on the ambiguous role of ethics in the Interdisciplinary Support Groups (ISGs), created by Quebec's _Ministère de la santé et des services sociaux_ (MSSS). As established, ISGs provide “clinical, administrative and ethical support to health care professionals responding to a request for Medical aid in dying (MAiD)” (Gouvernement du (...) Québec, 2015). It is suggested that their composition includes the participation of a person with an expertise in ethics. These ISGs represent an important innovation for stakeholders involved in MAiD. To date, no scientific research has specifically addressed ISGs and little research has been conducted in other jurisdictions on the roles, operations and practices of MAiD support structures, especially the implication of ethics. Several ISGs have certainly developed promising practices that could benefit all stakeholders in the wider field of ethics and end of life. We will explore the development of ISGs in Quebec as a support structure for MAiD by highlighting the role that ethics has played (and should play) in these morally and humanly challenging situations. (shrink)

In the social sciences and in everyday speech we often talk about groups as if they behaved in the same way as individuals, thinking and acting as a singular being. We say for example that "Google intends to develop an automated car", "the U.S. Government believes that Syria has used chemical weapons on its people", or that "the NRA wants to protect the rights of gun owners". We also often ascribe legal and moral responsibility to groups. But could groups literally (...) intend things? Is there such a thing as a collective mind? If so, should groups be held morally responsible? Such questions are of vital importance to our understanding of the social world. In this lively, engaging introduction Deborah Tollefsen offers a careful survey of contemporary philosophers? answers to these questions, and argues for the unorthodox view that certain groups should, indeed, be treated as agents and deserve to be held morally accountable. Tollefsen explores the nature of belief, action and intention, and shows the reader how a belief in group agency can be reconciled with our understanding of individual agency and accountability. _Groups as Agents_ will be a vital resource for scholars as well as for students of philosophy and the social sciences encountering the topic for the first time. (shrink)

This article analyzes the institutionalization of the global organic agriculture field and sheds new light on the conventionalization debate. The institutions that shape the field form a tripartite standards regime of governance that links standard-setting, certification, and accreditation activities, in a layering of markets for services that are additional to the market for certified organic products. At each of the three poles of the TSR, i.e., for standard-setting, certification, and accreditation, we describe how the corresponding markets were constructed over time (...) and the role of the different actors in their evolution. We analyze the politics at stake among the actors at each pole, their competing or cooperative interests and visions, and the tensions between them in the promotion of markets. Through the lens of the TSR heuristic, we show that the institutionalization of the organic field beginning in the 1990s and its de facto inclusion in the broader sustainability field beginning in the 2000s contribute to a progressive distancing between the organic movement and its initial political project of alterity, to which public and private actors both contribute actively. As a set of interlinked market institutions, the TSR orients and narrows the scope of debate, which becomes restricted to “market-compatible” dimensions and objects. We conclude that the TSR is a promising heuristic for analyzing contemporary global regulation. (shrink)

Louis Perron Le discours cosmologique actuel permet-il d’affirmer le caractère théophanique du cosmos, au sens où celui-ci pourrait être considéré comme le lieu de la manifestation visible et immédiate de Dieu? Plus généralement : est-il en mesure d’ouvrir un chemin vers la foi? Contrairement à un discours récurrent, l’auteur, s’appuyant sur l’oeuvre de Jean Ladrière, défend la thèse qu’il n’existe pas de voie royale conduisant de la science à la foi. Celle-ci peut cependant recueillir l’image scientifique du monde et (...) lui conférer une signification propre, moyennant un parcours herméneutique s’appuyant sur l’articulation des différents registres de sens et dont la médiation philosophique constitue le passage obligé. (shrink)

This book offers a new approach to the analysis of the multiple meanings of English modals, conjunctions, conditionals, and perception verbs. Although such ambiguities cannot easily be accounted for by feature-analyses of word meaning, Eve Sweetser's argument shows that they can be analyzed both readily and systematically. Meaning relationships in general cannot be understood independently of human cognitive structure, including the metaphorical and cultural aspects of that structure. Sweetser shows that both lexical polysemy and pragmatic ambiguity are shaped by our (...) metaphorical folk understanding of epistemic processes and of speech interaction. Similar regularities can be shown to structure the contrast among root, epistemic and speech act uses of modal verbs, multiple uses of conjunctions and conditionals, and certain processes of historical change observed in Indo-European languages. Since polysemy is typically the intermediate step in semantic change, the same regularities observable in polysemy can be extended to an analysis of semantic change. (shrink)

PERRON A and HOLMES D. Nursing Inquiry 2011; 18: 191–204Constructing mentally ill inmates: nurses’ discursive practices in correctionsThe concepts of discourse, subjectivity and power allow for innovative explorations in nursing research. Discourse take many different forms and may be maintained, transmitted, even imposed, in various ways. Nursing practice makes possible many discursive spaces where discourses intersect. Using a Foucauldian perspective, were explored the ways in which forensic psychiatric nurses construct the subjectivity of mentally ill inmates. Progress notes and individual (...) interviews constitute discursive spaces within which nurses construct patients’ subjectivities. Progress notes provide a written (and permanent) form of discourse, while interviews set the space for a more fluid and contextual form of discourse. We identified five types of subjectivities – the (in)visible patient, the patient as risk, the deviant patient, the disturbed patient and the disciplined patient. These subjectivities were rooted in various types of discourses circulating in the selected setting. Despite the multiple discursive dimensions of forensic psychiatric nursing, progress notes remain the main formal source of information regarding nursing care even though it is not representative of the care provided nor is it representative of nurses’ complex discursive practices in corrections. (shrink)

The debate surrounding the issue of collective moral responsibility is often steeped in metaphysical issues of agency and personhood. I suggest that we can approach the metaphysical problems surrounding the issue of collective responsibility in a roundabout manner. My approach is reminiscent of that taken by P.F. Strawson in "Freedom and Resentment" (1968). Strawson argues that the participant reactive attitudes - attitudes like resentment, gratitude, forgiveness and so on - provide the justification for holding individuals morally responsible. I argue that (...) the framework of the reactive attitudes extends to collectives and provides the justification for holding collectives morally responsible. (shrink)

The Romans had various ways of justifying their imperial aims and methods, some high-minded, some less so. We find in particular that they could give honourable and satisfying explanations of their aims and methods in war. Here for example is Cicero: quare suscipienda quidem bella sunt ob earn causam, ut sine iniuria in pace uiuatur; parta autem uictoria conseruandi ii, qui non crudeles in bello, non immanes fuerunt, ut maiores nostri Tusculanos, Aequos…in ciuitatem etiam acceperunt, at Carthaginem…funditus sustulerunt…mea quidem sententia (...) paci, quae nihil habitura sit insidiarum, semper est consulendum. et cum iis, quos ui deuiceris, consulendum est, tum ii qui armis positis and imperatorum fidem confugient, quamuis murum aries percusserit, recipiendi. (shrink)

In this paper, I discuss nurses' ongoing difficulty in engaging with politics and address the persistent belief that political positioning is antithetical to quality nursing care. I suggest that nurses are not faced with choosing either caring for their patients or engaging with politics. I base my discussion on the assumption that such dichotomy is meaningless and that engaging with issues of relationships firmly grounds nursing in the realm of politics. I argue that the ethical merit of nursing care relies (...) instead on positioning nurses squarely at the centre of care activities, experiences, and functions. Such positioning makes possible what Foucault called ‘practices of self‐formation’, that is, micro‐level processes that balance out the ubiquitous economic, cultural, legal, and scientific technologies that steadily constitute subjects in this era of modernity. Nurses, then, become not a group that needs to be controlled and governed, but individuals who must care for their self before they may care for anyone else. (shrink)

I will defend explication, in a Carnapian sense, as a strategy for revisionary ontologists and radical sceptics. The idea is that these revisionary philosophers should explicitly commit to using expressions like “S knows that p” and “Fs exist” differently from how these expressions are used in everyday contexts. I will first motivate this commitment for these revisionary philosophers. Then, I will address the main worries that arise for this strategy: the unintelligibility worry and the topic shift worry. I will focus (...) on the latter worry and provide a solution that makes use of a distinction between practically and theoretically oriented beliefs. On my view, the revisionary philosophers who admit to departing from the everyday language can still criticize everyday knowledge and existence claims, by arguing that while the language embedded in these claims is suitable for beliefs-1, it is not suitable for beliefs-2. (shrink)

This book offers the first philosophical treatment of biocultural sustainability and eco-deconstruction, presenting the most developed treatment of the notions of survival and life death in Derrida to date.

Peter McHugh’s influence on those of us who studied and worked with him as part of York University’s graduate sociology programme in Toronto from the mid-1970s until the late 1980s, while lasting and undeniable, is not necessarily immediately apparent nor easily articulated. What follows is a brief reflection on how this difficulty can be understood as integral to Peter McHugh’s unique contribution both to those of us fortunate enough to have studied with him, and more broadly, to the discipline of (...) sociology itself. (shrink)

Au nombre des sources philosophiques majeures de l’oeuvre de Jean Ladrière se trouve celle de Thomas d’Aquin. La notion de création est l’un des lieux où cette influence se laisse voir de manière particulièrement prégnante. Le traitement ladriérien se présente comme une reprise herméneutique de la doctrine thomiste de la création à la lumière des développements contemporains de la science. Cet article se propose de manifester les axes directeurs de cette réinterprétation.

Las prácticas teatrales contemporáneas se caracterizan por un fuerte coeficiente de hibridación. Esto conlleva un replanteo constante de las categorías que definen la teatralidad. En el marco de este problema, queremos pensar, a partir de los aportes de Gilles Deleuze, la intersección entre imagen y teatro, entendiendo que este cruce permite una modulación entre ambos. El aspecto fundamental de esta modulación es su desvinculación de la noción de representación mimética y su viraje hacia la presencia. A partir de la noción (...) de figura (analizada por Deleuze en su obra sobre Francis Bacon), vemos que la imagen se modula en un desajuste de la sensación, el cuerpo y su ritmo. Esto nos indica una operación teatral, de dislocación de la representación mimética y la puesta en escena de otros tipos de ritmo y otros tipos de corporalidad. Dado este vínculo, podemos establecer que la lógica de la sensación en la figura comparte el mismo esquema de variación que en el teatro. Por lo cual, establecemos el concepto de imagen teatral como un operador donde resuenan las nociones de presencia, imagen, cuerpo y desfiguración. (shrink)

There seems to be something self-evident—irresistibly so, to judge from its gleeful propagation—about the use of the phrase, “Jane Austen and the Masturbating Girl,” as the Q.E.D. of phobic narratives about the degeneracy of academic discourse in the humanities. But what? The narrative link between masturbation itself and degeneracy, though a staple of pre-1920s medical and racial science, no longer has any respectable currency. To the contrary: modern views of masturbation tend to place it firmly in the framework of optimistic, (...) hygienic narratives of all-too-normative individual development. When Jane E. Brody, in a recent “Personal Health” column in the NewYork Times, reassures her readers that, according to experts, it is actually entirely possible for people to be healthy without masturbating; “that the practice is not essential to normal development and that no one who thinks it is wrong or sinful should feel he or she must try it”; and that even “’those who have not masturbated … can have perfectly normal sex lives as adults,’” the all but perfectly normal Victorianist may be forgiven for feeling just a little—out of breath.3 In this altered context, the self-evidence of a polemical link between autoeroticism and narratives of wholesale degeneracy 4 draws on a very widely discredited body of psychiatric and eugenic expertise whose only direct historical continuity with late twentieth-century thought has been routed straight through the rhetoric and practice of fascism. But it now draws on this body of expertise under the more acceptable gloss of the modern, trivializing, hygienic-developmental discourse, according to which autoeroticism not only is funny—any sexuality of any power is likely to hover near the threshold of hilarity—but also must be relegated to the inarticulable space of infantility. 3. Jane E. Brody, “Personal Health,” New York Times, 4 Nov. 1987.4. Rosenblatt, “The Universities,” p. 3. Eve Kosofsky Sedgwick is professor of English at Duke University and the author of Between Men: English Literature and Male Homosocial Desire and Epistemology of the Closet. (shrink)

This essay focuses on conceptual engineers who aim to improve other people's patterns of inference and attention by shaping their concepts. Such conceptual engineers sometimes engage in a form of epistemic paternalism that I call paternalistic cognitive engineering: instead of explicitly persuading, informing and educating others, the engineers non-consultatively rely on assumptions about the target agents’ cognitive systems to improve their belief forming. The target agents could reasonably regard such benevolent exercises of control as violating their sovereignty over their own (...) belief formation. This is a pro tanto reason against such engineering. In addition to the relevant projects of conceptual engineering, paternalistic cognitive engineering plausibly includes certain kinds of nudging and evidence suppression. I distinguish the sovereignty-based concern from other ethical worries about conceptual engineering and discuss how one might justify the relevant conceptual engineering projects despite the sovereignty-based reason against them. (shrink)

On the day on which Dr Harold Shipman, the Manchester serial killer, was convicted, there was wall-to-wall coverage of it in the media. During the course of one of the many reports, the daughter of one of his victims was interviewed, and asked for her views on why Shipman had acted as he did. What she said was this: she’d tried and tried to understand or explain his deeds, and she could only come to the conclusion that he was a (...) really evil man. In saying this, she clearly meant to convey more than the obvious truth that what Shipman did was very wrong and entirely to be condemned. It seems to me that a secular as well as a religious audience would find the daughter’s appeal to evil as an appropriate explanation perfectly comprehensible. But what exactly was it that was being attributed to Shipman, and how was it thought to explain his actions? (shrink)

Change is inevitable, and increasingly rapid and continuous in healthcare as organizations strive to adapt, improve and innovate. Organizational change challenges healthcare providers because it restructures how and when patient care delivery is provided, changing ways in which nurses must carry out their work. The aim of this doctoral study was to explore frontline nurses’ experiences of living with rapid and continuous organizational change. A critical hermeneutic approach was utilized. Participants described feeling voiceless, powerless and apolitical amidst rapid and continuous (...) organizational changes which fuelled apathy, cynicism and disengagement from the organization. However, critical analysis of the data showed that nurses actively engaged with power, voice and politics through resistant and transgressive behaviours in micro‐ethical moments of practice. There is a need to reconceptualize the concepts of voice, power and politics in nursing as there is dissonance between nurses’ beliefs about these concepts and what they are enacting in practice. Recognizing their enactment of power, voice and political agency at the micro‐level may empower nurses. Empowerment would mitigate the high levels of reports of powerlessness experienced in practice during organizational changes. (shrink)

Fuller's program of social epistemology engages a rhetoric of inquiry that can be usefully compared and contrasted with other discursive theories of knowledge, such as that of Richard Rorty. Resisting the model of “conversation,” Fuller strikes an activist posture and lays the groundwork for normative “knowledge policy,” in which persuasion and credibility play key roles. The image of investigation is one that overtly rejects the “storehouse” conception of knowledge and invokes the metaphors of distributive economics. Productive questions arise as to (...) how notions of creation and distribution might guide this rhetoric. (shrink)

Objective: To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions. Design: Prospective clinical interventional study. Setting: Internal medicine department (70 beds) of the hospital of La Chaux-de-Fonds, Switzerland. Participants: Nine junior physicians in postgraduate training. Intervention: Information on the ethics of DNR and implementation of new DNR orders. Measurements and main results: Accurate understanding, interpretation, and use of (...) DNR orders, especially with respect to the patients’ involvement in the decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% (p<0.01) after the intervention and the patients’ involvement went from 17% to 48% (p<0.01). Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision. Conclusion: An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. (shrink)

The most popular emendation has been Heinsius's somnia sunt. I find the tone of this misplaced. Thepoet has since 66 laboriously catalogued variant aetiologies of Scylla monstrum. It is inappropriate that he should immediately follow this with the statement that all of them were ‘fancy’ or ‘nonsense’. For a start, we may note that the summation quidquid et ut quisque … presumably includes the version of Homer, to whose authority the poet had appealed in the case of the erroneous contamination (...) of the two Scyllas. Next, I suppose that if Scylla monstrum had been the subject of his poem, the poet might have wanted to say that some of the versions were wrong—or at least of less good authority, or less attractive than others for one reason or another. But Scylla monstrum is not the subject of his poem. He confutes, because it is his concern, the contamination; the listing of the rest, variants in a story not his subject, issues largely from an ‘Alexandrian’ delight in such learned display. It calls for no estimation of their lightness or wrongness: neither relative to one another—and certainly not absolutely. (shrink)