Is it possible to interfere with individual decision-making while preserving freedom of choice? The purpose of this article is to assess whether ‘libertarian paternalism’, a set of political and ethical principles derived from the observations of behavioural sciences, can form the basis of a viable framework for the ethical analysis of public health interventions. First, the article situates libertarian libertarianism within the broader context of the law and economics movement. The main tenets of the approach are then presented and particular (...) attention is given to its operationalization through the notion of a ‘nudge’. Essentially, a ‘nudge’ consists in an intervention, which aims to suggest one choice over another by gently steering individual choices in welfare-enhancing directions yet without imposing any significant limit on available choices. Finally, the article concludes that, while it fails as an overreaching framework of ethical analysis, libertarian paternalism nonetheless constitutes a valuable addition to the conceptual toolbox of public health ethics. (shrink)

On a souvent dit que la bioéthique émergea au confluent des sciences de la santé, de la théologie, de la philosophie et du droit. Or, pour poursuivre son évolution, la bioéthique se doit d’adopter une position critique vis-à-vis de cet héritage, notamment en ce qui concerne le droit.

Ce texte offre quelques réflexions épistémologiques et méthodologiques en réponse au texte d’Antoine Boudreau LeBlanc qui plaide pour une bioéthique renouvelée, capable de faire le lien entre science et politique afin de relever les défis majeurs auxquels l’humanité est actuellement confrontée. Cette proposition apparait nécessaire, compte tenu du paradoxe qui émerge du fait que l’expertise et la spécialisation grandissante ne se traduisent pas toujours par des solutions aux problèmes complexes qui affligent l’humanité. Il apparaît nécessaire de réfléchir à la nature (...) même de ces problèmes et de reconnaitre qu’ils se situent à une échelle qui dépasse l’individu. De même, il apparait nécessaire de considérer la dimension pratique de mise en oeuvre des solutions proposées. L’ouverture épistémique de la bioéthique semble être un atout important à cet égard. Toutefois, on peut se demander si le potentiel d’hybridation entre les savoirs défendu par Boudreau LeBlanc risque d’être atténué par la professionnalisation et la centralisation de la médiation entre ceux-ci. De même, il importe de préserver le caractère distinctif de la bioéthique. (shrink)

The notion of transparency regularly comes up in discussions about the secondary uses of health data. Few studies, however, examine the impact of the presence or absence of transparency on members of the public. This literature review responds to this gap in the scientific literature. It is the result of a secondary analysis of 124 texts from an exploratory review on transparency, following the PRISMAS-ScR guidelines. The results help to identify negative or positive impacts and associate these with certain communication (...) components relating to secondary uses of health data. They also make it possible to identify the components associated with communication deemed transparent or opaque by stakeholders. Transparency, and more specifically continuity of communication, is strongly associated with increased trust and social acceptability, whereas members of the public generally perceive a lack of transparency negatively. This literature review also deepens our understanding of the potential negative impacts of transparent communication. (shrink)

In April 2020, almost six out of 10 people around the world were in lockdown due to the COVID-19 pandemic. Being locked down usually has a deleterious effect on the confined individual's mental health. In this exceptionally challenging context, finding ways to minimize negative mood about the pandemic is essential. Pandemic-related negative states (“negative mood”) and recovery experiences were investigated in a sample of 264 individuals who completed daily surveys four times per day over 7 consecutive days. MSEMs analyses revealed (...) that negative mood persisted from moment-to-moment through the day, thus showing a response lag effect. Further analyses revealed that when someone experienced pandemic-related psychological detachment, relaxation, mastery, control, pleasure, or relatedness at specific periods of the day, mood had improved at the next measured time period, suggesting a protective effect. However, the pattern displayed by singles with dependents suggests that some recovery experiences at specific periods during the day seem to have a backfiring effect and worsen subsequent mood. These findings bring new insight into the role of recovery experiences during lockdowns and suggest that many could benefit from such experiences throughout the day when self-isolating. However, for individuals with multiple risk factors such as being single with dependents, some recovery experiences, at specific periods during the day, might not bring the desired outcome and future research is needed to examine if guilt or domestic burden may explain this finding. Results contribute to our understanding of how to take care of one's mental health during the current pandemic, and concrete recommendations adapted to individual contexts are provided. (shrink)