This article reflects on the intersection of the New Testament’s witness with current questions of illness, medication, risk, luck, death, and hope. Drawing principally on the Gospel of Matthew and the letters of Paul, I argue that, for Christians, hope in the resurrection—not the ability to avoid suffering and death—provides the best context for prudential judgment in light of the inscrutability of the future and the concomitant opacity that attends medical decision-making. We do not and will not know what we (...) would need to know in order to make decisions we can count on with surety, and we thus read Scripture in order to become the people who can make wise judgments in the meantime called hope. (shrink)

Background In June 2016, the Parliament of Canada passed federal legislation allowing eligible adults to request Medical Assistance in Dying (MAID). Since its implementation, there likely exists a degree of hesitancy among some healthcare providers due to the law being inconsistent with personal beliefs and values. It is imperative to explore how nurses in Quebec experience the shift from accompanying palliative clients through “a natural death” to participating in “a premeditated death.” Research question/aim/objectives This study aims to explore how Quebec (...) nurses personally and professionally face the new practice of MAID and their role evolution. Research design A grounded theory design was used. Participants and research context We recruited 37 nurses who participated in or coordinated at least one MAID. Semi-structured interviews and focus groups were conducted and audiotaped. Data collection and analysis followed Strauss and Corbin steps. Ethical considerations Ethics approval was received from the investigator’s affiliated University. Participants were informed regarding the research goal, signed a written consent, and were assigned pseudonyms. Findings/results Results show that nurses experienced the wide range of paradoxe during MAID centering around the following eight elements: 1) confrontation abouth death, 2) choice, 3) time of death, 4) emotional load, 5) new Bill, 6) relationship with the person, 7) communication skills, and 8) healthcare setting. The shifting of views and values in this new role is presented by the contradiction of opposites. Conclusions A better understanding of the paradox experienced by nurses involved with MAID paves the way for the development of interventions. (shrink)

Deontic modals are the topic of my dissertation. All deontic modals, yes, but justification in particular, and epistemic justification even more specifically. Deontic modals operate upon performances—they appraise performances. Positively appraised, a performance is appropriate, decent, justifiable, right, permissible, or proper; negatively appraised, inappropriate, indecent, unjustifiable, wrong, impermissible, or improper. Belief and knowledge and performances in exactly the same sense that action and intention are performances: all are products of powers that are in some sense responsive to reasons. The principal (...) difference is the direction of fit between mind and world. Knowledge and belief the product of cognitive powers aimed at adapting mind to world, action and intention the product of conative powers aimed at adapting world to mind. All are normatively evaluable and the characteristic normative appraisal of each is deontic. Epistemology, ethics, and rational choice all investigate the nature of deontic modals, differing only insofar as the central aims are epistemic, moral, or prudential in nature. In this sense, the general theory of deontic modals is the parent to epistemology, ethics, and rational choice. My project is to develop and defend a schematic theory of justification. I achieve this end by developing and defending a general theory of deontic modalities. Riffing on two pithy turns of phrase, the deontic theory may be tersely sloganized: value first and one must do the best one can. It is a teleological theory that defines all deontic concepts from the theoretically foundational notions of ability and value. Roughly, a belief is epistemically justifiable if, and only if, it is part of an epistemically optimific belief set the agent is able to have. Roughly, an act is morally justifiably if, and only if, it is part of a morally optimific action set the agent is able to perform. My pet interest is in the former. The resultant framework is enormously fruitful, especially in epistemology. (shrink)

As a preliminary step to beginning to assess the usefulness of clinical vignettes to measure ethical sensitivity in undergraduate medical students, five clinical vignettes with seven to nine ethical issues each were created. The ethical issues in the vignettes were discussed and outlined by an expert panel. One randomly selected vignette was presented to first, second and third year students at the University of Toronto as part of another examination. The students were asked to list the issues presented by the (...) patient problem. Responses from 281 students were obtained. These students identified an average of 2.72 ethical issues per vignette. Each response was classified under the domains of autonomy, beneficence and justice. Comparisons were made between classes and between vignettes. There was considerable variation between classes and the responses to different vignettes seem to indicate that different vignettes measure the various domains in different ways. It does appear that the use of vignettes is one way to measure aspects of ethical sensitivity in medical students but more study is required to clarify exactly what is being measured. (shrink)

An instrument to assess 'ethical sensitivity' has been developed. The instrument presents four clinical vignettes and the respondent is asked to list the ethical issues related to each vignette. The responses are classified, post hoc, into the domains of autonomy, beneficence and justice. This instrument was used in 1990 to assess the ethical sensitivity of students in all four medical classes at the University of Toronto. Ethical sensitivity, as measured by this instrument, is not related to age or grade-point average. (...) Sensitivity increases between the 1st and 2nd year and then decreases throughout the rest of undergraduate medical training, such that the 4th-year students identify fewer issues than those entering medical school. Students expressing a career choice of family medicine identify more issues than their peers. Several problems with the use of the instrument and the interpretation of the data were found. Nonetheless, these findings, if reproducible, are important and their meaning needs further discussion. (shrink)

This book explains why Tocqueville saw the central task of modern statesmanship as combating 'individualism,' a type of civic apathy that he thought capable of robbing modern citizens of human virtue and issuing in a historically unprecedented form of despotism. It looks in depth at the mechanisms he proposed for avoiding the perils and securing the promise of democracy in his own day, and discusses how Tocqueville's insights might be applied in our own time.

The central view of this dissertation is that a more comprehensive theory of scientific learning must incorporate insights from the disciplines of methodology and sociology. The standards of methodology play an indispensible role in learning by providing some of the principles necessary for theoretical evaluation. But such principles are not sufficient for socially embedded learning and they do not exclude the operation of social interests within science. It is the institutional structure of science that helps make up what abstract standards (...) alone lack: the material means with which to affect the advancement of learning. Institutions add something of their own dynamic to learning by helping to realize the abstract principles of methodology--they are never simply neutral husks. ;The views of a number of methodologists and sociologists are examined to demonstrate that this view of learning has not always been appreciated. Some methodologists have thought that by developing a theory of scientific method they were ensuring science's insulation from society at large. Such projects expect too much of methodology and the best methodology we have--fallibilism--leaves science open to social influence. Some sociologists have seen the role of a social theory as cutting across that of methodology--as if a social account of learning could only be at the expense of methodology. This had led some to deny methodology any explanatory power and others to limit sociology to accounting for merely the external aspects of scientific development. ;I throughout try to suggest how learning may be best accounted for by a fallibilist methodology combined with an institutional social theory. Such a dual view of learning is helpful because the advancement of learning is at times as dependent on its material constraints as on its intellectual ones. Thus, a comprehensive theory of learning can help science be a more critical enterprise and so contribute to its advancement. (shrink)

This article presents the results of a research that aimed to examine the phenomenon of student cheating on exams in faculties of education in Quebec universities. A total of 573 preservice teachers completed an online survey in 2018. The questionnaire consisted of 28 questions with a Likert scale related to individual and contextual factors associated with the propensity to cheat on exams as well as two yes/no items on the arguments for cheating. Descriptive and hierarchical linear regression analyses highlighted the (...) existence of cheating but also how three factors influenced the students’ propensity to cheat: influence of peers, methods of cheating, and institutional context. (shrink)

A force de lire à chaud les débats actuels de la philosophie et s'habituer aux diverses technicalités d'interprétation s'alimentant de la structure ouverte du texte philosophique; à force de dépouiller catalogues d'éditeurs et programmes de congrès avec la rapidité de celui qui se sait dans le coup de la contemporanéité la plus sophistiquée, nous oublions parfois la pertinence et le sens de l'étrangeté radicale des classiques. Nous préférons croire que de leur hauteur à première vue inaccessible, un peu surannée, les (...) philosophes de cette époque et—par une métonymie à la limite typographique—les textes classiques modélent des paysages intérieurs révolus, raffinent la quintessence d'une civilisation qui aurait manqué nos propres moyens d'action « plus réels », plus appropries à la conscience foncièrement progressiste qui nous tenaille. (shrink)

Este artigo científico procurou investigar o processo de adaptação da Universidade Brasileira aos novos paradigmas impostos pelas políticas neoliberais. A análise se faz a partir de breve histórico do liberalismo e de suas imbricações no ensino. Apontando também a relativização da suposta democratização e modernização do ensino pelas novas perspectivas impostas pelo mercado. São levantadas também questões como autonomia universitária e legitimação da instituição de ensino superior.

Rare diseases, defined as having a prevalence inferior to 1/2000, are poorly understood scientifically and medically. Appropriate diagnoses and treatments are scarce, adding to the burden of living with chronic medical conditions. The moral significance of rare disease experiences is often overlooked in qualitative studies conducted with adults living with rare diseases. The concept of morally problematic situations arising from pragmatist ethics shows promise in understanding these experiences. The objectives of this study were to (1) acquire an in-depth understanding of (...) morally problematic situations experienced by adults living with rare diseases in the province of Québec and (2) to develop an integrative model of the concept of morally problematic situations. To this end, an online survey targeting this population was developed through a participatory action research project. Respondents provided 90 long testimonies on the most important morally problematic situations they faced, often in healthcare settings. An integrative model was developed based on various qualitative analyses of these testimonies and relevant literature. The integrative model showcases that morally problematic situations have causes (i.e., contextual and relational factors, personal factors, jeopardized valuations), have affective repercussions (i.e., emotions and feelings, internal tensions), prompt action (i.e., through empowerment strategies leading to the evolution of situations), and elicit outcomes (i.e., factual consequences, residual emotions and feelings, positive or negative resolutions). In sum, this study advances understanding of the moral experiences of adults living with rare diseases while proposing a comprehensive conceptual tool to guide future empirical bioethics research on moral experiences. (shrink)

Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians is a concise and practical guide to ethical decision-making in medicine. The text is aimed at second- and third-year one-semester ethics courses offered in medical schools, health sciences departments, and nursing programs. By taking an applied approach rather than a theoretical approach, this text serves the needs of medical and nursing students, residents, and practicing physicians by sorting through questions of moral principles relevant to the diverse and growing (...) number of healthcare professionals. The many topics covered include truth telling, refusal of treatment, assisted suicide, managing error, and reproductive choice. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2017 Heft: 214 Seiten: 331-350.

In this groundbreaking, cross-disciplinary work of philosophy and biblical studies, New Testament scholar C. Kavin Rowe explores the promise and problems inherent in engaging rival philosophical claims to what is true. Juxtaposing the Roman Stoics Seneca, Epictetus, and Marcus Aurelius with the Christian saints Paul, Luke, and Justin Martyr, and incorporating the contemporary views of Jeffrey Stout, Alasdair McIntyre, Charles Taylor, Martha Nussbaum, Pierre Hadot, and others, the author suggests that in a world of religious pluralism there is negligible (...) gain in sampling from separate belief systems. This thought-provoking volume reconceives the relationship between ancient philosophy and emergent Christianity as a rivalry between strong traditions of life and offers powerful arguments for the exclusive commitment to a community of belief and a particular form of philosophical life as the path to existential truth. (shrink)

This article seeks to define what is semiotic and what is Semiotics. Provided first is a brief presentation of various perspectives of Semiotics. Pursuant to this, we will seek to uncover Semiotics’ particulars by evaluating various approaches. We will commence by framing the definitions of the word “Semiotic” to consider then Semiotics via eight particular anthropic – human-related – levels. This partition, derived by the author from a Rastier typology, defines the following levels: noumenophysical, phenophysical, semiotic, representational (“mental images” and (...) concepts), sens (physical), felt (affects), cognitive other and transcendental. From here, we will consider the place of Semiotics among disciplines. Finally, the text presents a typology of relationship between disciplines, including semiotics: anadisciplinarity, disciplinarity, valodisciplinarity, intradisciplinary (such as intertheoricity), multidisciplinary, interdisciplinary, transdisciplinary, metadisciplinarity). (shrink)

Frankfurt examples invite controversy over whether the pertinent agent in these examples lacks the specific ability to do otherwise, and whether what she does can be obligatory or permissible. We develop an account of ability that implies that this agent does not have the specific ability to refrain from performing the germane action. The account also undergirds a view of obligation that entails that it is morally required or prohibited for an agent to perform an action only if she has (...) the specific ability to do, and to do otherwise than, perform it. Therefore, in Frankfurt examples, it is neither obligatory nor impermissible for the relevant agent to do what she does. (shrink)

Ce texte a déjà paru dans L. Hébert (dir.), Signo, Rimouski (Québec), 2011. Nous remercions Louis Hébert de nous avoir autorisé à le reproduire ici. 1. Résumé Trois opérations sont nécessaires pour produire un rythme : la segmentation en unités, la disposition et la sériation de ces unités. « Disposition » désigne également la composante relative à la disposition des unités dans une étendue temporelle et/ou spatiale. Le rythme peut notamment être défini comme la configuration particulière que constituent (...) au (...) - Sur le concept de rythme – Nouvel article. (shrink)

ABSTRACTThis essay argues that retrieving insights from the ancient Stoic philosophers for Christian ethics is much more difficult than is often assumed and, further, that the “ethics of retrieval” is itself something worth prolonged reflection. The central problem is that in their ancient sense both Christianity and Stoicism are practically dense patterns of reasoning and mutually incompatible forms of life. Coming to see this clearly requires the realization that the encounter between Stoicism and Christianity is a conflict of lived traditions. (...) Precisely because we cannot simply extract Stoic insights from the lives in which they belong, the task of determining how Stoicism is useful for Christianity is exceptionally challenging. Indeed, doing justice to the Stoics has more to do with facing an alternative to Christianity than it does with appropriating insights for our own use. These points are developed in conversation with Elizabeth Agnew Cochran's recent article on the Stoic influence upon Jonathan Edwards. (shrink)

The problem of luck is advanced and defended against libertarian theories of responsibility-enabling ability. An outline of an account of ability is articulated to explore some features of the sort of ability moral responsibility requires. The account vindicates the luck objection and suggests a novel puzzle: Libertarianism is structurally barred from answering the problem of luck because responsibility requires, but inherently lacks, an explanation from reason states to actions that preserves reliability of connection between responsibility-grounding reasons-sensitivity and action.

Dignity is omnipresent in Western ethics, but it also provokes dissension and controversy. One of the most striking examples is the debate on medically assisted death, where dignity is invoked to support antagonistic positions. While some authors conclude that the concept is useless as an ethical reference, many others invite us to deepen our analysis from a multidimensional perspective, to enrich it and make it useful. This scoping study is intended to provide an overview of the different conceptions of dignity (...) used in the assisted dying debate, to better grasp the multiple facets of the concept. The Joanna Briggs Institute's JBI Manual for Evidence Synthesis guided the scoping review. Key words were based on the researchers' expertise and were used to identify relevant literature in French and English. Eleven databases covering the last six decades were consulted. Initially, 2,071 references were found in the databases. After excluding duplicates, screening titles, abstracts, and full texts, and after a specific literature search on the concept of relational dignity, 156 papers were found to match the identified inclusion criteria. The literature highlights the stark confrontation between two dominant conceptions of dignity: ontological and autonomist. However, a lesser-known conceptualization of dignity integrates these two perspectives, underlining the relational and social dimensions of dignity. As a result, dignity emerges as a dynamic, experiential, and dialogical concept, that modulates itself according to circumstances. This raises the possibility of breaking through the binary debate and questioning the current frameworks that define dignity. This multidimensional conceptualization of dignity could lead to a more complete and nuanced understanding of the concept, as well as open richer normative horizons regarding the issue of medically assisted death. (shrink)

This essay argues that retrieving insights from the ancient Stoic philosophers for Christian ethics is much more difficult than is often assumed and, further, that the "ethics of retrieval" is itself something worth prolonged reflection. The central problem is that in their ancient sense both Christianity and Stoicism are practically dense patterns of reasoning and mutually incompatible forms of life. Coming to see this clearly requires the realization that the encounter between Stoicism and Christianity is a conflict of lived traditions. (...) Precisely because we cannot simply extract Stoic insights from the lives in which they belong, the task of determining how Stoicism is useful for Christianity is exceptionally challenging. Indeed, doing justice to the Stoics has more to do with facing an alternative to Christianity than it does with appropriating insights for our own use. These points are developed in conversation with Elizabeth Agnew Cochran's recent article on the Stoic influence upon Jonathan Edwards. This essay is a response to C. Kavin Rowe's critique of my 2011 argument that certain dimensions of Roman Stoic ethics are at work in Jonathan Edwards's moral thought. Rowe raises questions about the act of selectively retrieving ideas from a philosophical tradition to support constructive work in another tradition. I argue for the importance of acknowledging how Christian thought has been shaped by what Jeffrey Stout describes as moral bricolage, the selective retrieval of ideas from various traditions, and I contend that this bricolage can continue to be a fruitful means through which Christian ethics engages external traditions. Moreover, the importance of Stoicism's retrieval in early modern philosophy makes the work of eighteenth-century theologians such as Edwards a particularly valuable resource for exploring the plausibility of Christian engagement with the Stoics. (shrink)