Si en droit public comme en droit privé, l’ordre public limite la liberté contractuelle et fonde des atteintes à la stabilité des relations contractuelles, sa force impérative apparaît aujourd’hui tempérée par la sécurité juridique et par les exigences du service public. Mais il s’agit en réalité de la confrontation de plusieurs éléments de l’ordre public, en raison de la place croissante accordée dans l’ordre social à des valeurs liées à l’institutionnalisation de la paix sociale.

L’acquisition des pronoms chez les enfants à développement langagier typique est complexe car elle combine de nombreux paramètres, notamment une capacité d’abstraction. Dans une première partie, ces paramètres sont décrits en rapport avec les trajectoires d’apprentissage mises en évidence par la littérature. La seconde partie est consacrée aux difficultés que pose l’acquisition des pronoms chez des enfants à développement langagier atypique, pour des raisons de troubles spécifiques du langage ou de surdité profonde.

MARY CAROLINE RICHARDS - "M.C." to her friends - attended Reed College (A.B.) and the University of California (M.A., Ph.D.).

L'ouvrage publié réunit les actes d'une journée d'étude consacrée à L'imprévu et le droit, souhaitée par les doctorants et organisée par l'Ecole doctorale de droit comparé de l'Université Paris 1 Panthéon-Sorbonne. Le sujet est immédiatement apparu très riche. Si le terme d'imprévu n'est pas essentiellement juridique, il fait écho à des critères du droit tels que la prévisibilité d'une situation ou d'un texte, ou l'imprévisibilité d'un événement comme cause exonératoire de responsabilité. Il renvoie plus généralement à l'exigence de sécurité juridique (...) qui s'opposerait à l'imprévu juridique. En outre le contexte était des plus propices, quelle que soit la discipline concernée, droit public, droit privé et/ou droit pénal. L'imprévu est entendu comme tout ce qui n'a pas été prévu, tout ce qui arrive lorsqu'on ne s'y attend pas. Prévoir, c'est admettre comme probable. La question de l'imprévu confronté au droit est intéressante car les deux concepts semblent antinomiques. Le droit apparaît en effet comme quelque chose de figé, permettant de régler par anticipation les comportements humains. Il doit permettre à chacun de régler sa conduite puisque nul n'est censé ignorer la loi. Le droit doit donc être à la fois connu et prévisible dans ses effets même s'il n'en est pas toujours ainsi. La notion d'imprévu semble rencontrer le droit de deux manières. D'une part, il existe la norme imprévue : la norme nouvelle, la coutume en formation ou l'interprétation surprenante. Se posent alors les questions de la prévisibilité du droit, et corrélativement celle de la sécurité juridique. D'autre part, il y a le fait imprévu. La norme doit se saisir de comportements humains ou de situations de fait qui n'avaient pas été anticipés. L'appréhension du risque et de la survenance d'événements inattendus par des règles de droit préexistantes devient alors un enjeu essentiel. (shrink)

BackgroundDeciphering the amount of work provided by different co-authors of a scientific paper has been a recurrent problem in science. Despite the myriad of metrics available, the scientific community still largely relies on the position in the list of authors to evaluate contributions, a metric that attributes subjective and unfounded credit to co-authors. We propose an easy to apply, universally comparable and fair metric to measure and report co-authors contribution in the scientific literature. MethodsThe proposed Author Contribution Index (ACI) is (...) based on contribution percentages provided by the authors, preferably at the time of submission. Researchers can use ACI to compare the contributions of different authors, describe the contribution profile of a particular researcher or analyse how contribution changes through time. We provide such an analysis based on contribution percentages provided by 97 scientists from the field of ecology who voluntarily responded to an online anonymous survey.ResultsACI is simple to understand and to implement because it is based solely on percentage contributions and the number of co-authors. It provides a continuous score that reflects the contribution of one author as compared to the average contribution of all other authors. For example, ACI(i) = 3, means that author i contributed three times more than what the other authors contributed on average. Our analysis comprised 836 papers published in 2014-2016 and revealed patterns of ACI values that relate to career advancement.ConclusionThere are many examples of author contribution indices that have been proposed but none has really been adopted by scientific journals. Many of the proposed solutions are either too complicated, not accurate enough or not comparable across articles, authors and disciplines. The author contribution index presented here addresses these three major issues and has the potential to contribute to more transparency in the science literature. If adopted by scientific journals, it could provide job seekers, recruiters and evaluating bodies with a tool to gather information that is essential to them and cannot be easily and accurately obtained otherwise. We also suggest that scientists use the index regardless of whether it is implemented by journals or not. (shrink)

À partir des travaux menés par le programme de recherche collaborative ANR LIMINAL, cette contribution propose une réflexion sur la centralité de la langue et de la traduction qui émerge notamment à la « lisière » (au sens de E. Hocquard), dans les espaces de migration, notamment dans les camps, campements, centres d’accueil. Ces espaces sont aussi des lieux de rencontre et de transition où, par les expériences singulières et collectives, se redéfinissent de nouvelles pratiques langagières et culturelles. De cette (...) réflexion ont émergé deux projets ( Migralect.org, DU H2M) où il s’agit ainsi, à travers la langue, de prôner les conditions politiques d’une hospibabélité. (shrink)

The ethical issues facing archaeologists must be considered in close coordination with the legal framework governing their activity. Ethics is defined as a “set of principles and values that guide social and professional behaviour”. It can inspire both laws and professional practices, referring to duties inherent to the exercise of a specific activity. The link between ethics and law, built from these multiple sources, is therefore complex. This contribution aims to understand these multiple forms of normativities and their interactions. Several (...) examples are particularly interesting from this point of view: that of the treatment of funerary archaeology which puts under tension the scientific interest and the principle of human dignity, sometimes also the expression of collective rights; that of scientific production and the sharing of the results and data on which they are based; that of the diligence to be observed in a context of possible looting; and also that of the articulation between scientific and heritage interest. The particular nature of the archaeological heritage, as soon as it is revealed at the moment of a discovery, will give rise to specific rules in both domestic and international law at the intersection of law and deontology, a relationship in which there could be a breach of law by deontology. These forms of internormativity are doubly manifest in the process of patrimonialization and when there is question of the appropriation of tangible elements, such as data. (shrink)

Sign languages modulate the production of signs in space and use this spatial modulation to refer back to entities—to maintain coreference. We ask here whether spatial modulation is so fundamental to language in the manual modality that it will be invented by individuals asked to create gestures on the spot. English speakers were asked to describe vignettes under 2 conditions: using gesture without speech, and using speech with spontaneous gestures. When using gesture alone, adults placed gestures for particular entities in (...) non-neutral locations and then used those locations to refer back to the entities. When using gesture plus speech, adults also produced gestures in non-neutral locations but used the locations coreferentially far less often. When gesture is forced to take on the full burden of communication, it exploits space for coreference. Coreference thus appears to be a resilient property of language, likely to emerge in communication systems no matter how simple. (shrink)

A growing body of research reveals that abusive supervision may have negative impacts in organizations. The purpose of the present study is to expand the knowledge regarding the impacts of this dysfunctional leadership behavior by examining its relationship with innovation in work teams. Specifically, we investigate the process through which abusive supervision may undermine team innovation by taking into account the mediating role of team proactive behavior. Moreover, we propose a boundary condition of the negative effect of abusive supervision by (...) considering leader–members interdependence as a moderator. Using a multisource approach, data were gathered from 394 members and 82 immediate supervisors in a public safety organization. Results of path analyses reveal that the relationship between abusive supervision and team innovation is mediated by team proactive behavior. Furthermore, we found that the relationship between abusive supervision and team proactive behavior is moderated by leader–members interdependence, such that this relationship is stronger when the level of interdependence is high. Taken together, the findings of this study improve the understanding of why and under what circumstances abusive supervision may impair team innovation. (shrink)

Recent efforts in a range of scientific fields have emphasised research and methods concerning individual differences and individualisation. This article brings together various scientific disciplines—ecology, evolution, and animal behaviour; medicine and psychiatry; public health and sport/exercise science; sociology; psychology; economics and management science—and presents their research on individualisation. We then clarify the concept of individualisation as it appears in the disciplinary casework by distinguishing three kinds of individualisation studied in and across these disciplines: Individualisation ONE as creating/changing individual differences (the (...) process that generates differences between individuals: intrapopulation or intraspecific variation/heterogeneity); Individualisation TWO as individualising applications (the tailoring or customising of something—information, treatment, a product or service, etc.—for an individual or specific group of individuals); and Individualisation THREE as social changes influencing autonomy, risk, and responsibilities (the process discussed under the rubric of sociological individualisation theory). Moreover, we analyse conceptual links between individualisation and individuality, and characterise different sorts of individuality that the disciplines study. This paper aims to promote interdisciplinary research concerning individualisation by establishing a common conceptual-theoretical basis, while leaving room for disciplinary differences. (shrink)

Individuals of many animal species are said to have a personality. It has been shown that some individuals are bolder than other individuals of the same species, or more sociable or more aggressive. In this paper, we analyse what it means to say that an animal has a personality. We clarify what an animal personality is, that is, its ontology, and how different personality concepts relate to each other, and we examine how personality traits are identified in biological practice. Our (...) analysis shows that biologists often study specific personality traits, such as boldness, sociability or aggressiveness, rather than personalities in general. We claim that personality traits are best understood as dispositions and that they are operationally defined in terms of certain sets of behaviours, which are studied in specific experimental set-ups. Furthermore, we develop an integrative philosophical account that specifies and formalises three criteria for identifying personality traits, which are used in biological practice. For an individual animal to have a personality trait it must, first, behave differently than others. Second, these behavioural differences must be stable over a certain time, and third, they must be consistent in different contexts. (shrink)

The historian Caroline Walker Bynum, who solicited and organized this set of five case studies, explains in her introduction to them that their intent is to bypass the currently popular and unsupported claim that the humanities have practical relevance and, instead, to offer ruminative descriptions of what happens when teachers and students meet to discuss texts and objects. She explains that the essays report in detail on five individual classes in five very different academic settings, in the hope of (...) helping to turn the international anglophone conversation about humanistic education away from utilitarian, presentist, all-inclusive claims and toward a demonstration of what the humanities do in practice. (shrink)

Using the Remember/Know procedure, we compared the impact of a reflective repetition by refreshing and a perceptual repetition on subjective experience during recognition memory. Participants read aloud words as they appeared on a screen. Critical words were presented once , immediately repeated , or followed by a dot signalling the participants to think of and say the just-previous word . In Experiments 1 and 2, Remember responses benefited from refreshing a word . In Experiment 2, this benefit disappeared when participants (...) had to refresh one of three active items. Perceptual repetition increased Remember responses in Experiment 1, but not in Experiment 2 regardless of whether participants had just previously seen 1- or 3-items. These findings indicate that under some circumstances, reflective and perceptual repetition may have different consequences for later subjective experience during remembering, suggesting differences in their underlying functional mechanisms. (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)

Research into consumer responses to corporate social responsibility (CSR) initiatives has expanded in the past four decades, yet the evidence thus far provided does not paint a cohesive picture. Results suggest both positive and negative consumer reactions to CSR, and unless such mixed findings can be reconciled, the outcome might be an amalgamation of disparate empirical results rather than a coherent body of knowledge. The current meta-analysis therefore tests whether the mixed findings might reflect consumers’ distinct, altruistic inferences across various (...) contingency factors. On the basis of 337 effect sizes, involving 584,990 unique respondents, in 162 studies published between 1996 and 2021, this study reveals that altruistic inferences are central to the current CSR paradigm, such that they mediate the effects of CSR initiatives on consumer responses across multiple contingencies. The mediation by altruistic inferences is stronger (weaker) in conditions favorable to dispositional (situational) motive attributions. Furthermore, consumers respond more favorably to cause marketing or philanthropy rather than business-related CSR initiatives, when the initiative is environmental (vs. social), the firm’s offering is utilitarian (vs. hedonic), the CSR initiative takes place in self-expressive (vs. survival) cultures and in earlier (vs. later) periods. These findings offer several ethical implications, and they inform both practical recommendations and an agenda for further research directions. (shrink)

Targeted transitions in chromatin states at thousands of genes are essential drivers of eukaryotic development. Therefore, understanding the in vivo dynamics of epigenetic regulators is crucial for deciphering the mechanisms underpinning cell fate decisions. This review illustrates how, in addition to its cell memory function, the Polycomb group of transcriptional regulators orchestrates temporal, cell and tissue‐specific expression of master genes during development. These highly sophisticated developmental transitions are dependent on the context‐ and tissue‐specific assembly of the different types of Polycomb (...) Group (PcG) complexes, which regulates their targeting and/or activities on chromatin. Here, an overview is provided of how PcG complexes function at multiple scales to regulate transcription, local chromatin environment, and higher order structures that support normal differentiation and are perturbed in tumorigenesis. (shrink)

Research into consumer responses to corporate social responsibility (CSR) initiatives has expanded in the past four decades, yet the evidence thus far provided does not paint a cohesive picture. Results suggest both positive and negative consumer reactions to CSR, and unless such mixed findings can be reconciled, the outcome might be an amalgamation of disparate empirical results rather than a coherent body of knowledge. The current meta-analysis therefore tests whether the mixed findings might reflect consumers’ distinct, altruistic inferences across various (...) contingency factors. On the basis of 337 effect sizes, involving 584,990 unique respondents, in 162 studies published between 1996 and 2021, this study reveals that altruistic inferences are central to the current CSR paradigm, such that they mediate the effects of CSR initiatives on consumer responses across multiple contingencies. The mediation by altruistic inferences is stronger (weaker) in conditions favorable to dispositional (situational) motive attributions. Furthermore, consumers respond more favorably to cause marketing or philanthropy rather than business-related CSR initiatives, when the initiative is environmental (vs. social), the firm’s offering is utilitarian (vs. hedonic), the CSR initiative takes place in self-expressive (vs. survival) cultures and in earlier (vs. later) periods. These findings offer several ethical implications, and they inform both practical recommendations and an agenda for further research directions. (shrink)

In vertebrates, single cell analyses of replication timing patterns brought to light a very well controlled program suggesting a tight regulation on initiation sites. Mapping of replication origins with different methods has revealed discrete preferential sites, enriched in promoters and potential G‐quadruplex motifs, which can aggregate into initiation zones spanning several tens of kilobases (kb). Another characteristic of replication origins is a nucleosome‐free region (NFR). A modified yeast strain containing a humanized origin recognition complex (ORC) fires new origins at NFRs (...) revealing their regulatory role. In cooperation with NFRs, the histone variant H2A.Z facilitates ORC loading through di‐methylation of lysine 20 of histone H4. Recent studies using genome editing methods show that efficient initiation sites associated with transcriptional activity can synergize over several tens of kb by establishing physical contacts and lead to the formation of early domains of DNA replication demonstrating a co‐regulation between replication initiation and transcription. (shrink)

Artificial Intelligence (AI) is increasingly being used in disaster risk management applications to predict the effect of upcoming disasters, plan for mitigation strategies, and determine who needs how much aid after a disaster strikes. The media is filled with unintended ethical concerns of AI algorithms, such as image recognition algorithms not recognizing persons of color or racist algorithmic predictions of whether offenders will recidivate. We know such unintended ethical consequences must play a role in DRM as well, yet there is (...) surprisingly little research on exactly what the unintended consequences are and what we can do to mitigate them. The aim of this perspective is to call researchers working on fairness, accountability, and transparency to work with DRM and local experts—so we can ensure that disaster mitigation and relief is accountable, considers local values, and is not unintentionally biased. (shrink)

L’article se propose d’explorer l’univers des facultés de droit sous la République de Weimar, que les contemporains jugent en « crise ». Cette perception renvoie tout d’abord aux difficultés d’adaptation d’un enseignement qui est de plus en plus écartelé entre les exigences de la science (transmettre une compréhension historique de l’évolution du droit) et celles de la pratique (préparer les étudiants au monde professionnel par une connaissance du droit en vigueur) : l’Université apparaît ainsi comme un lieu de confrontation entre (...) professeurs et autorités étatiques pour le contrôle du cursus juridique. Par ailleurs, dans un contexte de grande expansion des effectifs étudiants, les facultés de droit ne connaissent pas de démocratisation de leur public et restent le domaine des élites traditionnelles ; de ce fait, elles semblent en décalage avec leur époque et continuent de former un univers passéiste que conforte l’engagement des étudiants dans des corporations traditionnelles. Ce mode de socialisation explique leur radicalisation dans le camp antirépublicain dès les années 1920. (shrink)

The SALOMON project is a contribution to the automatic processing of legal texts. Its aim is to automatically summarise Belgian criminal cases in order to improve access to the large number of existing and future cases. Therefore, techniques are developed for identifying and extracting relevant information from the cases. A broader application of these techniques could considerably simplify the work of the legal profession.A double methodology was used when developing SALOMON: the cases are processed by employing additional knowledge to interpret (...) structural patterns and features on the one hand and by way of occurrence statistics of index terms on the other. As a result, SALOMON performs an initial categorisation and structuring of the cases and subsequently extracts the most relevant text units of the alleged offences and of the opinion of the court. The SALOMON techniques do not themselves solve any legal questions, but they do guide the user effectively towards relevant texts. (shrink)

This research aims to understand how two basic schemas—vigilante and reparation—influence online public complaining. Drawing on two experiments, a longitudinal field study and content analysis of online complaints, the current research makes three core contributions. First, we show that for similar service failures, each schema is associated with different justice motivations, which have different moral implications for consumers. Second, vigilante and reparation complainers write complaints in a different manner and are drawn to different online platforms; this information is helpful to (...) identify complainers using each schema. Third, the schemas moderate the process leading to different post-complaint benefits. Specifically, perseverance has a greater effect on obtaining a resolution for reparation complainers compared to vigilantes. Additionally, whereas a recovery leads to an increase in positive affect for reparation complainers, vigilantes experience a high level of positive affect simply by posting their complaint. The theoretical, ethical, and managerial implications of these findings are discussed. (shrink)

For living beings, information is as fundamental as matter or energy. In this paper we show: a) inadequacies of quantitative theories of information, b) how a qualitative analysis leads to a classification of information systems and to a modelling of intercellular communication.From a quantitative point of view, the application in biology of information theories borrowed from communication techniques proved to be disappointing. These theories ignore deliberately the significance of messages, and do not give any definition of information. They refer to (...) quantities, based upon arbitrarily defined probabilistic events. Probability is subjective. The receiver of the message needs to have meta-knowledge of the events. The quantity of information depends on language, coding, and arbitrary definition of disorder. The suggested objectivity is fallacious. (shrink)

BackgroundWith the emergence of Brain Computer Interfaces, clinicians have been facing a new group of patients with severe acquired brain injury who are unable to show any behavioral sign of consciousness but respond to active neuroimaging or electrophysiological paradigms. However, even though well documented, there is still no consensus regarding the nomenclature for this clinical entity.ObjectivesThis systematic review aims to 1) identify the terms used to indicate the presence of this entity through the years, and 2) promote an informed discussion (...) regarding the rationale for these names and the best candidates to name this fascinating disorder.MethodsThe Disorders of Consciousness Special Interest Group of the International Brain Injury Association launched a search on Pubmed and Google scholar following PRISMA guidelines to collect peer-reviewed articles and reviews on human adults published in English between 2006 and 2021.ResultsThe search launched in January 2021 identified 4,089 potentially relevant titles. After screening, 1,126 abstracts were found relevant. Finally, 161 manuscripts were included in our analyses. Only 58% of the manuscripts used a specific name to discuss this clinical entity, among which 32% used several names interchangeably throughout the text. We found 25 different names given to this entity. The five following names were the ones the most frequently used: covert awareness, cognitive motor dissociation, functional locked-in, non-behavioral MCS and higher-order cortex motor dissociation.ConclusionSince 2006, there has been no agreement regarding the taxonomy to use for unresponsive patients who are able to respond to active neuroimaging or electrophysiological paradigms. Developing a standard taxonomy is an important goal for future research studies and clinical translation. We recommend a Delphi study in order to build such a consensus. (shrink)

Cross-border reproductive care (CBRC) can be defined as the movement from one jurisdiction to another for medically assisted reproduction (MAR). CBRC raises many ethical concerns that have been addressed extensively. However, the conclusions are still based on scarce evidence even considering the global scale of CBRC. Empirical ethics appears as a way to foster this ethical reflection on CBRC while attuning it with the experiences of its main actors. To better understand the ‘in and out’ situation of CBRC in Canada, (...) we conducted an ethnographic study taking a ‘critically applied ethics’ approach. This article presents a part of the findings of this research, obtained by data triangulation from qualitative analysis of pertinent literature, participant observation in two Canadian fertility clinics and 40 semidirected interviews. Based on participants’ perceptions, four themes emerged: (1) inconsistencies of the Canadian legal framework; (2) autonomy and the necessity to resort to CBRC; (3) safety and the management of CBRC individual risks; and (4) justice and solidarity. The interaction between these four themes highlights the problematic of ‘reproductive outsourcing’ that characterised the Canadian situation, a system where the controversial aspects of MAR are knowingly pushed outside the borders. (shrink)

Derrida and the Future of the Liberal Arts highlights the Derridean assertion that the university must exist 'without condition' - as a bastion of intellectual freedom and oppositional activity whose job it is to question mainstream society. Derrida argued that only if the life of the mind is kept free from excessive corporate influence and political control can we be certain that the basic tenets of democracy are being respected within the very societies that claim to defend democratic principles. This (...) collection contains eleven essays drawn from international scholars working in both the humanities and social sciences, and makes a well-grounded and comprehensive case for the importance of Derridean thought within the liberal arts today. Written by specialists in the fields of philosophy, literature, history, sociology, geography, political science, animal studies, and gender studies, each essay traces deconstruction's contribution to their discipline, explaining how it helps keep alive the 'unconditional', contrapuntal mission of the university. The book offers a forceful and persuasive corrective to the current assault on the liberal arts. (shrink)

Whether or not conscious recollection in autobiographical memory is affected in schizophrenia is unknown. The aim of this study was to address this issue using an experiential approach. An autobiographical memory enquiry was used in combination with the Remember/Know procedure. Twenty-two patients with schizophrenia and 22 normal subjects were asked to recall specific autobiographical memories from four lifetime periods and to indicate the subjective states of awareness associated with the recall of what happened, when and where. They gave Remember, Know (...) or Guess responses according to whether they recalled these aspects of the event on the basis of conscious recollection, simply knowing, or guessing. Results showed that the frequency and consistency of Remember responses was significantly lower in patients than in comparison subjects. In contrast, the frequency of Know responses was not significantly different, whereas the frequency of patients’ Guess responses was significantly enhanced. It is concluded that the frequency and consistency of conscious recollection in autobiographical memory is reduced in patients with schizophrenia. (shrink)

A new approach to information is proposed with the intention of providing a conceptual tool adapted to biology, including a semantic value.Information involves a material support as well as a significance, adapted to the cognitive domain of the receiver and/or the transmitter. A message does not carry any information, only data. The receiver makes an identification by a procedure of recognition of the forms, which activate previously learned significance. This treatment leads to a new significance (or new knowledge).

Digital communication between a patient and their clinician offers the potential for improved patient care, particularly for young people with long term conditions who are at risk of service disengagement. However, its use raises a number of ethical questions which have not been explored in empirical studies. The objective of this study was to examine, from the patient and clinician perspective, the ethical implications of the use of digital clinical communication in the context of young people living with long-term conditions. (...) A total of 129 semi-structured interviews, 59 with young people and 70 with healthcare professionals, from 20 United Kingdom -based specialist clinics were conducted as part of the LYNC study. Transcripts from five sites were read by a core team to identify explicit and implicit ethical issues and develop descriptive ethical codes. Our subsequent thematic analysis was developed iteratively with reference to professional and ethical norms. Clinician participants saw digital clinical communication as potentially increasing patient empowerment and autonomy; improving trust between patient and healthcare professional; and reducing harm because of rapid access to clinical advice. However, they also described ethical challenges, including: difficulty with defining and maintaining boundaries of confidentiality; uncertainty regarding the level of consent required; and blurring of the limits of a clinician’s duty of care when unlimited access is possible. Paradoxically, the use of digital clinical communication can create dependence rather than promote autonomy in some patients. Patient participants varied in their understanding of, and concern about, confidentiality in the context of digital communication. An overarching theme emerging from the data was a shifting of the boundaries of the patient-clinician relationship and the professional duty of care in the context of use of clinical digital communication. The ethical implications of clinical digital communication are complex and go beyond concerns about confidentiality and consent. Any development of this form of communication should consider its impact on the patient-clinician-relationship, and include appropriate safeguards to ensure that professional ethical obligations are adhered to. (shrink)