L’auteur s’appuie sur le travail de F. André, L’enfant insuffisamment bon (1985), pour explorer l’idée que le handicap et la souffrance qu’il procure à son contact met en question l’identification humaine sur un plan familial et sociétal et entraîne des mécanismes d’indifférenciation entre l’humain et le non-humain, le vivant et le non vivant. Situés dans un mouvement protecteur au départ, ces mécanismes aggravent ensuite les effets du handicap au sein des familles ou des établissements spécialisés en empêchant le développement de (...) la sub-jectivité de chacun. Pour le comprendre, l’auteur expose deux exemples de thérapies familiales psychanalytiques, l’un dans le cas d’une enfant gravement handicapée (atteinte neurologique et psychose symbiotique), et l’autre dans le cas d’un enfant dont le handicap se trouve majoré par les éléments trans-générationnels réactivés à sa naissance et dont il va se retrouver porteur. (shrink)

L’adoption a la particularité d’activer un champ fantasmatique dont l’auteur se propose d’éclairer certains aspects. La résonance entre la situation adoptive et ce que Freud a appelé le « roman familial » en fait un lieu possible d’exacerbation des rivalités, des fantasmes de rapt, des mécanismes d’idéalisation, aussi bien au sein des familles adoptantes que dans leurs relations avec les professionnels chargés de les accompagner. L’idéalisation conjointe parents-pro-fessionnels de la situation adoptive a pour effet d’empêcher la reconnaissance de la négativité (...) présente dans toute forme de transmission. Elle peut empêcher aussi le repérage de ce que l’auteur propose d’appréhender comme une clinique de la rupture de transmission. Cette rupture a parfois comme conséquence la mise en place de clivages internes à chacun des protagonistes, clivages qui vont se redoubler et diffuser sous forme de sidération ou de conflits dans l’agencement des professionnels gravitant autour de ces situations. Ces situations complexes, bouleversant profondément chacun, nécessitent des espaces spécifiques de traitement et de réflexion pour en construire des modalités de compréhension. (shrink)

A translation of a dialogue between Evelyne Grossman and Jacob Rogozinski on Artaud, Deleuze, and the status of the ego.

The centrality of trust in traditional doctor–patient relationships has been criticized as inordinately paternalistic, yet in today's discussions about medical ethics—mostly in response to disruptive innovation in healthcare—trust reappears as an asset to enable empowerment. To turn away from paternalistic trust‐based doctor–patient relationships and to arrive at an empowerment‐based medical model, increasing reference is made to the importance of nurturing trust in technologies that are supposed to bring that empowerment. In this article we stimulate discussion about why the move towards (...) patient empowerment may not be able to keep clear of the criticism of trust in traditional patient–doctor relationships. First, we explore how such a shift in trust dynamics might corrode patient empowerment in the name of patient empowerment. Second, we examine how a translocation of trust may at best push the “trust issue” elsewhere and at worst make it harder to evaluate trustworthiness. (shrink)

People have various desires, but it is a contested moral issue when a desire becomes of such importance that it legitimizes a moral claim on others. This paper explores how the normative significance of desire satisfaction can be assessed and argues that a normatively significant desire can constitute a pro tanto obligation to help satisfy it. The paper presents a framework that relates the normative significance of a given desire to the general goal of living a reasonably valuable life and (...) inquires how the latter can be given determinate content without excluding a heterogeneity of the personal good. The paper contends that the set of possibly normatively significant desires is thus restricted by considerations about intelligibility, adequacy, and replaceability, which are mediated by societal background theories. (shrink)

An edition of the letters of Erasmus, regarded as one of the greatest humanist writers. All 12 volumes of this work have been reissued, complete with their scholarly apparatus of commentary and notes, as well as plates.

The erosion of the three interlocking dimensions of nature, society and self is the consequence of what Felix Guattari referred to as integrated world capitalism (IWC). In South Africa the erosion of nature, society and self is also the consequence of centuries of colonialism and decades of apartheid. In this paper I wish to explore how the African philosophy of ubuntu (humanness), which appears to be anthropocentric, might be invoked to contribute to the healing of the three ecologies—how healing of (...) the social might transversally effect healing of nature and the self. My theoretical exploration has relevance to education in South Africa, given that a mandate of national curriculum policy is that indigenous knowledge systems form part of the discursive terrains of all school learning areas/subjects. (shrink)

BackgroundBreakthroughs in animal studies make the topic of human application of ectogenesis for medical and non-medical purposes more relevant than ever before. While current data do not yet demonstrate a reasonable expectation of clinical benefit soon, several groups are investigating the feasibility of artificial uteri for extracorporeal human gestation.Main textThis paper offers the first comprehensive and up to date discussion of the most important pros and cons of human ectogenesis in light of clinical application, along with an examination of crucial (...) ethical (and legal) issues that continued research into, and the clinical translation of, ectogenesis gives rise to. The expected benefits include advancing prenatal medicine, improving neonatal intensive care, and providing a novel pathway towards biological parenthood. This comes with important future challenges. Prior to human application, important questions have to be considered concerning translational research, experimental use of human fetuses and appropriate safety testing. Key questions are identified regarding risks to ectogenesis’ subjects, and the physical impact on the pregnant person when transfer from the uterus to the artificial womb is required. Critical issues concerning proportionality have to be considered, also in terms of equity of access, relative to the envisaged application of ectogenesis. The advent of ectogenesis also comes with crucial issues surrounding abortion, extended fetal viability and moral status of the fetus.ConclusionsThe development of human ectogenesis will have numerous implications for clinical practice. Prior to human testing, close consideration should be given to whether (and how) ectogenesis can be introduced as a continuation of existing neonatal care, with due attention to both safety risks to the fetus and pressures on pregnant persons to undergo experimental and/or invasive procedures. Equally important is the societal debate about the acceptable applications of ectogenesis and how access to these usages should be prioritized. It should be anticipated that clinical availability of ectogenesis, possibly first as a way to save extremely premature fetuses, may spark demand for non-medical purposes, like avoiding physical and social burdens of pregnancy. (shrink)

John Evelyn (1620-1706) is best remembered for Sylva - his magnum opus - and his Diary . Alongside Pepys' diary, Evelyn's is as well known now as anything else written in their time. A connoisseur of architecture, painting, music, coins, and sermons, Evelyn was renowned for his practical knowledge on horticulture and arboriculture, and he was one of the original Fellows of the Royal Society. His Diary begins with an account of his early life and travels in Europe. In addition (...) to his own jottings of events, Evelyn drew on contemporary newspapers and pamphlets. (shrink)

In _Beyond Prejudice_, Evelyn B. Pluhar defends the view that any sentient conative being—one capable of caring about what happens to him or herself—is morally significant, a view that supports the moral status and rights of many nonhuman animals. Confronting traditional and contemporary philosophical arguments, she offers in clear and accessible fashion a thorough examination of theories of moral significance while decisively demonstrating the flaws in the arguments of those who would avoid attributing moral rights to nonhumans. Exposing the traditional (...) view—which restricts the moral realm to autonomous, fully fledged "persons"—as having horrific implications for the treatment of many humans, Pluhar goes on to argue positively that sentient individuals of any species are no less morally significant than the most automomous human. Her position provides the ultimate justification that is missing from previous defenses of the moral status of nonhuman animals. In the process of advancing her position, Pluhar discusses the implications of determining moral significance for children and "abnormal" humans as well as its relevance to population policies, the raising of animals for food or product testing, decisions on hunting and euthanasia, and the treatment of companion animals. In addition, the author scrutinizes recent assertions by environmental ethicists that all living things or that natural objects and ecosystems be considered highly morally significant. This powerful book of moral theory challenges all defenders of the moral status quo—which decrees that animals decidedly do not count—to reevaluate their convictions. (shrink)

Joseph Grange's beautifully written book provides a unique synthesis of two major figures of world philosophy, John Dewey and Confucius, and points the way to a global philosophy based on American and Confucian values. Grange concentrates on the major themes of experience, felt intelligence, and culture to make the connections between these two giants of Western and Eastern thought. He explains why the Chinese called Dewey "A Second Confucius," and deepens our understanding of Confucius's concepts of the way (...) (dao) of human excellence (ren). The important dimensions of American and Chinese cultural philosophy are welded into an argument that calls for the liberation of what is finest in both traditions. The work gives a new appreciation of fundamental issues facing Chinese and American relations and brings the opportunities and dangers of globalization into focus. (shrink)

This article explores the influence of Spinozism on the deep ecology movement and on new materialism. It questions the stance of supporters of the DEM because their ecosophies unwittingly anthropomorphise the more-than-human-world. It suggests that instead of humanising the ‘natural’ world, morality should be naturalised, that is, that the object of human expression of ethics should be the more-than-human world. Moreover, the article discusses Deleuze’s Spinozism that informs new materialism and argues that stripping the human of its ontological privilege does (...) not deprive the human animal from its ethico-normative distinctiveness. Implications of the discussion for an education aimed at cultivating human sensibilities are explored. (shrink)

Compassionate care is a foundation of the National Health Service. However, several high-profile inquiries into healthcare failures in the NHS suggest compassion is often absent in our hospitals. Ensuing policies mandate healthcare professionals to ‘show more compassion’ but, as the psychological evidence-base indicates, this instruction neglects the complexity of this social emotion. This paper applies the psychological research on compassion to modern healthcare settings with the aim of creating a better understanding of the pathways leading to uncompassionate care. A review (...) of the empirical evidence suggests a range of psychological factors modulate compassion. In particular, the psychological literature indicates the human compassion system is adaptive, highly attuned to its environment. As such, a healthcare professional’s ability to experience and display compassionate behaviour will be, in part, determined by the environment in which they practise; that is, aspects of the organisational environment will either facilitate or inhibit compassion. This paper argues that the typical organisational set-up of a modern healthcare setting seriously undermines compassionate care. Organisational features frequently associated with uncompassionate care include the understaffing of hospital wards, excessive working shift patterns and the dogged focus on achieving service efficiencies—each has been identified as contributing to the alarming breakdown of compassionate care at the centre of several healthcare failings. Policies focusing on culture change in the NHS neglect the growing psychological evidence base on compassion, but by applying a psychological understanding of compassion to healthcare settings, we can begin to adequately understand and address the real causes of uncompassionate care. (shrink)

"-Barbara Ehrenreich, Mother Jones "This book represents the expression of a particular feminist perspective made all the more compelling by Keller's evident commitment to and understanding of science.

Three experiments investigated whether a motor-linked measure (string typing speed) and an judgment-linked measure (grammatical judgment of strings) accessed the same implicit learning mechanisms in the artificial grammar learning task. Participants first studied grammatical strings through observation or through responding to each letter by typing it and then performed typing and grammatical judgment tests. Grammatical judgment test performance was better after observation than after respond learning, whereas typing test performance on higher order relations was worse after observation than after respond (...) learning (Experiment 1). Participants transferred grammatical knowledge across letter sets on the grammatical judgment test, but not on the typing test (Experiment 2). Typing speed did not differ for hits (grammatical strings classified by participants as grammatical) and misses (grammatical strings classified as nongrammatical, Experiment 3). These results are consistent with typing and grammatical judgment tests tapping independent mechanisms and indicate that implicit learning may consist of many different forms of learning rather than being a unitary learning mechanism. (shrink)

What do biologists want? If, unlike their counterparts in physics, biologists are generally wary of a grand, overarching theory, at what kinds of explanation do biologists aim? A history of the diverse and changing nature of biological explanation in a particularly charged field, "Making Sense of Life" draws our attention to the temporal, disciplinary, and cultural components of what biologists mean, and what they understand, when they propose to explain life.

Many pregnant women use pregnancy related mHealth applications, encompassing a variety of pregnancy apps and wearables. These are mostly directed at supporting a healthier fetal development. In this article we argue that the increasing dominance of PRmHealth stands in want of empirical knowledge affirming its beneficence in terms of improved pregnancy outcomes. This is a crucial ethical issue, especially in the light of concerns about increasing pressures and growing responsibilities ascribed to pregnant women, which may, in turn, be reinforced by (...) PRmHealth. A point can be made that it would be ethically askew if PRmHealth does not lead to improved pregnancy outcomes, while at the same time increasing maternal duties to closely monitor fetal development. We conclude that more research is needed to get a view on the benefits and burdens of PRmHealth in order to ethically assess whether the latter are proportionate to the former. If not, there is a case in saying that endorsement of PRmHealth is overdemanding. (shrink)

The implementation of care robotics in care settings is identified by some authors as a disruptive innovation, in the sense that it will upend the praxis of care. It is an open ethical question whether this alleged disruption will also have a transformative impact on established ethical concepts and principles. One prevalent worry is that the implementation of care robots will turn deception into a routine component of elderly care, at least to the extent that these robots will function as (...) simulacra for something that they are not (i.e. human caregivers). At face value, this may indeed seem to indicate a concern for how this technology may upend existing practices and relationships within a care setting. Yet, on closer inspection, this reaction may rather point to a rediscovery and a revaluation of a particularly well-entrenched value or virtue, i.e. veracity. The virtue of veracity is one of the values that is mobilized to argue against a substitution of human caregivers (while a combination of care robots and human caregivers is much more accepted). The subject of this paper is to explore how the moral panic surrounding care robots should not so much be interpreted as an anticipated and probable disruptor in a care setting, but rather as a sensitizing – in a way conservationist – argument that identifies veracity as an established value that is supposed to be protected and advanced in present day and future care settings. (shrink)

The National Health Service (NHS) has, for over four decades, been beset with numerous ‘scandals’ relating to poor patient care across several diverse clinical contexts. Ensuing inquiries proceed as though each scandal is unique, with recommendations highlighting the need for more staff training, a change of culture within the NHS based upon a ‘duty of candour’, and proposed criminal sanctions for employees believed to breach good patient care. However, mistakes reoccur and failings in patient safety continue. While inquiries describe _what_ (...) went awry in each case, questions of _how_ and _why_ such failures came to be remain unanswered. Psychology has a role in answering these questions. Applying psychological theory can guide an understanding of the _causes_ that lead to catastrophic failures in healthcare settings. Indeed, what is often neglected in inquiries is the role of human behaviour in contributing to these failures. Drawing upon behavioural, social and cognitive theories, a psychological analysis of key factors, typically present in clinical contexts where serious failures of care occur, is presented. Applying theory and models from the field of psychology can guide further understanding of the precipitants to poor care. (shrink)

In this paper, we aim to stimulate ethical debate about the morally relevant connection between ectogenesis and the foetus as a potential beneficiary of treatment. Ectogenesis could facilitate foetal interventions by treating the foetus independently of the pregnant woman and provide easier access to the foetus if interventions are required. The moral relevance hereof derives from the observation that, together with other developments in genetic technology and prenatal treatment, this may catalyse the allocation of a patient status to the foetus. (...) The topic of foetal medicine is of growing interest to clinicians, and it also deserves due attention from an ethical perspective. To the extent that these developments contribute to the allocation of a patient status to the foetus, normative questions arise about how moral responsibilities towards foetal interests should be balanced against the interests of the pregnant woman. We conclude that, even if ectogenesis could facilitate foetal therapy, it is important to remain sensitive to the fact that it would not circumvent the key ethical concerns that come with in utero foetal treatment and that it may even exacerbate potential conflicts between directive treatment recommendations and the pregnant woman's autonomous decision to the contrary. (shrink)

This study focuses on students’ learning approaches in the context of a competency‐based program on Applied Sciences, with portfolio assessment as its core mode of assessment. The study examines students’ perceptions of these assessment practices and the relationships to their learning approaches. Additionally, differences in perceptions and learning approaches between first‐year students and second‐year students, who already have one year of experience with the portfolio assessment practice, are investigated. A total of 110 students completed two questionnaires at the end of (...) the academic year: the Revised SPQ was used to measure their approaches to learning and the AEQ was used to measure their perceptions of the assessment practice. The results indicate that, when implementing portfolio assessment, feedback is essential. Moreover, it seems not to be the assessment design, but rather how it is implemented, and how students’ learning is stimulated through the assessment, that influences the quality of learning. (shrink)

It has been suggested that future application of stem-cell derived gametes might lead to the possibility for same-sex couples to have genetically related children. Still, for this to become possible, the technique of gamete derivation and techniques of reprogramming somatic cells to a pluripotent state would have to be perfected. Moreover, egg cells would have to be derived from male cells and sperm cells from female cells, which is believed to be particularly difficult, if not impossible. We suggest a more (...) plausible scenario to provide same-sex couples with the possibility to parent a child who is genetically related to both parents. Although technical feasibility is an advantage, disadvantages are that cooperation of a donor of the opposite sex is still required and that the partners are genetically linked to the resulting child in a different degree. However, since in our scenario the donor's genetic contribution would not outweigh any of the parents' genetic contribution, this alternative route may ease the fear for a possible parental claim by the donor. Like many other applications in the field of infertility treatment, the goal to create SCD-gametes for reproductive purposes is largely based on the high value attributed to genetic parenthood. Although we believe that genetic relatedness is neither a necessary nor a sufficient condition for ‘good’ parenthood, we do believe that many people may consider our scenario a welcome alternative. (shrink)

Recent medical innovations like ‘omics’ technologies, mobile health (mHealth) applications or telemedicine are perceived as part of a shift towards a more preventive, participatory and affordable healthcare model. These innovations are often regarded as ‘disruptive technologies’. It is a topic of debate to what extent these technologies may transform the medical enterprise, and relatedly, what this means for medical ethics. The question of whether these developments disrupt established ethical principles like respect for autonomy has indeed received increasing normative attention during (...) the past years. Yet, more fundamental ethical considerations of a possible disruption of the concept of ‘medical necessity’ (and the potential ensuing clinical ramifications) have been limited if not absent. It is our modest – though morally and practically relevant – aim to address this objective in this article, by exploring how the current wave of allegedly disruptive innovation is invoking a resurgence of this concept and related debates on ‘the’ goal(s) of medicine. (shrink)

While scientific terms lack the stability of physical objects, they are generally far more stable than the various meanings associated with them. As a consequence, they tend to carry older conceptions alongside those more recently acquired, thereby exerting an effective drag against conceptual change. I illustrate this claim with an analysis of the shifting meanings of the term genome, originally used to refer to a collectivity of genes, but more recently to an organism’s complement of DNA. While genes were originally (...) regarded as effectively autonomous formal agents, and DNA as collections of genes, contemporary research suggests that an organism’s DNA constitutes a far more complex system designed to adapt and respond to the environment in which it finds itself. (shrink)

A serial reaction time experiment tested the hypothesis that there are two independent forms of implicit learning: learning that is linked to making judgments about stimuli, and learning that is linked to motor processing. Participants performed 2, 6, or 12 blocks of single task SRT, dual task SRT, or observation with one of five sequences; each sequence had the same underlying structure. Participants then performed two implicit tests, SRT and pattern judgment, as well as a generation test and an explicit (...) knowledge test. There was a double dissociation of the effect of sequence surface structure on SRT and pattern judgment. SRT and pattern judgment competence developed independently of each other across length of acquisition task. Performance on both implicit tasks did not depend on explicit knowledge. These results indicate that the SRT and pattern judgment measures tap independent forms of implicit learning, which is consistent with the modular nature of memory and cognition. (shrink)

People who are involuntarily childless need to use assisted reproductive technologies if they want to have a genetically related child. Yet, from an ethical point of view it is unclear to what extent assistance to satisfy this specific desire should be warranted. We first show that the subjectively felt harm due to the inability to satisfy this reproductive desire does not in itself entail the normative conclusion that it has to be met. In response, we evaluate the alternative view according (...) to which the satisfaction of this desire is regarded as a way to meet one’s presumed intermediate need for parenthood. This view presupposes that parenthood is one of those general categories of experiences and activities that contribute an irreplaceable value to people’s lives, but the central difficulty is to find those characteristics that mark out parenthood as an irreplaceable constituent of a valuable life. We go on to argue, however, that even if one assumes that parenthood is such an irreplaceable constituent that makes life more valuable, this does not necessarily entail a moral duty to satisfy the desire for genetic parenthood. We conclude that there is a pro tanto obligation to help people conceive a genetically related child (if this is what they prefer), but that this can be outweighed by other moral considerations, such as safety and justice concerns. (shrink)

The aim of the article is to intervene in debates about the digital and, in particular, framings that imagine the digital in terms of epochal shifts or as redefining life. Instead, drawing on recent developments in digital methods, we explore the lively, productive and performative qualities of the digital by attending to the specificities of digital devices and how they interact, and sometimes compete, with older devices and their capacity to mobilize and materialize social and other relations. In doing so, (...) our aim is to explore the implications of digital devices and data for reassembling social science methods or what we call the social science apparatuses that assemble digital devices and data to ‘know’ the social and other relations. Building on recent work at CRESC on the social life of methods, we recommend a genealogical approach that is alive to the ways in which digital devices are simultaneously shaped by social worlds, and can in turn become agents that shape those worlds. This calls for attending to the specificities of digital devices themselves, how they are varied and composed of diverse socio-technical arrangements, and are enrolled in the creation of new knowledge spaces, institutions and actors. Rather than exploring what large-scale changes can be revealed and understood through the digital, we argue for explorations of how digital devices themselves are materially implicated in the production and performance of contemporary sociality. To that end we offer the following nine propositions about the implications of digital data and devices and argue that these demand rethinking the theoretical assumptions of social science methods: transactional actors; heterogeneity; visualization; continuous time; whole populations; granularity; expertise; mobile and mobilizing; and non-coherence. (shrink)