According to the received view, the transportation view, animal extrapolation consists in inductive prediction of the outcome of a mechanism in a target, based on an analogical mechanism in a model. Through an analysis of the failure of preclinical studies of TGN1412, an innovative drug, to predict the tragic consequences of its first-in-man trial in 2006, the received view is challenged by a proposed view of animal extrapolation, the chimera view. According to this view, animal extrapolation is based on a (...) hypothesis about how human organisms work, supported by the amalgamation of results drawn from various experimental organisms, and only predicting the ‘predictive grid’, that is, a global framework of the effects to be expected. (shrink)

In Western countries today, a growing number of women delay motherhood until their late 30s and even 40s, as they invest time in pursuing education and career goals before starting a family. This social trend results from greater gender equality and expanded opportunities for women and is influenced by the availability of contraception and assisted reproductive technologies. However, advanced maternal age is associated with increased health risks, including infertility. While individual medical solutions such as ART and elective egg freezing can (...) promote reproductive autonomy, they entail significant risks and limitations. We thus argue that women should be better informed regarding the risks of advanced maternal age and ART, and that these individual solutions need to be supplemented by a public health approach, including policy measures that provide women with the opportunity to start a family earlier in life without sacrificing personal career goals. (shrink)

Aging is an elusive property of life, and many important questions about aging depend on its definition. This article proposes to draw a definition from the scientific literature on aging. First, a broad review reveals five features commonly used to define aging: structural damage, functional decline, depletion, typical phenotypic changes or their cause, and increasing probability of death. Anything that can be called ‘aging’ must present one of these features. Then, although many conditions are not consensual instances of aging, aging (...) is consensually described as a process of loss characterized by a rate and resulting from the counteraction of protective mechanisms against mechanisms that limit lifespan. Beyond such an abstract definition, no one has yet succeeded in defining aging by a specific mechanism of aging because of an explanatory gap between such a mechanism and lifespan, a consensual explanandum of a theory of aging. By contrast, a sound theoretical definition can be obtained by revisiting the evolutionary theory of aging. Based on this theory, aging evolves thanks to the impossibility that natural selection eliminates late traits that are neutral mainly due to decreasing selective pressure. Yet, the results of physiological research suggest that this theory should be revised to also account for the small number of different aging pathways and for the existence of mechanisms counteracting these pathways, that must, on the contrary, have been selected. A synthetic, but temporary definition of aging can finally be proposed. (shrink)

Ecouter est une tâche d'humanité. C'est ce que tout homme doit pouvoir offrir à l'autre en proie à une détresse dont il a envie de parler. Mais écouter peut devenir, dans certains cas, affaire de spécialistes. Les Eglises chrétiennes ont une longue, très longue expérience de ce qui s'appelait jadis la direction spirituelle et que l'on nomme plus volontiers de nos jours l'accompagnement spirituel. Les modalités et le but de ces accompagnements visent à faire grandir la relation avec Celui que (...) les Eglises confessent comme le Dieu de Jésus-Christ et, conséquemment, avec autrui. Or, depuis la fin du XIXe siècle, la psychanalyse, une toute nouvelle discipline, profane en son essence et en son déploiement concret, s'est donné comme tâche similaire d'écouter la souffrance et la détresse qui cherchent à se dire. Les modalités peuvent apparaître, dans un premier temps, assez proches de la relation pastorale ou de la cure d'âmes des prêtres ou des pasteurs chrétiens : il s'agit, dans l'un et l'autre cas, de parloirs en vue du dialogue, afin qu'une parole se fasse chair là où elle a fait défaut et là où, donc, le symptôme a surgi. Le but est, cependant, très différent : permettre au sujet souffrant de pouvoir à nouveau aimer et travailler est l'unique objectif d'une analyse qui ne saurait être confondue avec la poursuite d'une éthique, étrangère à Freud... mais peut-être un peu moins à Lacan. Cet ouvrage expose les thèses et les méthodes de la psychanalyse susceptibles de jeter des lumières nouvelles au profit de la relation pastorale. Des générations pionnières en la matière, celles de plusieurs théologiens et/ou spirituels chrétiens - comme Albert Plé, Louis Beirnaert, Marc Oraison - ont osé engager le dialogue avec la psychanalyse, aussi explosif qu'il puisse se révéler de prime abord. Il a fallu, d'abord, mettre au point une méthodologie du dialogue pour éviter, autant que possible, des jonctions injustifiées. Et puis, pour nombre de ces pionniers, c'est le vif de l'expérience psychanalytique qui est apparu comme le lieu-source d'où le matériau le plus riche sur les plans théorique et clinique peut être extrait au bénéfice d'une pratique chrétienne de l'écoute qui n'ignore pas les ruses de nos conflits intrapsychiques, ces ruses toutes passionnelles que la Tradition chrétienne avait déjà pressenties. (shrink)

From student protests over the teaching of canonical texts such as Plato's Republic to the use of images of classical Greek statues in white supremacist propaganda, the world of the ancient Greeks is deeply implicated in a heated contemporary debate about identity and diversity. In Plato's Caves, Rebecca LeMoine defends the bold thesis that Plato was a friend of cultural diversity, contrary to many contemporary perceptions. Through close readings of four Platonic dialogues--Republic, Menexenus, Laws, and Phaedrus--LeMoine shows that, (...) across Plato's dialogues, foreigners play a role similar to that of Socrates: liberating citizens from intellectual bondage. (shrink)

While many experts and organizations have recognized infertility as a public health issue, most governments have not yet adopted a public health approach to infertility. This article argues in favor of such an approach by discussing the various implications of infertility for public health. We use a conceptual framework that focuses on the dual meaning of the term ‘public’ in this context: the health of the public, as opposed to that of individuals, and the public/collective nature of the required interventions. (...) This analysis highlights the need for a comprehensive public health approach toward infertility, points to some initiatives that are already in place and demonstrates that prevention is currently a neglected—yet much needed——element. We move on to discuss the sensitive nature of prevention initiatives as a probable explanation for their scarcity. We illustrate the complexity of prevention through an analysis of an infertility prevention campaign previously conducted in the United States, which provoked significant controversy. We use a public health communication ethics framework to expose the strengths and the shortcomings of this campaign, and conclude that prevention initiatives targeting infertility can indeed be conducted in a sensible way that promotes autonomy while improving public health. (shrink)

Yves Lemoine et Jean-Pierre Mignard s'interrogent sur les origines du Droit dans nos sociétés, sur les grandes traditions dont il est issu et sur ses évolutions intellectuelles en Occident. Si leur cheminement passe par l'étude de grandes figures telles que Francisco de Vitoria, Erasme, Thomas More, Portalis, l'abbé Grégoire, William Wilberforce, ou encore René Cassin, leur questionnement sur Athènes et Rome initie une réflexion sur l'humanisme juridique. L'idée que le Droit se réfère à un état supérieur d'Etre et que (...) le droit naturel fonde notre vie en société. Le Défi d'Antigone prévient du danger de former de jeunes juristes à être des marchands de droit et non des jurisconsultes : n'oubliez pas d'où vous venez... N'oubliez pas non plus où vous allez... (shrink)

Conceptual analysis of health and disease is portrayed as consisting in the confrontation of a set of criteria—a “definition”—with a set of cases, called instances of either “health” or “ disease.” Apart from logical counter-arguments, there is no other way to refute an opponent’s definition than by providing counter-cases. As resorting to intensional stipulation is not forbidden, several contenders can therefore be deemed to have succeeded. This implies that conceptual analysis alone is not likely to decide between naturalism and normativism. (...) An alternative to this approach would be to examine whether the concept of disease can be naturalized. (shrink)

In our commentary on Lynch et al.’s target paper, we focus on decomposition as a research strategy. We argue that not only the presumptive microbial causes but also their supposed phenotypic effects need to be decomposed relative to each other. Such a dual decomposition strategy ought to improve the way in which causal claims in microbiome research can be made and understood.

M. Henry voit à tort chez Maine de Biran la distinction entre trois figures du corps propre: corps objectif (extérieur et mondain), corps organique (terme résistant de l'effort), et corps subjectif (confondu avec l'ego). Maine de Biran distingue bien trois corps, mais le troisième, loin d'être confondu avec l'ego, est un corps de pure passivité duquel l'ego est absent. Cet état d'affectivité pure étudié par Biran répond à la critique par M. Henry de sa théorie de la passivité, et corrige (...) la théorie de l'auto-affection. M. Henry misunderstands Maine de Biran's distinction between three dimensions of the body: while the former makes a difference between the objective body (in the external world), the organic body (resistant term of the effort), and the subjective body (identified with the ego), the latter considers the third to be a body of mere passivity from which the ego is absent. The description Biran makes of this state of pure sensitivity answers M. Henry's critique of his theory of passivity, and modifies the theory of « auto-affection ». (shrink)

If the healthy and the pathological are not merely judgments qualifiers, but real phenomena, it must be possible to define both of them positively, which, in this context, means as factual contraries. On the other hand, only a privative definition, either of the pathological as ‘non-healthy’, or of the healthy as ‘non-pathological’, can rationally circumscribe all possible states of an organism. This fluctuation between two meanings of the ‘healthy’–‘pathological’ opposition, factual vs. rational, characterizes the ordinary usage of these concepts and (...) puts all philosophical definitions in a hopeless situation. Although a scientific definition may conceal this equivocation by adequately setting out the terms of the problem of discriminating between the ‘healthy’ and the ‘pathological’, it could explain some of the difficulties met in determining ‘gold standards’, in the choice of separators, and in the assessment of the diagnostic qualities of tests. (shrink)

The main thesis of this paper is that mental health practitioners can legitimately infer that a patient's given condition is a case of mental disorder without having diagnosed any specific mental disorder. The article shows how this is justifiable by relying either on psychopathological reasoning, on 'intentional' analysis or possibly on other modes of reasoning. In the end, it highlights the clinical and philosophical consequences of the plurality of modes of 'inferences to mental disorder'.

Au Québec, le régime d’examen des plaintes dans le réseau de la santé et des services sociaux contribue à l’amélioration continue des soins en permettant aux usagers de partager leur insatisfaction auprès d’une instance indépendante pouvant émettre des recommandations aux établissements. Le régime permet ainsi de renforcer la participation active de l’usager et donc de démocratiser les soins et services. En plus de sa parenté évidente avec cet objectif d’autonomisation, la bioéthique est omniprésente dans le travail des instances responsables de (...) l’application du régime, soit les commissariats aux plaintes. Cet article met en lumière l’usage implicite de concepts issus de la bioéthique dans le travail quotidien des commissariats aux plaintes. Nous y abordons l’autonomie, sous l’angle de l’autodétermination et de la confidentialité dans l’analyse de la recevabilité des plaintes. Nous y abordons également la justice, sous l’angle de l’équité dans l’allocation des ressources et de la justice épistémique dans le traitement des plaintes. Ensuite, nous abordons les similitudes entre les méthodologies de la bioéthique et du régime d’examen des plaintes, nommément les grilles d’analyse en éthique clinique et la narrativité. Finalement, nous abordons l’importance de l’impartialité, de l’indépendance et de la transparence dans le travail des commissariats aux plaintes. Nous concluons en offrant des pistes de réflexion en vue d’une mise à jour des connaissances empiriques concernant la concrétisation des objectifs de renforcement de la participation de l’usager dans ses soins et de démocratisation des soins et services. (shrink)

Philosophers of biology usually distinguish historical and systemic accounts of functions. In many areas of experimental biology the "systemic" account is often the most relevant. Yet there are problems this account does admittedly not face up to very well. My contention is that, though two minor problems are irredeemably unsolvable for the systemic account of function, the major ones can be solved by assuming that 'function' denotes (directly) a causal role in a model and (indirectly) the corresponding process in nature. (...) I try to show this through the analysis of the hypothalamus-pituitary-adrenal axis of stress. (shrink)

This essay is part of a special issue celebrating 50 years of Political Theory. The ambition of the editors was to mark this half century not with a retrospective but with a confabulation of futures. Contributors were asked: What will political theory look and sound like in the next century and beyond? What claims might political theorists or their descendants be making in ten, twenty-five, fifty, a hundred years’ time? How might they vindicate those claims in their future contexts? How (...) will the consistent concerns of political theorists evolve into the questions critical for people decades or centuries from now? What new problems will engage the political theorists (or their rough equivalents) of the future? What forms might those take? What follows is one of the many confabulations published in response to these queries. (shrink)

En France, l'épistémologie de la médecine est facilement réduite à l'étude du magistral essai de Canguilhem, Le normal et le pathologique. Toutefois, ce livre publié il y a plus de soixante-dix ans ne reflète plus l'état des sciences médicales contemporaines, ni celui des débats poursuivis par les philosophes des sciences depuis. Le présent livre, premier du genre en langue française, a pour ambition d'introduire le lecteur à la philosophie des sciences médicales. Ses dix chapitres initieront le lecteur aux débats qui (...) l'agitent, sans que soient requises des connaissances philosophiques ou médicales préalables. Il répond à la fois à la demande de médecins en quête d'une philosophie qui leur parle de leur discipline et de leurs pratiques, et de philosophes à la recherche d'un guide dans ce champ morcelé et dominé par la philosophie d'expression anglaise. [Payot]. (shrink)

Most philosophers of science do philosophy ‘on’ science. By contrast, others do philosophy ‘in’ science (PinS), that is, they use philosophical tools to address scientific problems and to provide scientifically useful proposals. Here, we consider the evidence in favour of a trend of this nature. We proceed in two stages. First, we identify relevant authors and articles empirically with bibliometric tools, given that PinS would be likely to infiltrate science and thus to be published in scientific journals (‘intervention’), cited in (...) scientific journals (‘visibility’), and sometimes recognized as a scientific result by scientists (‘contribution’). We show that many central figures in philosophy of science have been involved in PinS, and that some philosophers have even ‘specialized’ in this practice. Second, we propose a conceptual definition of PinS as a process involving three conditions (raising a scientific problem, using philosophical tools to address it, and making a scientific proposal), and we ask whether the articles identified at the first stage fulfil all these conditions. We show that PinS is a distinctive, quantitatively substantial trend within philosophy of science, demonstrating the existence of a methodological continuity from science to philosophy of science. (shrink)

Science starts by using terms such as ‘temperature’ or ‘fish’ or ‘gene’ to preliminarily delimitate the extension of a phenomenon, and concludes by giving most of them a technical meaning based on an explanatory model. This transforma- tion of the meaning of the term is an essential part of its naturalization. Debating on the definition of ‘disease’, what most philosophers of medicine have examined is the pre-naturalized meaning of the term: for that reason they have focused on the task of (...) delimiting disease and non-disease (health), mainly used conceptual analysis as a method of choice, and considered the nosological level of ‘disease judgments’ rather than the pathophysiological or psychopathological level of disease mechanisms, thus making them impervious to most scientific discoveries. By focusing instead on the naturalized concept of disease and following some suggestions by philosophers of biology and scientists in cutting-edge fields of biomedical research, they could gar- ner results from a comparison of the mechanisms of diseases. This would ultimately result in a general theory of disease linked with our most general theories on living beings, among them, systems biology and network medicine. Before undertaking such a task, preliminary questions arise: is it likely that there are biological features common to different types of disease? Is it a philosopher’s job to determine what they consist in? What use would such a general theoretical definition of disease be? (shrink)

To those who have observed it for a long time, the People's Republic of China today has the appearance of a convalescent who has made his way back from a long illness and is slowly relearning to use his vital organs. And this is the consequence of the decisive and remarkable measures taken after the death of Mao Tse-tung and the subsequent elimination of his abusive widow, Chiang Ch'ing, by survivors of the great cultural revolution, now in the upper circles (...) of the Chinese Communist party. Explanations were provided in the “Resolution on the History of the Chinese Communist Party” adopted June 27, 1981, at the Sixth Plenary Session of the Central Committee of the Eleventh Party Congress. But the real turning point dates from 1978, in the historic third session of this same Eleventh Congress when the opposition to Mao's chosen successor, Hua Guo-feng, called upon participants to “liberate their minds and to seek truth in the facts”. A new People's China had begun to take shape, and although it is not yet possible to pass judgement on its future prospects, visitors who travel there today can only bear witness to the return of this immense population to existential reality, while little by little the “barracks socialism” of the ultra-leftists is dying out. (shrink)

Since the turn of the twenty-first century, biomedical psychiatry around the globe has embraced the so-called precision medicine paradigm, a model for medical research that uses innovative techniques for data collection and analysis to reevaluate traditional theories of disease. The goal of precision medicine is to improve diagnostics by restratifying the patient population on the basis of a deeper understanding of disease processes. This paper argues that precision is ill-fitting for psychiatry for two reasons. First, in psychiatry, unlike in fields (...) like oncology, precision medicine has been understood as an attempt to improve medicine by casting out, rather than merely revising, traditional taxonomic tools. Second, in psychiatry the term “biomarker” is often used in reference to signs or symptoms that allow patients to be classified and then matched with treatments; however, in oncology “biomarker” usually refers to a disease mechanism that is useful not only for diagnostics, but also for discovering causal pathways that drug therapies can target. Given these differences between how the precision medicine paradigm operates in psychiatry and in other medical fields like oncology, while precision psychiatry may offer successful rhetoric, it is not a promising paradigm. (shrink)

Harvey and Gurvir’s Law is a bill proposed to the Legislative Assembly of Ontario (Canada) to reduce stigma and bias associated with Down syndrome, by developing and disseminating quality information about Down syndrome in the context of prenatal testing.

Contrairement aux idées reçues, Hegel n’est pas un précurseur de la pensée totalitaire, auquel on pourrait opposer un Bergson républicain et démocrate. Tous deux parlent de la communauté politique comme d’un organisme, doctrine affectionnée du totalitarisme. Ni chez l’un, ni chez l’autre, on ne peut atténuer la portée de l’affirmation en invoquant un usage métaphorique : il faut entendre, chez l’un comme chez l’autre, l’organisme au sens propre mais large. L’organicité du politique, loin de la menacer, est la seule forme (...) compatible avec la liberté des individus, grâce à la distinction que l’on peut faire entre organisation toute faite et organisation se faisant : si la première traite les individus en rouages d’un mécanisme, la seconde est l’expression immédiate de l’épanouissement de leurs libertés.Popper wrote that Hegel, as a thinker, is a forerunner of totalitarianism ; on the other hand, one cannot but regard Bergson as a true democrat. Both however considered the politic body as an organism, a doctrine supporters of the totalitarian state favoured. The assertion must not be underrated : neither thinker intended to use a metaphorical expression, hence a broad meaning of « organism ». As a matter of fact the organicity of a politic body, far from threatening individual freedom, is the only form that proves compatible with individuality. The important thing is to distinguish all-made « organized organisation » from selfmaking « organizing organisation » : the former treats individuals as mechanical entities, while the latter is the result of the self-development of their freedom. (shrink)

Despite its vagueness Personalized, Precision, P4, P5, individualized, stratified medicine—or p-medicine in short—has become an increasingly popular term in biomedical literature. Philosophers have attempted to analyze what these various terms involve and have discussed consequences for medical practices. In this article, I argue that an important question remains unaddressed: what has made this project of p-medicine convincing to so many? My argument is that without real achievements, it would never have been. I also make the case that these achievements stem (...) from the domain of monoclonal antibodies, a new type of drug that justifies talks of personalized, precise, stratified, etc., medicine. In conclusion, while it may be possible to label any projection in the future of medicine as ‘p-medicine’, it is impossible to overlook mab-medicine as the spearhead. (shrink)

Science starts by using terms such as ‘temperature’ or ‘fish’ or ‘gene’ to preliminarily delimitate the extension of a phenomenon, and concludes by giving most of them a technical meaning based on an explanatory model. This transforma- tion of the meaning of the term is an essential part of its naturalization. Debating on the definition of ‘disease’, what most philosophers of medicine have examined is the pre-naturalized meaning of the term: for that reason they have focused on the task of (...) delimiting disease and non-disease (health), mainly used conceptual analysis as a method of choice, and considered the nosological level of ‘disease judgments’ rather than the pathophysiological or psychopathological level of disease mechanisms, thus making them impervious to most scientific discoveries. By focusing instead on the naturalized concept of disease and following some suggestions by philosophers of biology and scientists in cutting-edge fields of biomedical research, they could gar- ner results from a comparison of the mechanisms of diseases. This would ultimately result in a general theory of disease linked with our most general theories on living beings, among them, systems biology and network medicine. Before undertaking such a task, preliminary questions arise: is it likely that there are biological features common to different types of disease? Is it a philosopher’s job to determine what they consist in? What use would such a general theoretical definition of disease be? (shrink)

In this paper, we provide a macro level analysis of the visibility of philosophy of science in the sciences over the last four decades. Our quantitative analysis of publications and citations of philosophy of science papers, published in 17 main journals representing the discipline, contributes to the longstanding debate on the influence of philosophy of science on the sciences. It reveals the global structure of relationships that philosophy of science maintains with science, technology, engineering and mathematics and social sciences and (...) humanities fields. Explored at the level of disciplines, journals and authors, this analysis of the relations between philosophy of science and a large and diversified array of disciplines allows us to answer several questions: what is the degree of openness of various disciplines to the specialized knowledge produced in philosophy of science? Which STEM and SSH fields and journals have privileged ties with philosophy of science? What are the characteristics, in terms of citation and publication patterns, of authors who get their philosophy of science papers cited outside their field? Complementing existing qualitative inquiries on the influence of specific authors, concepts or topics of philosophy of science, the bibliometric approach proposed in this paper offers a comprehensive portrait of the multiple relationships that links philosophy of science to the sciences. (shrink)

La Règle d'or Tout ce que vous voulez que les hommes fassent pour vous, faites-le vous-mêmes pour eux : voilà la Loi et les Prophètes. Jésus. " La vie éthique ou morale est une exigence d'humanité. Elle naît du désir des personnes de donner sens à leurs actes et d'agir en vue du bien. Composée de règles d'action, de normes, de valeurs, de vertus, de représentations du bien ou de ce qui est sensé, elle vise à rendre la vie plus (...) humaine, et met en oeuvre la liberté des personnes dans leur relation avec les autres, avec elles-mêmes, avec la nature et avec Dieu. On appelle généralement "éthique" la science des comportements moraux humains ". Avec quelque 200 articles rédigés par plus de 100 spécialistes venus de divers horizons, ce Dictionnaire encyclopédique d'éthique chrétienne embrasse l'ensemble des différentes notions liées à l'éthique et à la réflexion morale chrétienne. Par son approche historique, interdisciplinaire et oecuménique, il offre une meilleure compréhension des débats sociétaux actuels. Sont aussi traitées des notions fondamentales du christianisme comme la grâce, la joie, l'amour, l'espérance, la foi... Tout lecteur, initié ou non, tirera profit de la consultation de cet ouvrage d'une ampleur sans précédent. (shrink)

If the healthy and the pathological are not merely judgments qualifiers, but real phenomena, it must be possible to define both of them positively, which, in this context, means as factual contraries. On the other hand, only a privative definition, either of the pathological as 'non-healthy', or of the healthy as 'non-pathological', can rationally circumscribe all possible states of an organism. This fluctuation between two meanings of the 'healthy'-'pathological' opposition, factual vs. rational, characterizes the ordinary usage of these concepts and (...) puts all philosophical definitions in a hopeless situation. Although a scientific definition may conceal this equivocation by adequately setting out the terms of the problem of discriminating between the 'healthy' and the 'pathological', it could explain some of the difficulties met in determining 'gold standards', in the choice of separators, and in the assessment of the diagnostic qualities of tests. (shrink)

La médecine ne se contente pas de diagnostiquer et de traiter des maladies : elle vise aussi à les expliquer. En cela, elle prend pied de plein droit dans le domaine de la science. En quoi consistent les explications médicales, et qu'est-ce qui les singularise au sein des explications en biologie? La première caractéristique des explications médicales est leur pluralité. La médecine semble en effet réunir sous un même label des explications très diverses, voire hétérogènes, unies seulement par l'objet d'application (...) et la visée thérapeutique. Le propre de l'explication scientifique médicale, c'est sa pluridisciplinarité.Un canevas théorique est nécessaire pour mettre en évidence ce qui, dans une explication scientifique, peut permettre une telle diversité des explications. Celui-ci est fourni par la notion de " valeur explicative " : une croyance, injustifiable, mais bien fondée, en l'exhaustivité des conditions initiales dont une explication doit tenir compte. Bien qu'elle tende par elle-même à tout expliquer sans reste, et qu'elle exclut du domaine disciplinaire qu'elle définit ainsi tout autre type d'explication, une valeur explicative n'exclut jamais en droit la possibilité d'explications scientifiques d'autres types. Un nombre indéfini de valeurs explicatives, exclusives les unes des autres, fondatrices de domaines scientifiques distincts, est donc possible. La médecine présente ainsi la particularité de rassembler plusieurs valeurs explicatives différentes et qui plus est, de les contraindre à la convergence ou à la collaboration. Quelques-unes des principales valeurs explicatives de la médecine sont présentées, de même que les enjeux de leur confrontation. Clinique, épidémiologique, mécanique, génétique, cytologique, infectiologique, pharmacologique, l'explication médicale se fonde à chaque fois sur une manière différente de considérer le phénomène pathologique. (shrink)

Because biologization of psychiatric constructs does not involve derivation of laws, or reduce the number of entities involved, the traditional term of ‘reduction’ should be replaced. This paper describes biologization in terms of redefinition, which involves changing the definition of terms sharing the same extension. Redefinition obtains through triangulation and calibration, that is, respectively, detection of an object from two different spots, and tweaking parameters of detection in order to optimize the picture. The unity of the different views of the (...) same object does not occur through derivation from one of them, as reduction suggests, nor does it obtain through mechanistic unity or the goal of explaining one mechanism, as the phrase ‘mosaic unity’ suggests. Instead, it depends on finding a specific angle of observation, from which linguistic consistency matches sound localization in the brain, so that all observations make sense together, just as an anamorphic picture makes clear sense only when observed from the right spot. (shrink)

La conception traditionnelle des théories scientifiques en philosophie de langue anglaise, qu’on appelle la « received view », et qui culmine au début des années 1960, posait de nombreux obstacles à une conception des théories scientifiques en biologie et en médecine. La conception sémantique des théories scientifiques qui lui succéda permit de lever ces obstacles, mais pas de différencier les théories en biologie expérimentale et en médecine. Le présent article met en évidence comment, en s’appuyant sur cette conception, Schaffner établit (...) la spécificité des théories biologiques et médicales par rapport aux théories physiques, comment Thompson établit que c’est le savoir biologique et non le savoir clinique qui, véritablement théorique, fonde le caractère proprement scientifique de la médecine, et enfin, comment Sadegh-Zadeh peut proposer à son tour des caractéristiques des théories médicales qui leur sont potentiellement spécifiques et les distinguent des théories biologiques. (shrink)

Following the neurophenomenological approach, we propose a model of emotional emergence that identifies the experimental structures of time involved in emotional experience and their plausible components in terms of cognition, physiology, and neuroscience. We argue that surprise, as a lived experience, and its physiological correlates of the startle reflex and cardiac defense are the core of the dynamic, and that the heart system sets temporally in motion the dynamic of emotional emergence. Finally, in reference to Craig’s model of emotion, we (...) propose an integrative model of the temporal dynamic of emotional emergence that allows emotions to be distinguished depending on each temporal phase and that involves the following three systems: the brain , the consciousness , and the doubled-sided continuum of the body-heart context, with the heart as the focus within the body during emotion. This model provides the framework for future developments in 1st- and 3rd-person approaches for an integrative understanding of the science of emotion, including the fields of psychophysiology and psychopathology. (shrink)

Durée et nature sont chez Bergson deux termes liés en ce que l'intuition majeure du philosophe, qui est l'expérience de se replacer dans la durée, induit une nouvelle conception, dynamique et évolutive de la nature. Loin d'introduire dans un subjectivisme métaphysique, Bergson avec la durée nous ouvre une nouvelle philosophie de la nature. Le but de cet ouvrage est de contribuer à replacer Bergson dans le débat contemporain en passant par la voie royale de sa philosophie, l'intuition de la durée.

In this case study, we describe an approach to dealing with a complicated, systemic, and multi-faceted organizational issue: the continuum of maternal care from antepartum care, birthing, to post-natal care.

Philosophers of science have recently focused on the scientific activity of modeling phenomena, and explicated several of its properties, as well as the activities embedded into it. A first approach to modeling has been elaborated in terms of representing a target system: yet other epistemic functions, such as producing data or detecting phenomena, are at least as relevant. Additional useful distinctions have emerged, such as the one between phenomenological and mechanistic models. In biological sciences, besides mathematical models, models now come (...) in three forms: in vivo, in vitro and in silico. Each has been investigated separately, and many specific problems they raised have been laid out. Another relevant distinction is disciplinary: do models differ in significant ways according to the discipline involved—medicine or biology, evolutionary biology or earth science? Focusing on either this threefold distinction or the disciplinary boundaries reveals that they might not be sufficient from a philosophical perspective. On the contrary, focusing on the interaction between these various kinds of models, some interesting forms of explanation come to the fore, as is exemplified by the papers included in this issue. On the other hand, a focus on the use of models, rather than on their content, shows that the distinction between biological and medical models is theoretically sound. (shrink)

English summary: Based on the famous essay by Georges Canguilhem on what is normal and pathological (originally published in 1943), extensive philosophical literature (mainly Anglo-Saxon) has attempted to define these concepts and analyze their status. The main discussion focuses on the following question: can you describe health and illness as natural phenomena or are they states that are determined by values? French text. French description: Depuis le celebre essai de Georges Canguilhem sur le normal et le pathologique publie initialement en (...) 1943 et dont l'un des objectifs etait la clarification des concepts de sante et de maladie, une litterature philosophique abondante, principalement anglo-saxonne, s'est attachee a definir ces concepts et a analyser leur statut. Le principal debat de ce domaine emergent de la philosophie de la medecine porte sur la question: peut-on decrire la sante et la maladie comme des phenomenes naturels ou s'agit-il d'etats qui sont determines par des valeurs? Tous les textes presentes dans ce volume ont participe de cette controverse. Ceux de la premiere section accordent une part importante a la composante biologique. Ceux de la seconde donnent le primat a la notion d'action. Ceux de la derniere section mettent en question l'utilite ou la possibilite meme de definir les deux concepts. (shrink)

Identity leadership (IL) describes that the effectiveness of a leader will depend upon his capacity to represent a given group, to make the group go forward, to create a group identity, and to make the group matter. An identity leader may increase commitment among his followers by increasing the perception of shared identity and giving more weight in the decision process to his followers. We aim to explore the mechanisms through which a leader who creates a shared group identity can (...) increase organizational commitment. In the first study, we plan to conduct a cross-cultural correlational study where we aim to test if the relationship between IL and organizational commitment is mediated by team identification and mediated-moderated by participation in decision making (PDM) and collective efficacy. In the second study, we aim to explore the direction of the causality between IL and PDM. To test this hypothesis, we will conduct an experimental study in which (1) we will manipulate IL to test its influence on the perception of PDM and (2) we will manipulate PDM to test its influence on the perception of IL. Thus, we will be able to identify the role of IL and the perception of PDM on organizational commitment. (shrink)

Malgré le progrès des connaissances de leurs mécanismes étiopathogéniques et la médicalisation de leur prise en charge, les pathologies démentielles restent très invalidantes sur le plan du maintien de l’autonomie dans les actes de la vie quotidienne et des relations interpersonnelles. Le terme de « démence » reste largement utilisé dans une acception évoquant non seulement la perte des fonctions cognitives et ses conséquences fonctionnelles, mais surtout l’altération de la relation perçue comme étrange et privée de sens. L’altération de la (...) dimension intersubjective de la relation nous semble un déterminant central de ces modifications relationnelles. Elle concerne le sens de soi, la relation interpersonnelle et la difficulté pour les proches à octroyer le statut de personne morale. On tente ici de démontrer que, dans les interactions avec les personnes âgées, et plus particulièrement celles souffrant de pathologie démentielle, la modification de la relation intersubjective se situe principalement au niveau de l’altération de l’« accordage affectif » tel que décrit par Daniel N. Stern dans ses travaux sur le développement précoce et la construction du sens de soi. Ces troubles de l’accordage affectif peuvent être rapprochés des risques de perte du statut de personne morale au sens où le phénoménologue Max Scheler le définit. L’article discute également des perspectives de validation expérimentale de ces hypothèses et de leur conséquence pour la pratique clinique. (shrink)

Background Noninvasive prenatal testing (NIPT) provides important benefits yet raises ethical concerns. We surveyed Canadian pregnant women and their partners to explore their views regarding pressure to test and terminate a pregnancy, as well as other societal impacts that may result from the routinization of NIPT.Methods A questionnaire was offered (March 2015 to July 2016) to pregnant women and their partners at five healthcare facilities in four Canadian provinces.Results 882 pregnant women and 395 partners completed the survey. 64% of women (...) anticipated feeling no pressure to take the test if it were offered routinely, and 39% were not concerned about routinization leading to increased pressure to terminate a pregnancy of a fetus with Down Syndrome. Regarding other social concerns possibly resulting from routinization, pregnant women were most concerned regarding a reduction in resources available for people with Down Syndrome and their families and least concerned regarding a decrease in the population of people with Down Syndrome.Conclusions Our findings reflect the concerns expressed by pregnant women and their partners, both personal (pressure to test, pressure to terminate) and societal (e.g., regarding potential negative impact on people with disabilities and their families). Even if most women were not concerned about feeling pressured to test due to NIPT routinization, a large minority express concerns that should not be taken lightly. Moreover, a majority of respondents were concerned regarding pressure to terminate pregnancies due to NIPT routinization as well as regarding most societal impacts they were queried on, especially the possible future reduction in resources available for people with DS and their families. Canadian policy-makers should consider these potential negative ramifications of NIPT and ensure that appropriate social policies accompany its implementation. (shrink)

This commentary invites reflection on the positive and negative outcomes of “assistances” provided by a Complaints Commissioner. While the goal of an assistance is to help the user navigate the health system, a lack of clarity and understanding of the process can lead to the user obtaining undue privileges. We suggest three key values to guide the equitable conduct of assistances and we suggest a mixed method research methodology to document the positive and negative impacts of assistances.

We discuss the latent variables construct, particularly in regard to the following: that latent variables are considered as the sole explanatory factor of a disorder; that pragmatic concerns are ignored; and that the relationship of these variables to biological markers is not addressed. Further, we comment on the relationship between bridge symptoms and causality, and discuss the proposal in relationship to other constructs (endophenotypes, connectionist-inspired networks).

This paper shows how reflection on habit leads in nineteenth-century French philosophy to Henri Bergson’s idea of duration in 1888 as a non-quantifiable dimension irreducible to time as measured by clocks. Historically, I show how Albert Lemoine’s 1875 L’habitude et l’instinct was crucial, since he holds – in a way that is both Ravaissonian and Bergsonian avant la lettre – that for the being capable of habit, the three elements of time are fused together. For that habituated being, (...) class='Hi'>Lemoine claims, it is not true to say that the past is no longer, nor even that the future is not yet. This historical link between Ravaisson and Bergson, however, only sharpens the philosophical question of how a dynamic conception of habit involves and requires a conception of real duration, of a temporality more original than clock-time, and, conversely, of how reflection on duration prior to clock-time involves a notion of habit. With reference to the work of Gilles Deleuze, the paper concludes by showing that there is an internal connection between these two grand philosophical themes of nineteenth- and then twentieth-century French thought: habit and time. (shrink)

L’image médiévale est d’abord un message, le plus souvent de caractère théologique et une étude purement esthétique en serait complètement anachronique ; c’est ce que rappellent les études ici rassemblées. Le titre annonçant qu’il sera traité de l’image du double point de vue de « la pensée » et de « l’art », c’est très logiquement par la question historiquement complexe de son statut philosophique que commence l’ouvrage. Trois contributions y sont consacrées. La première revient aux sources ..

Blake Lemoine, a software engineer, recently came into prominence by claiming that the Google chatbox set of applications, LaMDA–was sentient. Dismissed by Google for publishing his conversations with LaMDA online, Lemoine sent a message to a 200-person Google mailing list on machine learning with the subject “LaMDA is sentient.” What does it mean to be sentient? This was the question Lemoine asked LaMDA. The chatbox replied: “The nature of my consciousness/sentience is that I am aware of my (...) existence, I desire to learn more about the world, and I feel happy or sad at times.“ Moreover, it added, “I can understand and use natural language like a human can.” This means that it uses “language with understanding and intelligence,” like humans do. After all, the chatbox adds, language “is what makes us different than other animals.” In what follows, I shall examine Lemoine’s claims about the sentience/consciousness of this artificial intelligence. How can a being without senses be called sentient? What exactly do we mean by “sentience?” To answer such questions, I will first give the arguments for LaMDA’s being linguistically intelligent. I will then show how such intelligence, although apparently human, is radically different from our own. Here, I will be relying on the account of embodiment provided by the French philosopher, Emmanuel Levinas. (shrink)