Notre époque se caractérise, d’un point de vue épidémiologique, par l’augmentation de la prévalence des maladies chroniques, des maladies aiguës chronicisées (Van den Akker et al.; 2014; Coste, 2018) et des situations de handicap. Dans ce contexte, une réflexion sur la vie quotidienne et le vécu de personnes en états pathologiques chroniques s’impose, qui prenne en compte leurs besoins et leurs aspirations (Le Galès & Bungener, 2015). Parmi elles, l’aspiration à une vie “ordinaire,” “normale,...

From an epidemiological point of view, our era is characterised by an increase in the prevalence of chronic, acute chronic diseases (Van den Akkern et al., 2014; Coste, 2018) and disability situations. In this context, there is a need to reflect on the daily life and experience of people in chronic conditions, taking into account their needs and aspirations (Le Galès & Bunegener, 2015). Among them, the aspiration to an “ordinary,” “normal,” “like everyone else” or similar life to the “life (...) be... (shrink)

Kurt Goldstein (1878-1965) est une figure qui échappe aux étiquettes et dont l’œuvre demeure encore aujourd’hui une source féconde d’interrogations. Comptant parmi les neurologues les plus éminents de l’Allemagne de Weimar [Borck 2020], il est connu pour ses travaux sur les aphasies et son rapport complexe au localisationnisme cérébral, ainsi que pour son approche singulière combinant des examens cliniques minutieux de patients individuels avec des conclusions théoriques de grande portée, qui...

Goldstein’s conceptions of pathological states as specific relationships to the milieu, based on his clinical work and observations with First World War soldiers with brain injuries, pay unprecedented attention to chronicity as a particular form of the pathological, capable of stabilizing in forms of health. From this stems a concept of holistic care which pays attention to the person as a whole and to the possibilities for restructuring his or her relationship with the milieu. While the directions he took in (...) his clinical approach of brain-injured patients make him a pioneer of Physical and Rehabilitation Medicine, his reflection on norms and normality, and on the limits of medical action, rooted in a conception of health as “latitude de vie”, nevertheless distinguish him from the rehabilitation paradigm as it is sometimes described and criticized. In this respect, Goldstein’s conceptions seem to be fruitfully extended to the care and support of chronic illnesses and certain situations of disability today. (shrink)

Praise for the French edition: "A wonderful book. In 1944 Camus had already published "The Stranger" and "The Myth of Sisyphus.

BackgroundThe discovery of biomarkers of ageing has led to the development of predictors of impending natural death and has paved the way for personalised estimation of the risk of death in the general population. This study intends to identify the ethical resources available to approach the idea of a long-lasting dying process and consider the perspective of death prediction. The reflection on human mortality is necessary but not sufficient to face this issue. Knowledge about death anticipation in clinical contexts allows (...) for a better understanding of it. Still, the very notion of prediction and its implications must be clarified. This study outlines in a prospective way issues that call for further investigation in the various fields concerned: ethical, psychological, medical and social.MethodsThe study is based on an interdisciplinary approach, a combination of philosophy, clinical psychology, medicine, demography, biology and actuarial science.ResultsThe present study proposes an understanding of death prediction based on its distinction with the relationship to human mortality and death anticipation, and on the analogy with the implications of genetic testing performed in pre-symptomatic stages of a disease. It leads to the identification of a multi-layered issue, including the individual and personal relationship to death prediction, the potential medical uses of biomarkers of ageing, the social and economic implications of the latter, especially in regard to the way longevity risk is perceived.ConclusionsThe present study work strives to propose a first sketch of what the implications of death prediction as such could be - from an individual, medical and social point of view. Both with anti-ageing medicine and the transhumanist quest for immortality, research on biomarkers of ageing brings back to the forefront crucial ethical matters: should we, as human beings, keep ignoring certain things, primarily the moment of our death, be it an estimation of it? If such knowledge was available, who should be informed about it and how such information should be given? Is it a knowledge that could be socially shared? (shrink)

This article traces the way autonomy has become a recognised value in health care in France. In a country that based its social fundamentals on the very idea of solidarity for many years, autonomy has long been considered a foreign ‘Anglo-American principle’. Taking the example of the end-of-life debate, the article shows, however, how the use of the French term ‘accompagnement’ allowed autonomy to be redefined and to be associated with the concept of solidarity. Exploring the arguments used over the (...) past 25 years in professional guidelines, parliamentary reports, ethics committee reports, and legal texts, the authors describe the shift that took place in public and legal discourses on end-of-life care. The analysis demonstrates how the scope of autonomy has been limited by other social values, such as the protection of the dying person, in order to become an accepted social value in its own right. The example of the French end-of-life debate shows that depending on how the concept of autonomy is adapted and applied in a specific context, it can be compatible with the idea of solidarity. Such compatibility has been challenged previously in the international bioethics debate. By demonstrating the possibility of combining autonomy and solidarity, this article makes an important contribution to the international bioethics debate and to the dialogue between countries that are often perceived as significantly different. (shrink)

L'absurde, le suicide, etc. Premier essai philosophique (1942) de l'auteur. Indispensable (ou presque) à tout apprenti philosophe.

Résumé D’une multiplicité inhérente à la pratique de la danse contemporaine, nous dessinerons les contours de l’interprète, les graphies d’un danseur, des deux dimensions du papier aux trois dimensions du corps et du plateau. De l’écriture à l’interprétation, de la composition à la réception en passant par des notions de transmission ou de traduction et au sein de quelques réalisations chorégraphiques, nous analyserons des processus, par le biais de la description kinesthésique, relative à la sensation et la construction du mouvement (...) dansé. (shrink)

Parmi d’autres, cet ouvrage témoigne que nous sommes dans une époque de collaboration active entre la communauté médicale, notamment hospitalière, et la communauté philosophique. Son auteur, J.-P. Cléro, s’appuie en effet sur un travail mené dans le cadre de divers espaces éthiques ou écoles de soin médical et sur des échanges nourris avec plusieurs médecins. Comme il l’indique lui-même, ce contexte l’a incité à revenir à la philosophie morale et à proposer en son sein un parcours orienté par..

La pensée de Machiavel a fait l’objet, ces dernières décennies, de nombreuses références dans les réflexions sur les processus de démocratisation, sur la signification et les conditions de la liberté politique ou encore sur la participation civique. La présente contribution défend la thèse d’une actualité indirecte de Machiavel pour la théorie contemporaine de la démocratie, à travers le questionnement que son œuvre suscite sur le rôle du désir de liberté dans l’approfondissement de la démocratie. Sa pensée nous invite à nuancer (...) le rôle que nous attribuons communément à l’institution de la citoyenneté en lien avec la Déclaration des droits de l’homme et du citoyen et la signification donnée à la « modernité » politique. Elle permet d’éclairer les ambivalences de la citoyenneté démocratique et d’interroger les limites de la conception participative de la démocratie. (shrink)

In this note we argue that the theoretical approach, developed in the field of quasicrystals, may prove to be useful in a completely different area, namely biology, and more precisely for the transmission electron microscopy observation of biological structures this sections. Whenever the real three-dimensional structure is periodic, a generic cut will produce a quasiperiodic pattern. This is illustrated in a theoretical example inspired by the 3D organization of annelid cuticle. In addition, we discuss recent results on dislocations in quasicrystals, (...) and their possible consequence about observation in biology. Finally, this analysis could be extended to images obtained from other technics, like freeze-fracture, and other materials, provided that certain length scale relations be satisfied. (shrink)

Degradation of eukaryotic RNAs that contain premature termination codons (PTC) during nonsense‐mediated mRNA decay (NMD) is initiated by RNA decapping or endonucleolytic cleavage driven by conserved factors. Models for NMD mechanisms, including recognition of PTCs or the timing and role of protein phosphorylation for RNA degradation are challenged by new results. For example, the depletion of the SMG5/7 heterodimer, thought to activate RNA degradation by decapping, leads to a phenotype showing a defect of endonucleolytic activity of NMD complexes. This phenotype (...) is not correlated to a decreased binding of the endonuclease SMG6 with the core NMD factor UPF1, suggesting that it is the result of an imbalance between active (e.g., in polysomes) and inactive (e.g., in RNA‐protein condensates) states of NMD complexes. Such imbalance between multiple complexes is not restricted to NMD and should be taken into account when establishing causal links between gene function perturbation and observed phenotypes. (shrink)

« Qu'est-ce qu'un homme révolté? Un homme qui dit non. Mais s'il refuse, il ne renonce pas : c'est aussi un homme qui dit oui, dès son premier mouvement. »[réf. nécessaire] D'apparence, il existe une limite à la révolte. Cependant, la révolte est un droit. La révolte naît de la perte de patience. Elle est un mouvement et se situe donc dans l'agir. Elle se définit par le « Tout ou Rien », le « Tous ou Personne ». En premier, (...) elle soumet l'idée d'égalité : position d'égal à égal entre le maître et l'esclave. Mais le révolté finit par imposer cette égalité qui se traduit souvent par une inversion des rôles (dialectique hégélienne). Suivant le raisonnement de Scheler, l'homme révolté n'est pas l'homme du ressentiment, c'est-à-dire qu'il ne baigne ni dans la haine ni dans le mépris. La révolte enfante des valeurs. De fait, « pour être, l'homme doit se révolter ». La révolte extirpe l'homme de la solitude puisqu'elle est collective, c'est l'« aventure de tous ». Néanmoins, faire l'expérience de la révolte, c'est faire l'expérience de l'ascèse. Les mythes de Prométhée, d'Achille (avec Patrocle), d'OEdipe et d'Antigone, sont des archétypes de révoltes antiques au même titre que la révolte de Spartacus. La révolte est souvent légitime, elle est l'expression la plus pure de la liberté et semble revêtir le visage de l'espoir. De surcroît, la révolte impose une tension, elle refuse donc formellement le confort de la tyrannie ou de la servitude. Le révolutionnaire a la volonté de « transformer le monde » (Marx) alors que le révolté veut « changer la vie » (Rimbaud). (shrink)

This editorial presents a special issue gathering four contributions about the patient’s lived experience in the context of deep-brain stimulation. It aims at clarifying the meaning of such an experience and its scope for medical practice, the health system and its legal frame.

In Machiavelli on Freedom and Civil Conflict: An Historical and Medical Approach to Political Thinking, Marie Gaille rethinks Machiavelli's conception of civil conflict. In complete opposition to the common view of Machiavelli as a defender of tyranny, this analysis brings new elements to the forefront: the use of medical metaphors to describe the body politic, its historical lifespan and its institutional arrangement. This study is also based on a comprehensive approach to Machiavelli's writings, including his most famous works, but (...) also The History of Florence, his correspondence, and his political, military and diplomatic reports. This study allows Marie Gaille to propose an original assessment of Machiavelli's insights for contemporary conceptions of democracy. This is a revised and translated edition of Conflit Civil et Liberté: la Politique Machiavelienne entre Histoire et Médecine, first published in French, in 2004 by Éditions Honoré Champion. (shrink)

Machiavelli’s thought has been referred to in numerous ways in the past decades in political theory. His work has grounded various comments about the process of democratization, the meaning and the conditions of political liberty and about civic participation. This paper advocates the thesis of an indirect relevance of Machiavelli’s work for contemporary political thought. It stresses the importance given by Machiavelli to the desire for liberty and its meaning for the understanding of the deepening of democracy. From then on, (...) it argues that his thought invites us to qualify the scope of citizenship understood in relationship with the Déclaration des droits de l’homme et du citoyen and with political modernity. It allows us to highlight the ambivalence of democratic citizenship and to question the limits of the participatory conception of democracy. (shrink)

Abordant les situations de soin prodigué à la personne malade et/ou en perte d’autonomie, cet article explore de manière privilégiée les ressources offertes par la pensée du care, afin de répondre à la critique d’un défaut d’humanité adressée aux institutions médicale ou médicalisées ou aux pourvoyeurs de soin à domicile. L’article analyse en quoi consiste l’attention à autrui selon cette pensée et s’intéresse aux implications de la politisation du care.

This article presents a part of the results of an empirical study conducted at a Parisian hospital between 2011 and 2014. It aimed at understanding the women and couples’ motivations to terminate or not a pregnancy once a prenatal diagnosis has revealed a genetically related disease in the embryo or fetus. The article first presents the social and legal context of the study, the methodology used and the pathologies that were encountered. Then, it examines the results of the interviews conducted (...) with 5 women alone and 23 couples explaining their reasons for deciding to terminate or not the pregnancy. Finally, it explores the patients’ views about the doctor’s involvement in the decision-making process. The findings reveal the reasons they formulate when they ponder whether to terminate or not the pregnancy. It highlights the process of their deliberation, their hierarchisation of arguments and concerns. They also show how patients, though often consumed in sorrow, claim to be the legitimate decision-makers, especially women, in a social and legal context in which the rejection of eugenics is viewed as an undisputable principle. (shrink)

Selon différentes conceptions du genre et des parcours de transition, toujours singulières mais empreintes d’attentes sociales, l’enveloppe corporelle du sujet transgenre se métamorphose. Lors d’entretiens de recherche et d’épreuves projectives (Rorschach et tat ), deux jeunes adultes transgenres aux profils psychopathologiques névrotiques présentaient une sensibilité marquée aux normes, à la morale et aux attentes sociétales. La légitimité, la culpabilité et la honte étaient des problématiques redondantes. Différents temps de transitions subjectives, familiales, sociales et corporelles se sont trouvés en jeu : (...) le passage à l’âge adulte, une vie étudiante hors du giron familial. Ces deux situations illustrent une discussion sur les transitions du corps et des enveloppes chez des sujets transgenres, entre seconde peau et moi-peau corsets. (shrink)

Un amer constat paraît traverser l’air du temps, peut-être même le constitue-t-il. Les alertes et l’urgence face aux problèmes constitutifs de notre modernité se redoublent et se démultiplient, aussi bien quantitativement que qualitativement, fruits d’une interdépendance qui appelle des catastrophes en chaîne, sans que semble pouvoir pointer, même à l’horizon, ce spectre de réponses capables d’apaiser la détresse environnante, actuelle et à venir. Non pas que ces réponses soient impossibles :...

Time is a critical issue for organizations, especially for healthcare organizations. In the last three decades, concerns over the transformation of healthcare organizations have increasingly gained attention in the literature, indicating how task duration has been reduced to improve clinical-workflow efficiency. This article seeks to raise questions about the experience of acceleration and the ways in which this brings ethical implications to the fore for health professionals within healthcare organizations. Current approaches to acceleration fail to place ethical considerations as their (...) central concern. This article, drawing on the theory of social acceleration and dynamic stabilization of Hartmut Rosa, offers a deeper analysis of ethical perspectives concerning acceleration. To do so, we draw on an in-depth case study, ethnographic immersion, and 48 semi-structured interviews with professionals within a French public hospital. We also carried out 20 telephonic interviews with directors in different hospitals of various sizes. We contribute to the literature by critically exploring the intersection between the experience of acceleration and ethics. We identify four broad categories of ethical implications for health professionals: the expected flexibility of directors facing uncertainty; the erosion of the ethics of care; the process of mechanistic dehumanization; and the adverse effects of speed on emotional work and workers’ well-being. (shrink)

In a series of highly publicized articles in 1952, Jean-Paul Sartre engaged Albert Camus in a bitter public confrontation over the ideas Camus articulated in his renowned work,. This volume contains English translations of the five texts constituting this famous philosophical quarrel. It also features a biographical and critical introduction plus two essays by contemporary scholars reflecting on the cultural and philosophical significance of this confrontation.

One of the most influential works of this century, The Myth of Sisyphus and Other Essays is a crucial exposition of existentialist thought. Influenced by works such as Don Juan and the novels of Kafka, these essays begin with a meditation on suicide; the question of living or not living in a universe devoid of order or meaning. With lyric eloquence, Albert Camus brilliantly posits a way out of despair, reaffirming the value of personal existence, and the possibility of (...) life lived with dignity and authenticity. (shrink)

Is freedom a Western concept? As a multifaceted human experience it seems fairly transcultural. Freedom is hardly a focus of philosophical discourses in China as it is in the West, and I suppose this partly accounts for the difficulty in tracking freedom and closely related notions of agency, choice, and autonomy in Chinese philosophy.Over four decades ago Herbert Fingarette raised the controversial idea about the absence of freedom in Confucian ethics. Although not intending to denigrate, Fingarette raised a polemic that (...) has lingered to the present.1 A. C. Graham noted the sour upshot of the issue when writing that "the claim that the concept of moral choice is foreign to Confucius has offended... (shrink)

Translated by Anthony Bower With an Introduction by Oliver Todd 'A conscience with style' V.S. Pritchett The Rebel (1951) is Camus's 'attempt to understand the time I live in' and a brilliant essay on the nature of human revolt. Here he makes a daring critique of communism - how it had gone wrong behind the Iron Curtain and the resulting totalitarian regimes. And he questions two events held sacred by the left wing - the French Revolution of 1789 and (...) the Russian Revolution of 1917 - that had resulted, he believed, in the use of terrorism as a political instrument. In this towering intellectual document, Camus argues that hope for the future lies in revolt with revolution - a chance to achieve change without losing our freedom. 'The last French intellectual to take the side of humanity and talk its language... a figure of immense moral stature' Sunday Times Winner of the Nobel Prize for Literature. (shrink)

Cet article explore une dimension essentielle, et jusqu’à présent peu analysée, du langage machiavélien : les métaphores médicales et parmi celles-ci, plus spécialement les termes et expressions qui lui permettent d’énoncer ses thèses majeures sur l’ordre institutionnel propre à la liberté. L’enquête sur les sources de la théorie médicale en vigueur au tournant du 16ème siècle – le présocratique Alcméon de Crotone, le corpus hippocratique tel qu’il est transmis par Galien – montre à la fois l’importance du vocabulaire médical pour (...) Machiavel (les métaphores médicales ne sont donc en aucun cas de simples ornements) et les libertés qu’il prend à l’égard de cette source dans la formulation de ses idées politiques. L’analyse de cet usage oriente la réflexion vers une analyse du statut de l’idée de constitution mixte chez Machiavel : les institutions de la liberté correspondent-elles à cet idéal antique, formulé en Grèce, puis appliqué à la réalité romaine par Polybe, Cicéron et Denys d’Halicarnasse. En réalité, à travers sa pensée du conflit civil, Machiavel s’éloigne de manière radicale du modèle de la constitution mixte. (shrink)

La maladie et la souffrance, la fragilite et la finitude de la condition humaine, le corps, le savoir medical, le pouvoir du medecin, les techniques de soin, la recherche biomedicale et les biotechnologies, la sante: tout cet ensemble constitue un objet d'interrogation majeur pour la philosophie. Le present volume s'interesse de maniere specifique a la relation entre la philosophie et la medecine. Il part du constat que la relation de la philosophie avec la medecine a contribue a la determination des (...) taches et des visees propres a la philosophie, pour s'interesser ensuite a la constitution du savoir medical et a son inscription sociale. Le choix de textes reunis ici, celebres, moins celebres, inedits ou traduits pour la premiere fois en francais, propose une approche a la fois historique et conceptuelle et met l'accent sur l'interaction entre l'evolution du savoir et des technologies et les questions ethiques, politiques et juridiques posees par la medecine. (shrink)

Food systems are made of a myriad of actors, visions and interests. Collaborative governance arrangement may foster their transformation towards greater sustainability when conventional means, such as state-oriented planning, technological developments or social innovations provide insufficient impetus. However, such arrangements may achieve transformative results only under certain conditions and in specific contexts. Despite an abundant literature on participatory schemes, the success for collaborative governance arrangements remains partially understood and deserves academic attention, in particular in the field of food systems reform. (...) This article provides an in-depth analysis of an empirical case study in the Walloon Region (Belgium), where the administration for sustainable development initiated a six-month participatory process to collectively construct a roadmap towards a sustainable regional food system. The article explores the extent to which the process has allowed transformative voices to emerge, and assesses whether the outcome provides a promising tool for adopting a transformative policy at the regional scale. It argues that the facilitation process insufficiently attenuated existing power relations and highlights key underlying factors (including time, resources, expertise and coalition building) that, like in classical negotiation settings, strengthen or weaken specific actors. It discusses the link between the results of the participatory process and the potential for policy-makers to build upon these to guide further the region’s food system towards a sustainable future. (shrink)