Cet article examine la politique autrichienne en matière de handicap concernant le travail protégé dans le cadre des lois régionales sur le handicap. L’analyse s’appuie sur le modèles paternaliste, libertaire et socio-relationnel, trois modèles théoriques des relations de service social dans le triangle des prestataires de services, des acteurs de l’État et de la personne concernée. À travers ce prisme, une analyse approfondie du contenu des lois, des règlements et des rapports de suivi a été réalisée. Cet article souligne que (...) les perspectives paternalistes et dis/ableist sur les personnes handicapées prédominent dans les lois fédérales sur le handicap, tandis qu’il n’y a qu’une faible présence des services de soutien qui fournissent l’éducation et les compétences pour un travail en désinstitutionalisation ou qui soutiennent les mesures d’emploi sur le marché du travail ouvert. La plupart des services d’aide concernent des emplois à vie avec de l’argent de poche, sans droits à l’emploi, dans des marchés du travail de substitution ségrégués. Les résultats montrent que, bien que la législation contient souvent une rhétorique progressiste promettant une plus grande autodétermination et une meilleure inclusion, il s’agit surtout d’une tentative des politiques d’austérité de masquer l’absence d’un soutien véritablement centré sur la personne pour obtenir un emploi rémunéré sur le marché du travail régulier. Ainsi, le système juridique crée une vulnérabilité inutile, c’est-à-dire pathogène, pour les personnes handicapées. (shrink)

Avoir un emploi est un facteur essentiel pour assurer à une personne un niveau d’indépendance et un sentiment d’estime de soi satisfaisant. Dans notre société où le travail occupe une place centrale, gagner sa vie grâce à un emploi suffisamment rémunéré permet de garantir sa propre existence et de mener une vie indépendante. Outre les bénéfices financiers, avoir un emploi est associé à des bénéfices psychologiques tels qu’un sentiment d’appartenance accru, une diminution de l’anxiété et un bi...

Having an employment is an essential determinant of an individual’s level of independence and sense of self-worth. Earning a living through sufficiently paid work secures one’s own existence in an employment-centred society and enables people to lead independent lives. Aside from the financial benefits, employment is associated with psychological benefits such as an increased sense of belonging, reduced anxiety, and higher mental wellbeing (Jahoda, 1982). On the contrary, being unemployed inc...

1. Version française Ce numéro de la revue Alter est le second consacré aux problématiques liées à l’emploi des personnes en situation de handicap. Le premier numéro a été publié en janvier 2021 (ALTER, 15-1). Ces deux numéros font suite à un appel à contribution diffusé en 2019. Le premier numéro a rassemblé les contributions issues de travaux de recherche s’intéressant aux politiques publiques relatives à l’emploi des personnes en situation de handicap et les travaux rendant compte plus par...

International research, sponsored by for-profit companies, is regularly criticised as unethical on the grounds that it exploits research subjects in developing countries. Many commentators agree that exploitation occurs when the benefits of cooperative activity are unfairly distributed between the parties. To determine whether international research is exploitative we therefore need an account of fair distribution. Procedural accounts of fair bargaining have been popular solutions to this problem, but I argue that they are insufficient to protect against exploitation. I argue instead (...) that a maximin principle of fair distribution provides a more compelling normative account of fairness in relationships characterised by extreme vulnerability and inequality of bargaining potential between the parties. A global tax on international research would provide a mechanism for implementing the maximin account of fair benefits. This model has the capacity to ensure fair benefits and thereby prevent exploitation in international research. (shrink)

This paper contends that a research ethics approach to the regulation of health data research is unhelpful in the era of population‐level research and big data because it results in a primary focus on consent (meta‐, broad, dynamic and/or specific consent). Two recent guidelines – the 2016 WMA Declaration of Taipei on ethical considerations regarding health databases and biobanks and the revised CIOMS International ethical guidelines for health‐related research involving humans – both focus on the growing reliance on health data (...) for research. But as research ethics documents, they remain (to varying degrees) focused on consent and individual control of data use. Many current and future uses of health data make individual consent impractical, if not impossible. Many of the risks of secondary data use apply to communities and stakeholders rather than individual data subjects. Shifting from a research ethics perspective to a public health lens brings a different set of issues into view: how are the benefits and burdens of data use distributed, how can data research empower communities, who has legitimate decision‐making capacity? I propose that a public health ethics framework – based on public benefit, proportionality, equity, trust and accountability – provides more appropriate tools for assessing the ethical uses of health data. The main advantage of a public health approach for data research is that it is more likely to foster debate about power, justice and equity and to highlight the complexity of deciding when data use is in the public interest. (shrink)

Public-private partnerships are established to specifically harness the potential of Big Data in healthcare and can include partners working across the data chain—producing health data, analysing data, using research results or creating value from data. This domain paper will illustrate the challenges that arise when partners from the public and private sector collaborate to share, analyse and use biomedical Big Data. We discuss three specific challenges for PPPs: working within the social licence, public antipathy to the commercialisation of public sector (...) health data, and questions of ownership, both of the data and any resulting intellectual property or products. As a specific example we consider the case of the UK National Health Service providing patient data to Google’s DeepMind AI program to develop a diagnostic app for kidney disease. This article is an application of the framework presented in this issue of ABR. Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. We use four specific values to help analysis these issues: public benefit, stewardship, transparency and engagement. We demonstrate how the Deliberative Framework can support ethical governance of PPPs involving biomedical big data. (shrink)

Throughout March and April 2020, debate raged about how best to allocate limited intensive care unit (ICU) resources in the face of a growing COVID-19 pandemic. The debate was dominated by utility-based arguments for saving the most lives or life-years. These arguments were tempered by equity-based concerns that triage based solely on prognosis would exacerbate existing health inequities, leaving disadvantaged patients worse off. Central to this debate was the assumption that ICU admission is a valuable but scarce resource in the (...) pandemic context.In this paper, we argue that the concern about achieving equity in ICU triage is problematic for two reasons. First, ICU can be futile and prolong or exacerbate suffering rather than ameliorate it. This may be especially true in patients with COVID-19 with emerging data showing that most who receive access to a ventilator will still die. There is no value in admitting patients with poor prognostic indicators to ICU to meet an equity target when intensive critical care is contrary to their best interests. Second, the focus on ICU admission shifts focus away from important aspects of COVID-19 care where there is greater opportunity for mitigating suffering and enhancing equitable care.We propose that the focus on equity concerns during the pandemic should broaden to include providing all people who need it with access to the highest possible standard of end-of-life care. This requires attention to culturally safe care in the following interlinked areas: palliative care, communication and decision support and advanced care planning. (shrink)

This paper aims to show that to reduce the level of exploitation present in (some) international clinical trials, research sponsors must aim to provide both an ex-ante expected gain in utility and a fair ex-post distribution of benefits for research subjects. I suggest the following principles of fair risk distribution in international research as the basis of a normative definition of fairness: (a) Persons should not be forced (by circumstance) to gamble in order to achieve or protect basic goods; (b) (...) In cases where one party is gambling with basic goods and the other party is not, the distribution of benefits and burdens must be arranged so that they are of greatest benefit to the worst off; (c) In relationships where one party is gambling for basic goods and the other party is not, the party gambling for basic goods must be assured of some guaranteed benefits in addition to the chance of gaining some potential benefits.These principles are applied to the case of HIV international research. I conclude that the research (as described) is mutually advantageous but still exploitative because the distribution of surplus benefits is unfair. It is unfair because research subjects are gambling with and for basic goods but they are not assured of a fair ex-post distribution of benefits. Principles (b) and (c) are not satisfied. Research participants are not accorded enough guaranteed benefits to outweigh the risks they undertake. (shrink)

In their response to ‘Public interest in health data research: laying out the conceptual groundwork’, Grewal and Newson critique us for inattention to the law and putting forward an impracticably broad conceptual understanding of public interest. While we agree more work is needed to generate a workable framework for Institutional Review Boards/Research Ethics Committees, we would contend that this should be grounded on a broad conception of public interest. This broadness facilitates regulatory agility, and is already reflected by some current (...) frameworks such as that found in the guidelines approved under Australia’s Privacy Act. It remains unclear which elements of our broad account Grewal and Newson would reject, or indeed where the substantive disagreement with our position lies. (shrink)

Many clinical ethics support services do not involve patients. This is surprising because of the broad commitment to provide patient-centered healthcare. Clinical ethics support services are a component of the healthcare system and have an influence on patient care, and should therefore align with the regulatory and ethical requirements of patient-centered care, just process and cultural competence. First, in order to achieve good patient care, it is essential to involve patients in making their own healthcare decisions. Second, just ethical deliberation (...) requires that the deliberating parties have access to complete, accurate and unbiased information – this is best achieved through direct patient input. These arguments are especially compelling in the case of non-dominant cultural and ethnic groups. Here, we argue that when a clinician refers a case to a clinical ethics support services for consideration, and that case involves a conflict between the views or values of the clinician and the patient, the patient is entitled to, at a minimum: (a) be informed of the referral; (b) have the opportunity to speak directly to the clinical ethics support services prior to deliberation; (c) be provided with any opinion directly from the clinical ethics support services; and (d) have the opportunity to speak to a clinical ethics support services member after the deliberation. We use New Zealand as a case study to support and extrapolate the ethical principles and the minimum patient involvement requirements. We draw on our empirical research with senior doctors at a tertiary New Zealand hospital. Clinicians in our study indicated that they would feel bound by clinical ethics support service advice and that the clinical ethics support service has a significant impact on patient care in the case it reviews. (shrink)

The question which this paper examines is that of the correct scope of the claim that extra-linguistic factors (such as gender and social status) can block the proper workings of natural language. The claim that this is possible has been put forward under the apt label of silencing in the context of Austinian speech act theory. The ‘silencing’ label is apt insofar as when one’s ability to exploit the inherent dynamic of language is ‘blocked’ by one’s gender or social status (...) then one might justly be said to be silenced. The notion that factors independent of any person’s linguistic competence might block her ability to exploit the inherent dynamic of language is of considerable social as well as theoretical significance. I shall defend the claim that factors independent of a person’s linguistic competence can indeed block her ability to do things with words but I will show that the cases that have been previously considered to be cases of illocutionary failure are instances of rhetic or locutionary act failure instead. I shall refine the silencing claim as previously advanced in the debate in at least one fundamental respect. I also show that considering the metaphysics of speech acts clarifies many of the issues previously appearing as thorny bones of contention between those who hold that the only notion of silencing that is coherent is that of physically preventing someone from speaking or writing and those who hold the opposite sort of claim sketched above. (shrink)

In queste pagine è delineata la vicenda esistenziale e intellettuale di Edith Stein. Donna straordinaria, è stata capace di racchiudere nella sua persona molte "possibili" vite. Le ha realizzate come ebrea e cattolica, fenomenologa e filosofa cristiana, docente e monaca carmelitana, agnostica e santa. Si tratta di un processo vitale dagli apparenti salti qualitativi, i quali si volgono all'ascolto di un medesimo nucleo identitario. Questa viva "formazione di sé" ha condotto Edith Stein a una "donazione di sé", culminata nell'Olocausto. Il (...) Diario di Edith si sovrappone ai pensieri di Angela Ales Bello, in veste di narratrice d'eccezione. Con la sentita partecipazione della narratrice, e insieme mantenendo il distacco critico della studiosa, viene scoperta la storia di un'anima. Le emozioni e le conquiste intellettuali trovano una sintesi grazie al peculiare approccio ai "fenomeni" che Edith Stein aveva appreso alla scuola di Edmund Husserl, di Tommaso d'Aquino e di Teresa D'Avila. Sintesi mirabile di pensatori che "si danno la mano" al di là dello spazio e del tempo--Front flap. (shrink)

Concerns about exploitation pervade the literature on commercial cross-border reproductive care, particularly egg selling and surrogacy. But what constitutes exploitation, and what moral weight does it have? I consider the relationship between vulnerability, limited choice, consent, and mutually advantageous exploitation. To elucidate the difference between limited choice and consent, I draw on an account of relational autonomy. In the absence of a normative principle of fair distribution, it is unclear whether the providers of reproductive goods and services are treated fairly (...) in such contracts, and therefore whether they have been exploited. I finish with some pragmatic recommendations for minimizing risks and empowering egg sellers and surrogates. (shrink)

One of the most contentious problems of contemporary philosophy revolves around the relation between idealism and realism in phenomenology. Husserl’s early students were the first to raise the question about the relation, noting a change of perspective from his Logical Investigations to his subsequent works, including The Idea of Phenomenology and Ideas Pertaining to a Pure Phenomenology and a Phenomenological Philosophy. Adolf Reinach was one of these students, and as Husserl’s assistant, he exercised a great influence on his own student (...) Edith Stein. (shrink)

There is increasing global pressure to ensure that pregnant women are responsibly and safely included in clinical research in order to improve the evidence base that underpins healthcare delivery during pregnancy. One supposed barrier to inclusion is the assumption that pregnant women will be reluctant to participate in research. There is however very little empirical research investigating the views of pregnant women. Their perspective on the benefits, burdens and risks of research is a crucial component to ensuring effective recruitment. The (...) Research In Pregnancy Ethics study set out to ascertain the views of pregnant women about research participation using an inductive thematic analysis. We conducted semi-structured interviews with 20 women who had participated in a double-blind randomised placebo controlled trial in Wellington while pregnant. Our results show that at least some pregnant women recognise the value and importance of research during pregnancy. The women we interviewed were deeply invested in the research process and outcomes. Key motivations for participating were altruism, playing a valuable civic role and the importance of research. The main perceived burdens related to inconvenience and time commitment. For some women, possible randomization to the placebo arm was regarded as a burden or disadvantage. (shrink)

In this commentary, we take up Yearby’s call for racism-sensitive research and apply this to the discourse regarding race and diversity in COVID vaccine research. We consider whether efforts...

As the demand for human eggs for stem cell research increases, debate about appropriate standards for recruitment and compensation of women intensifies. In the majority of cases, the source of eggs for research is women undergoing fertility treatment requiring ovarian stimulation and egg retrieval. The principle of "just participant selection" requires that research subjects be selected from the population that stands to benefit from the research. Based on this principle, infertile women should be actively recruited to donate eggs for fertility-related (...) research only. It is unethical to exclusively or predominantly recruit infertile women to donate eggs for stem cell research that concerns general medical conditions. It is preferable to recruit women from the general population to donate eggs for such research, and these women should be viewed as healthy volunteers. To avoid exploitation, these donors should receive compensation for both the direct and indirect costs associated with their donation. (shrink)

Humans are equipped with the remarkable ability to comprehend an infinite number of utterances. Relations between grammatical categories restrict the way words combine into phrases and sentences. How the brain recognizes different word combinations remains largely unknown, although this is a necessary condition for combinatorial unboundedness in language. Here, we used functional magnetic resonance imaging and multivariate pattern analysis to explore whether distinct neural populations of a known language network hub—Broca’s area—are specialized for recognizing distinct simple word combinations. The phrases (...) consisted of a noun (flag) occurring either with a content word, an adjective (green flag), or with a function word, a determiner (that flag). The key result is that the distribution of neural populations classifying word combination in Broca’s area seems sensitive to neuroanatomical subdivisions within this area, irrespective of task. The information patterns for adjective + noun were localized in its anterior part (BA45) whereas those for determiner + noun were localized in its posterior part (BA44). Our findings provide preliminary answers to the fundamental question of how lexical and grammatical category information interact during simple word combination, with the observation that Broca’s area is sensitive to the recognition of categorical relationships during combinatory processing, based on different demands placed on syntactic and semantic information. This supports the hypothesis that the combinatorial power of language consists of some neural computation capturing phrasal differences when processing linguistic input. (shrink)

Earp et al. (2024) sketch a thought-provoking potential use of generative AI to enhance supported decision-making for adults who have lost capacity/competence to make their own medical decisions. T...

This paper explores the question of the meaning of life, not only from the perspective of its temporal unfolding from birth to death but also from the perspective of its own particular meaning and its final cause, to use Aristotelian categories. In order to discuss this argument I refer myself to Edith Stein to show how crucial moments of her own life give rise to important and de????ining philosophical positions that touch upon questions of personal identity, social and communal relations, (...) and a relationship with God. (shrink)

L’idea di ritornare a dialogare sul tema del giudizio è nata da alcune letture fatte prima a Parigi e poi a Roma. Ripartendo in particolare da un convegno tenutosi a Cerisy-La Salle – di cui pubblichiamo in questo volume gli interventi Judicieux dans le différend, di Jean-François Lyotard, e Dies Irae, di Jean-Luc Nancy – abbiamo deciso di riprendere quel dibattito per rispondere, in primo luogo, all’interesse crescente delle scienze umane per i temi del diritto e della giustizia; nonché, in...

Se presentan los resultados de una investigación cualitativa hermenéutica sobre la lingüística cognitiva y la lingüística aplicada, relacionadas con otras ciencias en un contexto específico de la comunidad científica especializada. Desde una visión integral y holística de las ciencias biomédicas y humanas, asimismo, se estudian los lenguajes técnico-científicos de la ciencia y de la tecnología para facilitar la interrelación cognitiva entre las diferentes disciplinas. Este estudio permite crear capacidades para evaluar el acervo léxico en contexto, útil para la transmisión y (...) la transformación del conocimiento en un lenguaje propio acorde a la exigencia del método científico. El objetivo consistió en indagar sobre la relación de la unidad léxica con su nexo cognitivo a una unidad terminológica de uso cotidiano en la información y en la comunicación académica de la práctica médico-legal forense. Los resultados establecen diferencia y precisan cierta comprensión de la significación de unidades léxicas ambiguas de mayor relevancia y frecuencia, utilizadas en este ámbito del conocimiento, en cuatro categorías de análisis; según las características propias de la disciplina en dialogo con otras ciencias en contexto. Se evidencia la importancia de educar durante el proceso enseñanza-aprendizaje significativo de la disciplina en contexto, desde la metalingüística del objeto de estudio dimensionado y relacionado con otros objetos de estudio, que permita el proceso cognitivo del lenguaje técnico-científico transdisciplinar, la apropiación social y la circulación del conocimiento aplicado a las prácticas médico legales integrales en relación entre la Psicofarmacología, la Psiquiatría, la Antropología y la Psicología, con las ciencias biomédicas y humanas. In this work results of a qualitive hermeneutic research about a cognitive and applied linguistic related to other sciences in an specific context of a given scientific community were presented, a technical and scientific language regarding science and technology was pointed out from an integral vision in order to facilitate cognitive relationship among different disciplines. This study also allows to create capacities in order to assess vocabulary in context, useful for the transmission and transformation of knowledge according to a scientific method. The objective was directed to know about the relationship between the lexical unit and its meaning in a given communicative context and in the academic communication of a medical - legal forensic practice. The importance of educate during the teaching learning process is also mentioned in this research and the main objective is to develop an assertive medical practice among Psychopharmacology, psychiatric, anthropology and psychology with biomedical and human sciences. (shrink)

Este artículo describe el método de puesta en marcha del sistema de gestión de listas de lecturas de Leganto a través de tres asignaturas de la Universidad de León (ULE). Éste ha sido un proceso de colaboración entre el personal de la biblioteca y el profesorado, que ha permitido analizar la forma de integrar este recurso dentro del proceso de aprendizaje de nuestros estudiantes. Esta herramienta potencia y dinamiza el uso de los recursos de la biblioteca y facilita la actualización (...) de parte de la información de las guías docentes. (shrink)

_Thinking, Knowing, Acting: Epistemology and Ethics in Plato and Ancient Platonism_ aims to offer a fresh perspective on the correlation between epistemology and ethics in Plato and the Platonic tradition from Aristotle to Plotinus, by investigating the social, juridical and theoretical premises of their philosophy.

This book proposes a new interpretative key for reading and overcoming the binary of idealism and realism. It explores the way human consciousness unfolds through the relationship between the I and the world-a field of phenomenological investigation that cannot and must not remain closed within the limits of its own disciplinary boundaries. The book focuses on the question of realism in contemporary debates, ultimately dismantling prejudices and automatisms that one finds therein. It shows that at the root of the controversy (...) between realism and idealism there often lie equivocations of a semantic nature. By returning to the origins of modern phenomenology this study mines the Husserlian concept of transcendental idealism. Following this path, and neutralizing the extreme positions of an acritical idealism and a naïve realism, the book proposes a "transcendental realism": the horizon of a dynamic unity that embraces the process of cognition and that grounds the relation, and not the subordination, of subject and object. The close reading of this reciprocity offered here allows one to surpass the limits of the domain of knowing, leading one to fundamental questions about the ultimate sense of things and their origin. (shrink)

En este libro se han abordado algunos aspectos de la situación de Latinoamérica desde diversos enfoques. En ninguno de estos aspectos se ha pretendido ser exhaustivo, pero sí acercarse con una mirada crítica a los problemas que enfrenta Latinoamérica hoy, y que, en muchos sentidos, comprometen su futuro. Cuestiones tales como la multiculturalidad, la diversidad social, el resurgir del indigenismo, la construcción de los nuevos republicanismos y los procesos de revisión de las Constituciones democráticas, así como el desarrollo de una (...) ética pública, son extremos que afectan singularmente al desarrollo social y político de América Latina y son los temas tratados en este volumen. Sin embargo, no son estos los únicos problemas, también, emerge, con capacidad de generar conflicto, la integración panamericana que sigue, actualmente, vías diversas y contradictorias. Es obvio que estas contradicciones no contribuyen a favorecer el despliegue del liderazgo internacional de América Latina. De hecho, la integración y las formas de alcanzarla son terreno de controversia entre los diversos Estados latinoamericanos. Por otro lado, el mérito de este libro consiste en que todas las aportaciones se unen a la corriente crítica que, en la celebración del Bicentenario de las Independencias de Latinoamérica, se han esforzado por revisar dos procesos: el primero, la emancipación política de las nuevas naciones. Y en segundo lugar, el fracaso de esta emancipación con la aparición de la dependencia del subcontinente respecto de nuevos neoimperialismos, como sucede con el estadounidense. Además, se recogen aportaciones de autores que, si bien tienen en común su preocupación por reflexionar de modo crítico, parten de premisas no necesariamente coincidentes, poseen visiones diferentes y enfatizan cuestiones diversas. Ha contribuido a la diversidad de perspectivas el que los autores sean de continentes distintos y, por consiguiente, puedan afrontar los contextos sociales y políticos con miradas disímiles. (shrink)