Healthcare professionals may confront ethical issues in practice, particularly when their values conflict with that of their patients or clients. This paper explores an ethical case study in which a dietitian who practices Health at Every Size® has an older adult client who wishes to lose weight. The dietitian believes that losing weight is inappropriate for this client. Using a framework for ethical decision making, this article explores the problem or dilemma, identifies the potential issues involved, discusses the relevant ethical (...) codes, laws, and regulations, and explores possible courses of action and their consequences. By exploring an ethical issue that healthcare professionals may encounter in practice, we can gain a deeper understanding of ethical decision making. (shrink)

This book is a comparative study of the production and role of maps, charts, and atlases in early modern England and France with a particular focus on Paris and London.

Personhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civil rights and the right to decision making. A rising question is how severely brain-injured patients who regain consciousness can also regain their personhood. The case of patients with locked-in syndrome is illustrative in this matter. Upon restoration of consciousness, patients with LIS find themselves in a state of profound demolition of their bodily functions. From the third-person perspective, it can be (...) expected that LIS patients might experience a differential personal identity and may lose their status as persons. However, from the patients’ perspective, it is uncontested that they retain their personal identity and that they consider themselves to be persons. We here include results from a survey with patients with LIS aimed at identifying the primary expectations of patients for their care by non-medical professionals. Based on these first-hand reports, we argue that personhood in LIS is progressively regained as the widening circle of others recognizes them as persons. (shrink)

As highlighted by Pavarini et al., researchers in the field of bioethics have to remain critical and reflexive on the methodology and on the tools they use for their research purpose because...

Family Medicine Groups (FMGs) are the most recently developed primary care organizations in Quebec (Canada). Nurses within FMGs play a central role for patients with chronic diseases (CD). However, this complex role and the nursing activities related to this role vary across FMGs. Inadequate knowledge of nursing activities limits the implementation of exemplary nursing practices. This study aimed to describe FMG nursing activities with patients with CD and to describe the facilitators and barriers to these activities. A multiple‐case study was (...) performed with ten nurses practicing among patients with CD in FMGs. Five data sources were used to provide an in‐depth description of nursing activities and the facilitators and barriers to the development of these activities. After qualitative data analysis, findings show that nursing activities are clustered into five domains: Global assessment of the patient, Care management, Health promotion, Nurse–physician collaboration, and Planning services for patients with CD. Activities vary depending on contextual factors identified in each case. This multiple‐case study provides a clear description of nursing activities with patients with CD. There is a need for improved nursing activities and expertise in domains of activities that are less present in FMGs, such as case management and interprofessional collaboration. (shrink)

ZusammenfassungDie Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

L'œuvre de Michel Foucault, à l'écart des modes intellectuelles de son temps, et à la croisée de la philosophie et de l'histoire, ne propose ni vision globale du monde ni théorie générale de la société.

Despite the widespread use of automated decision-making (ADM) systems, they are often developed without involving the public or those directly affected, leading to concerns about systematic biases that may perpetuate structural injustices. Existing formal fairness approaches primarily focus on statistical outcomes across demographic groups or individual fairness, yet these methods reveal ambiguities and limitations in addressing fairness comprehensively. This paper argues for a holistic approach to algorithmic fairness that integrates procedural fairness, considering both decision-making processes and their outcomes. Procedural fairness (...) emphasizes the importance of fair decision-making procedures, which aligns with theories of relational justice that stress the quality of social relations and power dynamics. We highlight the need for substantive procedural fairness to ensure better outcomes and address forward-looking responsibilities. Additionally, we propose leveraging Public Engagement, a core dimension within the well-established Responsible Research and Innovation framework, to enhance procedural fairness in ADM systems. Our contribution underscores the value of Public Engagement in fostering fairer ADM processes, thereby expanding the current focus beyond technical outcome-based approaches to encompass broader procedural considerations. (shrink)

The integrative memory model formalizes a new conceptualization of memory in which interactions between representations and cognitive operations within large-scale cerebral networks generate subjective memory feelings. Such interactions allow to explain the complexity of memory expressions, such as the existence of multiples sources for familiarity and recollection feelings and the fact that expectations determine how one recognizes previously encountered information.

Humans can recollect past events in details and/or know that an object, person, or place has been encountered before. During the last two decades, there has been intense debate about how recollection and familiarity are organized in the brain. Here, we propose an integrative memory model which describes the distributed and interactive neurocognitive architecture of representations and operations underlying recollection and familiarity. In this architecture, the subjective experience of recollection and familiarity arises from the interaction between core systems and an (...) attribution system. By integrating principles from current theoretical views about memory functioning, we provide a testable framework to refine the prediction of deficient versus preserved mechanisms in memory-impaired populations. The case of Alzheimer's disease is considered as an example because it entails progressive lesions starting with limited damage to core systems before invading step-by-step most parts of the model-related network. We suggest a chronological scheme of cognitive impairments along the course of AD, where the inaugurating deficit would relate early neurodegeneration of the perirhinal/anterolateral entorhinal cortex to impaired familiarity for items that need to be discriminated as viewpoint-invariant conjunctive entities. The integrative memory model can guide future neuropsychological and neuroimaging studies aiming to understand how such a network allows humans to remember past events, to project into the future, and possibly also to share experiences. (shrink)

High prevalence of musicians’ physical and mental performance-related health issues (PRHI) has been demonstrated over the last 30 years. To address this, health promotion strategies have been implemented at some post-secondary music institutions around the world, yet the high prevalence of PRHI has persisted. In 2018, an international group of researchers formed the Musicians’ Health Literacy Consortium to determine how best to decrease PRHI, and to examine the relationship between PRHI and health literacy. An outcome of the Consortium was the (...) development of a new health literacy tool for musicians, the MHL-Q19, which drew from the theoretical framework of the European health literacy suite of tools, HLS-EU. The aim of the current study was to evaluate the validity and reliability of the MHL-Q19. Participants completed a battery of questionnaires, including the HLS-EU-Q16 for the assessment of general health literacy; the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM); the RAND-12 quality of life questionnaire; and the General Self-Efficacy scale (GSE). We hypothesized that the MHL-Q19 would have a weak correlation with the HLS-EU-Q16; moderate correlation with the physical component scale and weak correlation with the mental component scale of the RAND-12; moderate correlation with the GSE; and finally, moderate correlation with pain interference and weak correlation with pain intensity of the MPIIQM. A total of 549 post-secondary music students from six English-speaking countries completed the battery of questionnaires, and 328 of these participants provided valid responses to the MHL-Q19 alone 2 weeks later. The tool showed acceptable internal consistency and test–retest reliability. Three of our hypotheses were supported, although the strength of the correlations varied from what we had predicted. The fourth hypothesis was not supported; our findings indicate that lower health literacy scores were weakly related to higher MPIIQM pain intensity and interference scores. The results of this study support the notion that musicians’ health literacy is a distinct construct that cannot be fully evaluated with existing health literacy tools. Given that this is a new instrument, the evidence presented is positive and promising. Further studies will be needed to refine the tool. (shrink)

Οἱ λίθοι τῆς Δήλου, ὅπως καί ἄλλες ὁμάδες ἐπιγραφών πού ἔχουν ἤδη μελετηθεί καλύτερα, ἀποκαλύπτουν πολλούς ἀρχιτεκτονικούς τεχνικούς ὅρούς, άγνωστους ἤ πού χρησιμοποιοῦνται σπάνια. Πρόκειται γιά λέξεις πού προσδιορίζουν μέρη θυρυῶν καί πιό εἰδικά τά ὑπέρθυρα καί τούς παραστάτες, πού ἐξετάζονται ἐδῶ · προσπαθούμε συγχρόνως νά διακρίνουμε παραλλαγές στήν ἔννοια. Μέ αὐτά τά παραδείγματα θά θέλαμε νά ἀποδείξουμε, γενικώτερα, τό ἑνδιαφέρον πού ἔχει ἕνα ἑλληνικό ἀρχιτεκτονικό λεξιλόγιο στήν προσπάθεια νά λυθοῦν προβλήματα ἑρμηνείας πού ἐμφανίζονται διαρκῶς.

The account of the death of Patroklos occupies a strategic position in the narrative economy of the Iliad: before this event, Achilles has withdrawn from combat out of indignation against Agamemnon; afterwards, his anger turns against Hector, whom he holds responsible for his friend's death. Achilles returns to battle and kills Hector in an act of vengeance that, as we have known from the beginning of the poem, will lead to his own demise, which is not actually recounted in the (...) Iliad. This episode stands out because it is atypical both in the contents of the narration and in the means of expression used (what are generally termed “formulas”). I will give some examples of these oddities and then propose an interpretation. Here is the text, in the translation by Richmond Lattimore:So long as the sun was climbing still to the middle heaven, so long the thrown weapons of both took hold, and men dropped under them; but when the sun had gone to the time for unyoking of cattle, then beyond their very destiny the Achaians were stronger and dragged the hero Kebriones from under the weapons and the clamour of the Trojans, and stripped the armour from his shoulders. And Patroklos charged with evil intention in on the Trojans. Three times he charged in with the force of the running war god, screaming a terrible cry, and three times he cut down nine men; but as for the fourth time he swept in, like something greater than human, there, Patroklos, the end of your life was shown forth, since Phoibos came against you there in the strong encounter dangerously, nor did Patroklos see him as he moved through the battle, and shrouded in a deep mist came in against him and stood behind him, and struck his back and his broad shoulders with a flat stroke of the hand so that his eyes spun. Phoibos Apollo now struck away from his head the helmet four-horned and hollow-eyed, and under the feet of the horses it rolled clattering, and the plumes above it were defiled by blood and dust. Before this time it had not been permitted to defile in the dust this great helmet crested in horse-hair; rather it guarded the hear and the gracious brow a godlike man, Achilleus; but now Zeus gave it over to Hektor to wear on his head, Hektor whose own death was close to him. And in his hands was splintered all the huge, great, heavy, iron-shod, far-shadowing spear, and away from his shoulders dropped to the ground the shield with its shield sling and its tassels. The lord Apollo, son of Zeus, broke the corselet upon him. Disaster caught his wits, and his shining body went nerveless. He stood stupidly, and from close behind his back a Dardanian man hit him between the shoulders with a sharp javelin: Euphorbos, son of Pantho(s, who surpassed all men of his own age with the throwing spear, and in horsemanship and the speed of his feet. He had already brought down twenty men from their horses since first coming, with his chariot and his learning in warfare. He first hit you with a thrown spear, o rider Patroklos, nor broke you, but ran away again, snatching out the ash spear from your body, and lost himself in the crowd, not enduring to face Patroklos, naked as he was, in close combat. (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.

Chile and Colombia have undergone very different postconflict processes. Whereas in Chile there was an elite-based negotiated transition from a state terror regime, Colombia presents a gradual exit from an armed conflict involving multiple actors and taking place in one of Latin America’s most stable democracies. A strong common feature nevertheless exists in these two countries: important social movements—notably, student, afro-descendant, Indigenous, and peasant movements—that put forward memory, but which reach beyond the circle of direct victims. These “memory from below” (...) movements in both countries cannot be understood from their institutional contexts, since these are so different: while Chile’s democratic governments strengthened the amnesty law and led only to timid commemorative initiatives twenty years after the end of the dictatorship, Colombia adopted numerous laws that allowed an institutional presence of memory—notably, through the creation of the National Center for Historic Memory—while the armed conflict was still fully fledged. From a comparative politics perspective, these institutional differences lead one to investigate other causes for the presence of “memory from below” movements in both countries: interviews of participants show that these movements stem from a common understanding of the political role of memory, as well as from a common social imaginary of “shared suffering” that seeks to uncover state violence and that understands past human rights violations as being part of a historic continuum of structural and colonial violence aimed at criminalizing and crushing social movements in democracy. (shrink)

La publication de 49 balles de fronde inscrites, provenant de la coll. Froehner, entrée au Cabinet des Médailles de Paris, utilise les remarques et les lectures de Froehner. 14 balles sont attribuables à des chefs rhodiens, 12 à des Athéniens, 2 sont supposées béotiennes, 3 corcyréennes ; 6 se rapportent aux campagnes des princes macédoniens ou de leurs successeurs ; les autres sont d'origine diverse ou indéterminée.

Après une présentation du public qui peut accéder au diplôme de cadre de santé, pour une mission soit en hôpital, soit en institut de formation, une approche historique permet de mieux comprendre la lente évolution du dispositif de formation. Celle-ci, dans sa mise en œuvre à l’IFCS de Strasbourg, associe des valeurs humanistes à une construction de compétences. En outre, ses méthodes et moyens privilégient fortement un apprentissage en groupe ainsi que l’interactivité.

Faire de la biologie et penser la biologie constituent deux activités indispensables l'une à l'autre. L'exemple de la " métaphore du programme génétique " nous montre, qu'entre l'explication atomique des physiciens et l'explication vitaliste, il peut y avoir un niveau moléculaire spécifique d'analyse des propriétés du vivant. Cet ouvrage a pour double ambition de montrer comment cette métaphore s'est constituée et quels en sont les éléments discutables. Il se propose d'analyser le processus à travers lequel elle est passée historiquement de (...) l'état de concept dynamique et opératoire à celui d'une image figée de plus en plus décalée de la réalité de la connaissance biologique. (shrink)

Motivation plays an important role in students’ school behavior, and research has established that students’ learning environment experiences such as teachers’ behavior toward them contribute to their motivation and behavior at school. Self-determination theory offers an interesting frame of reference in the study of the relationship between students’ learning experiences at school and their school behavior. Considering three basic psychological needs, the SDT points to the importance of nutriments and support in the social environment in order to allow growth in (...) motivation, engagement, and well-functioning. In addition, thwarting these needs is supposed to contribute to maladaptive functioning. Teachers can play an important role in the fulfillment of students’ basic psychological needs by delivering support ; however, controlling instructional behavior, chaos in the classroom, and teacher rejection and neglect are supposed to be a treat to the fulfillment of students’ basic psychological needs. In the current innovative longitudinal study, teachers’ need-supportive behavior as well as teachers’ thwarting of these needs are considered and their relationship with students’ academic engagement and procrastination behavior is studied. In addition, attention is paid to differential effects of teachers’ behavior with regard to boys and girls. Participants were 566 students belonging to 20 mathematics/English grade 1 secondary education classes in the Netherlands. Multilevel analyses revealed evidence for the importance of both teachers’ need-supportive and need-thwarting behaviors in relation to students’ academic engagement and procrastination behavior. In addition, the findings revealed that teachers’ need-supportive behavior is more important for students’ academic engagement, while teachers’ need-thwarting behavior has larger effects on students’ procrastination behavior. Furthermore, evidence was found that boys often seemed to be more sensitive to their teachers’ behavior than girls. The findings highlight the importance of both teachers’ need-supportive and need-thwarting behaviors in daily classrooms and contribute to deepen our insight into and understanding of factors leading to adaptive and maladaptive functioning of boys and girls in relation to learning tasks at school. (shrink)

Entre tradiciones y procesos de transformación, asistimos a una poética del pensar del poema extenso en las Antillas hispanas. Desde la “décima”, venida de Europa, se desarrolla una creatividad lingüística por medio de una apertura pragmática, en estrecha relación con la particularidad colonial: entre mito del progreso y mito de la edad de oro. Para entender la inventiva caribeña, recordamos la práctica del Neobarroco, elaborado a base de las confluencias de lo heterogéneo. Vemos como a través de una heteroglosia discursiva, (...) el poema extenso se asienta en este espacio cultural que son las islas antillanas y subrayamos su papel actual en el relato de historias mínimas que alimentan por otro cariz la historia universal. (shrink)

Le conflit social autour de la réforme du régime d'assurance chômage des intermittents du spectacle a été marqué par son intensité et par sa durée. La thèse défendue ici est que la maîtrise du temps constitue l’un des enjeux majeurs de ce conflit. L'affrontement sur le terrain économique de la régulation de l'emploi et de l'industrie culturelle s'est doublé de l'affrontement sur le temps. La question du temps ne se limite pas à la régulation du temps de travail, elle concerne (...) la maîtrise du temps et les « formes de vie » auxquelles les individus aspirent. Les deux plans de l'emploi et du temps ne sont pas exclusifs l’un de l’autre, ils coexistent, mais le conflit autour de la maîtrise du temps est relativement imperceptible. L'objectif de cet article est de lui donner de la visibilité et d'en questionner le sens. (shrink)

Fairness of Artificial Intelligence decisions has become a big challenge for governments, companies, and societies. We offer a theoretical contribution to consider AI ethics outside of high-level and top-down approaches, based on the distinction between “reality” and “world” from Luc Boltanski. To do so, we provide a new perspective on the debate on AI fairness and show that criticism of ML unfairness is “realist”, in other words, grounded in an already instituted reality based on demographic categories produced by institutions. Second, (...) we show that the limits of “realist” fairness corrections lead to the elaboration of “radical responses” to fairness, that is, responses that radically change the format of data. Third, we show that fairness correction is shifting to a “domination regime” that absorbs criticism, and we provide some theoretical and practical avenues for further development in AI ethics. Using an ad hoc critical space stabilized by reality tests alongside the algorithm, we build a shared responsibility model which is compatible with the radical response to fairness issues. Finally, this paper shows the fundamental contribution of pragmatic sociology theories, insofar as they afford a social and political perspective on AI ethics by giving an active role to material actors such as database formats on ethical debates. In a context where data are increasingly numerous, granular, and behavioral, it is essential to renew our conception of AI ethics on algorithms in order to establish new models of responsibility for companies that take into account changes in the computing paradigm. (shrink)

The Soviet government utilized a variety of tactics while attempting to secularize the U.S.S.R. Oppression of the Russian Orthodox Church demonstrates how interconnected faith and the former tsarist regime were. It is ironic that while trying to wipe out religion, the Bolsheviks replacement methods carried religious-type qualities as well.

The historical context of mental health care in Quebec, which in recent years has given way to greater client participation in the decision-making process for which they are concerned, has reversed the previous medical conception of psychiatry. From a vision of internment, care is now adapted to the individual needs of the clientele served, even including the provision of care in the home. However, work with people weakened by mental illness is often fraught with questions and sometimes contradictory ethical issues. (...) Intensive follow-up teams in the community are a case in point. Working with a very vulnerable clientele, health workers must know how to be open and flexible in order to establish a therapeutic relationship with a clientele that is often involuntary and refractory to any form of treatment. To achieve this, they often have to get past refusals to follow-up by using various strategies derived from libertarian paternalism in order to maintain contacts that will become meaningful and allow these individuals to regain control over their lives. This sometimes-intrusive approach obviously raises its share of ethical issues, particularly regarding consent to care, and can be perceived as an infringement of fundamental rights by infringing rights to self-determination and decision-making autonomy. However, it is possible to reverse this position through a benevolent approach supported by an ethics of care that favours respect for the uniqueness of each individual by placing them at the heart of the therapeutic relationship. It is through dialogue, the place given to the other, respect for their choices, uniqueness and self-determination that it will then be possible to seek implicit consent and active participation of the user in the recovery process, even if sometimes there are binding legal measures. (shrink)