Context: Since 2015, physicians are the only health professionals who have the legal authority to administer medical aid in dying (MAID) in Quebec. A new legislative context is bringing major changes to their end-of-life care practice. Objective: Explore the meaning-making factors that emerge from the experience of physicians administering MAID in order to shed light on what leads them to integrate this practice into their professional continuum. Methodology: Semi-structured interviews were conducted with ten physicians who had performed at least one (...) MAID throughout the territory of the CIUSSS de l’Estrie. Analysis: Conducted using Pierre Paillé’s (1994) grounded theorization, it showed that MAID is a human approach requiring time and social skills, and where life skills are paramount. The results suggest that MAID is located at the boundaries of the physician’s personal and professional identity. In short, what motivates a physician to participate in the MAID process is their narrative identity, including the values and meaning that they give to their experiential journey. Conclusion: MAID is an existential form of care, and the process is experienced differently by each physician; therefore, it is important to respect the meaning and values of each physician, whether or not they incorporate MAID into their medical practice. (shrink)

For centuries, philosophy has been considered as an intellectual activity requiring complex cognitive skills and predispositions related to complex (or critical) thinking. The Philosophy for Children (P4C) approach aims at the development of critical thinking in pupils through philosophical dialogue. Some contest the introduction of P4C in the classroom, suggesting that the discussions it fosters are not philosophical in essence. In this text, we argue that P4C is philosophy.

Si l’histoire des sages-femmes est relativement bien connue pour les XVIIe et XVIIIe siècles, grâce aux ouvrages de Mireille Laget et Jacques Gélis, en revanche, pour le XIXe siècle, elle reste en grande partie à écrire. La situation parisienne a fait l’objet du livre de Scarlett Beauvalet-Boutouyrie sur la Maternité de Port-Royal et aussi de la thèse de IIIe cycle sur les sages-femmes parisiennes de Danielle Tucat, malheureusement non publiée. Pour la France profonde, on dispose d’un article...

We present here a new method for bioethics: systemic modelling. In this method, the complex phenomenon being studied (e.g. personalized medicine, genetic testing, gene therapy, genetically modified organisms) is modelled as a whole, to shed light on its organization and functioning, and major (bio)ethical issues and solutions for their resolution are then identified. This systemic modelling method is ideal for use in the identification of solutions, rather than their validation, with other methods then used to test the solutions found. We (...) provide a description and reproducible instructions for the application of systemic modelling in bioethics, together with a brief example of the application of this method to the study of the impact of personalized medicine on French society. (shrink)

Illiteracy is a concrete and real problem, which involves nearly one thousand million people in the world. And, according to UNESCO statistics, this number, far from decreasing, keeps increasing in undeveloped countries as well as in the industrialized ones.

I argue for a re-appropriation of the religious/philosophical concept of ‘anxiety’ regarding human finitude and fallibility as an ‘epistemic virtue’ thatshould frame the relationship between personal (including religious) belief and political participation and procedures. I contend that moral justificationsof liberal norms based on ‘respect for persons’ and ‘tolerance’ are insufficient without relation to such a (complementary) epistemic basis. Furthermore, Iargue that a careful examination of the internal logic of religious belief, per se, undermines traditional understandings of ‘faith’ (as being categoricallyopposed (...) to ‘doubt’) and reveals support for liberal norms as an necessary implication thereof. (shrink)

The practice and development of modern medicine requires large amounts of data, particularly in the domain of cancer. The future of personalized medicine lies neither with “genomic medicine” nor with “precision medicine”, but with “data medicine”. The establishment of this DM has required far-reaching changes, to establish four essential elements connecting patients and doctors: biobanks, databases, bioinformatic platforms and genomic platforms. The “transformation” of scientific research areas, such as genetics, bioinformatics and biostatistics, into clinical specialties has generated a new vision (...) of care. Molecular tumor boards are one response to these changes and are now providing better access to next-generation sequencing and new cancer treatments to patients with inoperable or metastatic cancers, and those for whom the usual treatment has failed. However, MTB face a crucial ethical challenge: maintaining and improving the trust of patients, clinicians, researchers and industry in academic medical centers supported by private or public funding rather than providing genetic data directly to private companies. We believe that, in this era of DM, appropriate modern digital communication networks will be required to maintain this trust and to improve the organization and effectiveness of the system. There is, therefore, a need to reconsider the form and content of informed consent documents at all academic medical centers and to introduce dynamic and electronic informed consent. (shrink)

Cet article est une tentative pour mesurer les conséquences démographiques, pour l�Empire, de la perte des provinces orientales du fait de la conquête musulmane. Les sources, surtout les sources grecques, sont rares et donnent seulement quelques informations ponctuelles sur les transferts forcés de population, sur quelques individus quittant le califat et rejoignant l�Empire à dessein et enfin sur la destinée de quelques renégats. Comme d�habitude à cette époque, en raison du quasi monopole des sources ecclésiastiques, les renseignements sont plus nombreux (...) sur le clergé et le flot ininterrompu d�exilés depuis l�Anastasis à Jérusalem jusqu�à Constantinople et Sainte-Sophie. (shrink)

This research questions the prevention and health promotion practices developed for young people, in France, and re-examines the nature of competences enlisted in the classical model of empowerment in health education. Moving away from the epidemiological postulate of evidence based medicine (EBM), it explores another approach of these educational practices. The research uses the perspective of narrative mediation; it tries also to identify issues about a better knowledge of oneself, making more comprehensive the issues of young students’ health.

Avec le mouvement de professionnalisation de l'enseignement, la compétence éthique est devenue une caractéristique désirée du professionnalisme dans l'enseignement.

How is it that ordinary people decide to take part in genocides? Philosophers and psychologists have attempted to provide explanations of how genocidal organizations bear on the moral judgement of genocide participants. Here, I resituate those findings within the field of human resource management. I highlight how basic principles of management and HR management can lead ordinary individuals to judge their participation in a genocide as acceptable. Although initially only designed to increase motivation and productivity, these techniques also affect individuals’ (...) awareness of ethical issues. Consequently, participants shift their judgements in favour of the genocidal organization, forgetting the victims. Management studies have seldom addressed the topic of genocide, despite clues in the literature that genocides are organizational in nature. By combining the three fields of management, business ethics and genocide studies within an approach based on transdisciplinary analysis, I hope to show that genocides constitute a legitimate subject for management studies. (shrink)

Professeures dans une école de gestion, nous menons, depuis des années, un dialogue réflexif sur nos pratiques de recherche et de publication. La gestion est un domaine de plus en plus populaire et où la concurrence entre écoles s’exacerbe. Les gestionnaires et les chercheurs des écoles de gestion ressentent un besoin stratégique d’excellence et de bonne réputation, ce qui passe, bien sûr, par la publication. Comment les contraintes actuelles de publication pèsent-elles sur nous, les chercheurs? Quels savoirs produisons-nous dorénavant et (...) pour qui? Nous tenterons de répondre à partir d’un examen de nos propres pratiques. Notamment, nous verrons que des barrières empêchent l’accès à ces savoirs. Comment sortir de ces problèmes? Toujours à partir de notre compréhension personnelle de l’intériorisation et de l’institutionnalisation des contraintes de publication, nous émettrons une opinion plutôt pessimiste sur les chances de l’accès libre de libérer la circulation des savoirs en sciences de gestion. (shrink)

This research project investigated manifestations of critical thinking in pupils 10 to 12 years of age during their group discussions held in the context of Philosophy for Children Adapted to Mathematics. The objective of the research project was to examine, through the pupils' discussions, the development of dialogical critical thinking processes. The research was conducted during an entire school year. The research method was based on the Grounded Theory approach; the material used consisted of transcripts of verbal exchanges among the (...) pupils. Analysis of the transcripts revealed that: critical thinking appears to the extent that a 'dia-logue' is established among pupils; on the cognitive level, dialogical critical thinking is comprised of four thinking modes: logical, creative, responsible and meta-cognitive; and on the epistemological level, dialogical critical thinking is only manifested in a context where egocentricity of perspective and relativism of beliefs are transcended. (shrink)

In early 1997, participants on the p4c-list, an email discussion list, reacted to an anecdote about Wittgenstein’s lectures at Cambridge by engaging in a three month long exchange on the nature of a Community of Inquiry. This article is a lightly edited transcript of that discussion and, as such, not only addresses many aspects of the substantive issue, but also provides an exemplar of at least one type of Community of Inquiry.

BackgroundIn the context of translational research, researchers have increasingly been using biological samples and data in fundamental research phases. To explore informed consent practices, we conducted a retrospective study on informed consent documents that were used for CARPEM’s translational research programs. This review focused on detailing their form, their informational content, and the adequacy of these documents with the international ethical principles and participants’ rights.MethodsInformed consent forms (ICFs) were collected from CARPEM investigators. A content analysis focused on information related to (...) biological samples and data treatment (context of sampling and collect, aims, reuse, consent renewal), including the type of consent. An automatic assessment of the readability of the ICFs were performed with the IT program “Flesch Score”.Results29 ICFs from 25 of 49 studies were analyzed after selection criteria were applied. Three types of consent were identified: 11 broad consents, six specific consents, and two opt-out consents. The Flesch Scores showed that most of the documents were too complex to be fully understood by most of the potential research participants. Most of the biological samples were collected during the healthcare routine, but the information content about secondary use of biological samples varied between ICFs. All documents mentioned personal data treatment but information about their reuse was not standardized in the ICFs.ConclusionsOur review of current IC procedures of CARPEM showed that practices could be improved considering new translational research methods. “Old fashion written ICFs” should be adapted to the translational research approach, to better respect individual rights and international research ethics principles. In this context, theoretically, a digital tool allowing dynamic information and consent of participants, through an electronic interactive platform may be a good way to promote more active participation in research. Nevertheless, its feasibility in the complex environment of biological samples and data research remains to prove. The way of a combination of a broad consent followed by dynamic information may be alternatively tested. (shrink)

Voici un livre à deux voix, où s’entrelacent en un dialogue (rendu sensible par des typographies contrastées) les réflexions d’une grande historienne de la maternité et celles d’un gynécologue obstétricien d’aujourd’hui. Il s’agit de comprendre les profondes transformations de la procréation et de la naissance dans nos sociétés en revenant sur l’histoire longue des croyances et des pratiques autour de la grossesse et de l’accouchement. Même s’il n’est pas question de proposer un retour à l’an...

The intention of this work is to trace in the most archaic human condition the anthropological roots that justify the foundation of an ethics, as conceived by Paul Ricœur in his book Oneself as Another . To do this, first I will try to expose the route that the creative image follows from its genesis in drives to its full semantics in the symbol, according to the dialogue that the author engaged with Freud in his work Freud and Philosophy based (...) on his hermeneutic concerns. Second, considering a critical remark that Ricœur makes about Freud, I will explore the intentional orientation towards “the good life”, whose reflexive sense, “self-esteem”, integrates the symbolic dimension of action and sets the basis for the realization ( épanouissement ) of the human person. (shrink)