The book on Adler is one of the key works in Kierkegaard's thought. By writing it the Danish philosopher was able to verify for himself the religious content of his vocation and the accuracy of his critique against the modern church and society. It presents a profound investigation into the fundamental Christian concepts of "revelation", of "divine authority", and of "apostle". The inquiry shows that Kierkegaard is more of an objectivist than a subjectivist because he pronounced qualitative distinction between what (...) belongs to the immanent order, i.e. to men, and what belongs to the transcendal order, i.e. to God. But The book on Adler is also the result of a profound dialectical and psychological study performed on a certain Adler who pactatively gratified himself whith a revelation. The book, then, gives in details the most obvious proofs of his confusion and gives an account of its real causes : an emotionnal shock, a lack in both a Christian conceptual formation and an ethico-religious education, and the negative influence of Hegelian philosophy. While it sees in Adler the epitome of his era, it makes us understand the continual danger of missing what is essential in religious phenomena. (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)

Understanding the mechanisms and the time and spatial evolution of penumbra following an ischemic stroke is crucially important for developing therapeutics aimed at preventing this area from evolving towards infarction. To help in integrating the available data, we decided to build a formal model. We first collected and categorised the major available evidence from animal models and human observations and summarized this knowledge in a flow-chart with the potential key components of an evolving stroke. Components were grouped in ten sub-models (...) that could be modelled and tested independently: the sub-models of tissue reactions, ionic movements, oedema development, glutamate excitotoxicity, spreading depression, NO synthesis, inflammation, necrosis, apoptosis, and reperfusion. Then, we figured out markers, identified mediators and chose the level of complexity to model these sub-models. We first applied this integrative approach to build a model based on cytotoxic oedema development following a stroke. Although this model includes only three sub-models and would need to integrate more mechanisms in each of these sub-models, the characteristics and the time and spatial evolution of penumbra obtained by simulation are qualitatively and, to some extent, quantitatively consistent with those observed using medical imaging after a permanent occlusion or after an occlusion followed by a reperfusion. (shrink)

Despite severe amnesia, some studies showed that Alzheimer Disease patients with moderate to severe dementia keep a consistent, but impoverished representation of themselves, showing preservation of the sense of identity even at severe stages of the illness. Some studies suggest that listening to music can facilitate the reminiscence of autobiographical memories and that stimulating autobiographical memory would be relevant to support the self of these patients. Consequently, we hypothesized that repeated participation to reminiscence workshops, using excerpts of familiar songs as (...) prompts would participate to the enrichment of autobiographical memories, self-representation and sense of identity. We included a group of 20 AD patients with severe dementia residing in nursing homes. Their performances were compared to a control group of 20 matched healthy residents living in the same institutions. The experiment was conducted in three phases over a 2-week period. On phase 1, an individual assessment of sense of identity was proposed to each participant. On phase 2, participants joined musical reminiscence workshops. During the third phase, individual evaluation of autobiographical memory and a second assessment of sense of identity were proposed. Our results showed that, despite their massive amnesia syndrome, autobiographical memories of AD reached at the end of the 2 weeks the number and quality of those of matched controls. Moreover, we confirmed a continuity of self-representation in AD patients with a stable profile of the answers between the first and second individual assessments of sense of identity. However, the increase in number and episodic quality of autobiographical memories was not accompanied by an enrichment of the sense of identity. In a complementary study, new patients participated in the same paradigm, but using movie extracts as prompts, and showed very similar effects. We discuss all of these results with regard to the literature showing the significant impact of repetition on the reactivation of memory traces even in very amnestic AD patients at severe stages of the disease. (shrink)

Through a close analysis of various moments within two hours of video-taped interaction, we investigate properties of the setting that the participants cannot ignore even as they transform them in various ways. These properties are not under local control. What is under control is revealed in the participants' “play” with the properties, including dangerous, “deep” play. In this process, some properties of the participants are rarely mentioned (e.g., that the laboring woman is an MD), others are repeatedly emphasized (e.g. the (...) strength of contractions). And others appear in ways that have not been dealt with adequately in current theoretical frameworks. To deal with life-threatening lies, and jokes about lies, we must move away from theories of hegemonic particularity that rely on a habitus. Rather we must acknowledge the practical understandings revealed in the collective submergence of that which may be actively noted as potentially relevant and then set aside so that other tasks can be foregrounded and achieved. (shrink)

BackgroundSince 2006, the genetic testing company 23andMe has collected biological samples, self-reported information, and consent documents for biobanking and research from more than 1,000,000 individuals, through a direct-to-consumer online genetic-testing service providing a genetic ancestry report and a genetic health report. However, on November 22, 2013, the Food and Drug Administration halted the sale of genetic health testing, on the grounds that 23andMe was not acting in accordance with federal law, by selling tests of undemonstrated reliability as predictive tests for (...) medical risk factors. Consumers could still obtain the genetic ancestry report, but they no longer had access to the genetic health report in the United States. However, this did not prevent the company from continuing its health research, with previously obtained and future samples, provided that consent had been obtained from the consumers concerned, or with health reports for individuals from other countries. Furthermore, 23andMe was granted FDA authorization on February 19, 2015, first to provide reports about Bloom syndrome carrier status, and, more recently, to provide consumers with “carrier status” information for 35 genes known to cause disease.DiscussionIn this Debate, we highlight the likelihood that the primary objective of the company was probably two-fold: promoting itself within the market for predictive testing for human genetic diseases and ancestry at a low cost to consumers, and establishing a high-value database/biobank for research and personal information).SummaryBy dint of this marketing approach, a two-sided market has been established between the consumer and the research laboratories, involving the establishment of a database/DNA biobank for scientific and financial gain. We describe here the profound ethical issues raised by this setup. (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)

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)

Developing countries face numerous barriers to conducting effective and efficient ethics reviews of international collaborative research. In addition to potentially overlooking important scientific and ethical considerations, inadequate or insufficiently trained ethics committees may insist on unwarranted changes to protocols that can impair a study's scientific or ethical validity. Moreover, poorly functioning review systems can impose substantial delays on the commencement of research, which needlessly undermine the development of new interventions for urgent medical needs. In response to these concerns, the Drugs (...) for Neglected Diseases Initiative, an independent nonprofit organization founded by a coalition of public sector and international organizations, developed a mechanism to facilitate more effective and efficient host country ethics review for a study of the use of fexinidazole for the treatment of late stage African Trypanosomiasis. The project involved the implementation of a novel ‘pre-review’ process of ethical oversight, conducted by an ad hoc committee of ethics committee representatives from African and European countries, in collaboration with internationally recognized scientific experts. This article examines the process and outcomes of this collaborative process. (shrink)

Discussion of Wittgenstein's Tractatus is currently dominated by two opposing interpretations of the work: a metaphysical or realist reading and the 'resolute' reading of Diamond and Conant. Marie McGinn's principal aim in this book is to develop an alternative interpretative line, which rejects the idea, central to the metaphysical reading, that Wittgenstein sets out to ground the logic of our language in features of an independently constituted reality, but which allows that he aims to provide positive philosophical insights into (...) how language functions. McGinn takes as a guiding principle the idea that we should see Wittgenstein's early work as an attempt to eschew philosophical theory and to allow language itself to reveal how it functions. By this account, the aim of the work is to elucidate what language itself makes clear, namely, what is essential to its capacity to express thoughts that are true or false. However, the early Wittgenstein undertakes this descriptive project in the grip of a set of preconceptions concerning the essence of language that determine both how he conceives the problem and the approach he takes to the task of clarification. Nevertheless, the Tractatus contains philosophical insights, achieved despite his early preconceptions, that form the foundation of his later philosophy. -/- The anti-metaphysical interpretation that is presented includes a novel reading of the problematic opening sections of the Tractatus, in which the apparently metaphysical status of Wittgenstein's remarks is shown to be an illusion. The book includes a discussion of the philosophical background to the Tractatus, a comprehensive interpretation of Wittgenstein's early views of logic and language, and an interpretation of the remarks on solipsism. The final chapter is a discussion of the relation between the early and the later philosophy that articulates the fundamental shift in Wittgenstein's approach to the task of understanding how language functions and reveal the still more fundamental continuity in his conception of his philosophical task. (shrink)

Pauline Kleingeld has argued persuasively that Kant’s Principle of Autonomy draws an analogy between two relationships: 1) that between an individual agent and their maxim, and 2) that between a legislator and their legislation. She also suggests that Kant’s evolving views on the normative significance of popular elections made his analogy inapt, which explains its disappearance from his later writings. This comment concurs with Sorin Baiasu that the merits of Kant’s analogy were untouched by his evolving political views. The analogy (...) presupposes that when lawmakers legislate, they do so as representatives of the people, but even Kant’s mature writings posit that unelected lawmakers are representatives of the people in the necessary sense. Facts about whether a lawmaker acquired legislative authority by election, heredity, or conquest do have normative implications in the larger context of Kant’s political theory, but such facts are necessarily temporally upstream of the relation between legislator and legislation, just as facts about how an agent became rational are upstream of the relation between individual agent and maxim. Because the analogy focuses exclusively on these two relationships, it cannot be damaged by such upstream facts. Moreover, we should consider the possibility that Kant’s Principle of Autonomy compares a human will to the united general will of the people itself rather than to the will of a fallible public official or institution. On this alternative reading, it is even more clear that Kant’s evolving views on the significance of elections could have no possible relevance to the Principle of Autonomy. (shrink)

Desire After Affect offers a detailed analysis of the affective turn and its consequences for the humanities.

Originally presented as the author's thesis, Paris-Sorbonne, 1974.

Liana Badr's The Eye of the Mirror explores the historical trauma of the 1975–6 siege of the Palestinian refugee camp Tal el–Zaatar in Beirut and the massacre of thousands of its inhabitants by Christian militias. Analogous to Holocaust writing, Badr's fictionalized history, grounded in actual survivor testimonies, enacts a complex politics of cultural memory, but does so from a specifically female perspective. Collapsing the personal and political, private and public, inside and outside through figured violations of bodies and psyches, Badr (...) repositions women at the centre of the Palestinians’ struggle for and story of survival. Badr's novel traces the annihilation of the possibility of address, accompanied by self–loss and the ability to witness, and the laborious recreation of address. Claiming authority on the basis of the emotional, visceral truth of suffering, she seeks to break the endless cycle of an oppressive and impotent masculine history, constructing an alternative history which at least attempts to address the voice of cultural, national, and gender difference. (shrink)

This article engages with Goldenberg's desire to abandon transcendence since it is the enemy of autonomy and to once more encounter corporeality as the site of immanence. The author is in agreement with Goldenberg but attempts to show that the negative outcomes associated with a reliance on transcendence are not necessary and have been produced by a false understanding on the part of Christianity.

Cet entretien revient sur l’histoire des oppositions de gauche en URSS (notamment trotskystes, mais pas uniquement) et sur l’évolution actuelle de la Russie post-soviétique. Il critique les approches considérant l’URSS comme un « capitalisme d’État » et analyse les transformations à l’œuvre de la Russie contemporaine, notamment en terme de rapports de propriété. La nomenklatura joue un rôle contradictoire, tenant à conserver le contrôle de l’État tout en impulsant une vague de privatisations sous pression internationale.

This paper shows how solidarity is one of the founding principles in Thomas More's Utopia. In the fictional republic of Utopia described in Book II, solidarity has a political and a moral function. The principle is at the center of the communal organization of Utopian society, exemplified in a number of practices such as the sharing of farm work, the management of surplus crops, or the democratic elections of the governor and the priests. Not only does solidarity benefit the individual (...) Utopian, but it is a prerequisite to ensure the prosperity of the island of Utopia and its moral preeminence over its neighboring countries. However, a limit to this principle is drawn when the republic of Utopia faces specific social difficulties, and also deals with the rest of the world. In order for the principle of solidarity to function perfectly, it is necessary to apply it exclusively within the island or the republic would be at risk. War is not out of the question then, and compassion does not apply to all human beings. This conception of solidarity, summed up as “Utopia first!,” could be dubbed a Machiavellian strategy, devised to ensure the durability of the republic. We will show how some of the recommendations of Realpolitik made by Machiavelli in The Prince correspond to the Utopian policy enforced to protect their commonwealth. (shrink)

Respected Catholic ethicists have recently defended the use of salpingostomy and methotrexate in the management of ectopic pregnancies.This article examines the arguments for the revised assessments to determine whether there are sound reasons to believe that these two methods do not constitute the direct and immediate killing of innocent human beings. National Catholic Bioethics Quarterly 11.1 (Spring 2011): 65–82.

1 Timothy and the Pastoral Letters appear to be efforts to codify structure and roles in the early church. These efforts largely reflected the patriarchal social structures of the time and as such are not relevant to the twenty-first-century church. But some of the concerns identified herein, for example expectations of church leaders, are useful for a current discussion. What is missing is any acknowledgement of the potential for identified church leaders to take advantage of vulnerable congregants, particularly women and (...) children. How might the writer of 1 Timothy have addressed this serious problem in the churches? (shrink)

Marie-Frédérique Pellegrin | : Poulain de la Barre fait un usage original des procédés d’inversion tels qu’on les trouve en littérature et en philosophie, afin de démontrer l’égalité des sexes. Chez lui, l’inversion des valeurs ne vise pas seulement à remettre en cause le bien-fondé de la domination masculine et à louer une supériorité féminine en matière de moeurs et d’intelligence. Cette inversion entend abolir toute hiérarchisation entre les sexes. Tout d’abord l’auteur émancipe le genre du sexe. Ensuite il (...) prône un efféminage de tous les êtres humains. Le concept d’efféminage que nous forgeons est à distinguer de celui d’efféminement, qui implique l’idée d’une féminisation au sens d’une inclination vers des valeurs considérées comme féminines d’un point de vue culturel. L’efféminage est une prescription morale et sociale à devenir femme au sens d’un retour à l’état prélapsaire parfait dont les femmes sont plus héritières que les hommes car elles ont moins été touchées par le péché originel. L’efféminage ne consiste donc pas à devenir femme au sens d’une simple féminisation — sociale — des moeurs. L’efféminage fait signe vers l’égalité et non vers une supériorité féminine que sous-entend l’impératif d’efféminement. Le concept d’efféminage permet donc de penser, de manière explicite, le genre contre le sexe, non pas comme inversion mais comme construction ou plutôt reconstruction d’une autre nature humaine. | : Poulain de la Barre made original use of methods of inversion such as are found in literature and in philosophy, in order to demonstrate the equality of the sexes. In his work, the inversion of values is aimed not only at calling into question the legitimacy of male dominance and at praising feminine superiority in matters of morals and intelligence. It is an attempt to abolish any organization of the sexes into a hierarchy. In the first place, the author liberates gender from sex. Next, he advocates the “efféminage” of all human beings. The concept of “efféminage” that we are constructing here is to be distinguished from that of “efféminement”, which implies the idea of feminization in the sense of an inclination toward values considered feminine from a cultural perspective. “Efféminage” is a moral and social prescription to become a woman in the sense of a return to the perfect prelapsarian state of which women are more properly the inheritors because they have been less affected by original sin. “Efféminage” does not then consist in becoming a woman in the sense of a simple social feminization of morals. “Efféminage” gestures toward equality and not toward the feminine superiority implied by the imperative of “efféminement”. The concept of “efféminage” allows us then to think explicitly about gender in distinction with sex, not as an inversion but as a construction or rather a reconstruction of another human nature. (shrink)