Cet ouvrage est une réédition numérique d’un livre paru au XXe siècle, désormais indisponible dans son format d’origine.

When abolitionists Thomas Clarkson and Ottobah Cugoano published their essays on slavery in the late eighteenth century, they became key participants in one of the most important human rights campaigns in history. British abolitionism sought to expose the realities of transatlantic slavery in addition to asking politicians to help dehumanized Africans in the New World, and this edition brings together two major essays of the 1780s that were influential in the spread of the early abolitionist movement: Clarkson’s _An Essay on (...) the Slavery and Commerce of the Human Species_ and Cugoano’s _Thoughts and Sentiments on the Evil and Wicked Traffic of the Slavery and Commerce of the Human Species_. A critical introduction and extensive historical appendices on British and American slavery and abolitionism, featuring contemporary arguments for and against slavery, are also included. (shrink)

Research into intuitive problem solving has shown that objective closeness of participants’ hypotheses were closer to the accurate solution than their subjective ratings of closeness. After separating conceptually intuitive problem solving from the solutions of rational incremental tasks and of sudden insight tasks, we replicated this finding by using more precise measures in a conceptual problem-solving task. In a second study, we distinguished performance level, processing style, implicit knowledge and subjective feeling of closeness to the solution within the problem-solving task (...) and examined the relationships of these different components with measures of intelligence and personality. Verbal intelligence correlated with performance level in problem solving, but not with processing style and implicit knowledge. Faith in intuition, openness to experience, and conscientiousness correlated with processing style, but not with implicit knowledge. These findings suggest that one needs to decompose processing style and intuitive components in problem solving to make predictions on effects of intelligence and personality measures. (shrink)

Recent buzzes around big data, data science and artificial intelligence portray a data-driven future for healthcare. As a response, Europe's key players have stimulated the use of big data technologies to make healthcare more efficient and effective. Critical Data Studies and Science and Technology Studies have developed many concepts to reflect on such overly positive narratives and conduct critical policy evaluations. In this study, we argue that there is also much to be learned from studying how professionals in the healthcare (...) field affectively engage with this strong European narrative in concrete big data projects. We followed twelve hospital-based big data pilots in eight European countries and interviewed 145 professionals between 2018 and 2020. In this study, we introduce the metaphor of dreams to describe how professionals link the big data promises to their own frustrations, ideas, values and experiences with healthcare. Our research answers the question: how do professionals in concrete data-driven initiatives affectively engage with European Union's data hopes in their ‘dreams’ – and with what consequences? We describe the dreams of being seen, of timeliness, of connectedness and of being in control. Each of these dreams emphasizes certain aspects of the grand narrative of big data in Europe, makes particular assumptions and has different consequences. We argue that including attention to these dreams in our work could help shine an additional critical light on the big data developments and stimulate the development of responsible data-driven healthcare. (shrink)

Il faut saluer la réédition aux Éditions Turquoise de la traduction de Die Waffen nieder!, l’ouvrage antimilitariste de la pacifiste autrichienne Bertha von Suttner, qui, dès sa parution en 1889, devint le best-seller incontesté de la fin du siècle, immédiatement traduit en une vingtaine de langues et en français en 1899. C’est du reste cette traduction, la seule existant à ce jour en langue française, qui est rééditée ici avec la préface d’époque signée par Gaston Moch, dreyfusard de la prem...

Much of the developing world, including Kenya, is rapidly urbanizing. Rising food and fuel prices in recent years have put the food security of the urban poor in a precarious position. In cities worldwide, urban agriculture helps some poor people gain access to food, but urban agriculture is less common in densely populated slums that lack space. In the Kibera slums of Nairobi, Kenya, households have recently begun a new form of urban agriculture called sack gardening in which vegetables such (...) as kale and Swiss chard are planted into large sacks filled with topsoil. This paper examines relationships among sack gardening, social capital, and food security in Kibera. We used a mixed methods approach, combining qualitative interviews with a household survey, as well as focus group discussions with both farmers and non-farmers. We present evidence that sack gardening increases social capital, especially for those households that undertake sack gardening in groups. We also find that sack gardening in the Kibera slums has a positive impact on household food security by improving household dietary diversity and by reducing the need to resort to painful coping mechanisms that are used during food shortages. (shrink)

Tiré d’un mémoire de maîtrise soutenue à l’Université de Paris I-Panthéon-Sorbonne, sous la direction de Jean-Clément Martin, ici préfacier, Marie-Antoinette et ses biographes. Histoire d’une écriture de la Révolution française, possède les qualités et les défauts de ce type d’exercice. Le titre en est ainsi trompeur, puisqu’il laisse envisager une enquête reposant sur l’ensemble des travaux portant sur la figure historique de Marie-Antoinette. En fait, cinq biographes ont été convoqués et fo...

This paper examines Stanley Cavell's theories from the perspective of a 'politics of cinema' and engages in a critical reading of Sofia Coppola's 2006 film, Marie Antoinette.

On comprend aisément pourquoi Slava Liszek, qui fut l’une des rédactrices d’Antoinette - le journal féminin de la CGT - a été touchée par Marie Guillot, au point de lui consacrer plusieurs années de recherche et, finalement, une biographie. À l’évidence, il s’agit d’un hommage rendu à une militante lucide et « incorruptible ». Le style trahit une profonde sympathie pour « Marie », qui pourra, selon les goûts, charmer, ou agacer. De toutes façons, le redoutable défi (...) d’une biographie de Marie G... (shrink)

On comprend aisément pourquoi Slava Liszek, qui fut l’une des rédactrices d’Antoinette - le journal féminin de la CGT - a été touchée par Marie Guillot, au point de lui consacrer plusieurs années de recherche et, finalement, une biographie. À l’évidence, il s’agit d’un hommage rendu à une militante lucide et « incorruptible ». Le style trahit une profonde sympathie pour « Marie », qui pourra, selon les goûts, charmer, ou agacer. De toutes façons, le redoutable défi (...) d’une biographie de Marie G... (shrink)

This paper reads The Monk by M. G. Lewis in the context of the literary and visual responses to the French Revolution, suggesting that its digestion of the horrors across the Channel is exhibited especially in its depictions of women. Lewis plays with public and domestic representations of femininity, steeped in social expectation and a rich cultural and religious imaginary. The novel’s ambivalence in the representation of femininity draws on the one hand on Catholic symbolism, especially its depictions of the (...) Madonna and the virgin saints, and on the other, on the way the revolutionaries used the body of the queen, Marie Antoinette, to portray the corruption of the royal family. The Monk fictionalizes the ways in which the female body was exposed, both by the Church and by the Revolution, and appropriated to become a highly politicized entity, a tool in ideological argumentation. (shrink)

This essay sketches the musical art of Frances Pelton-Jones, an American harpsichordist active at the beginning of the twentieth century. Almost entirely unknown today, she was widely acclaimed in her day for performing elaborate costume recitals dressed as Marie Antoinette. More than just a recitalist in costume, Pelton-Jones staged elaborate tableaux vivants with environmental decor to elicit fantasies of the past. Bridging the worlds of fashion, environmental design, and music, her performances offer a compelling case study to investigate (...) the aesthetic applications of Jane Bennett’s ecological theory of assemblages. Exploring how different human and nonhuman actants collaborated in Pelton-Jones’ art to evoke whole historical atmospheres for her audiences, I elaborate Bennett’s argument about the synthetic potential of combining certain materials to conjure an affect, highlighting how the delicacy of the assemblage as a whole often is contingent upon the frailty of the individual materials involved. Ultimately, Bennett’s theory affirms the aesthetic sensibilities of Pelton-Jones whose musical productions delighted audiences by harnessing the synthetic potential of well-coordinated vital materials. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:American Journal of Philology 126.3 (2005) 461-463 [Access article in PDF] Graham Zanker. Modes of Viewing in Hellenistic Poetry and Art. Wisconsin Studies in Classics. Madison: The University of Wisconsin Press, 2004. xiv + 223 pp. 34 black-and-white ills. Cloth, $39.95. The underlying contention here is that if a Hellenistic poetic description of a person, an animal, the weather, a scene, or an objet d'art adopts a particular way (...) of viewing, we have independent evidence for the habits of viewing that Hellenistic people would have brought to their contemplation of representational art. (4) So Graham Zanker summarizes the thesis of his new book, the most extensive and detailed account of Hellenistic visuality yet published. This is a carefully worded sentence. Zanker's enumeration of poetic descriptions of "a person, an animal, the weather, a scene or an objet d'art" deliberately exemplifies what he takes to be the scope of ekphrasis and hence reproves those who have taken ekphrasis more narrowly as the description of works of art (cf. 6–10). The target of this disapproval turns out to be especially Simon Goldhill, whom he attacks at 82–83 and in a long endnote (184–85, n. 26). Yet the care to be precise in matters of literary definition goes with such large, even lax, social and cultural generalizations as "Hellenistic people" and "representational art." What Zanker must mean by those whose contemplation of art can be evoked through poetic descriptions is a highly literate and educated social elite—perhaps the court itself—that may have played (Marie-Antoinette-like) at shepherds and fishermen (as in the cup of Theocritus' first Idyll) but surely did so from a much narrower social perspective than the totalizing generalism of "Hellenistic people." The weapon of precision is a dangerous one to use, when it may be turned back on the user.There are, moreover, numerous problems with both the notion of "independent evidence" and that of "habits of viewing." While the literary evidence of ekphrasis (not only in poetry) certainly encompasses viewing, its specially wrought and often spectacular cleverness may signal the exceptional, even the perverse, as much as (or more than) the habitual. Does a revolutionary statue like the Aphrodite of Cnidos (not actually Hellenistic, but nonetheless rightly incorporated at some length in Zanker's book) reflect or elicit the habitual gaze? In what sense? And, if so, when? Was the gaze it enticed at its moment of creation "habitual," or did that gaze only become "habitual" in its numerous—within our surviving material archive of examples, mainly Roman-period—versions and replications? More difficult still is "independent evidence." I am not really sure what that could be in a topic created from critical and interpretative explications of complex images and texts that do not themselves draw explicit or simple conclusions about viewing (or anything) beyond what readers may impute to them. How they may collectively constitute evidence about viewing can only come about as the result of argument. I think a compelling argument based on the critical interpretation of images and texts may be taken as evidence, but is that "independent evidence?" What does this mean? And such a complex argument is a very different kind of evidence from what Zanker seems to mean by any particular viewpoint we may find expressed in an ekphrasis. [End Page 461]Again, I do not think it follows that the evidence for viewing we may entice from a poetic description of a person, an animal, or the weather need necessarily be related to the contemplation of a work of art. Indeed, Zanker's use of the term contemplation (with its Kantian overtones) appears to indicate a specifically aesthetic zone of response. Certainly the Hellenistic period explicitly elevated creativity in the visual arts to a new canonical status with its creation of art-historical narratives and histories devolving on the rise of naturalism and on the genius of particular hallowed artists who are preserved for us by the likes of Quintilian and Pliny. That special aestheticism, marked in the choice of works of... (shrink)

Ce dictionnaire propose de réunir des portraits de brutes et de mégères dans le but de s'interroger sur les causes et les raisons de cette perception négative. Pourquoi certaines figures évoquent-elles la méchanceté? Que peut nous dire cette méchanceté dénoncée de nous-mêmes et de l'époque qui l'a engendrée? Il s'agira de retracer les portraits de ceux et celles ayant marqué l'Histoire et la fiction par leur cruauté, leur perfidie, leur machiavélisme, leur art de la dissimulation ou de la manipulation. S'attarder (...) sur la méchanceté et ses possibles, décliner les façons de la penser et de la vivre, de la subir ou de l'exercer, c'est s'intéresser à une facette peu valorisée de la sensibilité d'autant plus importante que chaque individu, de près ou de loin, est amené, un jour, à se montrer méchant. La méchanceté et ses manifestations, qu'elles soient conceptuelles ou biographiques, nous invitent donc à une introspection globale, à une immersion dans les affres de la noirceur des âmes dont la bouche n'est autre que celle de la méchanceté Le champ de cette entreprise est vaste et recouvre notamment : La Malice, le Machiavélisme, Orangina Rouge, Barbe Bleue, le cinéma d'Alfred Hitchcock, Marie-Antoinette, la Mauvaise conscience, Gilles de Rais, Harry Powell (La nuit du chasseur) Salomé-Hérodiade, Dracula, Tatie Danielle, Marie Tudor, la Perversité, la Mégère Grecque, Dark Vador, Mildred Ratched (Vol au-dessus d'un nid de coucou)... (shrink)

In the foreword to the Mercure de France edition of de Staël., Chantal Thomas, French historian and writer, writes that this apology in favor of Marie-Antoinette did not help the queen nor the author herself; on the contrary it only made the latter more unpopular. So why did Germaine de Staël write it? Mme de Staël and Marie-Antoinette did not share many interests; however, at the moment of The Women’s March on Versailles in October 1789, the (...) situation had changed. It was at this moment, when Mme de Staël witnessed people’s hatred for the Queen, that she for the first time felt that she was on her side. She had the feeling that the Queen would be a victim to a public opinion that had been “manipulated” in a systematic way, and to which she herself had been a victim. Pursuing some ideas formulated by Reddy and in their work on emotion and empathy in history and philosophy respectively, I hope to offer some suggestions, with the aid of cultural semiotics. More specifically I hope to be able to provide some answers to the question whether Mme de Staël’s apology might be regarded as an act of compassion. (shrink)

Thomas Carlyle, renowned nineteenth-century essayist and social critic, came to be thought of as a secular prophet by many of his readers and as the "undoubted head of English letters" by Ralph Waldo Emerson. _Historical Essays _brings together Carlyle's essays on history and historical subjects in a fully annotated modern edition for the first time. These essays, which were originally collected in _Critical and Miscellaneous Essays, _span Carlyle's career from 1830 to 1875 and represent a major facet of his writings. (...) This edition uses all the extant authoritative versions of the essays to create an accurate critical text and includes a mine of lucidly presented information to enhance readers' understanding of Carlyle's densely allusive prose. The collection includes essays on the French Revolution, Cromwell, Frederick the Great, and medieval Scandinavia. It also includes such essential pieces as "On History," "On History Again," "Count Cagliostro," and "The Diamond Necklace." Together the essays show Carlyle positioning himself in relation to the new Romantic historiography but not yet ready to adopt the strictures of modern scientific history. They also exhibit his talent for analyzing the historical significance of seemingly minor events. He describes a plot to steal a diamond necklace in which Marie Antoinette became implicated, a visit of Whig sympathizers to the National Assembly during the French Revolution, and the kidnapping of two fifteenth-century German princes, one of whose descendents was Carlyle’s contemporary Prince Albert. This volume, the third of the eight-volume Strouse Edition of Carlyle’s works, includes a historical introduction and illustrations along with complete textual apparatus. (shrink)

En ces temps où, dans la production éditoriale comme au cinéma, Marie-Antoinette est à la mode, il faut absolument s’arrêter sur cet ouvrage. Le titre exact de ce court pamphlet (30 p.), publié anonymement en août 1793 après le renvoi de Marie-Antoinette devant le Tribunal révolutionnaire, est Réflexions sur le procès de la reine par une femme. Et c’est aux femmes que l’auteure s’adresse en premier, aux « femmes de tous les pays, de toutes les classes (...) de la société » : sensibles, elles ne peu... (shrink)

This study reconsiders the purported benefits of community found in Community Supported Agriculture (CSA). Using an online survey of members who belong to CSAs in New York, between November and December 2010, we assess members’ reasons for joining a CSA, and their perceptions of community within their CSA and beyond. A total of 565 CSA members responded to the survey. Results show an overwhelming majority of members joined their CSA for fresh, local, organic produce, while few respondents joined their CSA (...) to build community, meet like-minded individuals or share financial risk with farmers. Members reported that they do not derive a strong sense of community from either their CSA or other forms of community, yet they volunteered at their CSA and appear to be engaged in activities within their communities, though the frequency of the latter is unknown. These data suggest New York CSAs are oriented toward the instrumental and functional models, which emphasize the economic aspects of farming rather than collaborative models, which foster community (Feagan and Henderson 2009). (shrink)

International institutions have become increasingly important not only in the relations between states, but also for individuals. When are these institutions legitimate? The legitimacy standards fo...

Abstract : This introduction to a special issue on "Normes and normativity" emphasizes the difficulties and challenges of distinguishing between a positive approach and a normative approach to norms in economics. Collective life is organized by norms, however the mere fact that they regularly influence behaviours does not imply their desirability. A strict description of norms may require consideration of ethical issues, which may be reported by different methods; choosing among norms however is an activity of a fundamentally normative nature, (...) which questions the legitimacy of decisions and evaluations. The very possibility of a demarcation between is and ought is not straightforward. In welfare economics in particular, the standard approaches that aim to avoid value judgements (welfarism) or to isolate them (axiomatics) can be problematic. To conclude, we present the four articles in the special issue meant to illustrate these issues regarding the nature, knowledge, value of norms and the positive-normative distinction. -/- Résumé : Cette introduction à un dossier thématique sur le thème "Normes et normativité" insiste sur les difficultés et les enjeux de la distinction entre les approches positives et normatives des normes en économie. La vie collective est organisée par des normes, mais qu’elles ordonnent les comportements dans les faits n’impliquent pas qu’elles soient désirables. Une stricte description des normes peut nécessiter de prendre en compte les questions éthiques, lesquelles peuvent être traduites par différentes méthodes ; choisir les normes en revanche est une activité de nature fondamentalement normative, qui interroge la légitimité des décisions et des évaluations. La possibilité même de démarcation entre positif et normatif ne va pas de soi : en particulier en économie du bien-être, les approches standards qui visent à éviter les jugements de valeur (le welfarisme) ou à les isoler (l’axiomatique) peuvent s’avérer problématiques. Pour conclure, nous présentons les quatre articles du numéro qui illustrent ces questionnements relatifs à la nature, la connaissance, la valeur des normes et la distinction entre normatif et positif. (shrink)

The Gods of our Ancient World are migrating toward the South. Pushed back by supermarkets, television shows and the rights of man divorced from himself, they have ended up taking refuge in the last Christian region that faces Islam: in Andalusia that is one of their last lands of asylum. They have left traces of their passage in our museums upon which we construct pyramids in order to feign our veneration for them. Now and then they accompany the silence of (...) a symphony to the rhythm of the high priest's baton. However, in the South they are alive. Accommodating themselves to the din of household appliances and of tourism, they appear sometimes in all the splendor of the Midi during the passage of the virgins of peace and bleeding christs. But most frequently they hide in the midst of the Andulusian festival, under the flanks of the fighting bulls or in taverns that are filled with raucous songs. Be it that they intrude upon a play in order to transform it into a ritual; be it that they honor art and sensuality in their celebrations — they choose for their appearances the blurred boundary between the world of the sacred and of the profane. (shrink)

Mary Shepherd's An Essay upon the Relation of Cause and Effect, first published in 1824, was a pioneering work in metaphysics and epistemology. Together with her 1827 Essays on the Perception of an External Universe, they make her one of the most important philosophers of her era. Although widely neglected by the history of philosophy in the decades after her death, her works have recently begun to attract the attention and sustained study they deserve. In the course of her writings, (...) Shepherd offers trenchant and detailed rebuttals of the arguments and conclusions of many prominent predecessors-including George Berkeley, Thomas Reid, Dugald Stewart, Thomas Brown, William Lawrence, and especially David Hume-but she is no merely negative thinker. On the contrary, her critiques are always in the service of her own distinctive and highly original doctrines, which are of striking contemporary interest. Appearing two hundred years after its original publication, this is the first full modern edition of her first book, which presents and defends the theory of causation and scientific knowledge that constitutes the cornerstone of her entire philosophy. The edition includes an extensive introduction and scholarly notes throughout that provide historical and philosophical context while explaining the central ideas of the work. It also includes Shepherd's two essays published in 1828 and all of her known letters-all but one of them published here for the first time-which shed significant additional light on her philosophical ideas. (shrink)

Despite being fundamental to democracy, the normative concept of the people, i.e. the demos, is highly unclear. This article clarifies the legitimacy of the demos’ boundaries by structuring the debate into three strains of justification: first, normative membership principles; second, its democratic functionality and the necessity of cohesion for this essential function; and third, a procedural understanding of the demos. It will be shown that normative principles can only justify its expansion towards the ideal of an unbounded demos. On the (...) other hand, the democratic function of the demos can be understood as a criterion for its restriction. This, however, is only possible on the basis of an existing polity and not for the initial constitution of the demos. Consequently, a legitimate demos has to take both inclusionary and exclusionary tendencies into account. These tendencies need to be weighed against each other in the democratic process, which leads to a fundamentally procedural understanding of the legitimacy of the demos. (shrink)

Introduction Compulsory care is controversial, since respect for the patient’s autonomy is a standard requirement in health care. Many psychiatrists have experienced that patients with borderline personality syndrome sometimes demand compulsory care for themselves in order not to exert self-harm—like Ulysses contracts. The aim of this study was to examine the possible existence and extent of borderline personality syndrome-patient demands for Ulysses contracts regarding compulsory care in acute psychiatry, and how external influences and demands could affect the caregivers’ decisions about (...) compulsory care. Method An anonymous questionnaire, with three questions with fixed answers, was distributed to 42 licensed medical doctors on call at the psychiatric emergency unit in the city of Stockholm. Thirty-three questionnaires were answered, giving a response rate of 79%. Results Ninety-four percent of the respondents recognized the phenomenon of borderline personality syndrome patients requesting compulsory care, 21% stated that this request had affected their clinical decision, and 55% had used compulsory care for other reasons than the patient’s best interest. Discussion The results indicate that compulsory care is sometimes given in the form of Ulysses contracts for borderline personality syndrome patients. Also, compulsory care is sometimes used for other reasons than the borderline personality syndrome patient’s best interest. Psychological mechanisms affect the decisions of both patients and caregivers. More research should be done concerning to whom, why, and with what consequences compulsory care is prescribed. (shrink)

This paper aims to clarify the status of capability in Sen’s idea of justice. Sen’s name is so widely associated with the concept of capability that commentators often assume that his contribution to the study of justice amounts to a capability theory, albeit underdeveloped. We argue that such a reading is misleading. Taking Sen’s reticence about operationalization seriously, we show that his contribution is inconsistent with a capability theory. Instead, we defend the idea that the capability approach plays a heuristic (...) role: capability is a step in his argument against alternative materials, but is not meant as a definitive end. Sen defends a critical perspective primarily to encourage public reasoning and respect for agency as regards the definition of what should count in the evaluation of social states. (shrink)

This paper discusses how the general and abstract concept of legitimacy applies to international institutions, using the United Nations Security Council as an example. We argue that the evaluation of the Security Council’s legitimacy requires considering three significant and interrelated aspects: its purpose, competences, and procedural standards. We consider two possible interpretations of the Security Council’s purpose: on the one hand, maintaining peace and security, and, on the other, ensuring broader respect for human rights. Both of these purposes are minimally (...) morally acceptable for legitimacy. Second, we distinguish between three different competences of the UNSC: 1) the decision-making competence, 2) the quasi-legislative competence, and 3) the referral competence. On this basis, we argue that different procedural standards are required to legitimise these competences, which leads to a more differentiated understanding of the Security Council’s legitimacy. While maintaining that the membership structure of the Council is a severe problem for its legitimacy, we suggest other procedural standards that can help to improve its overall legitimacy, which include broad transparency, deliberation, and the revisability of the very terms of accountability themselves. (shrink)

This study explores the aspects of the relationship between possible indicators of CEO narcissism and fraud. Highly narcissistic CEOs undertake challenging or bold actions to obtain frequent praise and admiration. The pursuit of narcissistic supply may result in a stronger likelihood of a CEO to undertake bold actions with potential detrimental consequences for the organization. The sample consists of all S&P 500 CEOs from 1992 till 2008 with more than 3 years of tenure. The measurement of CEO narcissism is based (...) on 15 objective indicators and fits the main conceptualization of narcissism. This data collection provides a score for all S&P 500 CEOs according to their narcissistic tendencies. The Accounting and Auditing Enforcement Releases on the SEC’s website are the indicators of managerial fraud. The findings confirm the expected influence of plausible proxies for CEO narcissism on fraud by showing a positive relationship. This confirms the psychologic perspective of CEO narcissism as a potential cause of fraud. (shrink)

This text is a transcription of Rouvroy’s presentation on 7th October 2014 at the “Digital Studies” seminar series at the Centre Georges Pompidou. This seminar series, organised by the French philosopher Bernard Stiegler, question the influence of digital technologies on knowledge from an epistemological point of view and from the way they alter academic disciplines.

Patients with borderline personality disorder (BPD) sometimes request to be admitted to hospital under compulsory care, often under the argument that they cannot trust their suicidal impulses if treated voluntarily. Thus, compulsory care is practised as a form of Ulysses contract in such situations. In this normative study we scrutinize the arguments commonly used in favour of such Ulysses contracts: (1) the patient lacking free will, (2) Ulysses contracts as self-paternalism, (3) the patient lacking decision competence, (4) Ulysses contracts as (...) a defence of the authentic self, and (5) Ulysses contracts as a practical solution in emergency situations. In our study, we have accepted consequentialist considerations as well as considerations of autonomy. We conclude that compulsory care is not justified when there is a significant uncertainty of beneficial effects or uncertainty regarding the patient’s decision-making capacity. We have argued that such uncertainty is present regarding BPD patients. Hence, Ulysses contracts including compulsory care should not be used for this group of patients. (shrink)

IntroductionBorderline personality disorder patients are often subjected to inpatient compulsory care due to suicidal behaviour. However, inpatient care is usually advised against as it can have detrimental effects, including increased suicidality.AimTo investigate what motives psychiatrists have for treating borderline personality disorder patients under compulsory care.Materials and MethodsA questionnaire survey was distributed to all psychiatrists and registrars in psychiatry working at mental health emergency units or inpatient wards in Sweden. The questionnaire contained questions with fixed response alternatives, with room for comments, (...) about the respondents’ motives for practising compulsory care of borderline personality disorder patients. The responses were analysed quantitatively with descriptive statistics, and comments were analysed with qualitative descriptive content analysis.ResultsThe psychiatrists’ views were divided on when it was justified to treat borderline personality disorder patients under compulsory care, as were their views on borderline personality disorder patients’ decision competence. When there was an assessed risk of harm, 53% were positive to compulsory care of decision-competent borderline personality disorder patients and another 31% because they considered the patients to be decision incompetent in such situations. Adding the risk of harm caused many respondents to alter their assessment of the patient from decision competent to decision incompetent.ConclusionThe large variations in doctors’ opinions indicate that the care of borderline personality disorder patients is arbitrary. Further, the assessed risk of harm increases the use of compulsory care, even though such care is advised against in clinical guidelines, has questionable legal support, and could lead to an increased suicide risk over time. (shrink)