Anne-Marie Gagné-Julien et Pierre-Olivier Méthot Durant les deux dernières décennies, plusieurs questions classiques de la philosophie de la médecine et de la psychiatrie ont connu un renouvellement. Des angles de recherche jusqu’alors peu explorés font désormais l’objet de vifs débats, et les questions traditionnelles ont été réinterprétées à la lumière de ces nouveaux développements. En examinant ces récents thèmes grâce aux contributions de chercheur.e.s francophones, ce dossier vise à nourrir la progression de cette « nouvelle » philosophie de la (...) médecine et de la psychiatrie, à apporter un éclairage inédit sur certains de ses domaines et de ses objets encore méconnus de même que sur ses courants et ses problématiques émergents, et ainsi à faire avancer des débats classiques sous des angles nouveaux. (shrink)

In this paper, my goal is to use an epistemic injustice framework to extend an existing normative analysis of over-medicalization to psychiatry and thus draw attention to overlooked injustices. Kaczmarek has developed a promising bioethical and pragmatic approach to over-medicalization, which consists of four guiding questions covering issues related to the harms and benefits of medicalization. In a nutshell, if we answer “yes” to all proposed questions, then it is a case of over-medicalization. Building on an epistemic injustice framework, I (...) will argue that Kaczmarek’s proposal lacks guidance concerning the procedures through which we are to answer the four questions, and I will import the conceptual resources of epistemic injustice to guide our thinking on these issues. This will lead me to defend more inclusive decision-making procedures regarding medicalization in the DSM. Kaczmarek’s account complemented with an epistemic injustice framework can help us achieve better forms of medicalization. I will then use a contested case of medicalization, the creation of Premenstrual Dysphoric Disorder in the DSM-5 to illustrate how the epistemic injustice framework can help to shed light on these issues and to show its relevance to distinguish good and bad forms of medicalization. (shrink)

This commentary samples some of the major bodies of counterevidence omitted by Howe et al., including the strong relationship between IQ and academic excellence, the limited effects of early stimulation programs, and the measurement of musical aptitudes. The authors' selective review and analysis of the surveyed literature, especially studies of prodigies and in behavioral genetics, is discussed.

This paper proposes a general analysis of the structure and imagery of the Salmacis epigram, a late Hellenistic verse inscription recently found in Bodrum which relates the foundation of Halicarnassus and lists the achievements of the city's authors. Focusing on the first part of the poem, I argue that the epigram can be seen to trace a complex symbolic map of the city in space and time. On a first level of reference the poem's episodes of foundation are consistently represented (...) as the aitia of ritual events. Superimposed on the catalogue of foundation episodes is a catalogue of the ritual events that commemorated them, and our epigram uses this level of reference to ground its portrait of Halicarnassus in the contemporary ritual life of the polis. In this way the poem is able to locate the city in the space of cult and to inscribe the linear time of primordial origins in the recurrent present of ritual practice. On a complementary level of reference, finally, the different episodes of foundation also function as so many statements of kinship—every founder effectively ties the city to another region and another people. As a parallel to the local space of ritual, then, the combination of these statements of kinship is made to locate the city in the wider space of ethnic geography. Behind a seemingly simple catalogic form, the Salmacis epigram actually combines two levels of reference to achieve a significant and multifaceted representation of a late Hellenistic city's cultural memory. (shrink)

In this paper, I argue for a new way to understand the integration of facts and values in the concept of mental disorder that has the potential to avoid the flaws of previous hybrid approaches. I import conceptual tools from the account of procedural objectivity defended by Helen Longino to resolve the controversy over the definition of mental disorder. My argument is threefold: I first sketch the history of the debate opposing objectivists and constructivists and focus on the criticisms that (...) led to the emergence of the debate. Second, I offer a reconstruction of the “Natural Function Approach” argument to make explicit an unsound assumption underlying this approach. The reconstruction will allow me to show that the NFO’s argument depends on the ideal of value-free science that I will criticize. Then I propose an alternative ideal for psychiatry: social objectivity. I argue that the concept of mental health should be seen as “socially objective” rather than value-free, moving the debate towards the social procedures by which the definition is produced rather than the normative and factual content of its definition. (shrink)

In this article, I side with those who argue that the debate about the definition of “disease” should be reoriented from the question “what is disease” to the question of what it should be. However, I ground my argument on the rejection of the naturalist approach to define disease and the adoption of a normativist approach, according to which the concept of disease is normative and value-laden. Based on this normativist approach, I defend two main theses: (1) that conceptual analysis (...) is not the right method to define disease and that conceptual engineering should be the preferred method and (2) that the method of conceptual engineering should be implemented following the principles of Alexandrova’s account of social objectivity in the context of the definition of disease. (shrink)

La création récente du diagnostic de trouble dysphorique prémenstruel (TDPM) dans le DSM-5 a été contestée sous de multiples angles. Les principales critiques mettent en avant les lacunes en faveur de la validité du TDPM, ainsi que le risque de pathologisation et de stigmatisation des changements physiques et comportementaux vécus par les femmes pendant leur phase prémenstruelle. Pour éclairer cette controverse, j’emprunte certains outils du cadre conceptuel des injustices épistémiques (IE) développé par Miranda Fricker. Plus précisément, je vais me baser (...) sur de récents travaux qui ont tenté d’appliquer ce cadre aux processus de catégorisation en médecine et en psychiatrie. Cela me permettra de mettre au jour un angle mort du débat actuel sur le TDPM, soit les perspectives des personnes touchées par ces symptômes. Ces points de vue ont été généralement négligés, mais le cadre des IE nous permet de recentrer le débat sur les intérêts et les besoins des personnes affectées par les processus de catégorisation psychiatrique. (shrink)

André Gagné | : Cet article s’intéresse à la signification et le rôle des solitaires–élus dans les logia 49-50 de l’Évangile selon Thomas. Après avoir répertorié les différents sens attribués au substantif monakhos par la recherche actuelle, nous proposons une interprétation nouvelle de l’expression au moyen d’une lecture synchronique et intratextuelle de l’EvTh. La conclusion est que les solitaires et les élus ne sont pas deux classes d’individus distincts, mais constituent plutôt un même groupe, une seule entité. L’EvTh caractérise (...) les solitaires–élus comme ceux qui s’adonnent à la quête du sens des paroles de Jésus, afin de ne pas goûter la mort . Étant issus du Royaume et de la lumière, ils sont aussi étrangers dans ce monde, à l’instar de Jésus, maître du plérôme. | : This article explores the function and meaning of the solitary–elect in logia 49-50 of the Gospel according to Thomas. Following a review of the various meanings attributed to the monakhos by modern scholarship, a fresh interpretation of this expression by means of a synchronic and intratextual reading of the GosThom. is offered. The conclusion is that the solitary and the elect are not two classes of individuals, but are rather a single unique group, a sole entity. The GosThom. characterizes the solitary–elect as those who seek the interpretation of the sayings of Jesus, in order to not taste death . Having originated from the Kingdom and the light, they are strangers in the world, just as Jesus, the lord of the Pleroma. (shrink)

ABSTRACT:One recent body of work has concerned medicalization and how it can create epistemic injustice. It focuses on medicalization as a hermeneutical process that shapes the conceptual framework(s) we use to refer to some conditions/experiences. In parallel, some scholars with lived experience of madness have started to explore the epistemic harms suffered by the Mad community. Building on this, I argue that the process of medicalization in psychiatry affects the Mad community in a specific way that has been overlooked in (...) the literature on medicalization and epistemic injustice. That is, medicalization can create what is called "contributory injustice." This form of injustice occurs when marginalized communities have been able to create alternative hermeneutical resources, but these resources are dismissed or discredited by the dominant group. I argue that the emerging field of Mad Studies is a victim of this type of injustice when Mad experiences are unilaterally medicalized. (shrink)

Since the era of deinstitutionalisation, many clinical approaches have emerged to enable the care and treatment of people suffering from mental illness. In recent years, the use of coercive approaches in the community (e.g., outpatient commitment or community treatment orders) has also increased internationally. Although nurses' role regarding these coercive approaches is central and significant, few empirical and theoretical writings have tackled this controversial nursing practice. The purpose of this paper is to analyse coercive nursing care through the lens of (...) French philosopher Gilles Deleuze's concept of ‘societies of control’. Taking up Michel Foucault's work on disciplinary power, Deleuze explores how the move from the striated spaces of closed institutions to the smooth spaces of societies of control took place since the middle of the 20th century. According to Deleuze, the overall objective of ‘societies of control’ is no longer simply to govern deviant behaviour in closed environments (e.g., psychiatric hospitals and prisons) but to ensure a regime of unrelentless surveillance in the open spaces of our communities. (shrink)

Robert Castel is an eminent figure in the social sciences because of his innovative contributions to various social and health fields. The seminal work of this poststructuralist author and social activist has influenced several research disciplines, but has not yet had a significant impact on nursing. In this article, we will present the thinking of this man, who considered himself a sociologist, philosopher and “historian of the present.” We will examine the most important issues he explored during his career, including (...) the psychiatric apparatus, the management of risk and the social vulnerability. We believe that this thinker's perspective on diverse social issues is very relevant to nursing practice and research and to the health sciences in general. The concepts he developed and utilized with finesse provide us with a critical reading of many contemporary health issues, particularly in mental health and psychiatric nursing. Castel's critical and engaged approach incites mobilization for social justice and greater protections for marginalized and vulnerable persons. These principles of advocacy and social justice are also at the heart of the nursing profession. (shrink)

This paper builds on previous work that investigated anticancer drugs as ‘informed materials’, i.e., substances that undergo an informational enrichment that situates them in a dense relational web of qualifications and measurements generated by clinical experiments and clinical trials. The paper analyzes the recent transformation of anticancer drugs from ‘informed’ to ‘informing material’. Briefly put: in the post-genomic era, anti-cancer drugs have become instruments for the production of new biological, pathological, and therapeutic insights into the underlying etiology and evolution of (...) cancer. Genomic platforms characterize individual patients’ tumors based on their mutational landscapes. As part of this new approach, drugs targeting specific mutations transcend informational enrichment to become tools for informing their targets, while also problematizing the very notion of a ‘target’. In other words, they have become tools for the exploration of cancer pathways and mechanisms. While several studies in the philosophy and history of biomedicine have called attention to the heuristic relevance and experimental use of drugs, few have investigated concrete instances of this role of drugs in clinical research. (shrink)

Historically, all societies have used comparison to analyze cultural difference through the interaction of religion, power, and translation. When comparison is a self-reflective practice, it can be seen as a form of comparatism. Many scholars are concerned in one way or another with the practice and methods of comparison, and the need for a cognitively robust relativism is an integral part of a mature historical self-placement. This volume looks at how different theories and practices of writing and interpretation have developed (...) at different times in different cultures and reconsiders the specificities of modern comparative approaches within a variety of comparative moments. The idea is to reconsider the specificities, the obstacles, and the possibilities of modern comparative approaches in history and anthropology through a variety of earlier and parallel comparative horizons. Particular attention is given to the exceptional role of Athens and Jerusalem in shaping the Western understanding of cultural difference. (shrink)

As the use of artificial intelligence (AI) technologies, particularly generative AI (Gen AI), becomes increasingly prevalent in nursing education, it is paramount to address the ethical implications of their implementation. This article explores the realm of cyberethics (a field of applied ethics that focuses on the ethical, legal, and social implications of cybertechnology), highlighting the ethical principles of autonomy, nonmaleficence, beneficence, justice, and explicability as a roadmap for facilitating AI integration into nursing education. Research findings suggest that ethical dilemmas that (...) challenge these five principles can emerge within the context of nursing education; however, adherence to these very principles, which is essential to improving patient care, can offer solutions to these dilemmas. To ensure the ethical and responsible use of Gen AI in nursing education, these principles must be woven into the fabric of curricula, and appropriate guidelines must be developed. Nurse educators have a pivotal role in strategizing comprehensive approaches for ethical AI integration, establishing clear guidelines, and instilling critical thinking among students. Fostering lifelong learning and adaptability is key to ensuring that future nurses can successfully navigate the constantly evolving landscape of health care technology. Future research should investigate the long-term impacts of AI utilization on learning outcomes and ethical decision-making. (shrink)

In the debate over the definition of ‘mental health,’ three different approaches are generally distinguished: the normativist approach (Szasz, Sarbin), the hybrid approach (Wakefield) and the naturalistic approach (Boorse). This paper qualifies this classification by clarifying the sense in which Christopher Boorse defends a naturalistic approachvis-à-visthe central concepts of psychiatry. This paper also clarifies in what way Boorse is opposed to the normativist approach advocated by some authors of the anti-psychiatric movement, such as Szasz.

In this paper, we want to take a critical stance towards Tsou’s recent proposal that a neuro-oriented version of the homeostatic property cluster kind model (MPCK) should be an ideal for the DSM. Our strategy will be to discuss the creation of the Social Pragmatic Communication Disorder (SPCD) in DSM-5 to show the limits of MPCK as an ideal for the next DSM deliberations over a set of diagnoses revisions. We argue that an ideal model for the DSM should address (...) the issues of deep uncertainties and pragmatic considerations to be useful in this context. (shrink)

Cet article analyse des séquences de débat polémique tiré d’un talk-show télévisé et fortement conflictuelles. A partir de la notion d’interpellation, et en combinant des éléments provenant de la théorie de l’énonciation et la linguistique interactionnelle, l’article montrera que le dispositif interpellatif mis en place conduit inévitablement au « clash ». En effet l’interpellativité qui est au cœur du dispositif est en prise directe avec le fait que les participants ont recours à des modes d’adresse qui accentuent la virulence des (...) échanges, interrompant leur interlocuteur et allant même jusqu’à l’insulter. La raison d’être de ce dispositif relève d’une volonté non pas d’informer mais de divertir le public en lui livrant le spectacle d’un affrontement et en faisant davantage appel à ses émotions qu’à sa raison. (shrink)

According to the literature, the family is now considered to be the most important resource for the care and support of a sick family member. Families are being increasingly invited and trained to play a utilitarian role, not just as family caregivers, but as healthcare agents. Healthcare institutions, based on neoliberal health policies, are encouraging them to perform increasingly complex and professionalized tasks. The burden associated with this expanded healthcare function, however, is significant (fatigue, emotional distress and exhaustion). The aim (...) of this article was to present French sociologist Jacques Donzelot's theoretical perspective on governing through the family. According to Donzelot, such a government is exercised through various power techniques, including the instrumentalization of the family role and the transfer to families of the responsibility for health care. This author describes how healthcare institutions call on the family to perform hospital and biomedical practices within the home. A spin‐off of neoliberalism, the practices of governing through families specifically target women, who are considered to be the pillar of the family. Donzelot's perspective is very relevant to nursing, but is still rarely mobilized in the discipline. His critical perspective allows for a re‐reading of relations of power and mechanisms of surveillance and control of families, issues that are often overlooked in nursing research. (shrink)

Ce volume rassemble les actes d’un colloque international tenu à Lyon en juin 2008. Le volume contient vingt-deux contributions organisées en trois sections : « Hymne et procédure hymnique », « Commenter un hymne homérique », et « Hymne, histoire religieuse et théologie ». Certains textes sont en français, les autres en anglais. Une copieuse bibliographie, une vingtaine d’images et figures, un index des auteurs et textes cités, un index des inscriptions, un index des noms propres, et un excel...

The original version of this article unfortunately contained a mistake. Three entries are incorrect in the reference list. The corrected references are given below.

This review summarizes the discussions held during the 3rd Bioethics Café in 2019, which focused on the theme: “The citizen as public health actor: challenges and opportunities”. Three panelists – Yan Kestens, Allison Marchildon and Karine Lefeuvre – enriched this meeting with their expertise in public health and ethics. This exchange highlighted the value of citizen participation in public health and the importance of nuancing its understanding and application. It is a priority to consider the relationships between the various stakeholders, (...) the contextual factors that can affect this process and the ethical strategies that can be used to strengthen “good” citizen participation. This meeting was part of a series of Bioethics Cafés held in Montreal and Quebec City on the subject of ethics, health and data. (shrink)

Psychiatric language and concepts, and the norms they embed, have come to influence more and more areas of our daily lives. This has recently been described as a feature of the ‘psychiatrization of society.’ This paper looks at one aspect of psychiatrization that is still little studied in the literature: the psychiatrization of our emotional lives. The paper develops an extended account of emotion pathologizing as a form of affective injustice that is related to psychiatrization and that specifically harms psychopathologized (...) people, i.e., people who are socially perceived to be mentally ill. After introducing an initial account of emotion pathologizing as articulated in Pismenny et al. (2024), we extend the account by demonstrating how processes and practices of emotion pathologizing are informed by (1) the dominant biomedical approach to psychiatry and (2) sanism, a system of discrimination and oppression that disadvantages people who have received a psychiatric diagnosis, or are perceived as in need of psychiatric treatment. We then argue that emotion pathologizing can manifest as an affect-related hermeneutical injustice that disadvantages psychopathologized individuals by unfairly constraining how they make sense of and understand their own emotional experiences. (shrink)

Nous tentons, dans cet article, de déterminer la place des comportements non conséquentialistes, notamment le respect des valeurs et des normes, dans la théorie du choix rationnel. Au départ, il n’y a pas de limites à ce qui peut constituer une préférence ou une valeur d’utilité; tout comportement non conséquentialiste peut être réduit à un comportement conséquentialiste. Un bref examen de certains modèles rationnels des normes sociales nous montre, d’une part, que la réduction conséquentialiste du conformisme laisse inexpliqués certains phénomènes (...) importants, et d’autre part, que l’emploi d’utilités autres qu’instrumentales pose de sérieux problèmes à la théorie. Pour terminer, nous discutons de deux autres approches de la théorie du choix rationnel faisant une large part aux comportements non conséquentialistes. Nous concluons que si, pour une même action, le type de motivation influence en soi les résultats de l’action collective, alors il nous faut dans ce cas sortir du cadre de la rationalité, sans toutefois complètement l’abandonner.In this paper, we attempt to find the place of non-consequentialist behavior, like respect of norms and values, in rational-choice theory. At the onset, there is no limit as to what can constitute a preference or a utility value; any non-consequentialist behavior can be reduced to a consequentialist one. A brief survey of several rational models of social norms shows us, on one hand, that consequentialist reduction of conformity leaves some important phenomena unexplained, and, on the other hand, that recourse to non-instrumental utilities generates serious problems within the theory. We end with a discussion of two alternative approaches to rational-choice theory that leave a large place for non-consequentialist behavior. We conclude by saying that if, for the same action, the type of motivation behind it has by itself an influence on the outcome of collective action, then in such cases we have to step out of rational-choice theory, without however abandoning it. (shrink)

Par l’analyse de l’oracle de Glaukos tel qu’il apparaît au chapitre 86 du 6e livre d’Hérodote, cet article se propose d’illustrer la richesse du matériau oraculaire des périodes archaïque et classique, et l’intérêt de redonner au chrèsmos hexamétrique sa place dans le grand paysage des traditions poétiques de la Grèce archaïque et classique.

La démocratie délibérative s’oppose fréquemment à une conception rationnelle du citoyen qui, selon ses théoriciens, ne permet pas d’atteindre une authentique démocratie. Pourtant, la démocratie délibérative souffre elle-même de difficultés théoriques importantes dont une partie des solutions a déjà été abordée dans la théorie du choix rationnel. Nous voulons montrer que le choix rationnel, dans sa version « étendue », peut servir à améliorer la démocratie délibérative sans pour autant en ébranler ses fondements. Nous effectuerons d’abord un survol de la (...) démocratie délibérative, en insistant sur les questions de formation et d’expression des préférences des citoyens dans l’agora. Nous y découvrirons certaines difficultés théoriques que nous tenterons par la suite de résoudre par un ensemble de mécanismes issus de la théorie du choix rationnel. Parallèlement, nous verrons que la délibération raisonnable est possible dans un paradigme rationnel, que nous appelons la « délibération circonstancielle ».Deliberative democracy frequently rejects the rational citizen model since, according to its proponents, it would not yield a proper democracy. And yet, deliberative democracy contains important theoretical difficulties, some of which have been dealt with by rational-choice theory. We intend to show that a “broad” version of rational-choice theory can actually improve deliberative democracy without condemning its foundations. First, we will briefly examine deliberative democracy, focusing on the formation and expression of citizens’preferences in the agora. Some theoretical problems will be identified; several mechanisms drawn from rational-choice theory will be used to try to solve them. Simultaneously, we will see that reasonable deliberation is possible in a rational-choice paradigm, in a model I call “circumstantial deliberation”. (shrink)