Enjeux éthiques et surdités

Deafness is a particular handicap in that it belongs to medicine on one hand and on the other, it is a cultural object with a language, the sign language, a culture and a world of its own, the “the world of deafness”. This specific position generates ethical challenges that must be discovered in their complexity around three areas: genetic discoveries versus eugenics, early diagnosis in the maternity unit versus the iatrogenic announcement affecting the early relationships and the cochlear implant versus the parents enlightened consent. In the face of the urgency of the medical discourse, the ethical debate can trigger another temporality and another discourse for the deaf child and his parents by defending its clinical singularity…     

Visions and Ethics in Current Discourse on Human Enhancement

Since it is now broadly acknowledged that ethics should receive early consideration in discourse on emerging technologies, ethical debates tend to flourish even while new fields of technology are still in their infancy. Such debates often liberally mix existing applications with technologies in the pipeline and far-reaching visions. This paper analyses the problems associated with this use of ethics as “preparatory” research, taking discourse on human enhancement in general and on pharmaceutical cognitive enhancement in particular as an example. The paper will outline and discuss the gap between the scientific and technological state of the art and the ethical debates, pointing out epistemic problems in this context. Furthermore, it will discuss the future role of genuine ethical reflection in discourse on human enhancement, arguing also that such discourse needs to include a technology assessment—in the broad sense of the term—which encompasses, inter alia, anthropological perspectives and aspects of social theory.     

Trinity, Temporality, and Open Theism

A number of thinkers today, including open theists, find reasons to attribute temporality to God. According to Robert W. Jenson, the Trinity is indispensable to a Christian concept of God, and divine temporality is essential to the meaning of the Trinity. Following the lead of early Christian thought, Jenson argues that the “persons” of the Trinity are relations, and these relations are temporal. Jenson’s insights are obscured, however, by problematic references to time as a sphere to which God is related. Schubert M. Ogden gives the notion of divine temporality coherent content by arguing that God’s actuality is best understood as an unending succession of experiences. This paper was delivered in the APA Pacific 2007 Mini-Conference on Models of God.     

心理学中话语分析的立场与方法

研究区分了两种不同的“话语”定义,它们各自引申出一类“话语分析”。最为常见的是话语的描述性定义——“话语是建构某个对象的意义、表征或陈述系统”;另一种是功能性定义——“话语即做事”;“话语即行动”;“话语即实践”。话语分析在心理学中首先是一种研究立场,其次是一类研究方法。作为研究立场,话语分析悬置了心理、人格等传统心理学构念;解构了实证研究的客观性原则;重新调整了心理学的研究目标。作为研究方法,心理学中的话语分析有修辞研究、隐喻研究、叙事研究等多种形式     

The Balance Between Providing Support,Prolonging Suffering,and Promoting Death: Ethical Issues Surrounding Psychological Treatment of a Terminally Ill Client

The concept of moral identity based on virtue ethics has become an issue of considerable import in explaining moral behavior. This attempt to offer adequate explanations of the full range of morally relevant human behavior inevitably provokes boundary issues between ethics and moral psychology. In terms of the relationship between the two disciplines, some argue for “naturalized (or psychologized) morality,” whereas, on the other hand, others insist on “moralized psychology.” This article investigates the relationship between virtue ethics and moral identity based on previous research on the relationship between ethics and moral psychology. This article especially attempts to show that meaningful links between the two concepts possible by using theoretical frameworks constructed by the most influential philosophers of science such as Kuhn and Lakatos.     

Breast cancer representations in Canadian news media: a critical discourse analysis of meanings and the implications for identity

Despite the importance of critical media work, much is to be learned about breast cancer representations within media discourses and the implications for women’s identity construction. Building on research from Australia from a discursive perspective, this article used an eclectic approach to critical discourse analysis to explore the cultural construction of breast cancer in 25 detailed stories within Canada’s two national newspapers, The Globe and Mail and the National Post. Ten images accompanying stories and 17 advertisements/public service announcements were also analyzed to contextualize discourses and subject positions/identities within the stories. Analysis of this media affords the unique opportunity to explore taken for granted assumptions and prevailing meanings about breast cancer and the implications for subjectivity. Two primary discourses were identified: a discourse of biomedicine and a discourse of healthism. Subject positions identified included “breast cancer survivor,” “the good consumer,” and the “medical expert.” The psychological, social, political, and health promotion implications are discussed.     

Gender as Lived Time: Reading The Second Sex for a Feminist Phenomenology of Temporality

This article suggests that Simone de Beauvoir's The Second Sex offers an important contribution to a feminist phenomenology of temporality. In contrast to readings of The Second Sex that focus on the notion of “becoming” as the main claim about the relation between “woman” and time, this article suggests that Beauvoir's discussion of temporality in volume II of The Second Sex shows that Beauvoir understands the temporality of waiting, or a passive present, to be an underlying structure of women's existence and subordination. Accordingly, I argue that Beauvoir does not see “woman” as a mere becoming, as that which unfolds in time, but instead understands becoming a woman to be realized as lived time. As such, Beauvoir's account shows that gender and temporality are deeply entangled, and thus she challenges the classic phenomenological account of temporality as a general, given structure of human existence. More specifically, I argue that her account shows how a particular experience of time is an underlying structure of sexual objectification, a claim that expands on the feminist phenomenological claim that a particular relation to space becomes a way in which women take up and negotiate their own subordination and objectification.     

马克思政治经济学批判的话语萌发与思想发端——《关于林木盗窃法的辩论》的文本贡献

《关于林木盗窃法的辩论》的主导话语是哲学话语,在该文中,马克思也开始使用政治经济学话语,在以哲学批判为主导分析框架的前提下构建了政治经济学批判的辅助分析框架。马克思在坚持从哲学层面分析“物质利益难事”的同时,使用了“劳动”“价值”和“额外价值”这些政治经济学核心话语。这些话语蕴含着马克思思想中的无产阶级立场、客观价值论和资本批判的方法。当然,这时政治经济学批判思想还不成熟,立场、观点和方法都处于话语萌发和思想发端阶段。     

POSSIBILITIES AND LIMITS OF MEDICAL SCIENCE: DEBATES OVER DOUBLE‐BLIND CLINICAL TRIALS OF INTERCESSORY PRAYER

Abstract. This article traces the intellectual history of scientific studies of intercessory prayer published in English between 1965 and the present by focusing on the conflict and discussion they prompted in the medical literature. I analyze these debates with attention to how researchers articulate the possibilities and limits medical science has for studying intercessory prayer over time. I delineate three groups of researchers and commentators: those who think intercessory prayer can and should be studied scientifically, those who are more skeptical and articulate the limits of science around this topic, and those who focus primarily on the pragmatic applications of this knowledge. I analyze these contests as examples of what Thomas Gieryn calls “epistemic authority” as medical researchers engage in what he describes as “boundary‐work” or “the discursive attribution of selected qualities to scientists, scientific methods, and scientific claims for the purposes of drawing a rhetorical boundary between science and some less authoritative residual non‐science.” (Gieryn 1999, 4 (Gieryn 1999, 4)).     

Configurations of time,the body,and verbal communication: Temporality in patients who express their suffering through the body

This paper focuses on the study of temporality used as a clinical pointer to processes of affect regulation in patients who express their suffering through a discourse driven by bodily allusions. Differences between symptoms revealed by body language that conveys an experience of conflict (psychoneurotic symptoms) and somatizations are reviewed. Somatization is examined as a benchmark for the failure to resolve states of tension. The body in the session is conceptualized as a speech event. The body is considered as a psychical construction organized in the exchanges with a fellow human‐being. It is thus established as a support for subjectivity. Two discourse registers are described: the discourse of the evoked body and the discourse of the perceived body. The study of Greek mythology allows us to distinguish two different types of temporality : Chronos and Kairos. Chronos represents chronological whereas Kairos subjective time. Both are present in the subject; but if greater mental disorganization supervenes, Chronos predominates as it paves the way for a defence against suffering, designed to avoid the unbearable meaning of ceasing to be. Adherence to one or other mode of temporality signals different conceptions of analytic work. The topics addressed are illustrated by various clinical vignettes .     

“Heaven and Hell on Earth” A critical discourse analysis of religious terms in Norwegian autobiographies describing personal experience of mental health problems

This article explores the use of religious terms in six Norwegian autobiographies written between 1925 and 2005 by people who themselves have been patients in the mental health services. Through a critical discourse analysis, we discuss the functions of religious discourse in the texts and its position in contrast to the medical discourse predominant in today's mental health services. It was found that religious (predominantly Christian) terms were used to varying degrees in all autobiographies as a means to capture the immensity and inherent ambivalence characteristic of mental health problems. Despite the “medical turn” in professional mental health discourse, there is no clear evidence of a decrease in the use of religious terms from the oldest to the most recent text. We propose that professional mental health workers to a larger extent take into account the religious dimension in therapy, and reflect on its larger historical and sociocultural context.     

A practitioner's notes on the free-associative method as existential praxis

Freud's pre-1914 texts demonstrate why he consistently asserted that his free-associative method was the sine qua non of his discipline. Prior to 1914, Freud's theorizing was intimately and inextricably connected to his lived experience with the discovery of this method. After 1914, he became more speculative in this thinking and writing; his models of the “mental apparatus” and its functioning drew increasingly on conceptual sources other than his experience with free association. The four fundamental coordinates of his discipline (the methodical disclosure that self-consciousness is repressive, the nonlinear “time of the mind,” the significance of our sensual embodiment or libidinality, and the formation of the repression barrier by the incest taboo) are all closely tied to free-associative experience. By contrast, post-1914 theoretical preoccupations (from object relations to the structural-functional model, and other formulations generated after Freud's life) are comparatively divorced from such experience. These conceptual edifices imply a conventional depiction of the theory–practice relationship, which is radically challenged by free-associative discourse. The notion of praxis is introduced as contesting the prevailing depiction of practice as an application of theory, and as serving to rescue psychoanalysis from the somewhat “sterile debates” over its scientific status and over the relevance of metapsychological speculation to clinical treatment. Against the normative ideology of theory and practice, the lived experience of free-associative discourse, with its potential for change and healing, can only be understood in terms of this notion of praxis, and this justifies Freud's claim to have initiated “a critical new direction in science.”     

Feminist directions in medical ethics

I explore some new directions—suggested by feminism—for medical ethics and for philosophical ethics generally. Moral philosophers need to confront two issues. The first is deciding which moral issues merit attention. Questions which incorporate the perspectives of women need to be posed—e. g., about the unequal treatment of women in health care, about the roles of physician and nurse, and about relationship issues other than power struggles. “Crisis issues” currently dominate medical ethics, to the neglect of what I call “housekeeping issues.” The second issue is how philosophical moral debates are conducted, especially how ulterior motives influence our beliefs and arguments. Both what we select—and neglect—to study as well as the “games” we play may be sending a message as loud as the words we do speak on ethics.     

See me,hear me: Using film in health-care classes

This essay argues that film deserves a place within the medical humanities curriculum and demonstrates effective strategies for employing it within medical ethics and humanities classrooms. Part One of the article emphasizes how and why medical ethics teachers can utilize documentary and fictional films, such as “Thomas Szasz and the Myth of Mental Illness,” “The Deadly Deception,”Whose Life Is It Anyway? and “Voices From the Front” in their courses. Such films encourage students to move beyond abstract debates and confront the human pain inherent in all ethical dilemmas. Part Two focuses on documentary and fiction film in the medical humanities classroom. In this section, the author details how to incorporates films, such asThe Doctor, The Waterdance andHospital, into the humanities classroom, juxtaposing them with various literary works, such asOther Women's Children, Borrowed Time, andCeremony. Part Three of the essay presents a detailed discussion ofThe Elephant Man andFrankenstein, illustrating how visual and literary texts compliment each other within the humanities classroom. Overall, the author demonstrates how films function as engaging and complex visual texts providing unique insights in the particularities of American health care and, as such, can become valuable components within medical ethics and humanities classrooms.     

Heidegger and the narrativity debate

One unresolved dispute within Heidegger scholarship concerns the question of whether Dasein should be conceived in terms of narrative self-constitution. A survey of the current literature suggests two standard responses. The first correlates Heidegger’s talk of authentic historicality with that of self-authorship. To the alternative perspective, however, Heidegger’s talk of Dasein’s existentiality, with its emphasis on nullity and unattainability, is taken as evidence that Dasein is structurally and ontologically incapable of being completed via any life-project. Narrativity imports into Being and Time commitments concerning temporality, selfhood, and ethics, which Heidegger rejects. Although both positions find good exegetic support for their conclusions, they can’t both be right. In this article, I navigate a path between these two irreconcilable positions by applying insights derived from recent debates within Anglo-American literature on personal identity. I develop an alternative thesis to Narrativism, without rejecting it outright, by arguing that Dasein can be analysed in terms of what I call “narratability conditions.” These allow us to make sense of the prima facie paradoxical notion of “historicality without narrativity.” Indeed, rather than reconciling the two standard positions, I hold that the tension between them says something important about Dasein’s kind of existence. Thus I conclude that while the narrativist question “Who ought I to be?” is perfectly legitimate within limits, what the existential analysis of the limits on narratability reveals is that no answer to this question can ever be definitive.     

Sur la tête de Gorgias. Le “parler beau” et le “dire vrai” dans Le Banquet de Platon

Rhetoric is at present the object of a rehabilitation on a grand scale, all the more as it overlaps the fields of literature, linguistics, and philosophy. Actually, if philosophy rejects and removes rhetoric, it is nevertheless, as a method of word, wholly impregnated with it. To investigate the complex relationship of mutual implication in which rhetoric and philosophy are involved is part and parcel of this plan of re-evaluation of rhetoric as “discourse art” with a view to a re-definition of its field and functions. In this perspective, rhetoric articulates itself within, in relation to, and with Plato's dialogues in a much more subtle and complex manner than warranted by the process of “anti-rhetoricalness” initiated by philosophy against rhetoric after Plato. Going back to the origins of this conflict and recalling the system of oppositions supporting the official Platonic vulgate, this study begins to pave the way for a micr-reading of the Platonic text regarded as a paradigm of philosophic textuality. It is certainly true that the Phaedrus, the Gorgias, and the Symposium set up a system of oppositions between between rhetoric and dialectrics which are in contrast with each other in the word practices, in the rules and methods of discourse, and which are antinomic in their ends. This system of oppositions always seems to be referable to the opposition between “speaking fair” and “speaking the truth”. But the strategies and procedures set going in the Symposium, in particular in “Agathon's speech” and in “Diotima and Socrates' speech” betray a much closer connection between the supposed “bad rhetoric” revealed by Phaedrus and the “good rhetoric” which is dialectrics. The search for this connection is conducted through two types of reading of the Symposium. In actual fact, between the paronomasia on the agathoi and that on “Gorgias' head” (this Gorgon of rhetoric) there takes place a speech, Agathon's, whose parodied, exacerbated, and counterfeit rhetoric allows us to gauge Plato's own rhetoric in this artefact which distances itself, more or less openly, from Gorgian rhetoric. This “hyper-rhetoricalness” and “over-grammaticalness” cannot be there with the sole aim of serving as evidence against rhetoric. It is in fact possible to perceive through the web of the text the ends, quite rhetorical themselves, which preside over the structure of Agathon's speech, seen from the viewpoint of the figure of the antithesis. Thus, it is in the play of a “neo-rhetoricalness” where we must, in the last analysis, look for the spring allowing the philosophical discourse to overturn the rhetorical one. And while in Giorgias what clothes the discourse is actually the truth, in Plato it is the antinomy between “speaking fair” and “speaking the truth”, conveniently set up, which forms the basis of the function of diversion by which Socrates points out — in the complex network of the continuity and discontinuity existing between rhetoric and philosophy — the structures of reversal and the original upheavals which Plato imposes on the relation between rhetorical and dialectric discourse. Actually, dialectrics is found in “Socrates and Diotima's speech”, not as “anti-rhetoric”, but rather as a “transposition” of the rhetorical discourse, thus acquiring the traits of a “neo-rhetoric”. The analysis of this discourse, which constitutes the second reading exercise of the Symposium, allows us to pick out the aversion and inversion strategies that turn dialectrics in an overtuned rhetoric. The founding deed of this “inversion” (rather than “separation”) is recognizable in the alteration it introduces in the first plase in the type of discourse, which from a rhetorical, explicitly addressed, macrological, monological, and continuous discourse turns into a dialectical, brachylogous, dialogic discourse with partners and interlocutors, i.e. into a dialogue; in the second place, the subject of the discourse shifts from the locuteur, author and signer of the discourse to ever-present interlocutors who end up by making room for a talking and knowing speaker in a regime of anonymous subjectivity: this is an extreme alteration of the anthropological and epistemic subject, culminating in the scientific discourse of Euclidean geometry. Finally, the inversion is recognizable in the object of the discourse, whose prâgma slips from being the predicate of a qualified grammatical subject into a process of objectivation and substantivation, thereby moving from the rhetorical question “What is beautiful?” to the philosophical question “What is the beautiful?”. The hypothesis of a “neo-rhetoricalness” of dialectics, underlying this research, is therefore more Platonic than it appears, insofar as between rhetoric and dialectics there has been a tradition which has tried to wipe out the traces of its transmission, but where the neo-rhetoricalness of dialectics shows through quite clearly, taking advantage, without admitting it, from a more ancient rhetoric than it is itself. (A.T.)     

“A Golly was simply a toy. End of”: Inoculation,attention deflection,and attempted puzzle-resolution in contesting racism in online discussions

In producing arguments against minority groups that are designed to avoid accusations of prejudice, speakers routinely deploy two discursive strategies. One strategy of “inoculation” seeks to ward off such accusations, while the other strategy of “attention deflection” directs attention away from the potential target group. Where despite use of one or both strategies accusations arise, the result is a puzzle that needs to be resolved through explanation. Here, in a discourse analysis of online discussions as to whether “blacking up” is to count as racism, we see contributors contest (a) whether absence of intention to offend inoculates individuals from accountability for potentially racist actions, (b) whether “blacking up” depicts toys/characters rather than people, and (c) whether attempted explanations of accusations of racism work to resolve the apparent puzzle that has arisen. Contributors do not reach any consensus. These findings point to the difficulties in attempting to challenge potential racism.