Sollicitude, dépendance et lien social

La croissance de la population vieillissante en Amérique du Nord a un impact significatif sur nos politiques sociales. Ainsi, l’État québécois met à la disposition des personnes âgées une aide afin de faciliter le maintien à domicile. Qui a maintenant la responsabilité de répondre aux besoins des personnes âgées; est-ce la famille ou l’État? Si la réponse peut nous aider à formuler des politiques sociales équitables, elle nous pousse aussi à repenser le lien social à la lumière de la dépendance. Dans un premier temps nous nous pencherons sur l’évolution de l’éthique de la sollicitude pour ensuite analyser les apports des études sur la production du handicap. Puisque la problématique de la dépendance s’avère cruciale dans ce débat, les écrits de deux théoriciens français, Albert Memmi et Bernard Ennuyer, nous aideront à élucider la question de la dépendance. Nous verrons par la suite comment ces divers apports peuvent nous amener à reconceptualiser le lien social.

Ricoeur's "Petite éthique": an ethical epistemological perspective for clinician-bioethicists

This is a preprint of an article published in HEC Forum, 2010 22(4): 311-26. URL: http://www.springerlink.com/content/jj08821k513u5747/

Modèle d’accompagnement des patients et des membres de leur famille lors de la transition vers des soins de fin de vie à l’unité des soins intensifs

Travail dirigé présenté à la Faculté des études supérieures et postdoctorales en vue de l’obtention du grade de Maîtrise ès sciences (M. Sc.) option expertise-conseil en soins infirmiers

Maxims of Action in a Financial Co-operative: Epistemological and Theoretical Issues

Full Text / Article complet

O Evangelho segundo a Pastoral da Criança :por uma pedagogia da sobrevivência

This work aims to analyze social and educational actions at Pastoral da Criança, using education as a survival tool. This was done at Parque dos Coqueiros, a neighborhood in Natal, Rio Grande do Norte. The methodology for data collection was composed of comprehensive interview (Jean Kaufmann), participant observation (Robert Bogdan) and documental analysis (Le Goff); all os which bring reflections related to concepts such as strategies, tatics and know how (Michel de Certeau), configuration (Nobert Elias), and control technology (Michel de Foucault), care ethics (Leonardo Boff) and etno-theories (Natália Ramos). Pastoral da Criança is a social action organism that belongs to the National Conference of Bishops of Brazil, originated at Florestópolis, Londrina (Paraná), in the year of 1983. These actions have been an expression of a new logic of actions of the Catholic Church. It values the participation of laymen in the activities of the Pastoral. Thus, the parish is seen as a nucleus that irradiates the Church s Social Doctrine. At Rio Grande do Norte this institution has guided poverty stricken families on issues related to children s health as well as working with laymen for volunteer work. This is considered devotion, that is firmed by an individual and group mystique. The social and educational actions are done in three axes: 1) Monthly home visits, where there is mother-child support; 2) Life Celebration Day, where they weigh children and promote nutritional surveillance; 3) Meeting for Evaluation and Reflection, that aims to articulate community leaders to think about problems attached to the social actions they realize. This action tripod , as it is called by the Pastoral Agents are the types of actions that fundament survival education for poor children ranging from 0 to 6 years old. The families learn to deal with prevention, the essential, the alternative and probabilities of survival tactics due to exclusion matters or even social extermination. The Pastoral da Criança aims to recover childhood emotions in poverty stricken areas. It also has influence in the diminishing of malnutrition and mother and child mortality. This education for survival is the base on the art of teaching and learning of poverty stricken children. It is a social educational action, non assistencialist, but considered a shy action in order to promote mobilization of the communities that are accompanied for the emancipation and change of social conditions

O cuidado e a ética do cuidado: um diálogo entre Leonardo Boff, Carol Gilligam e Nel Noddings

To elucidate the important contribution of care ethics in improving human relations and social intimates, this work reveals the fragility and lack of ethics on the formation of a just society, equal, peaceful and caring. To this end, we study on the moral development of men and women, warning of the natural differences between the sexes, which change for both the way of seeing life and live it - which does not imply inferiority to some genres. From this study it is clear that the natural care is innate to humans, it provides a tendency to act for the good of all life forms and nature as a whole. But it is evident here a greater sensitivity of women to such care because they possess perception and more emotion than men, which make them more participatory and involved in relationships. This greater openness to care found in women, due in part to the strong and lasting relationship with their mothers. Thus is revealed the power that women have to positively change the direction of human relationships, providing careful with your example, protective and caring, the awakening of a new and comprehensive ethics - opens to the truth, and features especially for affections. Therefore, the care ethics arises from the life experiences of women and aims, through them, to join the men's morality in order to bring out the relevant fact of interdependence between human beings, of human fragility and the need for relationships to the fullness of life

Percepção de enfermeiros recém graduados sobre sua autonomia profissional e sobre o processo de tomada de decisão do paciente

O estudo foi realizado junto a enfermeiros recém-graduados que atuam em um hospital público com os objetivos de descrever a percepção destes sobre sua autonomia profissional e sobre o processo de tomada de decisão do paciente. A estratégia adotada para obtenção dos dados foi a de grupo focal e o referencial metodológico a Grounded Theory. Dos resultados emergiram dois fenômenos: 1) Percebendo a fragilidade da autonomia do enfermeiro e do paciente. 2) Movendo-se em direção ao fortalecimento da autonomia do enfermeiro e do paciente. Isto possibilitou a identificação da categoria central: movimento empreendido por enfermeiros recém formados em direção ao fortalecimento de sua autonomia profissional e da autonomia do paciente. A compreensão da experiência nos permitiu ampliar o conhecimento sobre os enfrentamentos dos enfermeiros recém formados, favorecendo nossa atuação como professores de enfermagem.

Opiniões sobre a visita de enfermagem em unidades de cirurgia: tradução, adaptação e validação de questionários

Enquadramento: Apesar da visita de enfermagem ou passagem de turno junto dos doentes garantir a continuidade dos cuidados de enfermagem, origina diversas questões éticas. Objetivos: Traduzir, adaptar e validar 2 questionários de colheita de dados sobre a visita de enfermagem em unidades cirúrgicas para a cultura portuguesa; identificar a opinião dos doentes e dos enfermeiros sobre a visita de enfermagem. Metodologia: Tradução, retroversão e adaptação dos questionários aplicados em 7 unidades cirúrgicas de um hospital central em Portugal de 22/08/2008 a 28/06/2009. A amostragem não probabilística acidental foi constituída por 137 enfermeiros e 96 doentes. Resultados: A visita de enfermagem promove a relação empática e de ajuda; a observação do doente e o planeamento de cuidados, no entanto é necessário clarificar o seu objetivo; incentivar à participação e ao envolvimento dos doentes; utilizar um discurso compreensível e garantir a privacidade da informação. Conclusão: Os questionários revelaram-se fidedignos e válidos na identificação das opiniões dos doentes e dos enfermeiros sobre a visita de enfermagem nas unidades de cirurgia em estudo.

A youth vision of the city: The socio-spatial lives and exclusion of street girls in Bogota, Colombia

This dissertation documents the everyday lives and spaces of a population of youth typically constructed as out of place, and the broader urban context in which they are rendered as such. Thirty-three female and transgender street youth participated in the development of this youth-based participatory action research (YPAR) project utilizing geo-ethnographic methods, auto-photography, and archival research throughout a six-phase, eighteen-month research process in Bogotá, Colombia. ^ This dissertation details the participatory writing process that enabled the YPAR research team to destabilize dominant representations of both street girls and urban space and the participatory mapping process that enabled the development of a youth vision of the city through cartographic images. The maps display individual and aggregate spatial data indicating trends within and making comparisons between three subgroups of the research population according to nine spatial variables. These spatial data, coupled with photographic and ethnographic data, substantiate that street girls’ mobilities and activity spaces intersect with and are altered by state-sponsored urban renewal projects and paramilitary-led social cleansing killings, both efforts to clean up Bogotá by purging the city center of deviant populations and places. ^ Advancing an ethical approach to conducting research with excluded populations, this dissertation argues for the enactment of critical field praxis and care ethics within a YPAR framework to incorporate young people as principal research actors rather than merely voices represented in adultist academic discourse. Interjection of considerations of space, gender, and participation into the study of street youth produce new ways of envisioning the city and the role of young people in research. Instead of seeing the city from a panoptic view, Bogotá is revealed through the eyes of street youth who participated in the construction and feminist visualization of a new cartography and counter-map of the city grounded in embodied, situated praxis. This dissertation presents a socially responsible approach to conducting action-research with high-risk youth by documenting how street girls reclaim their right to the city on paper and in practice; through maps of their everyday exclusion in Bogotá followed by activism to fight against it.^

Migrant women’s employment in paid reproductive work through the crisis: the case of Italy (2007-2012)

Paid reproductive work, especially in the case of cleaning and home-care for elderly people, is an important sector for foreign women in Italy. For this reason, since the beginning of the current economic crisis, scholars have wondered about the impact of the recession on migrant domestic workers. They have looked particularly at possible competition with Italian women entering the sector for lack of better alternatives. Our paper takes this discussion a step further by assessing the overall changes affecting migrant women in the Italian labour market, 2007-2012. We will look at how their position has been transformed, by taking both an ethnic perspective, in relation to Italian women, and a gender perspective, in relation to migrant men. By way of a conclusion, the argument will be made that there is a substantial lack of competition between Italian and foreign women in the care and domestic sector due to differences in their earnings, hours of work and activities.

Feminist ethics and menopause : autonomy and decision-making in primary medical care

The construction of menopause as a long-term risk to health and the adoption of discourses of prevention has made necessary a decision by women about medical treatment; specifically regarding the use of hormone replacement therapy. In a study of general practitioners’ accounts of menopause and treatment in Australia, women's ‘choice’, ‘informed decision-making’ and ‘empowerment’ were key themes through which primary medical care for women at menopause was presented. These accounts create a position for women defined by the concept of individual choice and an ethic of autonomy. These data are a basis for theorising more generally in this paper. We critically examine the construct of ‘informed decision-making’ in relation to several approaches to ethics including bioethics and a range of feminist ethics. We identify the intensification of power relations produced by an ethic of autonomy and discuss the ways these considerations inform a feminist ethics of decision-making by women. We argue that an ‘ethic of autonomy’ and an ‘offer of choice’ in relation to health care for women at menopause, far from being emancipatory, serves to intensify power relations. The dichotomy of choice, to take or not to take hormone replacement therapy, is required to be a choice and is embedded in relations of power and bioethical discourse that construct meanings about what constitutes decision-making at menopause. The deployment of the principle of autonomy in medical practice limits decision-making by women precisely because it is detached from the construction of meaning and the self and makes invisible the relations of power of which it is a part.

Ethics, Law and Health Care : a Guide for Nurses and Midwives

Understanding ethics and law in health care is an essential part of nurses’ and midwives’ professional standards. Ethics, Law and Health Care focuses on teaching applied ethics and law in a manner that illustrates the real world applications of these core components of the nursing and midwifery curriculum and practice. It equips readers with the ability to recognise and address legal and ethical issues that will arise in their professional practice. The book uses the four principles of biomedical ethics (autonomy, non-maleficence, beneficence and justice) together with the use of both the Nursing and Midwifery Codes of Ethics and Codes of Professional Conduct, issued by the Nursing and Midwifery Board of Australia, as a central means through which to analyse and approach ethical and legal issues. Ethics, Law and Health Care is scaffolded to assist readers in understanding legal and ethical principles, to integrate them in the context of a particular issue within professional practice, and provide them with a decision-making framework to take action in a professional context by utilising the Codes as well as state and federal law. Aided by pedagogical features such as case studies, review questions, further reading and a glossary of common terms, this book is an essential resource for students, academics and practitioners.

Tolstoy, stories, and facilitating insight in end of life care: Exploring ethics through vicarious experience (with Glackin M and Henry R)

Facilitating moral insight in end of life care can be challenging, and the purpose of this paper is to illustrate how this can be nurtured by means of creative literature. Tolstoy's Death of Ivan Ilych is presented as an example of such literature. Aristotle's Nichomean Ethics provides the philosophical underpinning for the method used. Sources also include the nursing literature, and students' evaluations of the impact of Tolstoy's novella on their ability to perceive the ethical issues arising in end of life care. Comments from evaluations were analysed and significant themes emerged. Students' comments clearly support the suggestion that use of this novella has facilitated insight into ethical issues at the end of life. Evaluations also indicate that vicarious experience gained through reading this novella has helped to nurture sensitivity and professional insight into the importance of compassion and offering ‘comfort’ to the dying person.

Bob and Jane go to Argentina: The Ethics of Cross-Border Care

Étude de cas / Case study