Husserl's approach to transcendental intersubjectivity

It is our intention in the course of the development of this thesis to give an account of how intersubjectivity is "eidetically" constituted by means of the application of the phenomenological reduction to our experience in the context of the thought of Edmund Husserl; contrasted with various representative thinkers in what H. Spiegelberg refers to as "the wider scene" of phenomenology. That is to say, we intend to show those structures of both consciousness and the relation which man has to the world which present themselves as the generic conditions for the possibility of overcoming our "radical sol itude" in order that we may gain access to the mental 1 ife of an Other as other human subject. It is clear that in order for us to give expression to these accounts in a coherent manner, along with their relative merits, it will be necessary to develop the common features of any phenomenological theory of consdousness whatever. Therefore, our preliminary inquiry, subordinate to the larger theme, shall be into some of the epistemological results of the application of the phenomenological method used to develop a transcendental theory of consciousness. Inherent in this will be the deliniation of the exigency for making this an lIintentional ll theory. We will then be able to see how itis possible to overcome transcendentally the Other as an object merely given among other merely given objects, and further, how this other is constituted specifically as other ego. The problem of transcendental intersubjectivity and its constitution in experience can be viewed as one of the most compelling, if not the most polemical of issues in phenomenology. To be sure, right from the beginning we are forced to ask a number of questions regarding Husserl's responses to the problem within the context of the methodological genesis of the Cartesian Meditations, and The Crisis of European Sciences and Transcendental Phenomenology. This we do in order to set the stage for amplification. First, we ask, has Husserl lived up to his goal, in this connexion, of an apodictic result? We recall that in his Logos article of 1911 he adminished that previous philosophy does not have at its disposal a merely incomplete and, in particular instances, imperfect doctrinal system; it simply has none whatever. Each and every question is herein controverted, each position is a matter of individual conviction, of the interpretation given byaschool, of a "point of view". 1. Moreover in the same article he writes that his goal is a philosophical system of doctrine that, after the gigantic preparatory work. of generations, really be- . gins from the ground up with a foundation free from doubt and rises up like any skilful construction, wherein stone is set upon store, each as solid as the other, in accord with directive insights. 2. Reflecting upon the fact that he foresaw "preparatory work of generations", we perhaps should not expect that he would claim that his was the last word on the matter of intersubjectivity. Indeed, with 2. 'Edmund Husserl, lIPhilosophy as a Rigorous Science" in Phenomenology and theCrisis6fPhilosophy, trans". with an introduction by Quentin Lauer (New York.: Harper & Row, 1965) pp. 74 .. 5. 2Ibid . pp. 75 .. 6. 3. the relatively small amount of published material by Husserl on the subject we can assume that he himself was not entirely satisfied with his solution. The second question we have is that if the transcendental reduction is to yield the generic and apodictic structures of the relationship of consciousness to its various possible objects, how far can we extend this particular constitutive synthetic function to intersubjectivity where the objects must of necessity always remain delitescent? To be sure, the type of 'object' here to be considered is unlike any other which might appear in the perceptual field. What kind of indubitable evidence will convince us that the characteristic which we label "alter-ego" and which we attribute to an object which appears to resemble another body which we have never, and can never see the whole of (namely, our own bodies), is nothing more than a cleverly contrived automaton? What;s the nature of this peculiar intentional function which enables us to say "you think just as I do"? If phenomenology is to take such great pains to reduce the takenfor- granted, lived, everyday world to an immanent world of pure presentation, we must ask the mode of presentation for transcendent sub .. jectivities. And in the end, we must ask if Husserl's argument is not reducible to a case (however special) of reasoning by analogy, and if so, tf this type of reasoning is not so removed from that from whtch the analogy is made that it would render all transcendental intersubjective understandtng impos'sible? 2. HistoticalandEidetic Priority: The Necessity of Abstraction 4. The problem is not a simple one. What is being sought are the conditions for the poss ibili:ty of experi encing other subjects. More precisely, the question of the possibility of intersubjectivity is the question of the essence of intersubjectivity. What we are seeking is the absolute route from one solitude to another. Inherent in this programme is the ultimate discovery of the meaning of community. That this route needs be lIabstract" requires some explanation. It requires little explanation that we agree with Husserl in the aim of fixing the goal of philosophy on apodictic, unquestionable results. This means that we seek a philosophical approach which is, though, not necessarily free from assumptions, one which examines and makes explicit all assumptions in a thorough manner. It would be helpful at this point to distinguish between lIeidetic ll priority, and JlhistoricallJpriority in order to shed some light on the value, in this context, of an abstraction.3 It is true that intersubjectivity is mundanely an accomplished fact, there havi.ng been so many mi.llions of years for humans to beIt eve in the exi s tence of one another I s abili ty to think as they do. But what we seek is not to study how this proceeded historically, but 3Cf• Maurice Natanson;·TheJburne in 'Self, a Stud in Philoso h and Social Role (Santa Cruz, U. of California Press, 1970 . rather the logical, nay, "psychological" conditions under which this is possible at all. It is therefore irrelevant to the exigesis of this monograph whether or not anyone should shrug his shoulders and mumble IIwhy worry about it, it is always already engaged". By way of an explanation of the value of logical priority, we can find an analogy in the case of language. Certainly the language 5. in a spoken or written form predates the formulation of the appropriate grammar. However, this grammar has a logical priority insofar as it lays out the conditions from which that language exhibits coherence. The act of formulating the grammar is a case of abstraction. The abstraction towards the discovery of the conditions for the poss; bi 1 ity of any experiencing whatever, for which intersubjective experience is a definite case, manifests itself as a sort of "grammar". This "grammar" is like the basic grammar of a language in the sense that these "rulesil are the ~ priori conditions for the possibility of that experience. There is, we shall say, an "eidetic priority", or a generic condition which is the logical antecedent to the taken-forgranted object of experience. In the case of intersubjectivity we readily grant that one may mundanely be aware of fellow-men as fellowmen, but in order to discover how that awareness is possible it is necessary to abstract from the mundane, believed-in experience. This process of abstraction is the paramount issue; the first step, in the search for an apodictic basis for social relations. How then is this abstraction to be accomplished? What is the nature of an abstraction which would permit us an Archimedean point, absolutely grounded, from which we may proceed? The answer can be discovered in an examination of Descartes in the light of Husserl's criticism. 3. The Impulse for Scientific Philosophy. The Method to which it Gives Rise. 6. Foremost in our inquiry is the discovery of a method appropriate to the discovery of our grounding point. For the purposes of our investigations, i.e., that of attempting to give a phenomenological view of the problem of intersubjectivity, it would appear to be of cardinal importance to trace the attempt of philosophy predating Husserl, particularly in the philosophy of Descartes, at founding a truly IIscientific ll philosophy. Paramount in this connexion would be the impulse in the Modern period, as the result of more or less recent discoveries in the natural sciences, to found philosophy upon scientific and mathematical principles. This impulse was intended to culminate in an all-encompassing knowledge which might extend to every realm of possible thought, viz., the universal science ot IIMathexis Universalis ll •4 This was a central issue for Descartes, whose conception of a universal science would include all the possible sciences of man. This inclination towards a science upon which all other sciences might be based waS not to be belittled by Husserl, who would appropriate 4This term, according to Jacab Klein, was first used by Barocius, the translator of Proclus into Latin, to designate the highest mathematical discipline. . 7. it himself in hopes of establishing, for the very first time, philosophy as a "rigorous science". It bears emphasizing that this in fact was the drive for the hardening of the foundations of philosophy, the link between the philosophical projects of Husserl and those of the philosophers of the modern period. Indeed, Husserl owes Descartes quite a debt for indicating the starting place from which to attempt a radical, presupositionless, and therefore scientific philosophy, in order not to begin philosophy anew, but rather for the first time.5 The aim of philosophy for Husserl is the search for apodictic, radical certitude. However while he attempted to locate in experience the type of necessity which is found in mathematics, he wished this necessity to be a function of our life in the world, as opposed to the definition and postulation of an axiomatic method as might be found in the unexpurgated attempts to found philosophy in Descartes. Beyond the necessity which is involved in experiencing the world, Husserl was searching for the certainty of roots, of the conditi'ons which underl ie experience and render it pOssible. Descartes believed that hi~ MeditatiOns had uncovered an absolute ground for knowledge, one founded upon the ineluctable givenness of thinking which is present even when one doubts thinking. Husserl, in acknowledging this procedure is certainly Cartesian, but moves, despite this debt to Descartes, far beyond Cartesian philosophy i.n his phenomenology (and in many respects, closer to home). 5Cf. Husserl, Philosophy as a Rigorous Science, pp. 74ff. 8 But wherein lies this Cartesian jumping off point by which we may vivify our theme? Descartes, through inner reflection, saw that all of his convictions and beliefs about the world were coloured in one way or another by prejudice: ... at the end I feel constrained to reply that there is nothing in a all that I formerly believed to be true, of which I cannot in some measure doubt, and that not merely through want of thought or through levity, but for reasons which are very powerful and maturely considered; so that henceforth I ought not the less carefully to refrain from giving credence to these opinions than to that which is manifestly false, if I desire to arrive at any certainty (in the sciences). 6 Doubts arise regardless of the nature of belief - one can never completely believe what one believes. Therefore, in order to establish absolutely grounded knowledge, which may serve as the basis fora "universal Science", one must use a method by which one may purge oneself of all doubts and thereby gain some radically indubitable insight into knowledge. Such a method, gescartes found, was that, as indicated above by hi,s own words, of II radical doubt" which "forbids in advance any judgemental use of (previous convictions and) which forbids taking any position with regard to their val idi'ty. ,,7 This is the method of the "sceptical epoche ll , the method of doubting all which had heretofor 6Descartes,Meditations on First Philosophy, first Med., (Libera 1 Arts Press, New York, 1954) trans. by L. LaFl eur. pp. 10. 7Husserl ,CrisiS of Eliroeari SCiences and Trariscendental Phenomenology, (Northwestern U. Press, Evanston, 1 7 ,p. 76. 9. been considered as belonging to the world, including the world itself. What then is left over? Via the process of a thorough and all-inclusive doubting, Descartes discovers that the ego which performs the epoche, or "reduction", is excluded from these things which can be doubted, and, in principle provides something which is beyond doubt. Consequently this ego provides an absolute and apodictic starting point for founding scientific philosophy. By way of this abstention. of bel ief, Desca'rtes managed to reduce the worl d of everyday 1 ife as bel ieved in, to mere 'phenomena', components of the rescogitans:. Thus:, having discovered his Archimedean point, the existence of the ego without question, he proceeds to deduce the 'rest' of the world with the aid of innate ideas and the veracity of God. In both Husserl and Descartes the compelling problem is that of establ ishing a scientific, apodictic phi'losophy based upon presuppos itionless groundwork .. Husserl, in thi.s regard, levels the charge at Descartes that the engagement of his method was not complete, such that hi.S: starting place was not indeed presupositionless, and that the validity of both causality and deductive methods were not called into question i.'n the performance of theepoche. In this way it is easy for an absolute evidence to make sure of the ego as: a first, "absolute, indubitablyexisting tag~end of the worldll , and it is then only a matter of inferring the absolute subs.tance and the other substances which belon.g to the world, along with my own mental substance, using a logically val i d deductive procedure. 8 8Husserl, E.;' Cartesian 'Meditation;, trans. Dorion Cairns (Martinus Nijhoff, The Hague, 1970), p. 24 ff.

Low frequency Raman scattering in amorphous materials: fused quartz, "pyrex" boro-silicate glass and soda-lime silicate glass

Raman scattering in the region 20 to 100 cm -1 for fused quartz, "pyrex" boro-silicate glass, and soft soda-lime silicate glass was investigated. The Raman spectra for the fused quartz and the pyrex glass were obtained at room temperature using the 488 nm exciting line of a Coherent Radiation argon-ion laser at powers up to 550 mW. For the soft soda-lime glass the 514.5 nm exciting line at powers up to 660 mW was used because of a weak fluorescence which masked the Stokes Raman spectrum. In addition it is demonstrated that the low-frequency Raman coupling constant can be described by a model proposed by Martin and Brenig (MB). By fitting the predicted spectra based on the model with a Gaussian, Poisson, and Lorentzian forms of the correlation function, the structural correlation radius (SCR) was determined for each glass. It was found that to achieve the best possible fit· from each of the three correlation functions a value of the SCR between 0.80 and 0.90 nm was required for both quartz and pyrex glass but for the soft soda-lime silicate glass the required value of the SCR. was between 0.50 and 0.60 nm .. Our results support the claim of Malinovsky and Sokolov (1986) that the MB model based on a Poisson correlation function provides a universal fit to the experimental VH (vertical and horizontal polarizations) spectrum for any glass regardless of its chemical composition. The only deficiency of the MB model is its failure to fit the experimental depolarization spectra.

The versatility and utilization of phosphorus based compounds in classic carbon-carbon bond forming and esterification reactions

The phosphonium salt room temperature ionic liquid tetradecyltrihexylphosphonium chloride (THPC) has been employed as an efficient reusable media for the palladium catalyzed Suzuki cross-coupling reaction of aryl halides, including aryl chlorides, under mild conditions. The cross-coupling reactions were found to proceed in THPC containing small amounts ofwater and toluene (single phase) using potassium phosphate and 1% Pd2(dba)3'CHCI3. Variously substituted iodobenzenes, including electron rich derivatives, reacted efficiently in THPC with a variety of arylboronic acids and were all complete within 1 hour at 50°C. The corresponding aryl bromides also reacted under these conditions with the addition of a catalytic amount of triphenylphosphine that allowed for complete conversion and high isolated yields. The reactions involving aryl chlorides were considerably slower, although the addition of triphenylphosphine and heating at 70°C allowed high conversion of electron deficient derivatives. Addition of water and hexane to the reaction products results in a triphasic system, from which the catalyst was then recycled by removing the top (hexanes) and bottom (aqueous) layers and adding the reagents to the ionic liquid which was heated again at 50°C; resulting in complete turnover of iodobenzene. Repetition of this procedure gave the biphenyl product in 82-97% yield (repeated five times) for both the initial and recycled reaction sequences. IL ESTERIFICATIONREACTION A new class oftrialkylphosphorane has been prepared through reaction of a trialkylphosphine with 2-chlorodimethylmalonate in the presence oftriethylamine. These new reagents promote the condensation reaction of carboxylic acids with alcohols to provide esters along with trialkylphosphine oxide and dimethylmalonate. The condensation reaction of chiral secondary alcohols can be controlled to give either high levels of inversion or retention through a subtle interplay involving basicity of the reaction media, solvent, and tuning the electronic and steric nature of the carboxylic acid and stenc nature of the phosphorane employed. A coherent mechanism is postulated to explain these observations involving reaction via an initial acyloxyphosphonium ion.

The People's Republic of China and her relations with the countries of the association of Southeast Asian nations : 1969-1975

Phe Ihesis examines the evolution of the -policies of the People fs Jtenublie of China towards J?hail°nd, PTal ysia, Singapore, Iidonesia pad the Philip-pines, organised in the Association of Southeast Asian Nations from 1969 to 1975• 2ze first central point of this study is an *ir sumption that the foreign relations of The People's Tepublic of Chi la Towards Southeast ^sia have been motivated by a dynamic interplay of t^o main factors: (1) Farxist-Leninist ideology and ICao J^e-tung Ph^ught, which dictate to China to behave as a revolutionary Dover vhich must assist the insurgent movements in the area in their strug fle to overthrow the local governments; (2) national interest, vhich demands of China to safeguard the southern flank of her territory bordering on Southerst 'sia through Friendly relations, trade and ot*»er conventional inrtniments of diplomacy. hile the tvo main motive factors are nuTually antagonistic and exclusivet the Chinere leaders are nevertheless at te mi ting to oring them iirco a coherent policy under Mao's theory of tve {hniity of op-nosites," vhich believes that it is -possible to reconcile these co-posing tendencies into a dynamic enuibrium through vhich both opnosites could be promoted at the same time although not to the same extent* la other words, the Chinese leaders conceive the dynamic equilibrium as a continuum between them in a mix in which one or the other orientation predominates in different •periods* Bins we might see China1 s conduct motivated in one period by mostly ideological considerations at the expense of the staire-to-state relations, then ve might see her policy in the middle of the continuum and suf ering from immo bill sine and just muddling through, or finally ?fe might see her emphasising friendly ties at the expense of support of revolutionary movements at the other extreme -point of the spectrum* !fhe mechanism vhich enables Peking to move from one pole to the other of the spectrum is activated by the following elementsJ (1) the result of an internal power struggle within the leadership in Peking between ideologically radical and moderate elements, which enables the victorious faction to initiate nev policies; (2) Peking's assessment of the changing intentions and capabilities of the major powers in the area; (3) internal changes within the countries of the area and the changing attitudes of their governments towards China; (4) changing fortunes of revolutionary movements operating in the area* 'Phe second major point of this study is an assertion that while China's conduct toward Southeast *lsia after her foundation in 1949 was primarily based upon ideological considerations, the beginning of the seventies saw the national interest reasserting itself as the leading motive factor* Thus China talks with her neighbours in Southeast asia in terms of relevance of fllong historical ties," casting herself into the role of a benevolent "older brother11 who is entitled to reopect and deference in exchange for patronage and protection* Hence the traditional echoes of the past are emerging ever stronger and influencing her postures towards the region, while the open support to revolutionary moevments is underplayed at the moment.

Exploring the Design Process and Components of an Elementary Literacy Guide in an Ontario School Board Initiative

The skill to identify and use best practices in literacy to promote achievement for students of all abilities cannot be underestimated by elementary educators. This qualitative case study investigates 1 year of a literacy initiative for primary and junior educators organized by a southern Ontario school board. The goals of the initiative were to design a literacy guide for teachers while building teacher capacity with literacy practices. Data were culled and analyzed from an examination of the guide, the meetings’ field notes and artifacts, as well as interviews with the educators at the end of the year. Several themes from the results emerged. The educators perceived the design process as unclear but the collaborative components were deemed valuable. The guide’s incompletion led to mixed reactions from the educators about the guide and its structure. Overall, the first year of the 3-year initiative acted as a catalyst for professional learning on literacy. The findings of this study accentuated the value of training educators to use empirical research to support their practices and professional knowledge. Also, the significance of promoting strong leadership with a comprehensive layout consisting of coherent tangible goals for professional development is highlighted.

Methodology in Economics: the Logic of Appraisal

This Paper Intends to Develop a Coherent Methodological Framework Concerned with the Appraisal of Scientific Theories in Economics, and Which Is Based on a Postulated Aim of Science. We First Define the Scope of a Methodological Inquiry (Precise Definition of What Is Meant by the Logic of Appraisal of Scientific Theories) and Review the Work of Popper and Lakatos in the Philosophy of Science. We Then Use Their Results to Develop a Rational Structure of Scientific Activity. We Identify and Analyse Both a Micro and Macro Framework for the Process of Appraisal and Single Out the Importance of So-Called 'Fundamental Assumptions' in Creating Externalities in the Appraisal Process Which Forces Us to Adop a Multi-Level Analysis. Special Attention Is Given to the Role and Significance of the Abstraction Process and the Use of Assumptions in General. the Proposed Structure of Scientific Activity Is Illustrated with Examples From Economics.

Neuron participation in a synchrony-encoding assembly

Affiliation: Svetlana Shumikhina &Stéphane Molotchnikoff : Département de Sciences Biologiques, Université de Montréal

L'application de la notion d'entreprise entre le Code de commerce français et le Code civil du Québec

"Mémoire présenté à la faculté des études supérieures en vue de l'obtention du grade de maîtrise en droit des affaires LLM"

Pour une constitutionnalisation du droit à la sécession au Canada

"Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de maîtrise en droit, option recherche (LL.M.)"

Self-other asymmetry

In this paper, I present a non standard objection to moral impartialism. My idea is that moral impartialism is questionable when it is committed to a principle we have reasons to reject: the principle of self-other symmetry. According to the utilitarian version of the principle, the benefits and harms to the agent are exactly as relevant to the global evaluation of the goodness of his action as the benefits and harms to any other agent. But this view sits badly with the “Harm principle” which stresses the difference between harm to others and harm to the self. According to the deontological version, we have moral duties to ourselves which are exactly symmetrical to our duties to others. But there are reasons to believe that the idea of a duty to the self is not coherent.

La constitutionnalisation de la juridiction inhérente au Canada : origines et fondements

Bien que la juridiction inhérente des cours superIeures constitue une notion souvent utilisée par les tribunaux au Canada, plusieurs facettes importantes de cette notion demeurent inconnues et incomprises. Le présent mémoire s'attarde à retracer l'origine et les fondements des pouvoirs inhérents afin d'en expliquer la constitutionnalisation dans l'ordre constitutionnel canadien contemporain. Pour ce faire, nous avons retracé l'essence des pouvoirs inhérents au moyen d'une démarche historique afin d'énoncer une théorie constitutionnelle cohérente des pouvoirs inhérents qui permettra de juger du bien-fondé de leurs nombreuses manifestations contemporaines. L'enchâssement de la juridiction inhérente dans la Constitution canadienne repose sur le statut, la nature et les caractéristiques uniques des cours supérieures. Plus particulièrement, le principe constitutionnel de l'indépendance judiciaire constitue le fondement contemporain de la constitutionnalisation de la juridiction inhérente. Cette constatation permet alors d'avancer l'idée selon laquelle les pouvoirs inhérents nécessaires au maintien de l'indépendance judiciaire des cours supérieures doivent être élevés au rang de normes constitutionnelles supralégislatives.

Les terrains vacants et la lisibilité du centre-ville de Montréal.

Les terrains vacants sont, à Montréal, des éléments indéniables dans la composition de la trame urbaine. Leur présence soutenue intéresse déjà depuis longtemps de nombreux auteurs et décideurs municipaux. Toutefois, il s’avère que l’on connaît peu les caractéristiques paysagères de ces espaces. Cette recherche en aménagement vise à compléter nos connaissances sur cette typologie d’espace urbain. Elle porte sur la caractérisation paysagère des terrains vacants du centre-ville de Montréal et sur l’étude de leur potentiel visuel à mettre en valeur les attributs significatifs du paysage urbain. Ces deux études doivent permettre de comprendre le rôle joué par ces vides dans la perception du paysage urbain. Cette démarche s’interroge sur la possibilité que certains vides puissent être justifiés et légitimés en regard de la notion de lisibilité du paysage urbain (Lynch, 1976, 1982). Les terrains joueraient un rôle important au niveau de la perception des paysages urbains. Il s’agit de démontrer le potentiel des espaces vacants dans la mise en valeur du paysage urbain, dans l’optique, pour certains d’entre eux, de légitimer le vide ou une partie du vide qui les définit, de les rendre structurants dans la composition urbaine. Grâce à un travail d’observation des caractéristiques urbaines, contextuelles, visuelles et physiques, l’étude a pu à la fois dresser le portrait de ces espaces en attente de développement urbain et démontrer leur implication dans la lisibilité urbaine. Ce travail présente l’intérêt d’offrir un énoncé sur la planification du développement des terrains vacants du centre-ville de Montréal en regard de la notion de lisibilité urbaine partie prenante dans la qualité urbaine.

Impact de la collaboration entre médecins et infirmières sur la communication entre professionnels/patient et famille

Problématique : La collaboration entre infirmières et médecins est un élément crucial lorsque la condition des patients est instable. Une bonne collaboration entre les professionnels permet d’améliorer la qualité des soins par l’identification des patients à risques et l’élaboration de priorités dans le but de travailler à un objectif commun. Selon la vision des patients et de leur famille, une bonne communication avec les professionnels de la santé est l’un des premiers critères d’évaluation de la qualité des soins. Objectif : Cette recherche qualitative a pour objectif la compréhension des mécanismes de collaboration interprofessionnelle entre médecins et infirmières aux soins intensifs. L’étude tente également de comprendre l’influence de cette collaboration sur la communication entre professionnels/ patients et famille lors d’un épisode de soins. Méthode : La collecte de données est réalisée par le biais de 18 entrevues, qui ont été enregistrées puis retranscrites. Parmi les entrevues effectuées deux gestionnaires, six médecins et infirmières, et enfin dix patients et proches ont été rencontrés. Ces entrevues ont été codifiées puis analysées à l’aide du modèle de collaboration interprofessionnelle de D’Amour (1997), afin de déterminer les tendances de collaboration. Pour terminer, l’impact des différentes dimensions de la collaboration sur la communication entre les professionnels/ patient et famille a été analysé. Résultats : Médecins et infirmières doivent travailler conjointement tant avec les autres professionnels, que les patients et leur famille afin de développer une relation de confiance et une communication efficace dans le but d’établir des objectifs communs. Les patients et les familles désirent rencontrer des professionnels ouverts qui possèdent des talents de communicateur ainsi que des qualités interpersonnelles. Les professionnels doivent faire preuve de transparence, prendre le temps de donner des explications vulgarisées, et proposer aux patients et aux familles de poser leurs questions.

Addressing Adherence to Antiretroviral Therapy in Ouagadougou, Burkina Faso: Insights from hospital ethnography

L'épidémie de l'infection au virus de l'immunodéficience humaine (VIH) constitue une crise majeure en santé publique de nos jours. Les efforts de la communauté internationale visent à rendre les traitements antirétroviraux (TARV) plus accessibles aux personnes vivant avec le VIH, particulièrement dans les contextes à ressources limitées. Une observance quasi-parfaite aux TARV est requise pour tirer le maximum de bénéfices thérapeutiques à l'échelle individuelle et à l'échelle populationnelle. Cependant, l’accroissement de la disponibilité des TARV s'effectue dans des pays africains qui disposent de systèmes de santé fragiles et sous-financés. Ceux-ci souffrent également d'une pénurie de personnel de santé, lequel joue un rôle central dans la mise en oeuvre et la pérennité des interventions, notamment celle du soutien à l'observance thérapeutique. La présente étude ethnographique relate l'expérience de personnel de santé dans la fourniture des services de soutien à l'observance dans un contexte de ressources limitées et d'accroissement de l'accès aux TARV. L'étude a été menée dans deux centres hospitaliers de la capitale du Burkina Faso, Ouagadougou. Trois conclusions principales sont mises au jour. Tout d'abord, une bonne organisation – tant logistique que matérielle – dans la provision de services de soutien à l'observance est capitale. L’infrastructure d’observance doit aller au-delà des unités de prise en charge et s’intégrer au sein du système de santé pour assurer un impact durable. De plus, la provision des TARV dans le cadre d'une prise en charge médicale exhaustive est essentielle pour un soutien à l'observance efficace. Ceci implique la présence de professionnelles de santé en nombre suffisant et disposant d‘outils pour soutenir leur pratique clinique (tests de laboratoire, traitements pour infections opportunistes), ainsi que des mécanismes pour leur permettre d’aider les patients à gérer la vie quotidienne (gratuité des services, programmes d’alphabétisation et soutien psychosociale). Enfin, une amélioration de la coordination des programmes VIH au niveau national et international est nécessaire pour assurer une prise en charge cohérente au niveau local. La programmation conçue dans les pays étrangers qui est incomplète et de courte durée a un impact majeur sur la disponibilité de ressources humaines et matérielles à long terme, ainsi que sur les conditions de travail et de prestation de services dans les unités de soins.

Les limites de l'évaluation économique de la biodiversité

Devant le constat du déclin toujours plus rapide de la diversité biologique et les limites des ressources disponibles pour l’enrayer, il est nécessaire de déterminer quels moyens devraient être engagés dans sa protection. Pour ce faire, une méthode efficace serait d’évaluer les bénéfices tirés de la biodiversité afin d’estimer rationnellement les coûts légitimes de sa protection. L’évaluation économique, qui se présente d’emblée sur un mode quantitatif, serait alors un outil précieux. Dans ce texte, nous présentons différentes méthodes d’évaluation économique de la biodiversité ainsi que certaines de leurs limites méthodologiques. Par la suite, nous montrons qu’en dépit de ses avantages pratiques, l’évaluation économique échoue à représenter l’ensemble des valeurs en jeu dans la protection de la biodiversité. Nous décrivons alors trois types de valeurs incommensurables avec des bénéfices économiques : la valeur de legs, qui renvoie aux obligations de transmission du patrimoine naturel dont nous avons hérité ; la valeur d’existence, qui renvoie à la considération morale d’intérêts autres que ceux des êtres humains ; la valeur de transformation, qui renvoie à la capacité d’examiner et de critiquer nos préférences et inclinaisons afin d’inclure celles-ci dans une vision du monde rationnelle et cohérente. Pour conclure, nous plaidons en faveur de l’élaboration de méthodes de concertation et d’évaluation participatives et pluralistes permettant de rendre compte de la diversité et de l’hétérogénéité des valeurs de la biodiversité.