IN DUBIO PRO NATURA? A Philosophical Analysis of the Precautionary Principle in Environmental and Health Risk Governance

In this book, I apply a philosophical approach to study the precautionary principle in environmental (and health) risk decision-making. The principle says that unacceptable environmental and health risks should be anticipated, and they ought to be forestalled before the damage comes to fruition even if scientific understanding of the risks is inadequate. The study consists of introductory chapters, summary and seven original publications which aim at explicating the principle, critically analysing the debate on the principle, and constructing a basis for the well-founded use of the principle. Papers I-V present the main thesis of this research. In the two last papers, the discussion is widened to new directions. The starting question is how well the currently embraced precautionary principle stands up to critical philosophical scrutiny. The approach employed is analytical: mainly conceptual, argumentative and ethical. The study draws upon Anglo-American style philosophy on the one hand, and upon sources of law as well as concrete cases and decision-making practices at the European Union level and in its member countries on the other. The framework is environmental (and health) risk governance, including the related law and policy. The main thesis of this study is that the debate on the precautionary principle needs to be shifted from the question of whether the principle (or its weak or strong interpretation) is well-grounded in general to questions about the theoretical plausibility and ethical and socio-political justifiability of specific understandings of the principle. The real picture of the precautionary principle is more complex than that found (i.e. presumed) in much of the current academic, political and public debate surrounding it. While certain presumptions and interpretations of the principle are found to be sound, others are theoretically flawed or include serious practical problems. The analysis discloses conceptual and ethical presumptions and elementary understandings of the precautionary principle, critically assesses current practices invoked in the name of the precautionary principle and public participation, and seeks to build bridges between precaution, engagement and philosophical ethics. Hence, it is intended to provide a sound basis upon which subsequent academic scrutiny can build.

Les femmes, oubliées de la recherche clinique [Women, forgotten by clinical research].

Durant des années, les femmes ont été sous-représentées dans les études cliniques. Or, de nombreuses molécules n'ont pas le même effet chez les hommes et les femmes, en raison de différences pharmacodynamiques et pharmacocinétiques. Il en découle un manque d'informations sur les effets thérapeutiques ou indésirables des substances mais aussi, plus généralement, une moins bonne connaissance des pathologies chez les femmes et une prise en charge plus souvent sous-optimale.La sous-représentation est due à divers facteurs, allant de la perception des femmes au sein de la société à des enjeux éthiques vis-à-vis de la grossesse. L'importance d'inclure suffisamment de femmes comme sujets d'études nécessite ainsi une prise de conscience médicale et également sociale ; elle devra s'accompagner de changements entre autres politiques ou législatifs. For years, women were underrepresented in clinical studies. But the effect of many drugs differ among women and men, due to pharmacokinetic and pharmacodynamic differences. As a result, there is a lack of information on therapeutic or adverse effets of drugs and, more generally, a lack of knowledge on diseases, leading more frequently to sub-optimal medical care in women. This underrepresentation is due to various factors, including the social role of women or ethical issues about pregnancy. The need for adequate representation of women in clinical studies is a social as well as medical concern, that implies political and legal changes.

Local capitalism and neoliberalization in a Shenzhen former lineage-village

This article examines the process of neoliberalization in the Shenzhen special economic zone in Guangdong province, China. Building on the case study of a former peasant and almost single-lineage village that has become a part of Shenzhen city, I show how neoliberal principles aimed at advancing the transition to capitalism are combined with and countered by other ethical traditions. Owing to the long-standing conception of the lineage as an enterprise, the maintenance of the lineage structure in the transformation of the rural collectives has offered fertile ground for the emergence of a local capitalist coalition. Yet the current discourses on the necessity of obliterating the remains of the collective economy and introducing individual ownership run counter to the collectivist values of the lineage-village community and the embeddedness of its economy in kinship and territorial ties. I further illustrate this discordance by the way in which the villagers managed to save their founding ancestor's gravesite following government requests to clear the land by removing tombs. These policies form a complex blend of state interventions in the economy, neoliberal governance and Confucian principles.

La praxis reflexiva: un reto para la educación social

La educación social en sus diversas acepciones (profesión, práctica educativa y estudios universitarios) ha experimentado unos importantes cambios en los últimos años. De una actividad centrada en la solución de problemas concretos dentro de un ámbito específico, se ha ido avanzando hacia la necesidad de estar capacitado para el trabajo en entornos complejos y difusos. El ejercicio de la actividad en estos entornos requiere de un posicionamiento estratégico, de una visión global más allá de un manejo de recetas cerradas y de una perspectiva ética que trascienda el simple cumplimiento de instrucciones. Por ello, capacitar al profesional para el diseño y la aplicación de las acciones socioeducativas es una temática que requiere la integración de multiplicidad de competencias para que cada intervención sea una respuesta que se adapte a la situación, a las capacidades y al contexto de la persona atendida. En el periodo de formación universitaria, el practicum es un espacio de aprendizaje privilegiado donde se ponen en juego todos los conocimientos adquiridos y sirve de trampolín para empezar a ejercer la profesión en un contexto real pero seguro, que más adelante será el escenario cotidiano de la acción profesional

Vuokratyöntekijän työsuhdeturva: Sääntelyn haasteita ja tulkintoja

Tutkimus pyrkii selvittämään, vastaako vuokratyöntekijän työsuhdeturva työlainsäädännön tavoitteita ja niiden taustalla vaikuttavaa työntekijän suojelun periaatetta. Lainsäädännössä vuokratyöntekijän työsuhdeturvan kohdalla olevat keskeisimmät aukkokohdat ja tulkinnat esitetään juridisen argumentaation avulla. Tilanteen tekee ongelmalliseksi erityisesti se, että nykylainsäädäntö ei varsinaisesti estä käyttämästä vuokratyössä toistuvia, kunkin toimeksiannon mittaisia määräaikaisuuksia. Tulokset osoittavat, että sekä kollektiivinen että individuaaliperusteinen irtisanomissuoja on käytännössä heikko. Lisäksi työsuhdeturvan ja joustavuuden tasapaino työmarkkinoilla näyttää olevan melko vaikea yhtälö ratkaistavaksi. Eräänä mahdollisena ratkaisuna tutkimuksen lopussa esitetään Ruotsissa käytössä oleva malli, jossa työntekijät ovat toistaiseksi voimassa olevissa työsuhteissa, ja saavat palkkaa myös toimeksiantojen väliseltä ajalta. Järjestelmään liittyy vahvasti myös alan järjestäytyminen ja eettisten pelisääntöjen määritteleminen liittojen välisin sopimuksin. Tällä tavalla vuokratyöntekijän työsuhdeturvaan liittyvät ongelmakohdat ratkaistaan, mutta toisaalta vuokratyön työllisyyttä ja kilpailukykyä tukeva vaikutus menetetään. Vaihtoehtoisina keinoina on esitetty lukuisia kevyempiä keinoja yksittäisten ongelmakohtien ratkaisuksi.

The Changing Face of Psychiatric Nursing –Care or Control?

This report has been written as part of the project “Toward improved quality – developing nurse’s continuing vocational training in hospitals and inpatient units”. Its overall goal is to ensure high quality, ethically appropriate and therapeutically effective interventions to enable nurses to manage distressed and disturbed patients in European psychiatric hospitals and inpatient units. In this large-scale, multinational projects there are all together six European countries involved: Finland, Ireland, England, Portugal, Italy and Lithuania. The project work plan were during autumn 2006 and spring 2007. The content of this publication was produced in the first stage of the project aiming to collect the preliminary source material for the project. The literature review was carried out in the project stage, providing the groundwork for the next steps for the project. This project aims to develop an interactive multinational portal with training material. Therefore, it is important to share an understanding of basic information, psychiatric nurse’s continuing vocational education, laws and ethical codes and patient restriction used in mental health care. In this publication, the purpose of the material produced here is to understand nurses’ educational need related to vocational continuing education and to be used in further project stages as an empirical data collection. The data were collected as a preliminary source material for latter phases where nurse’s perceptions of the current practice, nurse’s attitudes to mental illness, prevalence of use of seclusion room and existing and desired vocational training provision will be collected in six different European countries. The following organisations are involved in this project: University of Turku, Dublin City University, St. Vincent Hospital, National Council for the Professional Development of Nursing and Midwifery, University of Padova, Klaipeda College - Health Faculty, Klaipeda Psychiatric Hospital, Escola Superior de Enfermagem de Lisboa, Centro Hospitalar Psiquiátrico de Lisboa, Omnia Vocational Institution the Espoo Region, Kellokoski psychiatric hospital, Hyvinkää hospital area, Pirkanmaa Hospital District, Kingston University & St. George’s Medical School and South West London & St. George’s Mental Health NHS Trust. A wide variety of different countries, organisations and individuals in this project give us a strong confidence that theoretical, practical, ethical and political issues around the topic of interest will be taken account during this project lifetime. We are aware the content of this book will be partially outdated almost as soon as it has been published. We still hope that this publication will encourage nurses and different professions working in mental health care field to have a basic understanding of similarities and differences between different European countries related in mental health care. We also hope that this publication will inspirate and motivate nurses in maintaining and developing the quality of psychiatric care in Europe.

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This paper discusses the issues involved in ICT from an ethico-political perspective, which states that an innovation is fully justifiable when it contributes to the empowerment, equality, and autonomy of the agent targeted. With this criterion in mind, discussing the foreseeable impacts of ubicomp-ICT, it focuses on the dangers linked to the enhanced asymmetry in the distribution of power within the organization which it is likely to bring about. If left to "laissez-faire", it is finally suggested, it might even be seen as a threat to democracy.

Adaptation of a Gaussia princeps Luciferase reporter system in Candida albicans for in vivo detection in the Galleria mellonella infection model.

For the past 10 years, mini-host models and in particular the greater wax moth Galleria mellonella have tended to become a surrogate for murine models of fungal infection mainly due to cost, ethical constraints and ease of use. Thus, methods to better assess the fungal pathogenesis in G. mellonella need to be developed. In this study, we implemented the detection of Candida albicans cells expressing the Gaussia princeps luciferase in its cell wall in infected larvae of G. mellonella. We demonstrated that detection and quantification of luminescence in the pulp of infected larvae is a reliable method to perform drug efficacy and C. albicans virulence assays as compared to fungal burden assay. Since the linearity of the bioluminescent signal, as compared to the CFU counts, has a correlation of R(2) = 0.62 and that this method is twice faster and less labor intensive than classical fungal burden assays, it could be applied to large scale studies. We next visualized and followed C. albicans infection in living G. mellonella larvae using a non-toxic and water-soluble coelenterazine formulation and a CCD camera that is commonly used for chemoluminescence signal detection. This work allowed us to follow for the first time C. albicans course of infection in G. mellonella during 4 days.

Gustav Hasford's Gothic Poetics of Demystification

Gustav Hasford is the author of two important Vietnam War novels: The Short-Timers (1979), which was adapted by Stanley Kubrick into Full Metal Jacket (1987), and The Phantom Blooper (1990), its sequel. Relentlessly critical of the war that destroyed his generation, Hasford uses an array of Gothic themes, tropes and figures - such as the werewolf, vampire, and ghost - to describe the transformation of men into monsters that begins with basic training and can never be reversed. These and other Gothic devices allow Hasford to demystify and disenchant the Vietnam War, to strip it of euphemisms and official myths, and to reveal the violence that lays beneath. Unlike other well-known writers of the same generation, such as Michael Herr and Chris O'Brien, Hasford eschews postmodern techniques in order to pursue a rhetorical strategy of horror combined with black humor. The results are two novels of extraordinary ferocity, critical acumen and wit. The chapter concludes with an analysis of the specifically Gothic reading experience of ethical dilemma - a Gothic exercise in judgment - choreographed by both narratives.

Body donations today and tomorrow: What is best practice and why?

There is considerable agreement that the use of human bodies for teaching and research remains important, yet not all universities use dissection to teach human gross anatomy. The concept of body donation has evolved over centuries and there are still considerable discrepancies among countries regarding the means by which human bodies are acquired and used for education and research. Many countries have well-established donation programs and use body dissection to teach most if not all human gross anatomy. In contrast, there are countries without donation programs that use unclaimed bodies or perhaps a few donated bodies instead. In several countries, use of cadavers for dissection is unthinkable for cultural or religious reasons. Against this background, successful donation programs are highlighted in the present review, emphasizing those aspects of the programs that make them successful. Looking to the future, we consider what best practice could look like and how the use of unclaimed bodies for anatomy teaching could be replaced. From an ethical point of view, countries that depend upon unclaimed bodies of dubious provenance are encouraged to use these reports and adopt strategies for developing successful donation programs. In many countries, the act of body donation has been guided by laws and ethical frameworks and has evolved alongside the needs for medical knowledge and for improved teaching of human anatomy. There will also be a future need for human bodies to ensure optimal pre- and post-graduate training and for use in biomedical research. Good body donation practice should be adopted wherever possible, moving away from the use of unclaimed bodies of dubious provenance and adopting strategies to favor the establishment of successful donation programs. Clin. Anat. 29:11-18, 2016. © 2015 Wiley Periodicals, Inc.

Soins palliatifs en établissements médico-sociaux: Caractéristiques et spécificités [Palliative Care in Nursing Homes: Characteristics and Specificities].

Elderly patients in palliative situations residing in a nursing home present characteristics and specificities that clearly distinguish them from patients with advanced cancer. Besides the difficulty to define a precise prognosis, their many comorbidities, their communication difficulties because of cognitive disorders, their high sensitivity to primary and secondary effects of drugs render their management a real challenge for physician and caregivers. Accompanying these patients at the end of their life also raises many ethical problems, especially when they are no longer able to express their wishes and have not previously expressed advance directives.

Sedation palliative: aspects cliniques pratiques [Clinical and practical aspects of palliative sedation]

Un certain nombre de patients palliatifs en fin de vie présentent des symptômes qui ne peuvent pas être soulagés malgré la mise en oeuvre de tous les moyens traditionnels à disposition. Pour ces patients, lorsque des symptômes réfractaires induisent une souffrance intolérable, la sédation palliative est un moyen de dernier recours qui peut leur offrir un soulagement transitoire ou même définitif. Tout en présentant les enjeux éthiques, cet article explore les dimensions cliniques d'ordre pratique qui peuvent se présenter lors d'une sédation palliative chez un patient en fin de vie. Patients at the end-of-life may present with refractory symptoms which cannot be adequately relieved despite the use of all traditional means. When refractory symptoms lead to intolerable suffering, palliative sedation is a last recourse temporary or definitive treatment. While discussing ethical issues, clinical practice dimensions of palliative sedation are explored in this article

DOHaD et information épigénétique - Enjeux sociétaux [DOhaD and epigenetic information: societal challenges].

The concept of the developmental origins of health and disease (DOHaD) alters our understanding of what constitutes "health" or "disease" intended as chronic, non-communicable diseases, which develop over the life course in high income and emerging countries. It implies a change in paradigm forming a basis for prevention policies across the globe. It also impacts psychological, social, economic, ethical and legal sciences. In line with the unanticipated underpinning epigenetic mechanisms are also the social issues (including public policies) that could be produced by the knowledge related to DOHaD that opens a wide field of inquiry. The information unveiled by epigenetics coupled with information on lifestyle including during the development phase, is of unforeseen nature, raising issues of different nature. Therefore it requires specific attention and research, and a specific support by a pluridisciplinary reflection since the very beginning of its production, to anticipate the questions that might be raised in the future.

La educación en valores democráticos en los manuales de la asignatura Educación para la Ciudadanía

Este artículo aporta los resultados de un estudio sobre legislación educativa y manuales de Educación para la Ciudadanía con el objeto de visibilizar la presencia de la educación en valores democráticos y su evolución en el contexto de los cambios sociales y políticos recientes. En la primera parte, nos adentramos en la reflexión sobre la moral y la vivencia de los valores en nuestras realidades, con el objeto de analizar la dimensión ética de la sociedad. Abordamos el debate de la crisis de valores y se realizan propuestas sobre la dimensión teleológica y axiológica de la educación en y para la democracia. En la segunda parte, se aporta la síntesis del estudio de la presencia de la educación en valores en algunas leyes educativas aprobadas a partir de la Constitución Española de 1978. Se describe cómo se ha incorporado la educación en valores a la normativa y qué formas ha ido adoptando. Se dedica especial atención al área de Educación para la Ciudadanía propuesta en la loe como espacio de formación ética y política. En el último apartado sobre educación en valores y manuales de ciudadanía se presentan, en primer lugar, diferentes significados y principios de ciudadanía para enmarcar teóricamente la investigación. A continuación, se visualizan los resultados del análisis de contenido de los valores presentes en una muestra de manuales de Educación para la Ciudadanía editados en el marco de desarrollo de la loe. Nuestro interés ha sido mostrar cómo los libros de texto traducen la legislación, qué valores de la democracia priorizan y cómo los conceptualizan. Se finaliza el artículo con las conclusiones que recogen un conjunto de apuntes en los que se considera la crisis como posibilidad y se propone seguir avanzando en proyectos de democracia, ciudadanía y educación en valores innovadores.