Medição funcional no domínio da ética empírica

This paper presents the proposal of an empirical approach to ethics derived from a psychological theory of human judgment proposed by Norman Anderson. It shows how the methodology specific to this theory —functional measurement— makes it possible to characterize the various personal positions that exist in all societies regarding public health problems. The main results of three studies carried out in three different countries (Guinea, France, and Colombia) on various problems are presented as an illustration of what this approach can offer. These analyses focused on three deliberately very different problems: (a) the duty to care for infected patients in the event of a pandemic that puts at risk the lives of the health professionals, (b) the acceptability of postmortem reproduction in the specific context of fallen soldiers, and (c) the acceptability of physicianassisted suicide.El presente artículo propone un enfoque empírico de la ética derivado de la teoría psicológica del juicio humano propuesta por Norman Anderson. Muestra cómo la metodología de esta teoría —denominada medición funcional— puede utilizarse para caracterizar las diversas posiciones personales que existen en todas las sociedades respecto a los problemas de salud pública. Los principales resultados de tres estudios realizados en tres países diferentes (Guinea, Francia y Colombia) se presentan como ilustración de lo que puede aportar este enfoque. Dichos análisis se centraron en tres problemas deliberadamente muy diferentes: (a) el deber de atender a los pacientes infectados, en caso de una epidemia que ponga en peligro la vida de los cuidadores; (b) la aceptabilidad de la reproducción postmortem, en el caso de los soldados que mueren en combate, y (c) la aceptabilidad del suicidio asistido por un médico.Este artigo propõe uma abordagem empírica da ética derivada da teoria psicológica do julgamento humano proposta por Norman Anderson. Mostra como a metodología dessa teoria —denominada medição funcional— pode ser utilizada para caracterizar as diversas posições pessoais que existem em todas as sociedades em relação aos problemas de saúde pública. Os principais resultados de três estudos, realizados em três países diferentes (Guiné, França e Colômbia), são apresentados como uma ilustração do que esta abordagem pode contribuir.Esses estudos se concentraram em três problemas deliberadamente muito diferentes: (a) o deber de cuidar de pacientes infectados no caso de uma epidemia que ponha em risco a vida dos cuidadores, (b) a aceitabilidade da reprodução postmortem no caso de soldados que morrem em combate, e (c) a aceitabilidade do suicidio assistido por médicos

Functional measurement in the field of ethics in politics

We present, in a synthetic way, some of the main findings from ten studies that were conducted in the field of ethics in politics, using the Functional Measurement framework. These studies were about (a) Angolan and Mozambican people’s views about the legitimacy of military-humanitarian interventions, (b) French people’s perspectives regarding the government’s responsibility for the health of consumers of illicit substances, (c) Togolese people’s views about the acceptability of political amnesties in a time of political transition, (d) the perspective of victims of the genocide of the Tutsis in Rwanda regarding the attribution of guilt by association to offspring of perpetrators, (e) slave descendants’ views about the acceptability of national policies on reparations for slavery, (f) Colombian people’s willingness to forgive perpetrators of violence who harmed family members during the civil war, (g) the attitudes of French and Colombian people about national drug control policies, (h) Indian students’ views about the appropriateness of the death penalty for murder or rape, (i) Colombian people’s perspectives regarding corruption, and finally (j) Venezuelan people’s conceptualization of human rights. The main findings are discussed in reference to six of the foundations of Moral Foundations Theory.Este texto presenta, de forma resumida, algunos de los principales resultados de diez estudios que se realizaron en el campo de la ética y la política, en el marco de la Medición Funcional. Estos estudios trataron de: (a) los puntos de vista de la gente de Angola y Mozambique sobre la legitimidad de las intervenciones militares-humanitaria; (b) las perspectivas de los franceses con respecto a la responsabilidad del gobierno con la salud de los consumidores de sustancias ilícitas; (c) las perspectivas de las personas de Togo acerca de la aceptabilidad de amnistías políticas en un momento de transición política; (d) las perspectivas de las víctimas del genocidio de los Tutsis en Ruanda en cuanto a la atribución de culpabilidad a los descendientes de los perpetradores de violencia; (e) los puntos de vista de los descendientes de esclavos acerca de la aceptabilidad de las políticas nacionales de reparaciones por la esclavitud; (f) la disposición de los colombianos a perdonar autores de la violencia que causaron daño a miembros de la familia durante el conflicto armado interno; (g) las actitudes de los franceses y colombianos acerca de las políticas nacionales de control de drogas; (h) los puntos de vista de los estudiantes indios acerca de la idoneidad de la pena de muerte por asesinato o violación; (i) las perspectivas de los colombianos con respecto a la corrupción, y, finalmente, (j) la conceptualización de los derechos humanos en la población venezolana. Los principales resultados se discuten en relación con seis de los fundamentos de la Teoría de los Fundamentos Morales

Judging the Acceptability of Amnesties: A Togolese Perspective

The relationships between the circumstances in which amnesties are granted and Togolese lay people’s judgments of their acceptability were examined. The 351 participants were instructed to read stories- created by the authors -in which a former police officer testified in front of a commission to receive amnesty. The stories were based on a five factor design: Quality of the information revealed, presence-absence of apologies, opportunity given to the victims for telling their story, compensation, and punishment of the applicant. Several interactions involving the truth and the apology factors were observed: Acceptability required the simultaneous presence of several positive aspects. Key words: amnesty, acceptability, Tog

Breaking bad news to Togolese patients

The aim of this study was to map Togolese people’s positions regarding the breaking of bad news to elderly patients. Two hundred eleven participants who had in the past received bad medical news were presented with 72 vignettes depicting communication of bad news to elderly female patients and asked to indicate the acceptability of the physician’s conduct in each case. The vignettes were all combinations of five factors: (a) the severity of the disease, (b) the patient’s wishes about disclosure, (c) the level of social support during hospitalization, (d) the patient’s psychological robustness, and (e) the physician’s decision about how to communicate the bad news. Five qualitatively different positions were found. Two percent of the participants preferred that the physician always tell the full truth to both the patient and her relatives, 8% preferred that the truth be told depending on the physician’s perception of the situation, 15% preferred that the physician tell the truth, but understood that in some cases, nondisclosure to the patient was not inappropriate, 33% preferred that the physician tell the full truth to the relatives but not as much information to the patient, and 42% preferred that the physician tell the full truth to the relatives only. These findings present a challenge to European physicians taking care of African patients living in Europe or working in African hospitals, and to African physicians trained in Europe and now working in their home countries. If these physicians respect the imperative of always telling the truth directly to their patients, their behavior may trigger anger and considerable misunderstanding among African patients and their families

Allocation of Antiretroviral Drugs to HIV-infected Patients in Togo: Perspectives of People Living with HIV and Healthcare Providers

Aim: To explore the way people living with HIV and healthcare providers in Togo judge the priority of HIV-infected patients regarding the allocation of antiretroviral drugs. Method: From June to September 2015, 200 adults living with HIV and 121 healthcare providers living in Togo were recruited for the study. They were presented with stories of a few lines depicting the situation of an HIV-infected patient and were instructed to judge the extent to which the patient should be given priority for antiretroviral drugs. The stories were composed by systematically varying the levels of four factors: (a) the severity of HIV infection, (b) the financial situation of the patient, (c) the patient’s family responsibilities and (d) the time elapsed since the first consultation. Results: Five clusters were identified: 65% of the participants expressed the view that patients who are poor and severely sick should be treated as a priority, 13% prioritised treatment of patients who are poor and parents of small children, 12% expressed the view that the poor should be treated as a priority, 4% preferred that the sickest be treated as a priority and 6% wanted all patients to get treatment. Conclusion: The WHO’s guideline regarding ART allocation (the sickest first as the sole criterion) currently in use in many African countries does not reflect the preferences of Togolese people living with HIV. For most HIV-infected patients in Togo, patients who cannot get treatment on their own should be treated as a priority. Keywords: health care rationing; antiretroviral therapy; public opinion; empirical research; Tog

La perception des risques (trois études comparatives Europe versus Afrique)

TOULOUSE2-BUC Mirail (315552102) / SudocSudocFranceF

Le recours à la coercition vis-à-vis des malades mentaux.

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