The ECOUTER methodology for stakeholder engagement in translational research.

BACKGROUND: Because no single person or group holds knowledge about all aspects of research, mechanisms are needed to support knowledge exchange and engagement. Expertise in the research setting necessarily includes scientific and methodological expertise, but also expertise gained through the experience of participating in research and/or being a recipient of research outcomes (as a patient or member of the public). Engagement is, by its nature, reciprocal and relational: the process of engaging research participants, patients, citizens and others (the many 'publics' of engagement) brings them closer to the research but also brings the research closer to them. When translating research into practice, engaging the public and other stakeholders is explicitly intended to make the outcomes of translation relevant to its constituency of users. METHODS: In practice, engagement faces numerous challenges and is often time-consuming, expensive and 'thorny' work. We explore the epistemic and ontological considerations and implications of four common critiques of engagement methodologies that contest: representativeness, communication and articulation, impacts and outcome, and democracy. The ECOUTER (Employing COnceptUal schema for policy and Translation Engagement in Research) methodology addresses problems of representation and epistemic foundationalism using a methodology that asks, "How could it be otherwise?" ECOUTER affords the possibility of engagement where spatial and temporal constraints are present, relying on saturation as a method of 'keeping open' the possible considerations that might emerge and including reflexive use of qualitative analytic methods. RESULTS: This paper describes the ECOUTER process, focusing on one worked example and detailing lessons learned from four other pilots. ECOUTER uses mind-mapping techniques to 'open up' engagement, iteratively and organically. ECOUTER aims to balance the breadth, accessibility and user-determination of the scope of engagement. An ECOUTER exercise comprises four stages: (1) engagement and knowledge exchange; (2) analysis of mindmap contributions; (3) development of a conceptual schema (i.e. a map of concepts and their relationship); and (4) feedback, refinement and development of recommendations. CONCLUSION: ECOUTER refuses fixed truths but also refuses a fixed nature. Its promise lies in its flexibility, adaptability and openness. ECOUTER will be formed and re-formed by the needs and creativity of those who use it

L’éthique de l’interprète en milieu social : neutralité et engagement

Cet article traite du rôle et du positionnement éthique de l’interprète en milieu social. Il distingue trois modèles possibles de la fonction de l’interprète dans ces contextes : celui de porte-parole de l’usager, de médiateur et du tiers neutre. Ce dernier est le plus adéquat à construire et préserver la confiance avec les deux interlocuteurs. Il comporte la nécessité pour l’interprète d’adopter une attitude à la fois impartiale et neutre. La différence entre les deux notions est importante et peut être éclaircie par le biais de discussions de philosophie politique : l’impartialité correspond à une attitude d’indépendance vis-à-vis de ses propres engagements idéologiques ou politiques, alors que la neutralité traduit l’égale distance de l’interprète vis-à-vis des deux personnes qui communiquent entre elles. Ces deux attitudes éthiques essentielles entrainent des tensions et des dilemmes auxquels l’interprète doit faire face dans l’exercice de son travail.This article discusses the ethical positioning, attitude and role of community interpreters. Three models are presented—advocate, mediator and neutral third party. Only the latter model manages to preserve the trust of both interlocutors—the professional and the client. The interpreter’s ethical code stresses his impartiality and neutrality. These two notions, though they are often associated, are different. The way that they are discussed in the context of political philosophy clearly shows this. Impartiality refers to the interpreter’s independence with respect to her own personal commitments and ideological positions, while neutrality refers to the equal distance the interpreter has to assume with respect to each of the two interlocutors: she does not have to lean on one side or the other. However, these two essential ethical principles raise a number of tensions and dilemmas the interpreter has to deal with when performing her role.Questo articolo tratta della posizione etica et del ruolo dell’interprete sociale. Tre modelli sono discussi: quello dell’avvocato, del mediatore e del terzo neutro. Solo il terzo modello permette di mantenere la fiducia dei due interlocutori. Il codice etico dell’interprete comporta i due principi dell’imparzialità e della neutralità. La prima significa che l’interprete deve prendere le distanze delle sue proprie opinioni e posizioni ideologiche, mentre la seconda indica che l’interprete deve essere a uguale distanza da ciascuno dei due interlocutori. Questi principi etici sono essenziali ma comportano delle tensioni e dei dilemmi che rendono complesso il lavoro dell’interprete sociale

Le récit comme forme d'explication : science et histoire

Stories as a Form of Explanation : Science and Narration The explanatory force of stories is thought due to the relation between temporality and causality. Beyond the difficulties in that relation, this theory never addresses what might be explanatory about a story qua story. Perhaps stories — good ones — present underlying « causal processes », only thus perceptible, through discontinuities.Spranzi-Zuber Marta. Le récit comme forme d'explication : science et histoire. In: Littérature, n°109, 1998. pp. 46-58

Arrêts de traitement et mort « naturelle » : une dissonance cognitive

International audienceLa pratique médicale contemporaine recèle un paradoxe : alors que plus de la moitié des décès sont le résultat d’une décision de fin de vie dans un contexte très technique, la mort « naturelle » reste un horizon normatif commun, auquel adhèrent bon nombre de praticiens. Le but de l’article est de documenter cette « dissonance cognitive » collective à partir des témoignages recueillis lors de deux protocoles de recherche en éthique clinique, l’un dans des services de réanimation adulte, l’autre dans un service de réanimation néonatale. On montrera d’une part que pour les professionnels, les deux principales conditions auxquelles la mort d’un patient après un arrêt de traitement peut être considérée comme naturelle sont que la causalité soit passive et que l’intention soit de soulager la souffrance. Mais d’autre part qu’ils perçoivent clairement les limites de ces deux critères. Après avoir passé en revue deux solutions possibles à la dissonance cognitive, on explorera une autre voie : celle de la recherche de la « bonne mort »

Galileo's Dialogue on the two chief world systems: rhetoric and dialogue

"La rhétorique des textes scientifiques au XVIIe siècle", Symposium, Gand , BELGIQUE (11/12/2003)International audienc