This thesis is a study of the coerciveness of legal systems. I defend two main claims: that typical legal systems are much less coercive than most legal and political philosophers think, and that legal systems are not necessarily coercive. My defence is developed in three parts. The first is dedicated to building the necessary theoretical framework to defend the main claims of this thesis. This is where I offer a rigorous formulation of the questions that this thesis addresses and contextualise them within broader debates about the relationship between law and coercion. A substantial portion of the first part of the thesis is devoted to the development of two accounts: an account of coercion and an account of the conditions legal systems must satisfy in order to be coercive. The second part is where I advance two arguments for the claim that typical legal systems are much less coercive than it is usually thought. The first is an argument that establishes that our legal systems rarely issue conditional threats. Given that issuing conditional threats is a necessary condition for any legal system to be coercive - or so I claim in the first part of the thesis - the fact that our legal systems rarely do so undermines the view that our legal systems are pervasively coercive. The second argument is based on the reasons why citizens comply with legal mandates. I analyse the relevant empirical data and show that compliance is not frequently owed to the threat of unwelcome consequences. This should not have been the case had our legal systems been as coercive as philosophers generally think. The third part deals with the claim that legal systems are necessarily coercive. There I address some methodological concerns that this claim gives rise to and propose two arguments for viewing coerciveness as a contingent feature of our legal systems.

The Committee of 100 (C100) (1960 – 68) were a British anti-nuclear protest group who campaigned for mass non-violent direct action (NVDA) in an effort to force the government to revise its defence policy. The formation of C100 created tensions with the already-established Campaign for Nuclear Disarmament (CND), whose leaders objected to C100's commitment to civil disobedience. The two anti-nuclear campaigns had some membership overlap but always remained separate. Until now, any investigation of C100 has been incorporated within wider studies of CND or has been quantitative in method. This thesis therefore addresses a historical gap by employing a life history approach to examine C100 as a distinct group. Drawing upon oral history interviews with twenty-four C100 members the resulting analysis reveals new aspects of C100's innovative structure and method, and identifies the particular nature of those who joined the campaign. A new image of first wave anti-nuclear activists emerges when focusing on C100 protestors. The respondents reveal motivations for campaign engagement that contrast with those of earlier representations of CND supporters. They were inspired by a common interest in global civil rights concerning human health and survival and a need to actively challenge rather than merely petition the authorities. Significantly, many C100 members came from left-wing, progressive or anarchist backgrounds. They were an erudite group with regard for knowledge, despite many putting conventional education on hold to fully engage in the campaign. This thesis examines C100's libertarian nature, and the extent to which its membership managed to be anti-hierarchical in structure, ethos and policy. It explores tensions within C100 concerning limits and definitions of NVDA that changed over time and came to radicalise the campaign. A biographical approach also reveals significant factors around C100 prison experience concerning issues of class and gender. This thesis serves to situate C100 for the first time in its own right on the socio-political map, both historically and globally.

Submitted by Fabielle Cheuczuk (fabielle.cheuczuk@unioeste.br) on 2018-12-06T18:09:39Z No. of bitstreams: 2 Dissertação Géssica v 2018 IMPRIMIR.pdf: 2570724 bytes, checksum: 6da6221ac3ad7c2711718ec79b69eb95 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-12-06T18:09:39Z (GMT). No. of bitstreams: 2 Dissertação Géssica v 2018 IMPRIMIR.pdf: 2570724 bytes, checksum: 6da6221ac3ad7c2711718ec79b69eb95 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-08-17 / Fundação Araucária de Apoio ao Desenvolvimento Científico e Tecnológico do Estado do Paraná (FA) / Theoretical-bibliographical study of FREUD, SKINNER and FOUCAULT’s theoretical matrices which deal with the social phenomena of coercion. To accomplishment of the present research, the initial step was a bibliographical survey of academic-scientific productions in Capes, Scielo, BDTD and of the seven (7) state public universities of Paraná databases, in verifying theses and dissertations of the Postgraduate Stricto Sensu programs. By descriptors, in which we used as categories of analysis, we were faced with the scarcity of papers that deal with coercion in the educational field. We did not find productions that related the categories searched either. In this sense, our objective lists the theoretical and philosophical matrices of the phenomena of coercion in FREUD, FOUCAULT and SKINNER. We approached a critical reflection about a philosophical, historical and anthropological foundation necessity in the educational formation before the coercion in the educational context. From the dialectic method, we investigated coercion by taking historical, philosophical analysis and its articulation with education, reflecting on the question of the theoretical-scientific basis for the performance of educators in the education field. We synthesized the theoretical contributions of FREUD, SKINNER and FOUCAULT, as important matrices of scientific production on coercion. Placed as references for scientific knowledge that presuppose coercion as a social phenomenon, present in the educational space. This research brings to the educators elements that make it possible to criticize the present coercion in the educational environment, by understanding the social, historical and cultural dialectics of the relations established around it.It subsidizes methodologies to treat coercion as a present, intentional and unintentional social phenomenon in the forms of control relations established in the school space, pointing out alternatives to the usage or presence of the social phenomenon of coercion in this environment. / Estudo científico de cunho teórico-bibliográfico, das matrizes teóricas de FREUD, SKINNER e FOUCAULT que tratam o fenômeno social da coerção. Para a realização da presente pesquisa, o passo inicial foi um levantamento bibliográfico de produções acadêmico-científicas nas bases de dados da CAPES, SCIELO, BDTD e das sete (7) universidades públicas estaduais do Paraná, nas quais verificamos teses e dissertações dos programas de pós-graduação Stricto Sensu. Destacamos que a partir de nossos descritores, os quais utilizamos como categorias de análise, nos deparamos com a escassez de trabalhos que tratassem da coerção no campo educativo. Também, não encontramos produções que relacionassem as categorias pesquisadas. Nesse sentido, nosso objetivo elencou as matrizes teóricas e filosóficas do fenômeno da coerção em FREUD, FOUCAULT e SKINNER. Abordamos uma reflexão crítica a respeito da necessidade de uma fundamentação filosófica, histórica e antropológica, na formação educativa frente à coerção no contexto educacional. A partir do método dialético, investigamos a coerção tomando a análise histórica, filosófica e sua articulação com a educação, refletindo sobre a questão da fundamentação teórico-científica para a atuação de educadores no campo da educação. Elaboramos sínteses a partir das contribuições teóricas de FREUD, SKINNER e FOUCAULT, como importantes matrizes da produção científica sobre coerção. Colocados como referenciais para o conhecimento científico que pressupõem a coerção como um fenômeno social, presente no espaço educativo. Esta pesquisa traz aos educadores elementos que possibilitam a crítica da coerção presente no meio educativo, ao compreender a dialética social, histórica e cultural das relações estabelecidas em torno da mesma. Subsidia metodologias para tratar a coerção como fenômeno social presente, intencional e não intencional, nas formas de relações de controle estabelecidas no espaço escolar, apontando alternativas ao uso ou presença do fenômeno social da coerção neste ambiente.

La Belgique et la France ont notamment intégré en 2002 dans leurs systèmes législatifs respectifs une loi consacrée aux droits des patients qui met au centre du système de santé le patient et le devoir de respecter son autonomie. Partant de l’idée selon laquelle les concepts et principes ne peuvent être pensés indépendamment de la manière dont ils sont susceptibles de s’articuler au sein de la « vie ordinaire », j’ai adopté une démarche de philosophie empirique impliquant un terrain d’enquête au sein de laquelle j’ai choisi d’explorer une situation que l’on peut qualifier de limite, en portant mon attention sur la question du consentement aux soins des patients atteints de la maladie d’Alzheimer hospitalisés en gériatrie pour un événement de santé aigu. En effet, la maladie d’Alzheimer implique une diminution des capacités (notamment cognitives) des personnes qui en sont affectées, mettant ainsi l’autonomie du sujet à l’épreuve. Les spécificités liées à cette maladie, doublées du caractère aigu de la prise en charge des personnes qui en sont affectées, font de ce contexte un terrain extrêmement fécond pour examiner les significations et les limites de ce principe tel qu’il est actuellement valorisé dans le domaine des soins de santé. La réflexion proposée dans le cadre de cette thèse s’est ainsi élaborée autour d’éléments recueillis lors d’une enquête de terrain comparative (comprenant différents sites hospitaliers belges et français) spécifiquement mise en place pour les besoins de ce travail. Cette enquête s’est concentrée sur la relation entre les patients et les « soignants de proximité » (infirmières et aides-soignantes), étant donné que c’est dans le cadre de cette relation que la question de la capacité d’autonomie du sujet atteint de la maladie d’Alzheimer émerge principalement en contexte de soin à l’hôpital. En outre, cette enquête s’est en grande partie intéressée à la problématique du refus de soin des patients, ainsi qu’à celle du recours à la contrainte. En effet, c’est essentiellement dans ce type de situations que la question du respect de l’autonomie des patients et du recueil de leur consentement se pose avec le plus d’acuité dans le secteur qui nous occupe. La mise en place de ce terrain d’enquête doit être comprise comme un outil méthodologique et épistémologique ayant pour objectif de nourrir la réflexion conceptuelle, critique et normative liée à la problématique du respect de l’autonomie des patients atteints de la maladie d’Alzheimer. L’ensemble de ce travail m’a permis de développer une nouvelle conception de l’autonomie qui se distingue des réponses les plus fréquemment proposées au sein de la littérature médicale, juridique et philosophique. L’idée principale défendue ici consiste à penser que le problème relatif à la question du respect de la capacité d’autonomie des patients atteints de la maladie d’Alzheimer ne réside pas tant au niveau de la capacité propre des personnes, mais qu’elle dépend avant tout de ce que je présente comme un geste d’octroi, résultant d’un processus de co-construction collectif des professionnels de santé, marqués par des affects et des motivations qui leur sont propres / In 2002, Belgium and France implemented a law that places patients and their right to autonomy at the center of the healthcare system. Based on the assumption that concepts and principles cannot be perceived independently of the way they are likely to be implemented in “ordinary life”, I applied an empirical-philosophical approach to the research field by choosing to examine what can be described as a borderline situation, bringing my attention to the issue of consent to medical care of patients with Alzheimer’s disease hospitalized in geriatric units for an acute health issue. Indeed, Alzheimer’s disease involves a decline of the patient’s abilities (including cognitive skills), thereby jeopardizing his autonomy. The specific characteristics of the disease coupled with the acute medical care it requires single it out as the perfect ground to question the meaning and limitations of the principle and its current use in the healthcare system. The reflection proposed in this thesis is based on information gathered during a comparative field study (including various Belgian and French hospital sites) specifically set up for the purpose of this work. The research focused on the relationship between the patients and the “immediate caregivers” (nursing staff), where the capacity of autonomy of Alzheimer patients in a hospital setting is most frequently questioned. Moreover, the present study largely dealt with the issue of treatment refusal by patients as well as the use of coercion. It is indeed mainly in this type of situation that the problem of respecting patient’s autonomy and obtaining their consent is most vividly debated in the present field of study. The introduction of this research field must be seen as a methodological and epistemological tool that aims at providing further conceptual, critical and normative inputs to the issue of respect of autonomy for patients suffering from Alzheimer’s disease. This work allowed me to develop a new understanding of autonomy, which differs from the most frequently proposed responses that are to be found in medical, legal and philosophical literature. The main advocated idea here is that the question of respect of autonomy for Alzheimer patients does not lie so much in the person’s own capacity, but actually depends on what I consider a granting gesture that results from a collective construction process of health professionals, biased by their own affects and motivations

The ability of direct care staff members to carry out behavior programs, specific protocols written by a behavior analyst, or recommendations made after completion of a functional behavioral assessment is an essential tool needed for such documents to actually be meaningful to patients. Since direct care staff members spend the most time directly working with patients, it is imperative that they carry out intervention procedures with reliability and fidelity. This study evaluated the effectiveness of staff training procedures as well as organizational behavior management techniques used to ensure that staff members are equipped with the tools they need and are properly motivated to carry out the proposed intervention procedures. Staff members received training on the Tools for Positive Behavior Change curriculum developed by the Behavior Analysis Services Program at the University of South Florida using a myriad of training techniques. Then, organizational behavior management techniques were implemented in order to maintain tool implementation and positive interactions with patients over time. Effectiveness of these procedures was measured using a concurrent multiple baseline across participant research design. Results showed that participants did not increase, or only slightly increased, tool use and positive interactions after being trained. However, tool use and positive interactions showed a more substantial increase for most participants after the implementation of organizational behavior management procedures.

Researchers have explored the effects of sociocultural factors on male and female sexual expression, as well as the relationship between sexual objectification and overall sexual well-being; however, few scholars have focused on how, when combined with early experiences of childhood maltreatment, such factors can result in increased long-term risks for a variety of concerns that may impede the development of healthy relationships in women. This quantitative study explores the relationship of childhood maltreatment and sexual coercion proclivity in adult women. The purpose of this study was to measure self-reports of 1 or more experiences with childhood maltreatment (i.e., physical, sexual, or emotional abuse or neglect) to determine if it is significantly correlated with sexual coercion (physical or verbal sexually aggressive behaviors as well as nonverbal or psychological sexually coercive behaviors) in adult women. The differences in the incidence of self-reported experiences of sexual aggression in 211 female participants recruited via an online survey over a 7-day period were explored to examine if there is a relationship between the development of sexually coercive behaviors as a result of their self-reported experiences of childhood maltreatment. Data were collected using the Qualtrics database and indicated a positive correlation between childhood maltreatment and sexual coercion. Positive social change implications resulting from this research are the inclusion of another professional perspective on childhood maltreatment and sexual coercion, providing information to improve existing public health education and training forums, preventing or reducing the potential negative effects of childhood maltreatment, and ultimately improving the delivery of competent mental health services to all clients.

<p>Syftet med studien var att beskriva sjuksköterskors upplevelser av att utföra tvångsåtgärder inom psykiatrisk slutenvård. Studien hade en deskriptiv design. Ett bekvämlighetsurval tillämpades som urvalsmetod och sex sjuksköterskor från en psykiatrisk slutenvårdsavdelning i Mellansverige deltog i studien. Data samlades in via ostrukturerade intervjuer och analyserades utifrån kvalitativ innehållsanalys. Resultatet visade att sjuksköterskorna upplevde positiva känslor i samband med utförandet av tvångsåtgärder. De upplevde att det var tur att tvångsåtgärderna finns som en möjlighet för patientens bästa. Ibland kunde tvångsåtgärder leda till att relationer skapades till patienten, då sjuksköterskan och patienten tillsammans upplevt en jobbig situation. Sjuksköterskorna upplevde att tvång var lättare att utföra när de kände patienten och i vissa tydliga situationer. Sjuksköterskorna upplevde även negativa känslor i samband med utförandet av tvångsåtgärder, att det inte var något de kände någon glädje över att utföra. Tvångsåtgärder uttrycktes i känslor av hämnd, dåligt samvete, rädsla och att det är jobbigt. De uttryckte att tvångsåtgärderna innebar en kränkning av patienten, och att det ibland kan kännas som att de begår övergrepp mot patienten. Sjuksköterskorna berättade även om situationer då tvång kändes svårare att utföra och att situationer där tvång utfördes kunde framkalla känslor av kluvenhet hos sjuksköterskorna. Sjuksköterskorna berättade även om hur hot om tvång ibland används mot patienten. Slutsatsen med föreliggande studie är att den psykiatriska vården är och förblir ett etiskt dilemma, då sjuksköterskorna kan ställas inför handlingar som kan skapa konflikt med hennes professionella, rättsliga, etiska och personliga ansvar för att hjälpa dessa patienter.</p> / <p>The aim of this study was to describe nurses' experiences of carrying out coercive measures in psychiatric inpatient care. The study had a descriptive design. A convenience sample was applied as sampling method, and six nurses from a psychiatric inpatient ward in central Sweden participated in the study. Data were collected through unstructured interviews and analyzed according to qualitative content analysis. The results revealed that nurses experienced positive feelings associated with using of coercive measures. They felt that it was good that the coercive measures were available as an option for the patient's best interests. Sometimes coercion led to development of therapeutic relationships between the nurse and the patient, because of the fact that they experienced a difficult situation together. The nurses felt that compulsion was easier to perform when they knew the patient and also in some obvious situations. The nurses also experienced negative feelings associated with the use of coercive measures, as it was not something that they felt any joy to perform. Coercive measures were expressed in feelings of revenge, remorse, fear, and that it was a burdensome issue. They expressed that coercive measures was a violation of the patient, and that it could sometimes feel like they were assaulting the patient. The nurses also told about situations where coercion felt more difficult to perform and situations where coercion was carried out could cause mixed feelings among the nurses. The nurses also told about how they sometimes used threat of coercion against patients. The conclusion of this study is that mental health care remains an ethical dilemma, since nurses may face options which may create conflict with her professional, legal, ethical and personal responsibility to help these patients.</p>

<p>SAMMANFATTNING</p><p><strong>Bakgrund</strong>: Patienters upplevelser av att vårdas inom slutenvården med stöd av Lagen om psykiatrisk tvångsvård. Människor med en allvarlig psykisk störning eller ett oundvikligt behov av vård får med stöd av lagen tvångsvårdas. Patienterna fråntas självbestämmandet och blir tvungna att delta i vård och behandling mot sin vilja. När självbestämmandet fråntas patienterna övertar vårdpersonalen ansvaret vilket kan leda till ett lidande för patienterna (1991:1128).</p><p><strong>Syfte</strong>: Syftet var att beskriva patienters upplevelser av tvångsvård inom psykiatrisk slutenvård. </p><p><strong>Metod</strong>: Systematisk litteraturstudie, sex artiklar användes för uppnått resultat.</p><p><strong>Resultat: </strong>Både positiva och negativa upplevelser av tvångsvård påvisades. Patienterna beskrev ett möte med vården kantat av upplevelser kring människovärde, delaktighet i sin egen vård, kommunikation, relationer, synen på våld, hot och straff samt upplevt lidande.</p><p><strong>Slutsats</strong>: Om patienterna bemöttes med respekt, människovärde samt fick tillräcklig information kring vård och behandling blev upplevelserna av tvångsvården mer positiv. Brist på delaktighet i fråga om vård och behandling och kommunikationsbrister var ett problem då patienterna hade lite sjukdomsinskt samt inte hade förståelse för behovet av tvångsvård.</p><p>Vidare forskning med kvalitativa intervjuer om patienters upplevelser av tvångsvård föreslås för att ge utökad förståelse och kunskap.</p>

<p> </p><p><strong>Bakgrund: </strong>Att vara inskriven enligt lagen om psykiatrisk tvångsvård, LPT, innebär att självbestämmandet tas ifrån en. Eftersom den nya lagen skapades för att skydda patienters integritet undersöker detta arbetet patienternas upplevelser av tvångsvård.<strong> Syfte:</strong> Syftet var att beskriva patienters erfarenheter av tvång med fokus på tvångsvård inom den psykiatriska vårdenheten.<strong> Metod: </strong>En litteraturstudie där sju vetenskapliga artiklar ingick. Systematisk granskning av artiklarna genomfördes.<strong> Resultat: </strong>Resultatet utgörs av tre kategorier: de som uppfattar tvång i störst utsträckning vilket var främst vita, högutbildade och kvinnor. Negativa erfarenheter av tvångsvård vilket inkluderade att ingen lyssnade eller tog en på allvar. Slutligen positiva erfarenheter av tvångsvård vilket bland annat innebar att ha någon att prata med och få viss kontroll över sin vård.<strong> Diskussion: </strong>Självbestämmande och kommunikation är viktiga faktorer som spelar en stor roll när det kommer till upplevelser av tvångsvård.<strong> Slutsats: </strong>Många faktorer spelar in vid upplevelser av tvångsvård och tvång. Både negativa och positiva upplevelser kom fram. Många problem hade kunnat undvikas om personalen hade pratat med patienterna och visat empati. Fler studier i ämnet behövs för att personalen ska kunna förstå patienterna och i slutändan ge en bättre vård.</p> / <p><strong>Background: </strong>To be admitted according to the law of coercive measures in psychiatric care, LPT, one is stripped of one’s self-determination. Since the new law was created to protect patients' integrities, the aim of this study was to determine how patients' experienced coercive measures. <strong>Purpose: </strong>The aim was to describe<strong> </strong>patient´s experience of coercive measures with focus on psychiatric coercive care within a psychiatric care unit.<strong> Method:</strong> A literature review in which seven scientific articles were included. Systematic review of the articles was used.<strong> Results: </strong>Three categories were found: Those who experience coercive measure the most which was mainly white people, women and those with a high education. Negative experience of coercive measures which included not being listened to and taken serious. Finally positive experience which included having someone to talk to and being given some control over one’s own care.<strong> Discussion: </strong>Self determination and communication are key factors when it comes to experiences of coercive measures in psychiatric health care.<strong> Conclusion: </strong>There are many factors that correlated<strong> </strong>with experience of coercive measures and coercion<strong>. </strong>Both negative and positive experiences were mentioned<strong>. </strong>Many problems could have been avoided if only the staff had talked to the patients and showed empathy<em>. </em>More studies are needed to make the staff understand patients and ultimately give them better care.<em> </em></p>

<p>Enligt Hälso- och sjukvårdslagen har patienten rätt att bli bemött med respekt för sitt självbestämmande och sin integritet. Många patienter blir dåligt bemötta i vården, de känner sig kränkta, utelämnade och maktlösa. Psykiatrisk tvångsvård kan innebära en konflikt mellan att bedriva god vård och utöva tvång. Det är därför av största vikt att undersöka hur tvångsvårdade patienter upplever att de blivit bemötta och vad bra bemötande är vid psykiatrisk tvångsvård. Syftet med denna studie är att undersöka hur patienter upplever att de blivit bemötta vid psykiatrisk tvångsvård. Studien genomfördes som en litteraturstudie med kvalitativ innehållsanalys som metod. Manifest och latent ansats användes. Resultatet baserades på 12 vetenskapliga artiklar och en avhandling. Resultatet i studien presenteras i två huvudteman: Dåligt bemötande vid tvångsvård och bra bemötande vid tvångsvård. Sex underteman framkom: att inte vara delaktig i vården, att bli bemött med makt, att förlora sitt människovärde, att känna sig delaktig i vården, att få god omvårdnad och att känna sig som en människa. Genom att ta reda på patienters upplevelse och behov, kan vården bli individuellt anpassad. Bra bemötande leder till att patienten känner sig respekterad och bekräftad som människa.</p>