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Patient autonomy and evidence-based choice – philosophical and ethical perspectivesMoore, Willem 03 1900 (has links)
Thesis (DPhil (Philosophy))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: This study involves a critically evaluation of evidence-based patient choice as partnership model in clinical decision making. It pays attention to the emergence of the concept of autonomy in modern moral philosophy and in particular to the pivotal contributions of Immanuel Kant and John Stuart Mill in this regard. Against this background, it elaborates on the ethical principle of respect for autonomy, informed consent as paradigm for patient autonomy in clinical decision making, the conflicts that arise between the ethical concepts of autonomy and beneficence, the dominance of paternalism in clinical decision making, the challenges posed to the dominance of paternalism, the resulting emergence of the concept of partnership in clinical decision making and evidence-based patient choice as partnership model in clinical decision making. Moreover, it provides an exposition of the context, nature and practice of evidence-based patient choice and of the four key decision making skills required from health care professionals to involve patients in clinical decision making, namely shared decision making, risk communication, decision analysis, and the use of decision aids. Against this background, it critically evaluates the effectiveness of evidence-based patient choice as partnership model in clinical decision making by judging it in terms of the ethical concept of patient autonomy as reflected in the informed consent elements of competence, disclosure, understanding and voluntariness and indicates that none of the key skills of evidence-based patient choice can be regarded as completely adequate in honouring the principle of respect for autonomy in clinical decision making and that consequently each of these four key skills leave evidence-based patient choice with a challenge that needs to be addressed from another angle in order to establish and maintain the ethical principle of respect for autonomy. In response to these challenges, the study makes three recommendations for the transformation of evidence-based patient choice to a therapeutic alliance health care, namely to review and further develop the philosophical foundations of evidence-based patient choice, to consider the continental philosophical perspectives of Edmund Husserl, Jean-Paul Sartre, Maurice Merleau-Ponty and Jürgen Habermas on the evidence-based patient choice challenges of the separate worlds of doctor and patient, the constitution of meaning in illness and the dangers of abstractions and informational manipulation in health care and to transform the practice of evidence-based patient choice to a therapeutic alliance in health care by individualising the provision of information by embedding it in the human processes of sense making, knowledge creation and decision making through which information is transformed into insight, knowledge and action. / AFRIKAANSE OPSOMMING: Die studie behels 'n kritiese evaluering van evidence-based patient choice as vennootskapsmodel in kliniese besluitneming. Dit verwys na die opkoms van moderne morele filosofie en in die besonder na die deurslaggewende bydraes van Immanuel Kant en John Stuart Mill in hierdie verband. Teen hierdie agtergrond bespreek dit die etiese beginsel van respek vir outonomie, ingeligte toestemming as paradigma vir pasiënt outonomie in kliniese bsluitneming, die moontlike konflikte tussen die etiese konsepte van outonomie en weldadigheid, die dominansie van paternalisme in kliniese besluitneming en die uitdagings wat dit ontlok het, die gevolglike ontstaan van die konsep van vennootskappe in kliniese besluitneming, asook evidence-based patient choice as vennootskapsmodel in kliniese besluitneming. Voorts verskaf die studie 'n uiteensetting van die konteks, wese en praktyk van evidence-based patient choice, asook van die vier sleutelvaardighede wat van medici vereis word ten einde pasiënte in kliniese besluitneming te betrek, naamlik gedeelde besluitneming, die kommunikasie van risikos, die analise van besluitneming en die gebruik van besluitnemingshulpmiddels. Teen hierdie agtergrond onderneem die studie 'n kritiese evaluering van die effektiwiteit van evidence-based patient choice deur dit te meet aan die ingeligte toestemming elemente van kompetensie, blootlegging, verstaan en vrywilligheid en toon aan dat geeneen van hierdie sleutelvaardighede as volledig toereikend in die nastreef van die beginsel van respek vir outonomie in kliniese besluitneming beskou kan word nie en evidence-based patient choice daarom met uitdagings laat wat vanuit 'n ander hoek bearbei moet word ten einde die beginsel in die praktyk te vestig en te onderhou. In reaksie hierop maak die studie drie aanbevelings met die oog op die transformering van evidence-based patient choice na 'n terapeutiese alliansie in gesondheidsorg, naamlik om die filosofiese grondslae van evidence-based patient choice in oënskou te neem en verder te ontwikkel, om oorweging te skenk aan die kontinentaal filosofiese perspektiewe van Edmund Husserl, Jean-Paul Sartre, Maurice Merleau-Ponty en Jürgen Habermas met betrekking tot die evidence-based patient choice uitdagings van die verskillende wêrelde van dokter en pasiënt, die konstituering van betekenis in siekte en die gevare verbonde aan die abstrahering en manipulering van inligting in gesondheidsorg en om op grond hiervan die praktyk van evidence-based patient choice te transformer. Dit sal gedoen word deur die verskaffing van inligting aan pasiënte te individualiseer deur dit in te bed in the menslike prosesse van sinmaking, kennis generering en besluitneming waardeur inligting getransformeer word tot insig, kennis en aksie.
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Autonomy and purity in Kant's moral theoryBenson, Carolyn Jane January 2010 (has links)
Kant believed that the moral law is a law that the rational will legislates. This thesis examines this claim and its broader implications for Kant’s moral theory. Many are drawn to Kantian ethics because of its emphasis on the dignity and legislative authority of the rational being. The attractiveness of this emphasis on the special standing and capacities of the self grounds a recent tendency to interpret Kantian autonomy as a doctrine according to which individual agents create binding moral norms. Where this line is taken, however, its advocates face deep questions concerning the compatibility of autonomy and the conception of moral requirement to which Kant is also certainly committed – one which conceives of the moral law as a strictly universal and necessary imperative. This thesis has two main aims. In the first half, I offer an interpretation of Kantian autonomy that both accommodates the universality and necessity of moral constraint and takes seriously the notion that the rational will is a legislator of moral law. As a means of developing and securing my preferred view, I argue that recent popular interpretations of Kantian autonomy fail to resolve the tensions that seem at first glance to plague the concept of self-legislation, where what is at stake is the legislation of a categorical imperative. In the second half of this thesis, I examine the connections between my preferred interpretation of self-legislation and Kant’s dichotomisation of reason and our sensuous nature. I argue that some of the more harsh and seemingly unreasonable aspects of Kant’s moral philosophy can be defended by bringing to light the ways in which they are connected to his commitment both to the autonomy of the will and to developing a genuinely normative ethics.
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The Role of Cultural Self-Construal and Autonomy on Athlete Preference for InterventionYu, Alexander Brian 08 1900 (has links)
Self-construal (SC) refers to the way people perceive their identities in relation to self and others (Markus & Kitayama, 1991b). It has been found in the literature to influence thinking, decision-making, and preferences (e.g., Sung, Choi, & Tinkham, 2012) which suggests that a person's SC may affect her/his preference on psychological interventions. However, no empirical studies can be located that examined this relationship. The study examined the effects of independent SC, interdependent SC, general autonomy (GA), and sport autonomy (SA) on athletes' preferences and desire to use the interventions in the future, especially how these relations might vary as a function of the type of intervention. It was hypothesized that the relationship between each of the predictors and preference for and desire to use intervention would be moderated by the type of intervention received. Four hundred and thirty-one current and former athletes were recruited to participate in this study. Participants completed a questionnaire that measured SC, GA, and SA and were then randomly assigned to receive one of two self-talk interventions, representing either a self- or other-focused intervention. Participants were asked to rate their preference for and desire to use the given intervention in the future. Results found positive significant relationships with all predictors and intervention preference, in both self- and other-focused groups. Initial hierarchical multiple and logistic regression analyses did not support a significant moderation effect of intervention type on the relationships between the independent and dependent variables. However, a post-hoc analysis that conducted a hierarchical multiple regression with participants separated by gender found a significant moderation effect of intervention type on the relationship between independent SC and preference for intervention for females only. Additional post-hoc analyses were conducted to replicate Sung et al.'s (2012) analysis procedures in which the SC continuous variables were transformed into categorical ones, and a 2x2 ANOVA and Pearson chi-square analyses were conducted. Post-hoc analyses revealed significant interaction effects of intervention type and participants' dominant self-construal type on their desire to use intervention. Limitations, implications for counseling/consulting, and future research directions are discussed.
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A dialectical interpretation of the history of Western medicine : perspectives, problems and possibilitiesRossouw, Theresa Marie 03 1900 (has links)
Thesis (MPhil)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: The health of the medical profession hangs in the balance. Scepticism, mistrust and legal
restraints have entered its hallowed corridors and are threatening its integrity and
independence. There are myriad seemingly intractable moral dilemmas that doctors,
ethicists and judges are trying to resolve with the aid of available principles and rules of
ethical discourse; yet, the answers remain elusive. Hegel, the eighteenth century
philosopher, postulated that perplexity only exists because we do not look at the world
correctly: because we tend to think in an oppositional way, we abstract from the complex
interrelation of things. He therefore suggested that one should step back and think
reflectively about the problem and seek the one-sided assumptions that led to the
impasse. My proposition is that at the heart of many of the current medical dilemmas lies
the opposition between paternalism and autonomy. These two fundamental concepts
arose out of two different traditions, and now, because they have been abstracted from the
contexts and histories that inform them, seem to be diametrically opposed.
Paternalism arose out of the ethics of competence that originated in ancient Greece. The
art of medicine was still in its infancy and physicians had to prove their ability and
benevolence to a mistrustful public. Demonstration of competence became a necessary
component of any successful practice. As the power of medicine grew with the scientific
and technological advances of the Enlightenment, professionals' authority and
competence were reinforced and systematically fostered a paternalistic attitude at the
expense of adequate protection of the individual. In response to the power differential
found in the political and social arena, individual human rights were promulgated in the
eighteenth century. In the medical sphere, the culture of rights was translated into, among
others, the fundamental right to autonomy. Patients now have the right to decide on
interventions and treatment in accordance with their own conception of a good life.
Paternalism thus developed out of a societal system that embraced the virtues and
communal responsibility within the bounds of the polis of antiquity; autonomy arose out
of the designs of the Enlightenment where the individual was hailed supreme. Remnants of both traditions are evident in contemporary medicine, but they have been abstracted
from their original purpose and meaning, leading to perplexity and antagonism.
Following the Hegelian method of dialectic, I postulate a thesis of paternalism, and in
response to this, an antithesis of autonomy. I attempt to show that an intransigent
insistence on one side or the other will only serve to strengthen the paradox and fail to
lead to an acceptable solution. I aim to develop a synthesis where both concepts are
embraced with the help ofa better understanding of human nature and the inevitable
limits of human knowledge. Influenced by the work of the psychoanalyst Carl Jung, I
firstly argue for the existence of a biological human need for compassion and thus the
importance of virtue ethics, which embraces this need. Secondly, focusing on the ethics
of futurity developed by Hans Jonas, I delineate the altered nature of human action and
the derivative need for an ethics of responsibility. I propose possibilities for the future
based on the ideas of compassion, virtue and responsibility and argue that they can only
be reconciled in a pluralistic ethic. / AFRIKAANSE OPSOMMING: Die mediese professie het'n dokter nodig. Een wat kan sin maak van die wantroue en
vyandigheid wat te bespeur is in die pasient-dokter verhouding en wat toepaslike terapie
kan voorskryf Al die pogings tot behandeling deur middel van reëls, regulasies en etiese
kodes het tot dusver misluk en het vele skynbaar-onoplosbare morele dilemmas agtergelaat.
Die Duitse filosoof, Hegel, het in die agtiende eeu aangevoer dat verwarring
onstaan bloot omdat ons die wêreld op die verkeerde wyse beskou: die mens is geneig tot
opposisionele denke en neem daarom nie die komplekse onderlinge verbintenisse van die
onderskeie elemente in ag nie. Hegel het dus voorgestel dat wanneer ons met sulke
hardnekkige situasies gekonfronteer word, ons 'n tree terug neem en die situasie
reflektiewelik ondersoek vir eensydige veronderstellings. My hipotese is dat baie van die
etiese dilemmas wat op die oomblik in medisyne voorkom, voortvloei uit die opposisie
tussen paternalisme en outonomitiet. Hierdie twee fundamentele beginsels het uit twee
verskillende tradisies ontstaan en nou, omdat hulle nie meer in hulle oorspronklike
konteks voorkom nie, vertoon hulle skynbaar teenstellend.
Paternalisme het onstaan vanuit die etiek van bevoegdheid wat teruggevoer kan word na
die tyd van Hippocrates. Medisyne was 'n nuwe professie wat nog sy eerbaarheid en
welwillendheid aan 'n wantrouige publiek moes bewys. Bevoegdheid was dus 'n
essensiële komponent van enige suksesvolle praktyk. Indrukwekkende vooruitgang in die
dissiplines van wetenskap en tegnologie sedert die agtiende eeu het dokters se gesag en
bevoegdheid bevorder en stelselmatig 'n paternalistiese houding gekweek ten koste van
toepaslike beskerming van die individu. In respons tot die magsverskil in die politieke en
sosiale sfeer het 'n beweging in hierdie tyd ontstaan om universêle mensseregte te
bewerkstellig. In medisyne het hierdie regsbeweging gekulmineer in, onder andere, die
fundamentele reg tot self-beskikking - in ander woorde, outonomiteit. Die pasient is dus
nou geregtig daarop om selfte besluit oor ingrepe en behandeling op grond van sylhaar
konsep van 'n goeie en sinvolle lewe. Paternalisme het dus ontstaan uit 'n samelewing
waar die deugte en gemeenskapsverantwoordelikhede integraal was tot die funksionering van die polis; outonomie aan die ander kant, het ontstaan uit die idees van Die Verligting
waar die individu as belangriker as die gemeenskap geag is.
Volgens die Hegeliaanse dialektiese metode, postuleer ek dus 'n tesis van paternalisme
en in respons daartoe, 'n antitese van outonomiteit. Ek voer aan dat 'n eiewillige
aandrang op een of die ander die dilemma net sal verdiep. Ek poog dus om 'n sintese te
ontwikkel wat albei konsepte inkorporeer met behulp van 'n analise van die aard van die
mens en die noodwendige beperkinge van sy kennis. Geskool op die werk van die psigoanalis
Carl Jung, bespreek ek die mens se biologiese behoefte aan medelye en stel dus die
saak vir die belang van 'n etiek van deugte wat hierdie behoefte onderskraag. Tweedens,
beinvloed deur die etiek van die toekoms, soos beskryf deur Hans Jonas, ontwikkel ek die
idee van die gewysigde skaal van menslike dade en gevolglik die noodsaklikheid van 'n
etiek van verantwoordelikheid. Ek postuleer dus 'n benadering wat wentel om die
konsepte van medelye, deug en verantwoordelikheid wat slegs in die vorm van 'n
pluralistiese etiek tot uiting kan kom.
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Ensino Médio e Filosofia: contribuições da Filosofia da Libertação para a formação da autonomia dos estudantes, na percepção dos professoresChacon, Jerry Adriano Villanova 21 June 2017 (has links)
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Previous issue date: 2017-06-21 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This dissertation parts from the problem of the recurrent difficulty of autonomy development of students in High School. It brings it as a hypotheses that liberation philosophy can help in the construction of this autonomy. The aim is to research how teachers who are teaching from the liberation philosophy perceive the pedagogical task of developing autonomy with their students, and to what extent and how the practice of these teachers can bring future contributions for the teaching of Philosophy itself. It discusses possible contributions of liberation philosophy to the promotion of autonomy of high school students. In this sense it is justified by the existing relationship between liberation philosophy and the critical theories of curriculum with the freirean project of education as a process of liberation. For the elaboration of this dissertation, the argumentative movement started with the resumption of the historical trajectory of education in Brazil with emphasis on High School, with critical analysis of the tactics that help the understanding of current problems of High School. It was developed in continuity to the analysis of the traces of youth in a dialogue with several areas of knowledge. Analysis were carried out about theories of curriculum and focus was given on the positions brought by Michael Apple. There is in the dissertation a constant dialogue between the perspectives of Dussel and Freire, being listed moments in which Dussel takes Freire as a basis for reflection. Finally, it is given the content analysis of the interviews granted by teachers with experience in philosophy teaching in High School who work based on critical theories in a more specific philosophy of liberation / Esta dissertação parte do problema da recorrente dificuldade de desenvolvimento da autonomia dos estudantes no Ensino Médio. Traz como hipótese que a filosofia da libertação pode ajudar na construção dessa autonomia. O objetivo geral é pesquisar como os professores que estão lecionando a partir da filosofia da libertação percebem essa tarefa pedagógica de formação da autonomia dos jovens e em que medida e como as práticas desses professores podem trazer contribuições futuras para o ensino de Filosofia. Discorre sobre as possíveis contribuições da filosofia da libertação para a promoção da autonomia dos estudantes do Ensino Médio. Ela se justifica pela relação existente entre a filosofia da libertação e as teorias críticas do currículo e com a concepção freireana de educação como processo de libertação. Para a elaboração desta dissertação o movimento argumentativo se deu a partir da retomada da trajetória histórica do Ensino no Brasil com destaque ao Ensino Médio, com análises críticas sobre os processos que ajudam a entender os atuais problemas do Ensino Médio. Desenvolveu-se em continuidade a análise dos traços das juventudes num diálogo com várias áreas do conhecimento. Foram elaboradas análises sobre as teorias do currículo e se deu foco às posições trazidas por Michael Apple. Há na dissertação um diálogo constante entre as perspectivas de Dussel e Freire, sendo elencados momentos em que Dussel toma Freire como base de reflexão. Por fim, dá-se a análise de conteúdo das entrevistas concedidas por professores com experiência no ensino de filosofia no Ensino Médio e que trabalhem pautados nas teorias críticas, de forma mais específica a filosofia da libertação
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Control and authenticity: reflections on personal autonomyPaphitis, Sharli Anne January 2010 (has links)
Currently the most influential accounts of personal autonomy, at least in the Englishspeaking world, focus on providing conditions under which agents can be said to exercise self-control. Two distinct accounts of personal autonomy have emerged in this tradition: firstly, hierarchical models grounded in the work of Harry Frankfurt; and secondly, systems division models most famously articulated by Gary Watson. In this thesis I show the inadequacies of both of these models by exploring the problematic views of the self and self-control underlying each model. I will suggest that the problems faced by these models stem from the fact that they endorse a problematic fragmentation of the self. I suggest that a Nietzschean account of personal autonomy is able to avoid these problems. The Nietzschean account can largely, I show, be drawn from Nietzsche’s understanding of both the ‘man of ressentiment’ and his opposite, the sovereign individual. On this picture wholeness of self – rather than fragmentation of the self – is required in order for us to be most fully autonomous. Furthermore, this wholeness of self requires the kind of integrity which is opposed to the problematic fragmentation endorsed by Frankfurt and Watson.
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The principle of respect for autonomy and the sterilization of people with intellectual disabilitiesDe Villiers, Suzanne 04 1900 (has links)
Thesis (MPhil)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: The implementation of eugenic policies reached its peak during the zo" century
when thousands of people with intellectual disabilities and other "undesirable
qualities" were involuntary sterilized. Although most of the eugenic policies have
been removed, countries such as South Africa, still make legally provision for the
involuntary sterilization of people with intellectual disabilities.
Torbjërn Tannsjë (1998) used the "argument from autonomy" to argue that
involuntary sterilization practices are wrong because it involves compulsion.
According to him, society should never interfere with people's reproductive choices
and people should never be required to qualify for the right to have children. The
aim of this assignment was to systematically assess the "argument from autonomy"
as far as the policy of involuntary sterilization of people with intellectual disabilities is
concerned. To this end, the concept of autonomy and the principle of respect for
autonomy are discussed and applied to the intellectually disabled. It is argued that
autonomy and respect for autonomy are useful concepts to apply to some people
with intellectual disabilities. These individuals should not be automatically assumed
to be incompetent, but their competence needs to be determined on an individual
level, with reference to the complexity of the decision to be made. Special effort is
needed from health care professionals to obtain (where possible) informed consent
from people with intellectual disabilities. The application of the principle of respect
for autonomy to matters of reproduction leads to the conclusion that people with
severe to profound levels of disability, are unable to provide informed consent for
sexual intercourse. Therefore some form of paternalistic protection is needed for
these individuals. People with mild to moderate intellectual disabilities who are
however competent to consent to sexual intercourse should never be prohibited
from procreation by means of involuntary sterilization. State interference in matters
of reproduction should be limited to interventions where (i) children are seriously
harmed by parents and (ii) to protect those who are incompetent to consent to
sexual interactions with others. Apart from these exceptions, the intellectually
disabled is entitled to the same procreative rights as all other citizens. / AFRIKAANSE OPSOMMING: Die implementering van eugenetiese beleid het gedurende die 20 ste eeu 'n
hoogtepunt bereik met die onwillekeurige sterilisering van duisende persone met
intellektuele gestremdhede en ander "ongewensde kwaliteite". Alhoewel meeste
van die eugenetiese wetgewing verwyder is, maak lande soos Suid-Afrika steeds
wetlik voorsiening vir die onwillekeurige sterilisasie van persone met intellektuele
gestremdhede.
Torbjërn Tannsjo (1998) maak gebruik van die "outonomie argument" om te
argumenteer dat onwillekeurige sterilisasie praktyke onaanvaarbaar is omdat dit
dwang bevat. Hy voer aan dat die samelewing nooit in die reproduktiewe keuses
van mense behoort in te meng nie en dat dit nooit vir mense nodig moet wees om
vir ouerskap te kwalifiseer nie. Die doel van hierdie werkstuk was om sistematies
die "outonomie argument" te analiseer ten opsigte van die beleid van die
onwillekeurige sterilisasie van persone met intellektuele gestremdhede. Met hierdie
doel voor oë word die konsep outonomie en die beginsel van respek vir outonomie
bespreek en toegepas op die intellektueel gestremde persoon. Daar word
aangevoer dat outonomie en respek vir outonomie nuttige beginsels is om in ag te
neem in kwessies rakende intellektueel gestremdes. Hierdie individue moet nie
outomaties as onbevoeg beskou word nie, maar hul bevoegdheid moet eerder op 'n
individuele basis beoordeel word, inaggeneem die kompleksiteit van die besluit wat
geneem moet word. Voorts word daar van gesondheidsorgpersoneel verwag om
moeite te doen met die verkryging van oorwoê toestemming (waar moontlik) by
persone met intellektuele gestremdhede. Die toepassing van die beginsel van
respek vir outonomie op aspekte rakende reproduksie, lei tot die gevolgtrekking dat
persone met ernstige intellektuele gestremdhede nie in staat is om toestemming tot
seksuele omgang te verleen nie. Dus, is 'n vorm van paternalistiese beskerming in
hierdie gevalle aangedui. Persone met intellektuele gestremdhede wat egter wel
bevoeg is om toestemming tot seksuele omgang te verleen, moet nooit weerhou
word van voortplanting deur middel van onwillekeurige sterilisering nie. Inmenging
deur die staat in kwessies rakende reproduksie moet beperk word tot intervensies
waar (i) kinders ernstige skade berokken word en (ii) die beskerming van persone
wat onbevoeg is om toestemming tot seksuele interaksies met ander te verleen,
benodig word. Afgesien hiervan, is die intellektuele gestremde persoon geregtig op
dieselfde reproduktiewe regte as alle ander landsburgers.
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Raison et création : le constructivisme et l’institutionnalisme postmétaphysiques de Cornelius Castoriadis / Reason and creation : castoriadis’ postmetaphysical constructivism and institutionalismTranchant, Thibault 05 July 2019 (has links)
L'objet de cette thèse doctorale est la réponse poïétique et institutionnaliste offerte par Castoriadis au problème de la constitution d'une universalité pratique dans un contexte post-métaphysique. La thèse s'ouvre sur une définition de la philosophie politique comme projet d'objectivation institutionnelle de la raison et sur l'exposition du problème, pour cette discipline, engendré par la critique de la métaphysique et l'émergence d'une conception procédurale de la raison lors de la modernité. La thèse est ensuite divisée en deux parties. La première porte sur la philosophie de Castoriadis, c'est-à-dire sur sa critique de la pensée métaphysique, son ontologie et sa théorie de la connaissance. Nous y défendons la thèse interprétative que sa philosophie est un « pluralisme ontopoïétique constructiviste ». La seconde porte sur sa conception de la raison pratique, que nous interprétons comme « institutionnalisme post-métaphysique ». Nous concluons en explicitant les nouvelles médiations établies par Castoriadis entre philosophie et politique, sa conception de l'universalité pratique, et, par conséquent, la place qu'il occupe dans le temps long de l'histoire de la philosophie politique. Une perspective comparative a été privilégiée tout au long de notre argumentaire. Nous apprécions la singularité castoriadienne en la comparant avec des philosophies ayant partagé des problèmes communs et certains horizons thétiques, notamment l'héritage hégéliano-marxien et les philosophies de la différence. / The purpose of this doctoral thesis is to expose Castoriadis’ poïetical and institutional answer to the following question: how can we constitute a practical universality in a postmetaphysical context. Starting with a definition of political philosophy as the progressive and institutional objectification of reason, I first show how the modern radical critic of metaphysical thoughts and the modern emergence of a procedural conception of reason were both problematic for political philosophy. The thesis is then divided into two parts. The first part is devoted to Castoriadis’ philosophy and presents his own critics of metaphysical thinking, his ontology and his theory of knowledge. I then follow the interpretative thesis according to which Castoriadis’ philosophy can be characterized as an ''ontopoïetical pluralistic constructivism'' The second part is about his conception of practical reason, which I interpret as a “postmetaphysical institutionalism”. I conclude by showing that Castoriadis offers not only new mediations between politics and philosophy but also an original conception of practical universality in the history of political philosophy. Using a comparative method, I put forward Castoriadis’ thoughts through a comparison with other philosophies that share common problems and thesis, e.g. the Hegelian-Marxian tradition and the philosophies of difference.
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