Ethique & sante最新文献

{"title":"Prendre soin quand on est soignant : compte rendu de l’ouvrage « Où vont les larmes quand elles sèchent » de Baptiste Beaulieu","authors":"T. Turroques","doi":"10.1016/j.etiqe.2024.07.010","DOIUrl":"10.1016/j.etiqe.2024.07.010","url":null,"abstract":"","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 4","pages":"Pages 320-321"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La transplantation cardiaque : performance technique ou aventure métaphysique ? Réflexions à partir d’une lecture de L’Intrus de Jean-Luc Nancy","authors":"P. Poingt","doi":"10.1016/j.etiqe.2024.07.003","DOIUrl":"10.1016/j.etiqe.2024.07.003","url":null,"abstract":"<div><div>The philosopher Jean-Luc Nancy underwent a heart transplant in 1992. Eight years later, he wrote L'Intrus (The Intruder), which attempts to reconstruct the mental chaos he experienced after the operation, describing how all the certainties about the identity of the subject and the relationship with the body were shattered. This article offers a few thoughts to further explore Nancy's ideas as expressed in this text. Even if it is widely accepted that a transplant cannot be reduced to replacing a failing organ with a healthy one, it is useful to understand how such a 'repair' may be experienced, and how it questions one's relationship with oneself and one's own body. Therefore, we need a phenomenology of the body. By drawing on analyses developed by Sartre and others, the move from the body-object to the body-subject could be clarified.</div></div>","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 4","pages":"Pages 285-291"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cœurs artificiels : maintenir en vie à tout prix ?","authors":"E. Flécher","doi":"10.1016/j.etiqe.2024.09.002","DOIUrl":"10.1016/j.etiqe.2024.09.002","url":null,"abstract":"<div><div>Il est désormais possible de maintenir une circulation sanguine dans un organisme humain, pendant plusieurs jours, plusieurs mois, voire plusieurs années, à l’aide de dispositifs d’assistance circulatoire mécanique de courte ou de longue durée. Ces dispositifs se développent considérablement dans les pays occidentaux avec des conséquences majeures en termes d’organisation de soins et de répartition sur un territoire. L’implantation de ces machines, véritables cœurs artificiels externes ou implantables, pose naturellement la question de la sélection du candidat, au sein des malades les plus graves et souvent les plus urgents. L’éthique et l’approche de la fin de vie ont toute leur place dans le développement de ces audacieux programmes médicaux tournés vers les technologies de pointe les plus modernes.</div></div><div><div>It is now possible to maintain blood circulation in a human body for several days, several months, or even several years, using short- or long-term mechanical circulatory assistance devices. These systems are developing considerably in Western countries with major consequences in terms of organization of care and distribution over a territory. The implantation of these machines, external or fully implantable artificial hearts, raises the question of the selection of the candidate, among the most sick and often the most urgent patients. Ethics and approach to the end of life have their place in the development of these daring medical programs focused on the most modern cutting-edge technologies.</div></div>","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 4","pages":"Pages 257-263"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avant-propos « Innovation et chirurgie cardiaque : ECMO, cœurs artificiels, greffes »","authors":"L. Marcucci ,&nbsp;R. Bouvet","doi":"10.1016/j.etiqe.2024.11.001","DOIUrl":"10.1016/j.etiqe.2024.11.001","url":null,"abstract":"","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 4","pages":"Pages 249-250"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"L. Marcucci","doi":"10.1016/j.etiqe.2024.07.008","DOIUrl":"10.1016/j.etiqe.2024.07.008","url":null,"abstract":"","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 4","pages":"Pages 292-293"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le médecin, homme de l’art ou homme de science aux yeux du droit. Choisir entre Apollon et Hermès au chevet de la médecine","authors":"Q. Le Pluard","doi":"10.1016/j.etiqe.2024.05.005","DOIUrl":"10.1016/j.etiqe.2024.05.005","url":null,"abstract":"<div><p>Qualifiée de manière hésitante comme un art et comme une science, la médecine apparaît, dans les dispositions juridiques, encadrées tantôt comme une pratique, tantôt comme un ensemble de connaissance. Et si chacune des deux conceptions sert à encadrer les dérives potentielles de l’autre, elles se retrouvent toutes deux subordonnées à la protection de la dignité de la personne, fondement de la bioéthique. Entre Apollon, dieu des arts, et Hermès, dieu des sciences, l’activité médicale vit aujourd’hui une métamorphose qui n’est pas sans atteindre ses figures tutélaires.</p></div><div><p>Hesitantly qualified as an art and as a science, medicine appears, in legal dispositions, pictured sometimes as a practice, sometimes as a knowledge. And if each of the two conceptions serves to tame the eventual excesses of the other, they both find themselves subordinated to the protection of the dignity of the person, the foundation of bioethics. Between Apollo, god of the arts, and Hermes, god of science, medical activity is undergoing today a metamorphosis, which is not without affecting its tutelary figures.</p></div>","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 183-191"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Du serment d’Hippocrate antique au serment moderne : la posture éthique du médecin","authors":"P. Poingt","doi":"10.1016/j.etiqe.2024.04.001","DOIUrl":"10.1016/j.etiqe.2024.04.001","url":null,"abstract":"&lt;div&gt;&lt;p&gt;Le serment d’Hippocrate dans sa dernière version qui date de 2012 paraît très éloigné de la version antique. Tous deux ont pourtant la même fonction : fonder la posture éthique du futur médecin. Or, dans la littérature, cet aspect est souvent secondarisé par rapport à la question déontologique. En s’appuyant sur une méthode philosophique, l’article vise à éclairer cette fonction proprement éthique du serment. À cet effet, l’analyse s’appuie tout d’abord sur la grille interprétative du philosophe Alasdair MacIntyre. Elle permet d’identifier les trois stades structurant la compréhension du serment antique : la pratique, l’ordre narratif d’une vie et une tradition morale. Mais, le jeune médecin qui prête serment aujourd’hui ne prétend ni s’engager à vie ni s’insérer dans un jeu de transmissions. Comme autrefois, la pratique dans laquelle le médecin s’engage constitue la posture éthique : elle consiste notamment en vertus et devoirs. Mais, le serment est aussi en lui-même une promesse. Ici, la pensée d’Hannah Arendt est mise à profit pour éclairer ces enjeux éthiques. Enfin, la puissance symbolique du serment, convoquant « &lt;em&gt;les lois de l’honneur&lt;/em&gt; », n’incarne-t-elle pas les « &lt;em&gt;institutions justes&lt;/em&gt; » que Paul Ricœur introduit dans sa définition de l’éthique ? Plutôt que de réduire le serment à un moment obligé d’un rituel, parfois perçu comme daté, l’article entend rendre accessibles les enseignements hippocratiques pour penser la notion d’engagement et son importance pour nous encore aujourd’hui.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;p&gt;The latest French version of Hippocratic oath (2012) seems far from the original, both fulfil the same function: to establish the ethical posture of medical practitioners. However, in the literature, ethics are often subordinate to deontology. Based on a philosophical approach, this article aims to shed light specifically on the oath's ethical functions. Therefore, the analysis draws on Alasdair MacIntyre's interpretative grid. It allows us to identify three stages, which structure the understanding of the oath: practice, the narrative order of a life and the moral tradition. But a young doctor taking the oath today does not necessarily intend a life-long commitment to the medical profession or to be part of its historical and cultural legacy. The practice to which they commit themselves is, as always, constitutive of their ethical posture and has implications in terms of virtues and duties, but the oath is also in itself a promise. Here, Hannah Arendt's thoughts are relevant to highlight these ethical challenges. Doesn’t the oath's powerful symbolism, calling as it does on the “&lt;em&gt;honour code&lt;/em&gt;”, embody the “&lt;em&gt;just institutions&lt;/em&gt;” introduced by Paul Ricœur in his definition of ethics? Instead of reducing the oath to an obligatory ritual, sometimes perceived as outdated, this article seeks to make accessible the Hippocratic teachings in order to think about the notion of commitment and its continuing relevance.","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 196-204"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1765462924000370/pdfft?md5=952c99d8858cc65de681521455f292ec&pid=1-s2.0-S1765462924000370-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quelle peut être aujourd’hui la signification du serment d’Hippocrate dans une pratique oncologique universitaire ?","authors":"R. de Crevoisier ,&nbsp;E. Vauléon","doi":"10.1016/j.etiqe.2024.06.007","DOIUrl":"10.1016/j.etiqe.2024.06.007","url":null,"abstract":"<div><p>Le serment d’Hippocrate revêt une importance majeure puisque sa prononciation est l’une des conditions préalables à l’obtention du titre de docteur en médecine en France et qu’il est théoriquement structurant pour la pratique médicale. L’objectif de cet article, dans une perspective de retour d’expérience très subjective, est de rapporter les réflexions de deux médecins oncologues (un oncologue radiothérapeute et un oncologue médical), concernant les implications de quelques points du serment d’Hippocrate qui leur semblent particulièrement pertinents et actuels dans leur pratique professionnelle cancérologique. Les points suivants du serment ont ainsi été relevés et développés : la solennité de la prononciation du serment et la réactivation de l’engagement à chaque soutenance, la nature de la probité en cancérologie et la question d’un juste revenu dans cette spécialité, l’importance d’une cancérologie préventive et de la promotion de la santé et, enfin, l’insistance sur le respect de la dignité et de l’autonomie du patient rejoignant de grandes questions éthiques en cancérologie. En conclusion, cette analyse confirme la grande pertinence et l’actualité du serment d’Hippocrate dans une perspective de bonne pratique cancérologique. Cet état de fait justifie une attention particulière, probablement plus soutenue envers le serment, à la fois lors des soutenances de thèse et tout au long de l’activité professionnelle.</p></div><div><p>The Hippocratic Oath is of major importance since its pronunciation is one of the prerequisites for obtaining the degree of Doctor of Medicine in France and it is theoretically structuring for medical practice. The objective of this article, from a subjective feedback perspective, is to report the reflections of two oncologists (one radiation oncologist and one medical oncologist), concerning the implications of some points of the Hippocratic Oath, which seem particularly relevant to them and current in their professional oncology practice. The following points of the oath were thus noted and developed: the solemnity of the pronunciation of the oath and the reactivation of the commitment at each defense, the nature of probity in oncology and the question of a fair income, the importance of preventive oncology and health promotion and, finally, the insistence on respect for the dignity and autonomy of the patient, joining major ethical questions in oncology. In conclusion, this analysis confirms the great relevance and topicality of the Hippocratic Oath in a good cancer practice. This statement justifies particular and probably more sustained attention to the oath, both at the time of thesis defenses and throughout professional activity.</p></div>","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 218-224"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"« De l’acte – le serment d’Hippocrate, du sacré au social »","authors":"E. Borgnis Desbordes","doi":"10.1016/j.etiqe.2024.06.008","DOIUrl":"10.1016/j.etiqe.2024.06.008","url":null,"abstract":"&lt;div&gt;&lt;p&gt;Le serment d’Hippocrate est sans nul doute le serment professionnel le plus connu, serment que les jeunes médecins prononcent au seuil de leur carrière, serment qui engage compétence, responsabilité, sens du devoir, dignité dans les actes professionnels, respect de la vie privée d’autrui. Le caractère ‘sacré’ du serment - historiquement référé au ‘divin’ – a très longtemps prévalu. Mais au ‘divin’ s’est substitué des préoccupations bien plus humaines. Pour autant l’engagement devant la communauté des hommes à prêter serment et à respecter ses principes éthiques ne doit pas pour autant perdre en valeur. Il participe derrière ce qu’il énonce et ce à quoi il engage, un pacte symbolique qui, comme tout contrat, régule le rapport des êtres entre eux selon des principes éthiques forts. Plus encore, comme toute « formation humaine », il réfrène les excès, les pulsions, les jouissances. Si de nombreuses critiques estiment que le serment d’Hippocrate est obsolète et ne reflète pas suffisamment les enjeux contemporains de la pratique médicale, il est important de rappeler sa valeur de régulation symbolique du rapport social qui d’une altérité constituante, tire sa cause. Il serait sans nul doute déplorable que les nouveaux enjeux contemporains poussent à la dilution des principes éthiques d’un serment prêté et que par là même, soit occultée cette dimension symbolique de l’acte lui-même qui élève celui qui s’y engage à toujours plus grande dignité. A l’heure du délitement du lien social et de la dérégulation des jouissances, les médecins sont de plus en plus sollicités à accueillir la précarité symbolique. L’engagement dans ces longues études et dans leur profession les pousse à œuvrer non pas simplement à l’allégement des souffrances mais à miser, auprès de chaque patient, pour que cette altérité constituante - toujours pour une part référée au corps – soit prise en compte et trouve renouvellement incessant. Prêter serment, c’est parier sur l’humanité.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;p&gt;The Hippocratic Oath is undoubtedly the well-known professional oath, an oath that young doctors take at the beginning of their careers, an oath that commits them to competence, responsibility, a sense of duty, dignity in professional acts and respect for the private lives of others. The ‘sacred’ nature of the oath - historically referred as ‘divine’ - has long prevailed. But the ‘divine’ has been replaced by far more human concerns. Nevertheless, the commitment before the community of men to take an oath and respect its ethical principles must not lose its value. Behind what it says and what it commits to is a symbolic pact which, like any contract, regulates the relationship between people according to strong ethical principles. What's more, like all ‘human formation’, it curbs excesses, impulses and pleasures. While many critics believe that the Hippocratic oath is obsolete and does not sufficiently reflect the contemporary challenges of medical practice, it is important to rememb","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 205-210"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’humble recours au serment d’Hippocrate","authors":"C. Hazif-Thomas","doi":"10.1016/j.etiqe.2024.07.002","DOIUrl":"10.1016/j.etiqe.2024.07.002","url":null,"abstract":"","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 173-174"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}